In the context of the global AIDS epidemic, sex between men is significant because it involves anal sex – a practice that, when no protection is used, carries a higher risk of HIV transmission than unprotected vaginal sex. Historically, AIDS was first discovered among self-identified young gay men in the USA, and throughout the course of the global epidemic, consistently high levels of HIV infection have been found among MSM in many countries.
Organisations representing MSM have also played an active and outspoken role in the response to AIDS. In the USA and the UK for example, gay men’s organisations have raised a great deal of awareness about HIV and AIDS. These groups continue to provide many services to both prevent people becoming infected with HIV, and to help those who are HIV-positive. Another example is Brazil, where groups of gay men exerted a lot of pressure on the government to protect the rights of HIV-positive people in the early years of the nation’s AIDS epidemic.
In many countries however, MSM are not so visible. Sex between men is stigmatised, officially denied and criminalised in various parts of the world. This adds to the vulnerability of MSM, making it difficult to monitor them, and making it near impossible to carry out relevant HIV prevention campaigns in some countries. In places where homosexuality is not tolerated, MSM often hide their same-sex relations from their friends and families to avoid persecution. Many have wives, or have sex with women as well as men, and this means that they may transmit HIV to their female partners if they become infected. The significant impact that HIV is having on MSM is therefore not an isolated problem, but one that is very much linked to countries’ wider HIV epidemics.