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The persistent and evolving HIV epidemic in American men who have sex with men.
Mayer, Kenneth H; Nelson, LaRon; Hightow-Weidman, Lisa; Mimiaga, Matthew J; Mena, Leandro; Reisner, Sari; Daskalakis, Demetre; Safren, Steven A; Beyrer, Chris; Sullivan, Patrick S.
  • Mayer KH; Beth Israel Deaconess Medical Center, Harvard Medical School, Fenway Health, Boston, MA, USA. Electronic address: kmayer@fenwayhealth.org.
  • Nelson L; School of Nursing, Yale University, New Haven, CT, USA.
  • Hightow-Weidman L; School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
  • Mimiaga MJ; Fielding School of Public Health and David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
  • Mena L; Medical Center, University of Mississippi, Jackson, MS, USA.
  • Reisner S; Boston Children's Hospital, Fenway Health, Boston, MA, USA.
  • Daskalakis D; New York City Department of Health, New York, NY, USA.
  • Safren SA; University of Miami, Coral Gables, FL, USA.
  • Beyrer C; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
  • Sullivan PS; Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Lancet ; 397(10279): 1116-1126, 2021 03 20.
Article in English | MEDLINE | ID: covidwho-1525995
Semantic information from SemMedBD (by NLM)
1. Coitus PROCESS_OF Male population group
Subject
Coitus
Predicate
PROCESS_OF
Object
Male population group
2. HIV PROCESS_OF Male population group
Subject
HIV
Predicate
PROCESS_OF
Object
Male population group
3. Abnormal behavior AFFECTS HIV
Subject
Abnormal behavior
Predicate
AFFECTS
Object
HIV
4. Coitus PROCESS_OF Male population group
Subject
Coitus
Predicate
PROCESS_OF
Object
Male population group
5. HIV PROCESS_OF Male population group
Subject
HIV
Predicate
PROCESS_OF
Object
Male population group
6. Abnormal behavior AFFECTS HIV
Subject
Abnormal behavior
Predicate
AFFECTS
Object
HIV
ABSTRACT
Men who have sex with men (MSM) in the USA were the first population to be identified with AIDS and continue to be at very high risk of HIV acquisition. We did a systematic literature search to identify the factors that explain the reasons for the ongoing epidemic in this population, using a social-ecological perspective. Common features of the HIV epidemic in American MSM include role versatility and biological, individual, and social and structural factors. The high-prevalence networks of some racial and ethnic minority men are further concentrated because of assortative mixing, adverse life experiences (including high rates of incarceration), and avoidant behaviour because of negative interactions with the health-care system. Young MSM have additional risks for HIV because their impulse control is less developed and they are less familiar with serostatus and other risk mitigation discussions. They might benefit from prevention efforts that use digital technologies, which they often use to meet partners and obtain health-related information. Older MSM remain at risk of HIV and are the largest population of US residents with chronic HIV, requiring culturally responsive programmes that address longer-term comorbidities. Transgender MSM are an understudied population, but emerging data suggest that some are at great risk of HIV and require specifically tailored information on HIV prevention. In the current era of pre-exposure prophylaxis and the undetectable equals untransmittable campaign, training of health-care providers to create culturally competent programmes for all MSM is crucial, since the use of antiretrovirals is foundational to optimising HIV care and prevention. Effective control of the HIV epidemic among all American MSM will require scaling up programmes that address their common vulnerabilities, but are sufficiently nuanced to address the specific sociocultural, structural, and behavioural issues of diverse subgroups.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Acquired Immunodeficiency Syndrome / Homosexuality, Male / Sexual and Gender Minorities Type of study: Diagnostic study / Etiology study / Incidence study / Prognostic study / Qualitative research / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Adolescent / Adult / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: Lancet Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Acquired Immunodeficiency Syndrome / Homosexuality, Male / Sexual and Gender Minorities Type of study: Diagnostic study / Etiology study / Incidence study / Prognostic study / Qualitative research / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Adolescent / Adult / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: Lancet Year: 2021 Document Type: Article