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The HIV epidemic of the 1970s and 1980s: Why is it so relevant to gay men?
Since reports of the emergence and spread of human immunodeficiency virus (HIV) in the United States in the 1970s and 1980s, the HIV/AIDS epidemic has often been associated with gay, bisexual, and other male-to-male sexual intercourse by epidemiologists and medical professionals. (MSM) are linked together. In 1981, doctors discovered the first clusters of Kaposi's sarcoma and Pneumocystis pneumonia among gay men in Los Angeles, New York City, and San Francisco. On June 5, 1981, the Centers for Disease Control and Prevention (CDC) published the first official report on the virus, detailing the cases of five young gay men hospitalized with severe infections. Subsequent reports revealed that 41 gay men were diagnosed with Kaposi's sarcoma, and eight died less than 24 months later.
By 1982, the condition was known in the medical community as "gay-related immunodeficiency" (GRID), designated as "gay cancer" or "gay compromise syndrome."
The term was suggested to replace GRID in July 1982, and it was not until September that the CDC officially used the abbreviation AIDS for the first time. Scientists and doctors now know that HIV/AIDS does not only affect MSM but can infect anyone regardless of gender or sexual orientation. Despite this, MSM are considered a "critical group" globally, meaning they have high rates of HIV infection and are at high risk.
MSM as a behavioral category
Male-to-male sex (MSM) refers to sexual intercourse between men of the same sex, regardless of how they self-identify. Many MSM choose not to identify as gay or bisexual. Additionally, this label excludes men who identify as gay or bisexual but have never had sex with other men.
The terms "male-to-male sexual intercourse" (MSM) and "female-to-female sexual intercourse" (WSW) have been used in medical scholarship and research since 1990. The term is believed to come from Glick et al., as their 1994 study solidified the concept's place in medical terminology. The MSM is often used in medical literature and social research to study such men as a group, regardless of issues of self-identification, as this provides a better context than identity-based categories such as "gay," "bisexual," or "bisexual." "heterosexual") is a better behavioral category because a man who identifies as gay or bisexual may not necessarily have had sex with men.
MSM Demographics in the United States
Population estimates of men who have sex with men (MSM) in the United States vary widely. The Centers for Disease Control and Prevention estimates that MSM make up about 2% of the U.S. population. According to a 2005 study, an estimated 6% of American men ages 15 to 44 have ever had oral or anal sex with another man, and about 2.9% have had at least one male partner in the past 12 months. Another 2007 study estimated that there were 7.1 million MSM in the United States, or 6.4% of the overall U.S. population. The proportion of MSM varies greatly across states, with South Dakota having the lowest proportion (3.3%) and the District of Columbia having the highest proportion (13.2%). However, the study found that 57% of MSM identify as heterosexual or bisexual.
Risk factors
According to UNAIDS, in 2018, the global risk of MSM acquiring HIV was 22 times higher than that of all adult men. Although HIV transmission rates gradually declined in the 1990s, they stalled again in the early 2000s. Many factors contribute to increased risk, including stress, emotional problems and the laxity of safe contraceptive measures, resulting in the widespread phenomenon of "contraceptive fatigue". Most men choose to have unprotected sex for a variety of reasons, including erectile dysfunction, mental health issues, poor communication, or lack of intimacy.
Accessibility of epidemic prevention and testing
To address HIV/AIDS prevention and treatment, the first wave of direct advocacy organizations for HIV/AIDS patients were established in the late 1980s. In recent years, UNAIDS has observed a “sero-selection” phenomenon, indicating that many MSM select partners based on their HIV status. According to CDC research, one in five MSM in major U.S. cities is infected with HIV, and half of them do not know they are infected.
Home testing is considered a particularly important prevention method because as many as 39% of partners in partner counseling and referral services are found to have HIV infection of which their partner was unaware.
In the current scenario, antiviral prophylaxis such as PrEP (pre-exposure prophylaxis) is considered an effective HIV prevention method, especially among MSM. However, actual effectiveness depends on medication compliance, and missing doses will significantly reduce its effectiveness.
In the face of the continued threat of the HIV/AIDS epidemic, the public still needs to think about how to find a balance between knowledge, prejudice and practical actions to effectively combat the continued spread of this epidemic?
