Young Gay Men & HIV/AIDS: A Global Epidemic

WORLD AIDS DAY DECEMBER 1, 2013 WORLD AIDS DAY DECEMBER 1, 2013 WORLD AIDS DAY DECEMBER 1, 2013 WORLD AIDS DAY DECEMBER 1, 2013 YOUNG GAY MEN & HIV/AIDS: A GLOBAL EPIDEMIC In every region of the world, two things are true - gay men are at increased risk for HIV, and so are young people. Due to a confluence of factors, young gay men are often left out of research, policy and programs that are designed for adult gay men, the general pool of youth, or the overall population. WHAT IS THE CURRENT STATE OF THE GLOBAL EPIDEMIC AMONG YOUNG GAY MEN, AND HOW DO WE ADDRESS IT? HIV PREVALENCE AMONG YOUNG GAY MEN IN SELECT COUNTRIES RUSSIA 9% AGE 18-22 USA 6% CHINA AGE <30 19% AGE 18-30 PERU AGE 18-20 13% 22% MALAWI AGE 24-29 NAMIBIA AGE 24-29 17% BOTSWANA 21% AGE 24-29 In March 2012, the Global Forum on MSM & HIV (MSMGF) formed a research team to implement a global survey to identify trends among the global gay population. The survey got nearly 2,500 responses. 3% 3% 2% Who were the participants? 6% 12% 8% 10% 28% 19% 42% 33% 64% 22% 48% REGIONAL BREAKDOWN I Asia I Eastern Europe & Central Asia I Latin America I Western Europe & North America I Sub-Saharan Africa I Oceania I Middle East & North Africa HIV STATUS I Negative I Unsure I Positive AGE I 26-30 I 21-25 I <21 O Caribbean Stable housing and income are important components of HIV prevention. Many young gay men are dependent on family that may not understand or accept their sexuality, putting them at greater risk of losing housing or financial support, which can lead to increased HIV risk behaviors - the lack of housing and income are strong predictors of HIV infection. HOW MANY YOUNG GAY MEN (VS. OLDER GAY MEN) REPORTED: %24 NO STABLE HOUSING NO HEALTH CARE COVERAGE NO CONSISTENT HEALTH CARE PROVIDER ACCESS TO LOW-COST MEDICAL CARE ACCESS TO LOW-COST MENTAL HEALTH SERVICES NO INCOME 20% 2% 30% 17% 22% 12% 52% 29% 17% 24% 10% 12% YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN "[Young gay men] are often unable to respond effectively to homophobia because of their age - they have no income, no employment, and they are dependent on family for housing. If they get kicked out, and they often do, they end up on the street where they may be forced to trade sex for food, shelter, or protection." -Daniel Townsend, Jamaica DO YOUNG GAY MEN HAVE GREATER OR LESS ACCESS TO HIV PREVENTION SERVICES THAN OLDER GAY MEN? +/- HIV Sex Ed. ACCESS TO LOW-COST CONDOMS ACCESS TO LOW-COST LUBRICANTS ACCESS TO LOW-COST ACCESS TO LOW-COST STI TREATMENT ACCESS TO GAY-FOCUSED SEX EDUCATION ACCESS TO HIV EDUCATION MATERIALS ACCESS TO HIV RISK REDUCTION PROGRAMS STI TESTING 33% 37% 18% 24% 24% 40% 14% 30% 7% 13% 9% 19% 7% 15% OLDER GAY MEN OLDER GAY MEN YOUNG GAY MEN YOUNG GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG YOUNG GAY MEN YOUNG OLDER OLDER GAY MEN GAY MEN GAY MEN YOUNG GAY MEN GAY MEN GAY MEN OLDER OLDER GAY MEN " There is a severe lack of general sexual health services in the Middle East and North Africa, let alone those which are equipped and sensitized to cater to the needs of young MSM, who do not have the social or financial support to consult a private care provider. [Young gay men] need access to information and services to keep themselves healthy." -Johnny Tohme, Lebanon Early initiation of treatment results in reduced viral load, slower disease progression, and reduced risk of HIV-related death and illnesses. Effective management of HIV for those who are positive has two benefits: It helps HIV-positive people live longer, healthier lives; and it reduces the risk of HIV transmission. HOW MANY YOUNG GAY MEN ARE IN TREATMENT, AND HOW ARE THEY DOING? VL TREATMENT-ELIGIBLE GAY MEN NOT ON HIV TREATMENT GAY MEN LIVING WITH HIV WHO DO NOT HAVE SUPPRESSED VIRAL LOADS NO ACCESS TO VIRAL LOAD TESTING NO KNOWLEDGE OF VIRAL LOAD 44% 17% 62% 27% 10% 3% 33% 10% YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN OLDER GAY MEN YOUNG GAY MEN OLDER GAY MEN YOUNG GAY MEN “Homophobia and discrimination are still two of the main issues that [young gay men] have to deal with every day, and their negative impact on [young gay men] is strong and far-reaching. Most [young gay men] are more focused on the challenges of coming to terms with their sexual orientation and identity than they are on their sexual health. We cannot address sexual health for [young gay men] without acknowledging these issues." -Sergio López, Paraguay WHAT ARE SOME RECOMMENDATIONS TO REMEDY THESE DRASTIC INEQUALITIES AND LOWER HIV RISK? Address Housing Stability and Economic Dependence Provide Comprehensive HIV Prevention Tailored to Young Gay Men 3 Improve Treatment and Care for Young Gay Men Living With HIV Address Barriers (Homophobia, Violence) and Facilitators (Community Engagement, Connection to Gay Community and Comfort With Service Providers) That Impact Access to HIV Services Support Leadership and Involvement of Young Gay Men in Developing Responses to Their Needs 1. Treatment-Eligible is defined here as gay men who have a CD4 count less than 350, according to the World Health Organization's guidelines for starting anti-retroviral therapy (ART). CD4 cells are those cells that help fight infection in the body. Resources: "Young Men Who Have Sex With Men: Health, Access, & HIV" by The Global Forum on MSM & HIV http://www.msmgf.org/files/msmgf//Publications/MSMGF_YMSM_PolicyBrief.pdf THE BODY The Complete HIV/AIDS Resource