Men who have sex with men: stigma and discrimination

Abstract

The first cases of AIDS were identified in gay men in the USA, and the disease was originally termed gay-related immune deficiency (GRID). Mobilisation of attention and resources was slow, partly because of the association between AIDS and male homosexuality and corresponding reluctance on the part of government officials to acknowledge the importance of the epidemic. 25 years later, the same reluctance is evident in many parts of the world, and again, scarcity in attention and resources is affecting responses to HIV transmission in homosexual men. 1 Beyrer C Baral SD van Griensven F et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012; (published online July 20.)http://dx.doi.org/10.1016/S0140-6736(12)60821-6 Google Scholar The complex relation between homosexuality and HIV continues to mark the epidemic, even in countries where most infections are unrelated to homosexual contact. 2 Dowsett G The ‘gay plague’ revisited. in: Herdt GH Moral panics, sex panics. New York University Press, New York2009: 130-156 Google Scholar That most societies regard homosexuality with a mixture of disdain and disgust has therefore been, and remains, a major factor in the development of the epidemic. 3 Parker R Aggleton P HIV and AIDS-related stigma and discrimination. Soc Sci Med. 2003; 57: 13-24 Crossref PubMed Scopus (1648) Google Scholar The cultural challenge of HIV/AIDSAs the HIV epidemic enters its fourth decade, HIV transmission in several parts of the world shows no sign of abating—for example, in sub-Saharan Africa an estimated 1·9 million people became newly infected in 2010.1 Certain affected populations in the epidemic are more marginalised than others, notably gay men and other men who have sex with men. A biologically heightened vulnerability to HIV and the limited uptake and use of barrier methods, especially among younger cohorts of men who have sex with men, fuelled by stigma and in some parts of the world criminalisation, makes addressing the issue of HIV/AIDS in men who have sex with men complex, as this Lancet Series shows. Full-Text PDF