HIV Numbers Reveal Impact on MSM Community

For years, CDC data have shown that men who have sex with men (MSM) account for the majority of new HIV and syphilis infections in the United States. Now for the first time, CDC has created an estimate of the size of the U.S. MSM population that allowed it to calculate the prevalence of these diseases among MSM.

By conducting a meta-analysis of nationally representative studies, CDC found that men who have had sex with another man in the previous five years represent 2 percent of the U.S. population age 13 and older, said Dr. Jonathan Mermin, director of CDC's Division of HIV/AIDS Prevention. The analysis shows that MSM comprise 4 percent of the U.S. male population.

With this information, CDC researchers were able to estimate the range of new HIV diagnoses as 522-989 cases per 100,000 MSM, more than 44 times the rate for other men (12 diagnoses per 100,000) and more than 40 times the rate for women (13 cases per 100,000). The estimated rate of new primary and secondary syphilis diagnoses is 91-173 cases per 100,000 MSM, more than 46 times that for other men (two per 100,000) and more than 71 times that of women (one per 100,000).

The findings were presented this month in Atlanta at CDC's 2010 National STD Prevention Conference.

The complex factors that contribute to the disparity include high HIV/STD prevalence among MSM, which increases the risk of continued exposure; the role STDs play in facilitating the spread of HIV; the efficiency of anal sex for HIV transmission; MSM's tendency to have more sexual partners than heterosexuals; the prevalence of substance abuse in the MSM community; complacency about risk, particularly among young MSM; difficulty practicing safe sex for every sexual encounter; lack of syphilis awareness; limited access to prevention services; and discrimination that can prevent MSM from seeking prevention, testing, and treatment services.

"We need to provide accurate information to the public, the gay community, and activists, and we all need to start thinking more carefully about how we're concentrating our resources for effective interventions and research that will allow new interventions to specifically help gay and bisexual men," Mermin said.

"Prevention in the HIV epidemic has been led by gay and bisexual men since the beginning of the epidemic, and I'd encourage all gay and bisexual men to stay active in those activities," Mermin said. He called on MSM to limit their number of sex partners, practice safe sex, and be screened at least annually for HIV and STDs.

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