TY - JOUR
T1 - Mental health in 2020 for men who have sex with men in the United States
AU - Batchelder, Abigail W.
AU - Safren, Steven
AU - Mitchell, Avery D.
AU - Ivardic, Ivan
AU - O'Cleirigh, Conall
N1 - Funding Information:
Dr OCleirighs time on this manuscript was supported by the NIMH (HIV Prevention and Trauma Treatment for MSM with Childhood Sexual Abuse Histories, R01MH095624, PIOCleirigh) and by NIAID (Harvard University Center for AIDS Research, 5P30AI06035412 PI Walker). Dr Safrens time was supported by grant from NIDA (Addressing Psychosocial Comorbidities in HIV Treatment and Prevention, 9K24DA040489, PI Safren). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health (NIMH), The National Institute for Drug Abuse (NIDA) or the National Institutes of Health (NIH).
Publisher Copyright:
© CSIRO 2017.
PY - 2017
Y1 - 2017
N2 - Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.
AB - Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.
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U2 - 10.1071/SH16083
DO - 10.1071/SH16083
M3 - Review article
C2 - 28055823
AN - SCOPUS:85012257212
VL - 14
SP - 59
EP - 71
JO - Sexual Health
JF - Sexual Health
SN - 1448-5028
IS - 1
ER -