Since the first homosexual was found to have the HIV virus in America in the year 1981, Men who have sex with men (MSM) have been a core group of population prevalently affected by HIV and AIDS (Beyrer, et al. A call to action 2012). Though it is believed that people had been living with HIV virus long before it was discovered, the discovery of the Virus in a homosexual marked the beginning of stigmatization of those living with HIV and AIDS. To some extent, the stigmatization limited an effective public health initiative making the virus spread in populations globally (Beyrer, et al. A call to action 2012). For a long period, people with HIV have continued to face stigmatization and discrimination in society. No population has suffered this most than men who have sex with men alias MSM. Though MSM form an enormous population of the people with HIV, they have suffered discrimination and stigmatization. This is because first, HIV is shunned by many and also the aspect of sexuality is not acknowledged by many in society. This has worsened the situation making HIV spread rapidly among the MSM population despite many steps having been made forward to fight HIV such as the discovery of antiretroviral drugs among others. In fact, Beyrer in another article argues that epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries (Beyrer, et al. Global epidemiology 2012). This paper looks into the reasons why HIV spread in MSM continue unabated and some of the solutions to lessen the spread of HIV among the MSM.
In the article, the author blames the stigmatization of (MSM) on the spread of HIV (Beyrer 2012). The MSM remains stigmatized, discriminated and criminalized community in the society. The stigmatization, discrimination, and criminalization manifests itself in various ways. For instance the MSM, despite prevalently forming part of the community infected with HIV, they have not viewed and acknowledged as a threat and as part of public health concern. They are thus left out in public health initiatives though they are an important part of society. For instance, out of a possible 195 countries in the world, only 87 of them had reported the widespread presence of HIV in MSM. Not only that, in other areas like the Middle East and African countries, there are criminal sanctions against homosexuality, which make HIV spread amongst themselves challenging. In most of these areas, MSM with HIV are left without medical care and treatment leave alone preventive measures. For instance, they rarely get access to antiretroviral for preventive measures. They also do not get access to condoms (Beyrer, et al. A call to action 2012). All these manners of discrimination and stigmatization cause impact the spread of HIV in MSM.
Another study by Philip et al blames the increase in HIV among MSM on condomless sexual relations, a point that had been echoed by Beyer et al 2012. The authors argue that the failure of the MSM to use condoms while having sex precipitates the spread of HIV and AIDS in the MSM population (Phillips, et al 2013). This explains why there is a prevalence of HIV infections in MSM networks because they have unprotected sex amongst themselves thereby spread HIV. Sullivan et al argue that behavioral interventions aimed at lessening the protection of anal sex have not achieved much in preventing the spread of HIV in MSM. Though they have some level of efficacy, they are not effective alone but need to be used in conjunction with biomedical preventive measures Sullivan et al.
Beyler et al propose various solution to curb the prevalent spread of HIV. According to these authors, from a human right perspective, stigmatization, discrimination, and criminalization of MSM must change if there are any hopes of curbing the spread of HIV amongst the MSM community (Beyrer, et al. A call to action 2012). Once these people are accepted for who they are, that will be the right step towards preventing the spread of HIV. Accepting them will first appreciate that these people are a vulnerable part of the population that need specialized attention when it comes to HIV. Decriminalization of MSM also needs to occur in those areas where the practice of homosexual is prohibited. Besides the human right angle of the solution, there is the public health solution according to Beyler et al. First there is need to ensure that the MSM get proper treatment to curb the spread of HIV. Preventive measures such as an increased provision of Condoms as well as lubricants can also be undertaken to ensure that MSM with HIV does not infect others in their population. Besides that, there is also the use of antiretroviral drugs address HIV spread. Although Beyler et al suggest those remedies, they also argue that there is a need to continue researching, and making structural reform to tackle the spread of HIV in MSM.
Beyrer et al argue in another article that though there are biological ways to lower the spread of HIV in MSM such as the use of antiretroviral among others, they are often made ineffective by structural factors such as discrimination and stigmatization that make MSM adopt a low health-seeking behavior (Beyrer, et al. Global epidemiology 2012). For Philips however, the best solution to the problem is to increase the rate of HIV testing for MSM in combination with viral suppression by use of biological means to reduce the infection incidences. However, in order not to erode the benefits realized through induced viral suppression, there is a need for MSM to adopt the use of Condoms (Phillips, et al 2013). Sullivan et al join Philips in stressing the need for abandoning the use of standalone mean to tackling the spread of HIV but instead adopt both behavioral intervention and biomedical intervention (Sullivan et al). The use of the combined means can curb the spread of HIV.
From the studies conducted, it is evident that HIV spread in MSM is prevalent and need much intervention. Though all the researchers have different means of curbing the spread of HIV in MSM, they agree that both medical intervention and behavioral intervention need to be adopted to tackle the spread of HIV in MSM. A combination of all strategies available can help prevent the spread of HIV. For instance, MSM should be encouraged to use Condoms and antiretroviral as biomedical preventive strategies. For behavioral interventions, there is a need to accept MSM as part of the community without discriminating and stigmatizing them.
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