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article imageAIDS — Harsh reality despite the many advances made over decades

By Karen Graham     Jul 8, 2016 in Health
In the decades since the HIV virus was discovered, we have made great strides in the diagnosis and treatment of a disease that once was a death sentence. And while HIV infection rates are falling among heterosexuals, it's not the case with gay men.
Thanks to advances in drug treatments and services, along with the availability of pre-exposure prophylaxis (PrEP), there has been a dramatic reduction in the transmission of the HIV virus among gay men.
But looking at data worldwide, a new study has found that gay, bisexual and other men who have sex with men continue to have disproportionately high burdens of HIV infection, say researchers at Johns Hopkins Bloomberg School of Public Health. And surprisingly, this trend is being seen in low, middle and high-income countries around the world.
These latest findings will be published in the July 9 issue of Lancet, reports EurekAlert, four years after the same group of researchers issued a call to action, laying out a plan to curtail HIV epidemics in gay men, setting targets for policy reform and funding, as well as better prevention and treatment protocols for HIV/Aids.
Study leader Chris Beyrer, MD, MPH, the Desmond M. Tutu Professor of Public Health and Human Rights at the Bloomberg School and president of the International AIDS Society said, "While HIV rates have flattened overall in recent years, we're really concerned that the HIV epidemic is continuing among gay men and we're going in the wrong direction."
Dr. Beyrer calls where we are today in our attempt to stop the AIDS virus a "tragic situation," adding that "it's painful that the history of AIDS is looking like its future. But the first step in taking on a problem is recognizing and articulating it and we've really done that here."
The failure to meet the needs of gay men will be one of many topics discussed at the 21st annual International AIDS Conference from July 18 through 22 in Durban, South Africa, which Dr. Beyrer will be overseeing.
For the study, Beyrer and his colleagues looked at published medical research from January 2007 to October 2015, checking to see which parts of their "call to action" had been achieved. The investigation showed very few successes.
In the U.S., a $100 million investment fund from the President's Emergency Plan for AIDS Relief (PEPFAR) has been set up covering key populations, including gay men affected by the virus. They also found that several nations had either approved or initiated PrEP projects.
But Dr. Beyrer says that there has been a failure, as well as backsliding, in getting PrEP to the people who need it most - those who are HIV negative and are at high risk of infection. The Daily Mail says this is especially true in Russia, Nigeria, and Uganda where gay and bisexual men are discriminated against and subject to civil penalties or worse.
In the U.S., PrEP is available if a person has health insurance, although there are real racial and economic disparities when it comes to who actually gets it. The study points out that in many Southern states, low-income people can't get the PrEP because Medicaid has not been expanded to provide wider health coverage, so the HIV epidemic continues. In the UK, despite its proven effectiveness, PrEP is not covered under the country's health plan.
As for the rest of the world, it is difficult getting medication if a person is gay or bisexual because of either the political climate or sodomy laws as well as many other discriminatory practices against gays that make it hard to seek medical care when it is needed.
"Stigma and discrimination continue to play a very big role in these epidemics," Beyrer says. "In many countries, these men are just not welcome in health clinics and the fear of discrimination stands in the way of not only treatment but even just the testing that can go a long way toward stemming the spread of disease."
"The global epidemic of HIV in gay men is ongoing and efforts to address it remain insufficient," he says. "This must change if we are ever to ever truly achieve an AIDS-free generation."
More about HIVAIDS, gay and bisexual men, advances, Discrimination, preexposure prophylaxis
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