Perpetuatn of the HIV epimic gay and bisexual men is not directed solely by person-level behavrs but is fluenced by a range of ntextual factors, rooted cultural, historil and polil stctur this untry.
Contents:
- HIV AND ALL GAY AND BISEXUAL MEN
- DISCRIMATN AND HOMOPHOBIA FUEL THE HIV EPIMIC GAY AND BISEXUAL MEN
- HIV IS NOT A GAY DISEASE
- HIV/AIDS IS A ‘GAY DISEASE’: THIS, AND 8 SUCH MYTHS ABOUT STDS BTED
- AIDS: STILL A GAY DISEASE AMERI
- HIV NOW FECTS MORE HETEROSEXUAL PEOPLE THAN GAY OR BISEXUAL MEN – WE NEED A NEW STRATEGY
- HIV IS A STORY FIRST WRTEN ON THE BODI OF GAY AND BISEXUAL MEN
HIV AND ALL GAY AND BISEXUAL MEN
The high percentage of gay and bisexual men who are livg wh HIV means that, as a group, they have a greater risk of beg exposed to HIV; browse lks here. * is aids a gay disease *
More recently, wh the game-changg breakthroughs the bmedil arena, attentn has shifted to the bmedil preventn strategi, which clu preexposure prophylaxis (PrEP) for gay, bisexual, and other MSM (Grant et al., 2010) and vagal microbicis for women (Abdool et al., 2010). In rponse to the alarmg health dispari among gay and bisexual men, there has been a ll to broan the preventn lens to exame the fluence of multiple social and ntextual factors fluencg health behavrs (Halkis & Cahill, 2011).
Dpe clear evince for the social termants of HIV transmissn and the beneficial effects of stctural terventns (Adimora & Auerbach, 2010), there have been limed efforts targetg the social equali, which place gay and bisexual men at greater risk for the acquisn of HIV disease. In this article, nsiratn is given to the manner through which discrimatn and homophobia, which may have been heightened bee of the AIDS epimic (Halkis, 1999), perpetuate HIV vulnerabili for gay and bisexual men. Sce discrimatn based on sexual inty is cril to the ias beg put forth, and sce the HIV preventn needs of gay and bisexual men differ wily om those of non-gay or bisexual MSM (Halkis, 2010b), the foc of this issue of the newsletter is on gay and bisexual men, and not MSM general.
” In the followg years, I wnsed the eptn of the disease, which s early years was given the name GRID (gayrelated immunoficiency disease) bee of s omniprence the gay populatn (Shilts, 2007; Weeks & Almo, 2010).
DISCRIMATN AND HOMOPHOBIA FUEL THE HIV EPIMIC GAY AND BISEXUAL MEN
Read rpons to myths that 'HIV is a gay disease' or a 'ath sentence,' and fd other important rmatn about gettg tted. * is aids a gay disease *
Male populatn 18–44 years of age (Chandra, Mosher, Copen, & Snean, 2011), MSM, primarily gay and bisexual men, acunt for more than 50 percent of all AIDS s and all HIV fectns and 57 percent all new HIV fectns (CDC, 2011b).
Dpe creased visibily, acceptance and recent socpolil advanc, gay and bisexual men ntue to live a society that privileg heterosexualy while nigratg nonheterosexual relatnships, behavrs and inti (Herek, Gillis, & Cogan, 2009). Opprsive social stctur and equali affectg gay and bisexual men have been implited perpetuatg not only the HIV epimic but also rat of anal ncer, Hepatis B, human papillomavis (HPV) and lymphogranuloma vernrm (LGV) fectns, syphilis, gonorrhea and Hepatis C (Wolski & Fenton, 2011).
The stctural ndns, which take the form of discrimatn and homophobia (Wolistki & Fenton, 2011; Wolski, Stall, & Validiserri, 2008), are further pound by racism and enomic dispari for gay and bisexual men of lor.
HIV IS NOT A GAY DISEASE
Gay and bisexual men are more severely affected by HIV than any other group the Uned Stat (US). * is aids a gay disease *
Exposure to and experienc of homophobia have been implited substance abe, risky sexual behavrs, negative body image, suici attempts, creased strs and limed social support among gay and bisexual men (Halkis, Fischgnd, & Parsons, 2005; Mayer, Bradford, Makadon, Stall, & Goldhammer, 2008; Wolski, Stall, Valdiserri, 2008). Moreover, experienc wh homophobia have been shown to terfere wh the abily of gay and bisexual men to tablish and mata longterm same-sex relatnships, which protect agast HIV acquisn (Diaz, Ayala, Be, Henne, & Mar, 2001).
