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Successes and challenges of HIV prevention in men who have sex with men.


ABSTRACT: Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse, which, although somewhat efficacious, did not reduce HIV transmission. Biomedical prevention strategies reduce the incidence of HIV infection. Delivery of barrier and biomedical interventions with coordinated behavioural and structural strategies could optimise the effectiveness of prevention. Modelling suggests that, with sufficient coverage, available interventions are sufficient to avert at least a quarter of new HIV infections in MSM in diverse countries. Scale-up of HIV prevention programmes for MSM is difficult because of homophobia and bias, suboptimum access to HIV testing and care, and financial constraints.

SUBMITTER: Sullivan PS 

PROVIDER: S-EPMC3670988 | biostudies-literature | 2012 Jul

REPOSITORIES: biostudies-literature

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Successes and challenges of HIV prevention in men who have sex with men.

Sullivan Patrick S PS   Carballo-Diéguez Alex A   Coates Thomas T   Goodreau Steven M SM   McGowan Ian I   Sanders Eduard J EJ   Smith Adrian A   Goswami Prabuddhagopal P   Sanchez Jorge J  

Lancet (London, England) 20120720 9839


Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse,  ...[more]

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