May 14, 2010
Reinvigorating HIV Prevention for Men who have Sex with Men
NAMHC Concept Clearance
Andrew D. Forsyth, Ph.D.
Chief, Primary HIV Prevention Program
Division of AIDS Research (DAR)
The goal of this initiative is to facilitate the development and testing of new, efficacious HIV prevention interventions, which, if scaled-up and implemented, will help to curb incident HIV infections, reduce HIV-associated morbidity and mortality, and reduce health disparities in HIV among men who have sex with men (MSM).
HIV incidence and prevalence among MSM in the U.S. is alarmingly high, with ethnic minority MSM bearing a disproportionate burden of the epidemic. Transmission among these men accounts for 53 percent of new all infections, even though they represent less than 5 percent of the population. Although the epidemic is stable or retreating in other population groups, it is surging among MSM due to a range of factors, including HIV stigma and related discrimination; impaired access to quality HIV testing, prevention, and treatment; acute HIV infections that cluster within social networks; co-morbid conditions and disorders that increase risks of transmission and acquisition (e.g., substance abuse, depression, untreated STIs); and prevention fatigue.
Implementing agencies in the U.S. face a dearth of evidence-based, proven interventions that can be deployed as part of comprehensive public health strategy to avert new infections for MSM at greatest risk. Thus, there is a critical need to invest in new HIV prevention interventions to curb incident HIV infections that address the needs of MSM at continuing risk.
This initiative seeks to build new research in several scientific areas that include, but are not limited to, the following:
- Develop innovative strategies to improve reach, uptake of prevention
- Expand focus on stable dyads and social networks
- Understand the interplay of the social, biological, and behavioral determinants of risk
- Examine the impact of arousal states on judgment and decision-making
- Elucidate the role of sero-adaptive strategies in onward transmission
- Foster developmentally tailored interventions for youth
- Test novel strategies to intervene at community and structural levels
- Support policy and cost-effectiveness studies to optimize resource allocation
- Address mental health and substance use co-morbidities
- Understand protective factors in individuals, couples, and communities
- Investigate the use of digital technology for recruitment, assessment, retention, and intervention
- Evaluate homegrown, community-developed strategies to increase outreach, uptake, and impact