Dear Colleague: September 22, 2022

September 22, 2022

Dear Colleague,

September 27 is National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD), a day to help end HIV stigma and encourage HIV testing, prevention, and treatment among gay, bisexual, and other men who have sex with men. As we celebrate the progress we have made in HIV prevention and treatment among gay and bisexual men, we must also acknowledge the challenges we still face. Racism, poverty, stigma, and homophobia serve as barriers to care and prevention, and continue to drive inequities that cause gay and bisexual men—particularly Black/African American and Hispanic/Latino men—to be overrepresented in the HIV epidemic.

This NGMHAAD, we acknowledge the additional public health challenges and continued stigma that gay and bisexual men face. Although we are still learning about monkeypox amid the current outbreak, we are seeing similar patterns of inequity, with Hispanic/Latino and Black/African American gay and bisexual men representing the majority of people with monkeypox. Recently, CDC released a Morbidity and Mortality Weekly Report showing that people with HIV and with a recent history of other sexually transmitted diseases (STDs) are disproportionately affected by monkeypox. This represents an important opportunity to use existing HIV and STD prevention and care models and resources to ensure equitable access to monkeypox information and services among gay and bisexual men, people with HIV, and people who experience increased incidence of STDs. Learn more about CDC’s efforts to reduce stigma in monkeypox communication and community engagement.

Despite ongoing challenges, the efforts of public health and community advocates are making a difference in lowering new HIV infections among gay and bisexual men. From 2015 to 2019, the number of estimated new HIV infections among gay and bisexual men in the United States decreased from 26,900 to 24,500. Nonetheless, gay and bisexual men accounted for 70% of the total 34,800 estimated new HIV infections in the United States in 2019. Across the country, some communities—specifically Black/African American gay and bisexual men, and Hispanic/Latino gay and bisexual men—are disproportionately affected by HIV. In 2019, Black/African American gay and bisexual men accounted for 26% and Hispanic/Latino gay and bisexual men accounted for 24% of estimated new HIV infections. As public health and community advocates, we must continue our work to address these racial and ethnic disparities.

One of the most effective tools we have to address ongoing challenges in HIV prevention is pre-exposure prophylaxis (PrEP). Unfortunately, not everyone who can benefit from PrEP has access to it. Current PrEP data reflect racial and regional disparities driven by structural challenges such as stigma, racism, and mistrust in the health care system. Among Black/African American people who could benefit from PrEP [PDF – 2.5 MB], only 11% were prescribed PrEP in 2021, followed by 20% of Hispanic/Latino people and 80% of White people. In the South in 2020, only three states were at least halfway to the Ending the HIV Epidemic in the U.S. goal of 50% PrEP coverage by 2025.

CDC monitors HIV surveillance data to identify communities with rapid HIV transmission and implement tailored interventions that address these communities’ needs. A new Morbidity and Mortality Weekly Report analyzed data from 38 HIV clusters in 2018-2019 that had grown to more than 25 people by the end of 2021. Of those 38 clusters, 29 were primarily among gay and bisexual men, and these clusters also reflected racial and ethnic disparities.

The persistence of racial, ethnic, and regional HIV disparities reflects the effects of stigma, homophobia, racism, and discrimination that gay and bisexual men continue to face and shows us where we need to scale up treatment and prevention services. Identifying these gaps through cluster detection and response, a pillar of the Ending the HIV Epidemic in the U.S. initiative, allows CDC to deploy tailored interventions to those areas to improve health outcomes and reduce disparities and health inequities, a primary goal of the 2022-2025 National HIV/AIDS Strategy. Additionally, CDC continues to fund and support health departments and community-based organizations to develop and implement tailored HIV prevention programs for gay and bisexual men, including Black/African American gay and bisexual men and Hispanic/Latino gay and bisexual men.

As we work together toward ending the HIV epidemic, partners like you are essential at every step of the process—from improving the reach of HIV prevention education, to reducing barriers to HIV prevention services like PrEP, and providing stigma-free care for people with HIV. Help us raise awareness about HIV testing, prevention, and treatment for gay and bisexual men by downloading and sharing resources from CDC’s Let’s Stop HIV Together campaign. If you are a health care provider, you can download HIV testing, prevention, and care materials to better serve gay and bisexual men. You can also share social media content from CDC’s digital toolkit using the #NGMHAAD and #StopHIVTogether hashtags.

This NGMHAAD, as we continue to raise awareness about HIV and its disproportionate impact on gay and bisexual men, we encourage you to help address the current monkeypox outbreak. Learn more about monkeypox symptoms, transmission, prevention (including safer sex), and treatment, and share this information with your friends, families, communities, and colleagues. You can also download and share materials from our social media toolkit and communication resources page. As we learn more about monkeypox, we will continue updating our guidance for health departments and health care providers. Please check back regularly.

Together, we can build on the progress we have made and improve the quality of life and sexual health among gay and bisexual men, and all communities affected by HIV and monkeypox.

/Robyn Fanfair/

Robyn Neblett Fanfair, MD, MPH
Captain, USPHS
Acting Division Director
Division of HIV Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

/Jonathan Mermin/

Jonathan H. Mermin, MD, MPH
Rear Admiral and Assistant Surgeon General, USPHS
Director
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Stay connected: @DrMerminCDC & Connections