Addressing the Social Determinants of Health Inequities Among Gay Men & MSM

Published: December 1, 2014

Trust for America’s Health
Original Article:

With support from the M·A·C AIDS Fund, TFAH undertook a literature review and convened a one-day consultation to consider strategies to mitigate the social determinants of health inequities among gay men and other men who have sex with men (MSM).† Invited participants included research scientists, lesbian, gay, bisexual and transgender (LGBT)‡ health service providers, public policy advocates, and federal officials.*

After reviewing current research pertaining to health inequities among MSM (including HIV epidemiology) and theoretical constructs to explain disparities, the remainder of the meeting focused on identifying opportunities for the federal government to intervene. Two caveats underpinned the discussion: 1) the need for additional research was stipulated, and 2) it was acknowledged that, while the evidence base to support interventions to address social determinants of health (SDH) among MSM is slim, health disparities (particularly HIV) are sufficiently grave to warrant taking immediate action. As such, meeting participants were charged with articulating ways in which the federal government could respond now to continuing health inequities among MSM based upon existing data. While Addressing the Social Determinants of Health Inequities Among Gay Men and Other Men Who Have Sex With Men in the United States reflects those conversations, the views expressed are solely those of Trust for America’s Health.

In the United States, gay men and other MSM continue to be more profoundly impacted by HIV than any other group. Though representing approximately 2 percent of the population, MSM comprise a majority of new HIV infections (66 percent in 2010) and represent more than half (56 percent) of all persons living with an HIV diagnosis. HIV incidence is disproportionately higher among Black MSM than any other risk group.

MSM also face a variety of other mental, physical and sexual health disparities, including substance abuse and depression, both of which correlate with high-risk behaviors for HIV infection, as well as suicide. MSM also have elevated rates of syphilis, gonorrhea, and other sexually transmitted diseases (STDs), which are associated with an increased risk for HIV infection as well. Young MSM are more likely than their heterosexual counterparts to report emotional distress, depression, or self-harm, and are at higher risk of suicidal ideation or attempts and becoming homeless.

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