Despite good predictive validity demonstrated for the sexual risk-behavior and psychosocial items, some inconsistent reporting between the Global and Event-specific formats is evident. Likely sources of this reporting bias are considered in light of the literature, and strengths and limitations of the overall study are discussed in the closing chapter.
Human Rights; Risk behavior; Cost-effectiveness; Low and middle income countries; Human Immunodeficiency Virus; Epidemic; Men who have sex with men; Attributable fraction; Intervention/Prevention; Homosexuality.
The term "men who have sex with men" - frequently shortened to MSM - describes a behaviour rather than a specific group of people. It includes self-identified gay, bisexual, transgendered or heterosexual men. Many men who have sex with men do not consider themselves gay or bisexual. They are often married, particularly where discriminatory laws or social stigma of male sexual relations exist. Largely because of the taboo, the female partners of men who have sex with men are often unaware of their partner's other liaisons, and the threat posed to themselves. Forced sex among men is not uncommon, especially in men-only environments such as prisons. Men who have sex with men are found in all societies, yet are largely invisible in many places. In terms of HIV, sex between men is significant because it can involve anal sex, which when unprotected carries a very high risk. Sex between men is thought to account for between 5 and 10% of global HIV infections, although the proportion of cases attributed to this mode of transmission varies considerably between countries. It is the predominant mode in much of the developed world. Globally less than one in twenty men who have sex with men have access to the HIV prevention and care services they need. Many factors contribute to this situation including denial by society and communities, stigma and discrimination, and human rights abuse. Vulnerability to HIV infection is increased where sex between men is criminalised, as men are either excluded from, or exclude themselves from, sexual health and welfare agencies out of fear. A range of interventions to reduce risk behaviours among men who have sex with men have proven successful, including: condom promotion, safer-sex campaigns and skills training; peer education with outreach programmes; and programmes tailored to subpopulations such as male sex workers and men in prisons. Specific policy measures are crucial for making prevention, care and support available to men who have sex with men. First and foremost, they must be included in national HIV programming and funding priorities. The governments must support organisations of men who have sex with men, enabling them to promote HIV prevention and care programmes and to participate in HIV planning and policymaking. Legislation should be changed, decriminalizing same-sex acts and providing protective laws against discrimination based on sexual orientation.
Men who have sex with men (MSM) are at increased risk for infection with human immunodeficiency virus (HIV). In 2006, 57% of new HIV infections in the United States occurred among MSM. To estimate and monitor risk behaviors, the Center for Disease Control and Prevention¿s National HIV Behavioral Surveillance System (NHBS) collects data from metropolitan statistical areas using an anonymous cross-sectional interview of men at venues where MSM congregate, such as bars, clubs, and social organizations. This report summarizes NHBS data from 2008. Illustrations. This is a print on demand edition of an important, hard-to-find report.
The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.
Most public health students, academicians, and practitioners recognize the association between racial/ethnic minority status and the disproportionate burden of preventable disease in the United States. Much less attention has been directed, however, toward health disparities that affect gay and bisexual men. These disparities affect the lives of an estimated 5.3-7.4 million American men, and are an important concern for public health. Until very recently, the relative invisibility of this group and a paucity of empirical data have hampered attempts to identify health disparities experienced by gay and bisexual men. This book proposes to review and synthesize evidence of health disparities among gay and bisexual men, identify individual and community factors that contribute to these disparities, and articulate strategies for public health efforts to eliminate disparities. To date, these disparities have been largely discussed in isolation in the research literature in a manner that does not permit a comprehensive examination of these problems, their underlying causes, and potential solutions. Thus, a primary emphasis of the book will be to document health disparities among gay and bisexual men while also describing public health solutions to these challenges.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
"These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv
