 HIV and Syphilis amoung MSMDear Colleague: Today, the Centers for Disease Control and Prevention (CDC) presented a new analysis at its 2010 National STD Prevention Conference underscoring the disproportionate impact of HIV and syphilis among men who have sex with men (MSM) in the United States. While CDC data have shown for years that more than half of new HIV and syphilis infections are among gay and bisexual men, new analyses allowed us to estimate the rate of these diseases among the total U.S. population of MSM. Based on a meta-analysis of nationally representative surveys, CDC estimated that MSM comprise 4% of the U.S. male population or 2% of the overall U.S. population aged 13 and older. The rate of new HIV diagnoses among MSM is between 44 and 86 times that of other men and between 40 and 77 times that of women. The rate of primary and secondary syphilis among MSM is between 46 and 89 times that of other men and between 71 and 135 times that of women. CDC’s press statement containing more detailed information on this analysis is available at http://www.cdc.gov/nchhstp/newsroom/msmpressrelease.html. CDC is in the process of developing breakdowns of MSM rates by race and age, and is in the early planning stages of developing estimates for rates of HIV among injection drug-users (IDU) and high-risk heterosexuals. These estimates will inform our collective approach to HIV and STD prevention, ensuring that resources, programs, and policies are reaching populations in greatest need of services. CDC remains gravely concerned about the severe impact HIV continues to have on gay, bisexual, and other men who have sex with men. We are committed to ensuring that those most affected by the epidemic have access to proven behavioral interventions and accurate information about HIV prevention. CDC supports a range of proven HIV prevention interventions through the Diffusion of Effective Behavioral Interventions (DEBI) program and in health department and community-based programs around the country. We are reviewing the most recent scientific evidence on prevention strategies for gay, bisexual and other MSM and remain committed to the wide release of fact sheets and other tools to ensure that gay and bisexual men have the most accurate and useful HIV prevention information possible. CDC will soon be releasing a new fact sheet specifically targeting MSM that focuses on serosorting, or engaging in unprotected anal intercourse with partners believed to be of the same serostatus, that will provide clear information about the risks and benefits of serosorting for HIV-negative and HIV-positive MSM. The new fact sheet is currently in the final stages of review at CDC and will be posted online in the coming weeks. A notice will be sent to you when the fact sheet is published. Preventing HIV and STDs among gay and bisexual men is a top priority for CDC but we also recognize that there is no single or simple solution. We need intensified prevention efforts that are as diverse as the gay community itself; and solutions for young MSM so that HIV does not become a rite of passage for each new generation of gay men. We need increased attention to the impact of HIV among black and Hispanic MSM who bear an even greater burden of HIV. While the heavy toll of HIV and syphilis among MSM has been long recognized, this analysis illustrates the stark health disparities between this and other populations. Ending the U.S. HIV epidemic will require every affected community, along with health officials nationwide, to prioritize the HIV prevention needs of gay and bisexual men. Epidemiological drivers of risk including high prevalence of HIV among MSM, the efficacy of transmission through anal sex, and numbers of sex partners, are not the only factors contributing to high rates of infection among MSM. Because discrimination, poverty, and cultural issues are also factors, there are things we must do individually and in our families and workplaces to make a difference in this epidemic such as decreasing stigma and eliminating homophobia and its negative effects on physical and mental health. It is clear that ending the U.S. HIV epidemic will require increased action from all segments of our society—including our families, civic organizations, the private sector and beyond. Thank you for doing your part to help end this epidemic. Sincerely, Jonathan H. Mermin, M.D., M.P.H. Director Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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