In the late 1980s the first direct advocacy groups for people with HIV/AIDS were created. Notably, the AIDS Coalition to Unleash Power (ACT UP) formed at the Lesbian, Gay, Bisexual & Transgender Community Center in New York in the wake of the antiretroviral drug AZT to petition better access to drugs as well as cheaper prices, public education about AIDS and the prohibition of AIDS-related discrimination. The Joint United Nations Program on HIV/AIDS (UNAIDS) published a paper in 2005 offering specific policy solutions for alleviating the spread of the HIV virus in the MSM population for specific regions around the world. They pointed to “a profound lack of knowledge” and stigma about<unk> ual identity as worldwide barriers to preventing transmission and encouraging those infected to seek treatment. The UNAIDS program has recommended that the South African government implement “sex positive” policies to reduce societal stigma around homosexuality and promote the use of water-based lubricants. Particularly in Morocco, the program has advocated distributing condoms in prisons. In recent years, the Chinese government has begun to acknowledge the<unk> uality of its constituents. According to UNAIDS, the “Government has made significant progress in recognizing the issue of male-to-male<unk> ual health and HIV.” In Latin America, outreach to rural areas is critical to ensuring care to all individuals. The United Nations also emphasizes a focus on LGBT populations that are most vulnerable in Latin American nations. In Jamaica, as in many countries across the globe, homosexuality is outlawed so there are unique challenges to HIV prevention in the MSM community. The UN is trying to implement community-based strategies in Jamaica while still ensuring the anonymity of the people served. In Norway, UNAIDS has observed an increasing number of MSM who have untreated<unk> ually transmitted infections, and their emphasis is on promoting condom use within the gay community. Despite Canada’s “liberal and progressive” reputation on the world stage, HIV-related stigma is still related to the gay community. The United Nations believes the United States needs to recognize<unk> ual education as a fundamental human right. Additionally, better research on MSM in the U.S. would positively affect funding for HIV prevention and treatment programs. Studies have shown that although there is a large market for vaginal microbicides in developing nations, rectal microbicides are stigmatized and less researched. No microbicide has yet been proven to effectively protect against the risks of unprotected anal intercourses, but advocates believe greater funding for research is needed since condom usage rates are so low. However, stigma and homophobia would potentially be barriers to individuals buying the product. The authors<unk> tion this is especially a concern in Caribbean countries where HIV prevalence is high but homosexuality is still illegal and highly stigmatized (See HIV/AIDS in the Caribbean.) Access to testing UNAIDS has observed “sero-selection” (choosing a partner based on their HIV status) becoming increasingly prevalent in partner choice and transmission in the United States. A 2008 CDC study found that one in five (19%) of MSM in major U.S. cities were infected with HIV and almost half (44%) were unaware of their infection. Many HIV-infected individuals do not seek treatment until late in their infection (an estimated 42% do not seek treatment until they begin to experience signs of illness.) Furthermore, a significant portion of individuals who are tested for HIV never return for their test results. Studies have advocated for funding and implementation of HIV tests that can be administered outside medical settings since 2003. Home testing is considered especially important because 8%-39% of partners tested in studies of partner counseling and referral services (PCRS) were found to have a previously undiagnosed HIV infection that their partner was unaware of. In October 2012, OraQuick, the first rapid HIV home-testing kit, went on sale for $40. The test is nearly 100% accurate when it predicts HIV-negative results for HIV-negative individuals. However, for HIV-positive individuals that are not yet producing the antibodies detected by the test, it produces a false negative 93% of the time. Although the manufacturer, OraSure Technologies, is not advertising the test for use for selection of partners, experts have suggested that it may prevent unprotected<unk> ual contact with partners that lie about or are unaware of their HIV status. A recent study examined how the OraQuick test would identify the behavior of 27 self-identified gay<unk>  who frequently had unprotected<unk>  with acquaintances. The researchers gave each participant 16 tests to use over the course of three months. 101 potential partners were tested, and 10 were positive. None of the participants had<unk>  with someone who tested positive. 23 other potential partners refused testing and left the encounter. 2<unk>  admitted they were HIV-positive. Most participants said they would continue using home tests after the study ended to test potential partners on their own. The researchers considered home testing to be an effective prevention method for high-risk groups. However, the test’s $40 cost is considered a major deterrent to commonplace partner testing.
HIV and men who have sex with men
Women and HIV/AIDS
HIV/AIDS in Europe
HIV/AIDS in North America
HIV/AIDS in Asia
FACE AIDS
HIV/AIDS in Laos
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