MSM and HIV – the global picture

Worldwide, it’s estimated that sex between men accounts for between 5 and 10% of HIV infections. The situation varies between countries however, and in much of the developed world – including the USA, Canada, the UK, Australia and New Zealand – more people have become infected with HIV through male-male sex than through any other transmission route.

Sex between men is also a prominent feature in the spread of HIV in less developed regions. In Latin America, sex between men accounted for a quarter of new HIV infections during 2005. In Asia, HIV prevalence levels among MSM have reached as high as 18% in Andhra Pradesh, India, 15% in Phnom Penh, Cambodia, and 28% in Bangkok, Thailand – figures that are many times higher than those found among these countries’ overall populations. In Japan, around 60% of HIV-positive people are MSM.2 In Africa – a region not commonly associated with male-male HIV-transmission – there’s evidence from some countries that transmission through this route is a significant problem. In Senegal for instance, one study recorded that 22% of MSM were living with HIV.3

Although statistics like these give an idea of the impact that AIDS is having on MSM, data is still extremely scarce in many countries. This is largely due to the fact that MSM often have no separate social identity, and are simply counted as part of the general population. It is also due to the reluctance of governments to acknowledge MSM, and to monitor this group.

Another factor blurring statistics is that it’s not always possible to tell how a man became infected. If he is having sex with women as well, he may well report that HIV was transmitted to him from a woman (or even if he is only having sex with other men, he may lie because of stigma). This can distort figures.

From the information that is available, it’s clear that HIV is a significant burden to communities of MSM around the world. But why is this the case? To answer this question, we need to look at the factors that put MSM at risk.