Despite advances in HIV prevention and treatment services, gay, bisexual and many men who have sex with men (MSM) remain to account for the majority of HIV cases around the world.

According the research team led by Johns Hopkins Bloomberg School of Public Health, this prompts policy reform, increased HIV services funding and expanded access to the HIV drug pre-exposure prophylaxis (PrEP).

As stated in the study published on July 9 in The Lancet, people with HIV can now live normally and the overall HIV rates have dropped in recent years but gay men continue to be the worst affected. The president of the International AIDS Society and research leader Chris Beyrer say the findings imply that current approach to control HIV is insufficient.

The research team sought reasons for this high HIV incidence from previous studies on HIV conducted from January 2007 to October 2015. They observed that the 100-million-dollar President’s Emergency Plan for AIDS Relief (PEPFAR) has worked in reducing HIV cases in many countries.

HIV cases

Gay pride. Credit: Tim Schapker/Wikimedia

However,  they saw that PrEP, which prevents HIV transmission, was not given to people who are HIV negative, the ones who need it the most. The declining rights of gay men in Russia, Nigeria and Uganda also played a role in the high rates among gay men. In Russia, websites that relay HIV information have been shut down.

Economic and racial disparities also impact people’s access to PrEP. In the US, people from minority groups and those with low income cannot pay for health insurance that will cover this treatment.

In other countries like the UK, PrEP is still not covered under health insurance. Meanwhile, Mexico, Argentina and the Netherlands are expected to expand the use of PrEP

Moreover, various nations, where PrEP is available, still discriminate and criminalize gay men. Consequently, gay men would rather not receive the treatment than face harm or be imprisoned.

Beyrer cites one incidence in Malawi where a man who went to get tested for STDs was arrested after authorities learned that his HIV-positive status was the result of having sex with another man.

Beyrer will supervise the 21st annual International AIDS Conference in Durban, South Africa from July 18 to July 22.