Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora |
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Authors: | Gregorio A Millett William L Jeffries John L Peterson David J Malebranche Tim Lane Stephen A Flores Kevin A Fenton Patrick A Wilson Riley Steiner Charles M Heilig |
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Institution: | National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 20201, USA. gmillett@CDC.gov |
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Abstract: | Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM across the African diaspora share common experiences such as discrimination, cultural norms valuing masculinity, concerns about confidentiality during HIV testing or treatment, low access to HIV drugs, threats of violence or incarceration, and few targeted HIV prevention resources. |
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