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Why is the HIV Infection Rate Among Gay Men on the Rise?

Why is the HIV Infection Rate Among Gay Men on the Rise?

Recently released statistics say that HIV rates among gay Australian men have reached a record high. Why are HIV rates continuing to rise among gay men, and what can be done about it?

The Kirby Institute at the University of New South Wales’ Australia Annual Surveillance Report provides statistics that show HIV infections in Australia rose by 10% in the past 12 months. That’s the largest increase in 20 years.

To put that in real terms, last year 1,253 cases of HIV were diagnosed. To compare, in 1999 there were just 719 new diagnoses. Even accounting for better testing methods and better testing uptake, that’s still a troubling increase. The report also suggested that, based on predictors like past figures, researchers believe there may be a further 25% of undiagnosed HIV cases.

The most common method of transmission was unprotected sex among gay men, though there was also a worrying upward trend of HIV transmission in the wider population due to intravenous drug use.

It’s not just HIV infection rates that are worrying Australia’s health officials. The report also showed an increase in a number of sexually transmitted infections, including chlamydia and gonorrhoea.

The report does note, however, that the HPV vaccine appears to have dramatically reduced instances of genital warts among young women aged 21 years or younger, decreasing rates from 12.1% of women in 2007 to 1.1% in 2012. Given that the HPV vaccine can also prevent cervical cancer, this uptake is encouraging.

Yet HIV rates continue to rise, particularly among gay men — and not just in Australia, but among many gay populations in the UK, America and across Europe. Why is this?

Complacency About HIV

One of the main factors appears to be age. One of the main demographics presenting with rising HIV numbers, at least in Australia’s case, appears to be 20-something gay men for whom the AIDS crises of the 80s and early 90s fails to register. As such, they are unlikely to see HIV as lethal as it once was, mindful of how antiretroviral treatments have meant that those infected with HIV can live relatively normal — and, crucially, long — lives.

Professor David Wilson, who conducted the study, is quoted as saying:

“It’s very alarming what’s happening with HIV at the moment. We’ve had over 1,250 cases of HIV recorded, that’s those that have been diagnosed. HIV is no longer the death sentence it once was. With good, effective treatments, it can keep people alive to almost a full life expectancy. So I think it’s perhaps a little bit of complacency that’s set in.”

However, Wilson cautioned that this could be the seeds of another epidemic, with a particular fear that the young Aboriginal population, which was burdened with one of the biggest increases, is particularly at risk, especially because the population has a rising rate of drug use.

While not wanting to scaremonger and risk further stigmatizing those living with HIV, how can health services and governments better educate and help at risk groups when, apparently, the messaging that worked so well in the 80s and 90s has now lost some of its impact?

Condoms Aren’t Necessarily the Only Answer

Pre-Exposure Prophylaxis, or PrEP, is a relatively new HIV prevention method in the form of a daily pill for HIV negative people. It is intended for high risk populations and has shown remarkable effectiveness for reducing HIV infection risk among adult men and women who might contract HIV through sexual activity or intravenous drug use.

The pill is not intended as a sole prevention method and cannot completely cut HIV infection risk, but studies have shown that PrEP can provide 44% additional protection to men who have sex with men who were also receiving comprehensive sexual health care services like HIV testing, condom provision and support for dealing with sexually transmitted infections.

The level of protection offered by PrEP varies dramatically as it is dependent on how regularly subjects use the drug, but in those who have adhered to a daily regimen, the risk of HIV acquisition can be cut by 50% or more, with some studies finding rates in the 80-90% range.

PrEP will not be suitable for all at risk populations and individual circumstances will have to be evaluated, but making such treatments not just available but well publicized may now be key in convincing younger populations and the wider gay community to take preventative measures to help stop HIV infection and transmission because, for a complex set of reasons, they are no longer using condoms.

Also, and drawing a thread from above, improving access and knowledge of the availability of HIV screening and sexual health care are all recommended by health experts. Recognizing, then, that men who have sex with men are not a homogeneous group and instead span a wide variety of demographics, in terms of wealth, education, race and age, can all help to create programs that can specifically answer the needs of individual MSM populations.

