Since the beginning of the HIV/AIDS epidemic, the majority of HIV cases in the United States have been among gay and bisexual men (men who have sex with men, MSM). Nearly half of Ryan White HIV/AIDS Program (RWHAP) clients are MSM. Most are virally suppressed due to the comprehensive system of HIV care they receive. See the HRSA HIV/AIDS Bureau Fact Sheet, Gay, Bisexual, and Other Men Who Have Sex with Men (MSM) Clients: Ryan White HIV/AIDS Program, 2018 (January 2020).
In 2017, 70% of HIV diagnoses were among MSM, with 37% of those cases being African American MSM, 29% Hispanic/Latino MSM, and 28% White MSM.
Ryan White and MSM
Of the more than half a million clients served by RWHAP, 47.3% are MSM.
- 63.7% are from racial/ethnic minority populations
- 51.8% were living at or below 100% of the federal poverty level
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39.5% are 50 and older
MSM RWHAP clients have a slightly higher viral suppression percentage (88.1%) than the national RWHAP average of 87.1%. By race/ethnicity, viral suppression among MSM was lowest among blacks/African Americans, at 82.3%. From 2010-2018, RWHAP viral suppression rates have improved significantly for RWHAP clients, overall and for various sub-populations.
HRSA TA/Training Supporting MSM
HRSA’s HIV/AIDS Bureau has a number of initiatives underway to enhance access to HIV care for MSM in HIV care: social media, outreach, health literacy, and more. Below are recent projects.
- HIV Disparity Interventions (e.g., adherence support, peer programs, clinic flow, helping clients meet basic needs) target varied populations, including MSM. They were tested and implemented by participating agencies of the end+disparities ECHO Collaborative.
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SPNS Social Media Initiative Demonstration Site Resources utilize social and digital media methods to engage hard-to-reach youth and young adults in HIV care.
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Culturally Appropriate Interventions of Outreach, Access and Retention among Latino/a Populations Initiative: Intervention Monographs. Varied strategies were developed by this SPNS project to engage MSM and other Latino/a populations in HIV care.
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Improving Sexually Transmitted Infection Screening and Treatment among People with or at Risk for HIV is developing clinic-based interventions (e.g., specimen collection, sexual history assessments) and has developed a number of screening and patient survey tools for use by clinics.
Earlier HRSA initiatives to support Black MSM in HIV care include:
- Well Versed is an online resource and conversation forum for health care providers and Black MSM that presents a simple platform describing what to do before, during, and after a clinic visit.
- His Health provides a compendium of care models, training modules, and resources for enhanced linkage, retention, and engagement strategies to support Black MSM living with HIV. This site is geared to providers and offers continuing medical education (CME) and continuing nursing unit (CNU) credits for clinicians to increase their capacity to accelerate health care service delivery to Black MSM in culturally appropriate ways.
- In It Together was designed to improve the capacity of health departments and community-based organizations to deliver health-literate HIV services, with a particular focus on health services provided to Black/African American MSM.
Investigating New Models of Care
In 2018, HRSA's SPNS program started a new initiative to support the implementation and evaluation of evidence-informed models of care designed to engage, link, and retain Black MSM in HIV medical care and supportive services. The effort is called Implementation of Evidence-Informed Behavioral Health Models to Improve HIV Health Outcomes for Black Men Who Have Sex With Men.