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Rural Health Information Hub

Men Who Have Sex with Men

The group that is most affected by HIV in the United States is men who have sex with men (MSM). MSM include:

“men who identify as gay or bisexual, transgender men who have sex with men, and men who identify as heterosexual.”

MSM accounted for 69% of all new HIV infections in 2018. Black/African American MSM accounted for 25% of new HIV diagnoses and Hispanic/Latino MSM accounted for 20% of new HIV diagnoses. Black/African American and Hispanic/Latino individuals continue to be disproportionately affected by HIV overall. Infection rates vary geographically. In 2018, 50% of all new cases of HIV were diagnosed in MSM in the South, where there were more diagnoses of HIV infection among MSM than any other region of the United States.

The number of MSM living with HIV infection is highest in urban areas and as a result, HIV prevention program funding for MSM has been focused there. However, better access to testing and preventive services is needed in rural areas as well. Rural MSM have lower HIV rates compared to urban MSM, but have rates higher than the general population, and in some areas are similar to large metropolitan areas. MSM in rural areas lack HIV prevention tools, since availability of culturally competent HIV prevention resources generally decreases as rurality increases.

Rural communities are implementing interventions focused on rural MSM populations including high-impact prevention initiatives such as Mpowerment, which focuses on reaching young MSM.

In addition, the National Alliance of State & Territorial AIDS Directors (NASTAD) focuses on MSM health through several initiatives aimed to address the health needs of this population. NASTAD provides technical assistance to health departments throughout the country to focus on improving health equity and cultural competency.

Resources to Learn More

Fast Facts: HIV and Gay and Bisexual Men
Provides current statistics on HIV prevalence, risk, and transmission among gay and bisexual men. Discusses the prevention challenges in this population and CDC's efforts in supporting high-impact HIV prevention approach focusing on Black and Hispanic/Latino gay and bisexual men.
Organization(s): Centers for Disease Control and Prevention (CDC)

Implementing Comprehensive HIV and STI Programmes with Men Who Have Sex with Men: Practical Guidance for Collaborative Interventions
A comprehensive guide for implementing the full range of services for HIV and sexually transmitted infections (STIs) for men who have sex with men (MSM). Addresses community empowerment, violence, prevention, condom and lubricant supplies and marketing, counseling, pre- and post-exposure prophylaxis, antiretroviral therapy, mental health, substance use, and treatment of STI and co-infections such as tuberculosis and viral hepatitis. Discusses using technology for outreach, support and advocacy, and effective program management of HIV and STI prevention programs.
Organization(s): United Nations Population Fund, Global Forum on MSM & HIV, United Nations Development Programme (UNAIDS), World Health Organization (WHO), U.S. Agency for International Development, World Bank
Date: 2015

HIV and Men Who Have Sex with Men
Explains factors that heighten the risk of HIV for MSM and discusses program considerations that can help prevent transmission of HIV among this population.
Organization(s): AVERT

Assessing the Health Care Experiences of Rural Men Who Have Sex with Men (MSM)
Investigates the healthcare experiences and perceived stereotypes MSM living in rural Oklahoma face and how they affect their perceptions when accessing healthcare. Discusses religious ideology, quality of doctor and patient relations, and knowledge of LGBT issues as common themes affecting healthcare encounters.
Author(s): Giano Z., Hubach R., Meyers H., et al.
Citation: Journal of Health Care for the Poor and Underserved, 31(1), 235-248
Date: 2/2020