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Voluntary HIV Counseling and Testing for Gay, Bisexual Men and Men Who Have Sex With Men
A Fact Sheet for National HIV Testing Day Organizers

June 2006

Voluntary HIV Counseling and Testing for Gay, Bisexual Men and Men Who Have Sex With Men
Gay men, bisexual men and men who have sex with men (MSM) but don't identify as such continue to be at great risk of HIV infection. In 2003, they accounted for an estimated 57% of AIDS cases among men1 and 45% of all estimated HIV/AIDS cases.2 The public perception about gay men is that they are "white, middle class, college-educated and urban," but this group includes men of all races and ages, socio-economic and geographic backgrounds.


Factors to Consider When Promoting and Providing HIV Prevention and Treatment

A Second Wave

Increasing HIV infection rates and recent studies suggest that a second wave of this epidemic is occurring among this group. The more heavily affected communities are younger MSM and MSM of color. A CDC study in six cities found that among MSM ages 23-29, 32% of African American men3 and 14% of Latino men were HIV-positive, compared to 7% of Caucasian men.4 MSM of color now account for a majority of AIDS cases reported among MSM.2 MSM in the Asian and Pacific Islander community make up the largest proportion of AIDS cases (72%) compared to other communities of color.5 Research shows young MSM continue to practice high risk behavior, highlighting the need to continue appropriate prevention efforts for each generation.


HIV-Related Stigma

Experts believe that reducing social stigma is essential to effectively stopping the epidemic.6 Negative public views regarding people with HIV/AIDS hinder discussions and disclosure regarding HIV status. For example, a study among gay men found that 83% who were HIV-negative and 74% who didn't know their status preferred partners who were HIV-negative. In addition, many individuals must contend with other social prejudices, such as homophobia and racism, as well as fear of legal and moral retribution related to sexual and drug use behaviors and immigration status. Some individuals don't test or return for their results for fear that a positive result will damage their self-image and their family and social relationships.6


Sexual Behavior and Orientation

For many MSM, a gay or bisexual identity is an important part of self-identification, while for others it is a question of sexual practice rather than identity. In fact, some MSM identify as heterosexual and may not relate to prevention messages directed towards self-identified gay men.7 While this may signal internalized homophobia, it is important to focus on connecting individuals with the desired services and working on maintaining safer sex practices. Some programs incorporate interventions that help men who are questioning their sexual identity develop a positive self-image and build supportive social networks.


Misconceptions About Treatment

Many gay men and MSM today tend to practice unprotected sex because they are overly optimistic about the benefits of new combination therapies. Some hold the mistaken perception that HIV-positive people who have an undetectable viral load can't transmit HIV.6


Suggestions for Effective Services and Campaign Messages


References

  1. The Henry J. Kaiser Family Foundation, The HIV/AIDS Epidemic in the United States, March 2004.

  2. CDC, HIV/AIDS Surveillance Report, Vol. 15, December 2004.

  3. The Henry J. Kaiser Family Foundation, African Americans and HIV/AIDS, February 2005.

  4. The Henry J. Kaiser Family Foundation, Key Facts: Latinos and HIV/AIDS, February 2005.

  5. Centers for Disease Control and Prevention. (2004). HIV/AIDS Surveillance Report. Vol. 16, 21.

  6. CDC, Best Practices in Prevention Services for Persons Living with HIV, December 2004.

  7. CDC, Fact Sheet: HIV/AIDS among Hispanics, November 2004.




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