The upward trajectory of HIV infection trends among gay men worldwide points to a dire future for that demographic, even as overall HIV incidence rates in the general population have been steadily dropping, aidsmap reports. Kevin Fenton, MD, PhD, the national director of health and wellbeing at Public Health England, presented a report on the epidemic among gay men to the British HIV Association fall conference.

Effective means to curb transmissions notwithstanding, the prevalence of the virus among men who have sex with men (MSM) is rising in almost all nations, with incidence levels unwaveringly stable. (Prevalence refers to the total number of people infected with the virus and incidence refers to the number of new HIV infections each year.) According to Fenton, controlling the epidemic in MSM will require optimizing testing programs for this population, although this effort will pose a significant challenge.

In low-income countries, MSM have an estimated eight-fold higher HIV prevalence rate compared with the general population, and MSM in high-income nations have 23 times the prevalence rate of the general population. There is apparently no country in the world where the HIV prevalence rate among MSM is lower than that of the population at large.

Part of the explanation for the disparity is biological. Anal sex is an estimated 18 times more efficient at transmitting HIV than vaginal intercourse.

The high prevalence of HIV in a “sexual network” also plays into the high prevalence rates among MSM. With higher numbers of partners and a more overlapping and interconnected network of partners, there are greater connections through which the virus can spread.

Psychosocial matters also contribute to high infection rates, including depression, anxiety, substance use, racism, childhood sexual abuse, familial rejection, homophobia and partner violence.

To read the aidsmap story, click here.

To read the report, click here.