HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions

Abstract

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.

Figure 1

CDC estimated numbers of diagnoses of HIV infection among adolescents and young adults ages 13-24 years, by transmission category, in 37 States and 5 U.S. Dependent Areas with confidential name-based reporting, 2008. Notes: Graph created by authors using data reported by the CDC (2010b). MSM = Male-to-male contact. IDU = Injection Drug Use. MSM + IDU = individual in both MSM and IDU transmission risk categories. Data from 3 youth with “other” cause of infection were removed to increase clarity of graph.

Figure 2

A visual depiction of Bronfenbrenner’s (1979) multi-systemic ecological theory of development, applied to HIV risk and protective factors among YMSM. We used this model to structure our review, placing each risk-related variable into one of the categories below and discussing each category successively.