HIV Positive Gay Men, MSM, and Substance Use: Perspectives on HIV Prevention

Abstract

Multiple factors interfere with the development and implementation of effective HIV prevention programs for HIV positive men who have sex with men (MSM) who use substances. Chief among these is being a member of multiple communities (e.g., sexual minority, racial/ethnic minority, substance user, HIV positive) and concomitant challenges from stigma and discrimination that can produce a syndemic condition, in which the negative impact of the whole is greater than individual elements. HIV positive MSM who use substances face restricted access to antiretroviral (ARV) medications compared to non-substance users, which differentially compromises their health outcomes and increases potential for new infections. Few behavioral HIV prevention programs address the unique needs of HIV positive MSM who use substances. Given efficacious HIV prevention tools for non-substance users, it is time to marshal the political will to provide access to resources for ARVs and behavioral prevention programs that function as treatment and prevention for HIV positive MSM who use substances.