Texas HIV/STD Prevention Community Planning Group (TxCPG) Priority Populations
3. MEN WHO HAVE SEX WITH MEN (MSM) Who are MSM in Texas? MSM refers to men of all ages, ethnicities, racial groups, and sexual identities who have sex with men. This brief does not specifically address Black MSM, who are addressed in a separate priority population brief. However, some information provided in this brief includes Black MSM. In 2007, MSM of all races and ethnicities represented 52% of all new cases[1]. The overwhelming majority of infections among White males and Hispanic males were MSM, 80% and 68%, respectively[1]. For other racial/ethnic categories, MSM made up 81% of new diagnoses[1]. Prevalence rates are not calculated for MSM; however, the acknowledged small proportion of MSM among the overall population and the high proportion of PLWHA from this category reveals the alarming prevalence of HIV/AIDS among these men[1]. Men who have sex with men are not a homogeneous group. Most men who have sex with men identify as gay, though others identify as bisexual, heterosexual, or refuse any identity label, regardless of behaviors[2]. Geographic location, age, and race/ethnicity influence how these men live their lives. Urban communities often have access to larger social and sexual networks of gay men and other MSM as well as commercial establishments catering specifically to their needs. Rural communities may not have access to networks of gay men and other MSM or to commercial establishments; therefore, MSM may be less likely to disclose their sexual behaviors and/or sexual identity in comparison to their urban counterparts[3]. What places MSM at risk? Specifically, MSM are at risk for HIV through unprotected anal intercourse (UAI) with an HIV-‐positive partner. However, for the MSM population in particular, HIV/AIDS is a life-‐ long issue. Among MSM, the probability of exposure to HIV remains high from adolescence to adulthood due to high HIV prevalence among MSM, especially in urban communities. Both Houston and Dallas have an HIV prevalence of 26%[4]. HIV risk is associated with many other issues, such as dating, sex, love, substance use, homophobia, racism, and poverty[5, 6]. Age may be a risk factor for particular cohorts of MSM. Data analyses show that Latino MSM tend to seroconvert before the age of 30, while White MSM tend to seroconvert after the age of 30[1]. In Texas, new diagnoses have remained steady in most age cohorts of MSM and have increased in groups such as younger MSM of color and White men in their 30s and 40s. Studies indicate that the increase in new diagnoses from 2002 to 2007 is related to four phenomena:
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