UNAIDS: Gay men still the group most affected by HIV in many rich countries

HIV continues to spread amongst gay men in richer countries, according to the UNAIDS annual update on the world AIDS epidemic published today. The report highlighted that in several European countries, as well as Australia gay men still accounted for the majority of new infections. Resurgent epidemics of sexually transmitted infections (STIs), particularly syphilis, suggesting to UNAIDS an increase in risky sexual behaviour amongst gay men.

In the USA, UNAIDS reported on the increasing prevalence of HIV amongst African American men, many of whom have sex with both men and women.

UNAIDS estimates that in the world’s richest countries, including western Europe, north America, Australasia, and Japan, a total of 1.6 million people are now living with HIV, including 80,000 who are estimated to have been infected with HIV in the last year. Although the epidemiology of HIV is changing in many rich countries, with a growth in infections seen amongst heterosexuals, particularly recent migrants, gay men still account for a substantial number of new infections.

In Germany, Greece, the Netherlands and Australia gay men still account for the majority of new cases of HIV transmission. UNAIDS highlights recent resurgent epidemics of STIs across the industrialised world as a pointer of “a revival of high-risk sexual behaviour – especially among young people, including men who have sex with men.”

Syphilis outbreaks amongst gay men in France, Ireland, the Netherlands and UK suggest to the UNAIDS authors that “the prevention programmes that had achieved notable success in limiting HIV transmission in the 1990s, especially among men whi have sex with men, appear to have been shifted to the back burner by many high income countries.”

In the US, 50% of the 40,000 new HIV infections this year were among African Americans (12% of the national population). Women account for an increasing proportion of these infections, with many having no risk activity other than sex with their regular male partner. Data from eleven US states shows that 34% of HIV-positive African American men report having sex with both men and women. Few of the men’s female partners know of the men’s bisexual behavior. “The secrecy surrounding such overlapping risk behaviour seems rooted mainly in the stigma that remains attached to homosexuality” says the UNAIDS report. This stigma has serious consequences, as HIV is now the leading cause of death amongst young African-American women, and 90% of HIV-positive young African-American men who have sex with men are unaware that they are infected with HIV.