The human immunodeficiency virus is a retrovirus (Retroviridae family) that contains RNA and affects the immune system by attacking CD4+ T-lymphocytes, macrophages and dendritic cells. As the damage to the immune system progresses develops the acquired immunodeficiency syndrome (AIDS) – an advanced stage of HIV infection characterized by the body’s exhaustion and opportunistic infections.
HIV is a global spread infection. According to the WHO, approximately 36,7 million people were infected at the end of 2016. Approximately half (16.7 million) of them were men older than 15. About 30% of infected individuals are not aware of their condition.
As at 2010, 76% of HIV-positive individuals in the USA were men.
As at 2012, in the USA and 6 dependent areas (according to CDC) diagnoses of HIV by transmission were:
- 64% – due to male-to-male sexual contact;
- 17% – heterosexual contact (females);
- 9% – heterosexual contact (males);
- 4% – injection drug use (males);
- 3% – injection drug use (females);
- 3% – male-to-male sexual contact + injection drug use;
- 1% – other (including hemophilia, blood transfusions, perinatal exposure etc.)
Men who have sex with men
Men who have sex with men are 24 times more likely to get infected than the general population. In 2014 men who have sex with men accounted for 54% of new HIV infections in Western Europe, 68% in North America and 30% in Latin America and the Caribbean.
Why are men who have sex with men at higher risk?
- Anal sex is the riskiest type of sexual intercourse. Receptive anal sex is even 13 times riskier for getting HIV than insertive anal sex.
- Men who have sex with men relatively rare use condoms. However, even when they use them there is a risk of a condom insufficiency.
- Alcohol and drug abuse is common in gay communities. Sexual intercourse when a person is under the influence of psychoactive substances associated with high HIV infection risk.
- Men who have sex with men tend to have multiple sexual partners. Having numerous partners increases a risk of HIV infection.
- In many countries same-sex conduct is considered a crime. Homophobic stigma and discrimination are also common. Therefore, the LGBT community has no access to HIV prevention facilities.
Injected drug use
In general, males are using drugs more often than females.
According to the WHO, around 13 million people worldwide inject drugs, approximately 1.7 million of them are HIV-positive. Sharing needles, syringes, the water in which drugs are mixed, or the cotton through which drugs are filtered with an infected person puts you at risk of contracting HIV. If several persons share the same needles and equipment the risk of HIV is even higher.
According to the CDC, about 7% of HIV positive persons were infected by injection drug use in the USA and about 10% – worldwide. HIV prevalence rates are higher (up to 15%) among injection drug users than in the general population.
Male circumcision for HIV prevention
Male circumcision – a surgical removal of the tissue that covers the head of the penis – reduces the risk of HIV infection in men acquired by heterosexual contact by approximately 60%.
WHO recommends male circumcision as an additional HIV-preventing measure.