Anal Sex is Main Cause of HIV Pandemic: Study

According to a Lancet Series publication, Professor Chris Beyrer, Johns Hopkins Bloomberg School of Public Health, has shown that the vast majority of all transmission of HIV occurs through anal sex, most significantly involving two men, but also via infected men having anal sex with uninfected women. The study also shows that HIV transmission would drop dramatically if homosexual men behaved monogamously rather than having serial escapades, as is the norm.

For background, read Federal Government Reports Majority of New HIV Cases from Homosexual Behavior and also read HIV Infections Rampant Among Homosexuals Says Fed. CDC as well as HIV Cure: False Hope to Victims, Money to Others

-- From "Biology Leaves Gay Men Highly Vulnerable to HIV: Study" by Randy Dotinga, HealthDay Reporter 7/20/12

According to UNAIDS, HIV is more common among gay and bisexual men than adults in general in all areas of the world, even Africa. In North America, an estimated 15 percent of gay and bisexual men are infected with HIV; the rate is the highest, 25 percent, in the Caribbean.

Previous research has shown that being on the receiving end of anal intercourse is equally risky whether you're a man or a woman. The risk was estimated at 1.4 percent per sex act with an infected person -- about 18 times more risky than male-to-female vaginal intercourse.

The study authors estimate that if receptive anal intercourse were only as risky as vaginal intercourse, HIV cases would fall by 80 percent to 98 percent among gay and bisexual men over five years. They also estimate that cases would fall by 29 percent to 51 percent if more gay and bisexual men had sex in long-term relationships instead of casual encounters.

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From "HIV rates in men who have sex with men ‘uncontrolled’" by Mark Gould, OnMedica.com (Wilmington Healthcare Limited) 7/20/12

. . . In many high-income settings—including the UK, Australia, France, and the USA—overall HIV epidemic trends are in decline except in men who have sex with men (MSM), where they have been expanding even in this modern era of highly active antiretroviral therapy (HAART).

The biology of HIV transmission in anal sex, MSM network features, and their related dynamics are key drivers, meaning that reducing infectiousness through initiatives like treatment as prevention and pre-exposure prophylaxis are likely to be key in curbing HIV in this group.

These increasing HIV infection rates have been described as re-emergent epidemics in MSM. In the USA, HIV infections in MSM are estimated to be increasing at roughly 8% per year since 2001. And in much of Africa, Asia, and Latin America, the highest rates of HIV infection in any risk group are in these men.

Well-documented risk factors for HIV infection among MSM include unprotected receptive anal intercourse, high frequency of male partners, high number of lifetime male partners, injection drug use, high viral load in the index partner, African-American ethnic origin (in the USA), and non-injection drug use, including use of amphetamine-like substances (ATS). But these risks alone are insufficient to explain the dramatic differences between HIV epidemics among MSM and other populations.

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From "Study: HIV Rates in Gay Black Men Are Alarmingly High" by Alexandra Sifferlin, Time Magazine 7/23/12

The new-infection rate in gay black men under 30 is . . . 6% a year, according to the new data presented Monday at the annual International AIDS Conference in Washington, D.C. These numbers are comparable to HIV rates seen in sub-Saharan Africa, in countries that are hardest hit by HIV, the authors of the study note.

Last week, another new study by the Black AIDS Institute also highlighted the alarming rate of infection among black men who have sex with men (MSM). While only 1 in 500 Americans is a black gay or bisexual male, they account for 1 in 4 new HIV infections in the United States, the report found. It also found that a black gay man has a 1 in 4 chance of becoming infected by age 25; by age 40, he has a 60% of becoming HIV positive.

The Centers for Disease Control and Prevention (CDC) notes that from 2006 to 2009, HIV infections among black gay and bisexual men under 30 increased 48% and that African Americans are overall disproportionately affected by HIV. Blacks make up 14% of the U.S. population, but account for 44% of all new HIV infections. According to 2009 data, 73% of new infections in black men are in gay and bisexual men.

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