Essentially, the key message to emerge here seems to be that a focus solely on condoms is no longer working. Encouraging wider education on HIV/AIDS, stressing the importance of regular HIV testing, and providing better access to cheap PrEP medications may now have to play a more prominent role while reinforcing that considering sexual health isn’t just important for individuals, but is vital for the health of entire communities.

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Photo credit: Thinkstock.

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50 comments

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12:54PM PST on Jan 5, 2014

i am RODA by name, i want to tell the whole world how i got my hiv cured, i live in Manchester united kingdom, presently i am working as a teacher in an high school, i was once a stripper in a club and i got affected with HIV due to the nature of my job, in February 2nd 2009, This is not design to convince you but its just a personal health experience.
I never taught doctor LAWCY could ever get my HIV-AIDS cured with his healing herb spell, i have been spending so much buying my drugs for the past three years now and taking several medication but no relieve, until one day i was just browsing on the internet when i came across a great post of MARIAN, who explained to me how a great dr called PAPA LAWCY helped her, by curing her from HIV, i thought as much and i quicklly contacted him, and he gave to me the assurance that he is going to help me with his herbs, he told me to buy the herbs which he will use for the preparation of my medicine which i did, he prepared the medicine and told me how i am going to take them which i did, just three days later i went to the hospital to give the final test and the doctor confirm that i am now negative, i am so happy that GOD sent DR LAWCY to help me out of my problems, if you are out there passing through this kind of problem, you can also contact him on DRLAWCYSPELLHOME@GMAIL.COM.com, and i pray that he will help you also.
All thanks to DR LAWCY, you can contact me on +44702407841

8:01PM PDT on Oct 28, 2013

I agree with Ron B/

4:57AM PDT on Oct 28, 2013

and medications can prolong your life and you live well for years, why does one still tempt the treacherous terrain and flirt with a possible HIV diagnosis?

4:53AM PDT on Oct 28, 2013

You are so right Ron B., you can't save everyone, so you might as well save yourself! People now a days do not care whom they hurt or kill in the process of free expression. They do not care about the ill effects of their fickle and damaged thought process. If it is that important to a person to lay down with any one who comes along, and with true abandon of all thought that goes into making poor choices, then by god by all that is true and just, cover yourself at least and let others know of your status and quit playing God and feeling its ok to kill others just because of your decision to die! What is wrong with every society the world over, is that everyone forgot how it is to respect each other and love one another. We do not discuss AIDS anymore anywhere as if this has now become an obsolete disease. There are no discussions as when the disease first appeared in our living room thought media tv and discussions the world over. Today, no one really cares because if it feels good they are going to do it in spite of hell. Death doesn't dissuade or change how a person acts and feels when they are on a mission. Whether drugs or illicit sex, if it feels good do it! That's the attitude. For those that do not die, they feel its much better to live with an HIV status than it is to have practiced safely, or used clean needles where such programs existed. Everyone needs to wake up and smell the coffee Shirley, because this infectious disease is all but over! Even if one does not die

8:04PM PDT on Oct 27, 2013

Someone I knew told me a tale about his ex that horrified me. This ex would with go to sex parties with another friend and have unprotected sex with other men. Some of these other men were also married to women. My friend's ex boyfriend is HIV positive.

There are actually websites where you can sign up and be part of this community of men who like to do this.

I am not sure if this person reported his ex-boyfriend but I encouraged him to do so as this is irresponsible. The HIV guy may as well be going around shooting or stabbing people as far as I'm concerned.

10:00PM PDT on Oct 26, 2013

The WORLD'S media need to inform the population of this epidemic. It MIGHT make the GAYS sit up & take notice & use more care in their encounters.

4:01AM PDT on Oct 26, 2013

Noted

12:41AM PDT on Oct 26, 2013

Thanks. I agree with Rob B.

10:39PM PDT on Oct 25, 2013

thanks for sharing

7:01PM PDT on Oct 25, 2013

Steve Williams..." And not just in Australia but AMOUNG GAY POPULATIONS IN UK ,AMERICA AND ACROSS EUROPE....WHY IS THIS ?" It's becoming an epidemic worldwide ! Typical Steve Williams with his myoptic vision....He's gotta be joking surely...But nah...he cannot understand the obvious even if it smacked him between the ears

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