WASHINGTON, D.C., USA – Certain groups are more vulnerable to HIV/AIDS than others, particularly in low-income countries where there is less education about how HIV is transmitted and more stigma surrounding HIV/AIDS.
MSM: “Men who have sex with men” (MSM) is a term that was developed by global health professionals to aid in the fight against HIV/AIDS though MSM more accurately describes a behavior rather than a specific sexual orientation or gender identity. The term is a catch-all for men who engage in sexual activities with other men. It can include gay men, bisexual men and other men who have sex with men. MSM make up the largest population of those infected by HIV/AIDS both in the United States and globally. Though young MSM in particular have a very high rate of HIV infections, the general high prevalence of HIV in MSM communities contribute to the spread of the disease in these groups. Furthermore, the discrimination that MSM face also means men are reluctant to get tested for HIV or seek medical care if they known they are infected, thus curtailing prevention efforts and increasing the spread of HIV. The Caribbeans, for example, illustrates how countries where homosexuality is persecuted have much higher rates of HIV/AIDS than countries where homosexuality is legal.
Prisoners: In most countries prisoners have higher rates of HIV/AIDS than the general population. Injection drug use, unsafe sexual practices, rape, violence, overcrowding and poor health care all impact the transmission of HIV/AIDS in prison. Prisons also tend to have a high population of MSM (although these men do not necessarily identify as gay or bisexual). Moreover, policies that could prevent the spread of HIV and other infectious diseases in prisons are not often put forward because of the general denial that these factors are indeed taking place. In addition, inmates who already have an HIV diagnosis are often not able to access antiretroviral treatment or adequate food and healthcare. This is a serious human rights violation.
Sex Workers: ‘Prostitutes,’ or people who sell sex, are particularly vulnerable to contracting HIV. Sex work is a more respectful and neutral way of describing this practice, though it is controversial whether sex workers are merely a vulnerable group or whether they also help spread HIV and fuel the epidemic. In general, the spread of HIV through sex workers is not as large an issue in Western Europe and North America, as sex workers in these areas normally use safe sex practices with their customers. However in many developing countries, Asia in particular, many sex workers have HIV, thus contributing to the epidemic.
Injection Drug Users (IDU): About 30% of HIV infections are caused by injection drug use while 80% are related to drug use in general. There are 16 million injection drug users world wide and 3 million of them have HIV/AIDS. In such cases, HIV/AIDS is spread through shared needles and syringes that are not cleaned between uses. As such, the World Health Organization strongly supports a harm reduction approach to HIV/AIDS prevention in IDU. A harm reduction approach includes the distribution of clean syringes and needles and drop boxes for used needles. It is easy to stigmatize injection drug users but it is important to remember that IDU often come from marginalized groups including the homeless, mentally ill, alienated or depressed individuals and those from socially disadvantaged backgrounds. It should also be noted the majority of IDU are teens and young adults. A report from UNAIDs found that 70% of IDU are under 25 and more than half of those began using drugs in their teens.
– Lisa Toole