New MSMGF Research: The HIV Treatment Cascade among MSM Worldwide

Published: October 6, 2014

 New MSMGF Research:

HIV Treatment Cascades that Leak:
Correlates of Drop-off from the HIV Care Continuum among MSM Worldwide


Dear all,

The MSMGF Research Group’s most recent publication is now available online!

Using data from the 2012 Global Men’s Health and Rights Survey (2012 GMHR), findings indicate significant drop-off at every point of the HIV care continuum among MSM, with the most dramatic drop-off occurring among younger MSM and MSM living in lower income countries. Fewer than 50% of MSM living with HIV surveyed were virologically suppressed. The paper identifies numerous correlates to being on antiretroviral treatment (ART) and retained in care, including comfort with health service providers and engagement in a gay community. Homophobia was identified as a barrier to being on ART and retained in care.

The findings argue for appropriate service delivery models that address the HIV treatment needs of MSM, including sensitive and knowledgeable health service providers, safe spaces for MSM, greater access to treatment generally, and reduced homophobia overall.

The abstract is available below:

  • Objectives: The health and prevention benefits of antiretroviral therapies (ART), delivered as part of comprehensive HIV care programs, remain unrealized for men who have sex with men (MSM). This multilevel study explores the correlates of drop-off from the HIV care continuum in an international study of MSM, taking into account individual and regional differences in access to and utilization of care.

    Methods: We conducted a study of the continuum of HIV diagnosis and care among 6095 MSM using data collected from an international online survey of MSM conducted in 2012. In this model of the HIV treatment cascade, we treated each point along the continuum as an outcome variable. We then investigated the relationships between clinical care outcomes and a set of demographic and psychosocial factors that were hypothesized to correlate with the outcomes using bivariate and multivariable statistical techniques.

    Results: Among MSM living with HIV for longer than 12 months (n=632), 50% (n=319) were virologically suppressed. Among MSM recently infected with HIV (n=91), the proportion was relatively smaller at 33%. Significant correlates of being on ART and retained in care included: accessibility of HIV treatment; comfort with a healthcare provider; and engagement in a gay community. Perceptions of homophobia were negatively associated with being on ART and being retained in care.

    Conclusions: These findings underscore the need for service delivery models that sensitively address HIV among MSM. Public health officials should adopt comprehensive HIV programs that include mutually reinforcing components and that address varying needs of MSM newly diagnosed and living with HIV. Comprehensive HIV programs must also support the critical role communities play in linking and retaining MSM into HIV services. Further studies validating the findings in country-specific contexts are warranted.

The full text of the article is available online here. The full collection of peer-reviewed publications by the MSMGF Research Group is available on our website here, including these additional papers developed using the 2012 GMHR data set:

This research is made possible by those who participate in the biennial GMHR. The 2014 GMHR is currently open. If you identify as MSM and have not yet taken the survey, you can find the survey at Please circulate the announcement among your networks, available at

Please feel free to write to us at with any questions, feedback, or requests. 

Kind regards,


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