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Heterosexual men

Heterosexual men are affected by HIV

HIV is a concern for heterosexual men, as almost 14% of new male HIV cases in 2016 occurred among heterosexuals, through sex with a woman (9.5%) and injecting drug use (3.9%). Most of those cases were among Black (63%) and Latino (22%) men, and men living in the Southeast (62%) and Northeast (19%) of the US.[1]

These statistics, however, may not give us an accurate picture of HIV among heterosexual men. Because sexuality is complex, some heterosexually-identified men may have sex with men, but still identify as straight.[2] The CDC tracks HIV infections through means of infection, not by a person’s identity. Therefore, a heterosexual man who tells his healthcare provider he ever had a sexual encounter with a man is categorized under “men who have sex with men,” and if he says he has ever injected a drug, is categorized under “people who inject drugs (PWID).”

Because of this, heterosexual men are seldom mentioned or addressed in the world of HIV prevention, care and research—where men are classified based on federal guidance and misconceptions, and not on men’s own identity.[3] This may be helpful for tracking the HIV epidemic, but it hampers service organizations who want to serve straight men who are at risk for or living with HIV, because funding for programs is linked to mode of transmission.

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Stigma

HIV-related stigma is a significant problem globally. HIV stigma inflicts hardship and suffering on people living with HIV and interferes with research, prevention, treatment, care and support efforts. HIV-related stigma refers to negative beliefs, feelings and attitudes towards people living with HIV, their families and people who work with them. HIV stigma often reinforces existing social inequalities based on gender, race, ethnicity, class, sexuality and culture. Stigma against many vulnerable populations who are disproportionately affected by HIV (such as the stigma of homosexuality, drug use, poverty, migration, transgender status, mental illness, sex work and racial, ethnic and tribal minority status) predates the epidemic and intersects with HIV stigma, which compounds the stigma and discrimination experienced by people living with HIV (PLWH) who belong to such groups.1 HIV-related discrimination, also known as enacted HIV stigma, refers to the unfair and unjust treatment of someone based on their real or perceived HIV status. Discrimination also affects family members and friends, caregivers, healthcare and lab staff who care for PLWH. The drivers of HIV-related discrimination usually include misconceptions regarding casual transmission of HIV and pre-existing prejudices against certain populations, behaviors, sex, drug use, illness and death. Discrimination can be institutionalized through laws, policies and practices that unjustly affect PLWH and marginalized groups.

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Designing Primary Prevention for People Living with HIV

This monograph is based largely on presentations and discussion at the June, 1999 policy forum Primary HIV Prevention: Designing Effective Programs for People Living with HIV. The Forum was hosted by the AIDS Research Institute at UCSF and the National Association of People with AIDS. The Forum was sponsored by the National Institute of Mental Health (NIMH), the NIH Office of AIDS Research (OAR), and the Centers for Disease Control and Prevention (CDC).
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Prevention Strategies of HIV Positive Injection Drug Users (VENUS Study)

New HIV infections are decreasing among IDUs. This decrease has been related to the practice of injection risk reduction among IDUs such as the use of needle exchange programs where available. However, recent research has found that sexual risk behavior among IDUs may account for more new HIV infections than injection practices.2 We need to know more about the sexual practices of IDUs. To date, most HIV prevention efforts have focused on how HIV negative people can stay negative. This has overlooked the important role that HIV positive individuals can play in the prevention of new HIV infections. HIV positive people also need support to not spread the virus and to keep themselves healthy (avoid STDs, Hepatitis C, abscesses, etc.). The need for prevention efforts targeting HIV positive individuals has only recently been addressed.
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National HIV Testing Day—June 27, 2010