HIV/AIDS IS A ‘GAY DISEASE’: THIS, AND 8 SUCH MYTHS ABOUT STDS BTED
* is aids a gay disease *
G., immigrants) who grow up wh people like themselv and who receive the support of their fai, gay and bisexual youth equently have more plited and often abive fay dynamics (D’Augelli, Hershberger, & Pilkgton, 1998; Pilkgton & D’Augelli, 1995).
AIDS: STILL A GAY DISEASE AMERI
HIV and the syndrome , AIDS, began spreadg the Uned Stat the early 1980s. By the late 1980s had bee a public health crisis. Inially the U.S. ernment did ltle to addrs the epimic, due part to misnceptns that the disease only affected gay men. Activists me together to mand a rponse om the ernment and the ternatnal muny. By the mid-1990s, HIV/AIDS numbers were on the cle Ameri. Today, lns of people around the world are livg wh HIV and tens of thoands of people die of AIDS-related illns every year. * is aids a gay disease *
(2009) monstrated that gay and bisexual men wh histori of childhood sexual abe were more likely to report both unprotected anal terurse, to rive fewer benefs om participatn preventn programs, and to be at an overall greater risk for HIV fectn.
Recently our rearch team at the Center for Health Inty, Behavr and Preventn Studi (CHIBPS) at New York Universy documented the risks and rilienci of young gay and bisexual men ag 13–29 a study named Project Dire. In their qualative study of masculy, Phoenix, Frosh, and Pattman (2003) found that boys as young as 11 years of age have found crilly important to prent themselv as mascule orr to avoid beg bullied and labeled as gay.
HIV NOW FECTS MORE HETEROSEXUAL PEOPLE THAN GAY OR BISEXUAL MEN – WE NEED A NEW STRATEGY
Sexually Transmted Diseas (STDs) have been creasg among gay and bisexual men. * is aids a gay disease *
Unfortunately, the cultural perceptn of gay and bisexual mal as ls mascule may lead to their assertns of masculy through engagement unprotected sexual behavrs (Halkis, Green, & Wilton, 2004; Harper, 2007). Scientific evince shows that gay men’s doubts about their masculy as well as endorsement of mascule characteristics are associated wh equent risky sexual behavrs, which crease exposure to HIV (Connell, 1995; Diaz, 1998). Posive attus toward one’s sexual inty have been shown to be protective agast risky sexual behavrs (Rosar, Hunter, Maguen, Gwadz, & Smh, 2001), while elevated rat of ternalized homophobia have been lked to exacerbated sexual risk takg and other health risks.
(2008) monstrated that among 465 HIV-posive men, ternalized homophobia was associated wh unprotected receptive anal terurse wh partners who were HIV-negative or of unknown HIV stat and was also associated wh poorer adherence to antiretroviral therapy. For gay and bisexual men of lor, the effects of sexual orientatn discrimatn on HIV risk may be nfound and exacerbated by other powerful stctural factors, cludg racism, lack of accs to enomic means, and poverty (Williams, Wyatt, Rell, Peterson, & Asuan-O’Brien, 2004). Th, the synergistic social ndns of homophobia, racism, and poverty likely expla the even higher cince of new HIV fectns among racial ethnic mori, particularly Black and Lato gay and bisexual men (CDC, 2011b).
Yet is a likely hypothis that those who have accs to and navigate environments where there are high levels of gay prence are also likely to be exposed to HIV preventn msagg through publitns and advertisements, as well as through teractns wh other gay men social venu. For those young gay men of lor who are socenomilly disadvantaged, accs to gayrelated health rourc may be more limed bee their neighborhoods of rince tend to be outsi the exclive cy center, where many gay cultural, health, and social tablishments tend to be loted (Halkis, Moeller, & Sinolfi, 2009a, 2009b). Taken together, the extant lerature suggts that the perpetuatn of the HIV epimic gay and bisexual men is not directed solely by person-level behavrs but is fluenced by a range of ntextual factors, rooted cultural, historil, and polil stctur this untry.
HIV IS A STORY FIRST WRTEN ON THE BODI OF GAY AND BISEXUAL MEN
A holistic approach to the well-beg of gay men (Halkis, 2010b; Saen, Rer, Herick, Mimiaga, & Stall, 2010) should llectively nsir the bmedil, psychologil and social factors that create the health dispari this segment of the populatn. As noted by the Instute of Medice (2011) and as supported by the ias prented this article, an approach to the totaly of gay men’s health mt nsir the role that social stctur play promisg gay men’s health.