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Surveillance Data: HIV/AIDS and Gay Men

Today, more than one-half of the more than 1.1 million Americans living with HIV/AIDS in the U.S. are gay men, and the rate of new HIV diagnoses among this population is 44 times that of other men and 40 times that of women.

HRSA continues its commitment to serving this population and, just as in those early days of the epidemic, gay men continue to be pivotal in implementing HRSA’s Ryan White HIV/AIDS Program.43,44

Additionally, gay HIV-positive men may be at risk for drug interactions if taking meth. Meth’s interaction with the HIV protease inhibitor ritonavir, for example, can result in a 3- to 10-fold increase in meth levels in the bloodstream. Ritonavir prolongs the meth high by increasing absorption and decreasing the metabolism of meth and therefore can cause increased toxicity and potentially severe reactions or overdose.38,39 Delavirdine, a nonnucleoside analog reverse transcriptase inhibitor, also slows the metabolism of meth.40

HIV-infected gay men report using meth as a way to deal with survival guilt, internalized homophobia, and prejudice. Many HIV-positive meth users also cite using meth to counter fatigue and other side effects of antiretrovirals. Treating HIV-positive meth users requires intensive collaboration among mental health specialists, dentists, pharmacists, social workers, primary care physicians, substance abuse counselors and, in some cases, correctional employees. Meth use has been a growing focus of Ryan White grantees and providers as the crisis has increased.41 HRSA’s AETCs have conducted trainings Exit Disclaimer on the topic and HRSA focused on meth for an issue of their HRSA CAREAction newsletter (PDF – 1.1 MB).

The increase of risky sexual practices among meth users is just one example of why the Ryan White HIV/AIDS Program has put increasing emphasis on prevention with all HIV-positive gay men. Other indicators such as rising STD rates in certain communities, treatment optimism after initiation of HAART, HIV prevention fatigue, extended and healthier lifespans for people living with HIV, all contribute to the need for integrating HIV prevention into the clinical care.42

Looking Ahead

HRSA’s Ryan White HIV/AIDS Program grew out of the response that the gay community created in the first decade of the AIDS crisis. Since the early 1980s, the program’s committed and experienced leadership has become a lifeline for thousands of gay men nationwide. Without the services of the Ryan White HIV/AIDS Program, many gay men and others living with and affected by HIV/AIDS would have perished. As science and research continue to work towards developing new treatments and hopefully finding a cure for AIDS one day, HRSA and its grantees will continue to work to improve the health and wellbeing of gay men living with HIV disease.

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