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Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men.

Publication ,  Journal Article
Mayer, KH; Wheeler, DP; Bekker, L-G; Grinsztejn, B; Remien, RH; Sandfort, TGM; Beyrer, C
Published in: J Acquir Immune Defic Syndr
July 2013

Men who have sex with men (MSM), including transgender women, comprise a heterogeneous group of individuals whose sexual behaviors and gender identities may vary widely between cultures and among individuals. Their sources of increased vulnerability to HIV are diverse, including the increased efficiency of HIV transmission via unprotected anal intercourse, sexual role versatility, asymptomatic sexually transmitted infections, and behavioral factors that may be associated with condomless sex with multiple partners. Societal stigmatization of homosexual behavior and gender nonconformity may result in internalized negative feelings that lead to depression, other affective disorders, and substance use, which in turn are associated with increased risk-taking behaviors. Social stigma and punitive civil environments may lead to delays in seeking HIV and sexually transmitted disease screening, and later initiation of antiretroviral therapy. The iPrEX study demonstrated that chemoprophylaxis can decrease HIV acquisition in MSM, and the HIV prevention trials network 052 study established the biological plausibility that earlier initiation of highly active antiretroviral therapy can decrease HIV transmission to uninfected partners. Despite these advances, MSM remain among the most significantly HIV-affected population in resource-rich and limited settings. New studies will integrate enhanced understanding of the biology of enhanced rectal transmission of HIV and the focused use of antiretrovirals for prevention with culturally tailored approaches that address the potentiating social and behavioral factors associated with enhanced HIV spread among MSM.

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Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

July 2013

Volume

63 Suppl 2

Issue

0 2

Start / End Page

S161 / S167

Location

United States

Related Subject Headings

  • Young Adult
  • Virology
  • Transgender Persons
  • Stereotyping
  • Sexual Partners
  • Sexual Behavior
  • Risk-Taking
  • Primary Prevention
  • Middle Aged
  • Male
 

Citation

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ICMJE
MLA
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Mayer, K. H., Wheeler, D. P., Bekker, L.-G., Grinsztejn, B., Remien, R. H., Sandfort, T. G. M., & Beyrer, C. (2013). Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men. J Acquir Immune Defic Syndr, 63 Suppl 2(0 2), S161–S167. https://doi.org/10.1097/QAI.0b013e318298700e
Mayer, Kenneth H., Darrell P. Wheeler, Linda-Gail Bekker, Beatriz Grinsztejn, Robert H. Remien, Theodorus G. M. Sandfort, and Chris Beyrer. “Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men.J Acquir Immune Defic Syndr 63 Suppl 2, no. 0 2 (July 2013): S161–67. https://doi.org/10.1097/QAI.0b013e318298700e.
Mayer KH, Wheeler DP, Bekker L-G, Grinsztejn B, Remien RH, Sandfort TGM, et al. Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men. J Acquir Immune Defic Syndr. 2013 Jul;63 Suppl 2(0 2):S161–7.
Mayer, Kenneth H., et al. “Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men.J Acquir Immune Defic Syndr, vol. 63 Suppl 2, no. 0 2, July 2013, pp. S161–67. Pubmed, doi:10.1097/QAI.0b013e318298700e.
Mayer KH, Wheeler DP, Bekker L-G, Grinsztejn B, Remien RH, Sandfort TGM, Beyrer C. Overcoming biological, behavioral, and structural vulnerabilities: new directions in research to decrease HIV transmission in men who have sex with men. J Acquir Immune Defic Syndr. 2013 Jul;63 Suppl 2(0 2):S161–S167.

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

July 2013

Volume

63 Suppl 2

Issue

0 2

Start / End Page

S161 / S167

Location

United States

Related Subject Headings

  • Young Adult
  • Virology
  • Transgender Persons
  • Stereotyping
  • Sexual Partners
  • Sexual Behavior
  • Risk-Taking
  • Primary Prevention
  • Middle Aged
  • Male