title: Global epidemiology of HIV infection in men who have sex with men.
abstract: Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world.
authors: Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. cbeyrer@jhsph.edu
authors: Chris
authors: C
authors: Beyrer
authors: Stefan D
authors: SD
authors: Baral
authors: Frits
authors: F
authors: van Griensven
authors: Steven M
authors: SM
authors: Goodreau
authors: Suwat
authors: S
authors: Chariyalertsak
authors: Andrea L
authors: AL
authors: Wirtz
authors: Ron
authors: R
authors: Brookmeyer
mesh_terms: D014943:Global Health / Q000639:trends*; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000472:pathogenicity; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013269:Stochastic Processes