Gay and Bisexual Men's Health
CDC Programs At-A-Glance
CDC's approach to protecting the health of gay, bisexual, and other men who have sex with men (MSM) involves three areas of commitment: 1) engage gay, bisexual, and other MSM communities and strategic partners, 2) expand effective prevention and, 3) evaulate and communicate timely dissemination of this information.
These commitments are carried throughout the CDC-funded projects in the United States. A few examples of some of the efforts supported by CDC are listed below:
CDC/ATSDR Sexual and Gender Minorities (SGM) Workgroup—The goals of this cross-agency work group are to improve understanding of SGM health disparities and needs, increase two-way communication with key SGM external partners, and promote SGM program services, education and communication products, data collection, and research.
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) MSM Executive Committee—The primary purpose of the NCHHSTP MSM Executive Committee is to provide a forum for discussion and coordination of activities related to the prevention of HIV/AIDS, viral hepatitis, and other STDs among gay, bisexual, and all other MSM. The Executive Committee is responsible for providing input on emerging issues that affect risk for sexually transmitted infections among MSM. These issues should be addressed in surveillance, research, prevention programs, capacity building, policy, monitoring and evaluation, and communications to NCHHSTP staff, external partners, and consumers.
Act Against AIDS Campaign—This five-year $45 million campaign includes multiple phases targeting all Americans and those at increased risk for HIV. Act Against AIDS activities include efforts focused on Black Men who engage in Sex with Men (BMSM) HIV Testing. An early phase of the campaign is designed to increase HIV testing among BMSM. The initial efforts of this phase have been primarily online with banner ads strategically placed on social networking sites, dating websites, and blogs as well as a variety of Black Pride websites. An external expert workgroup was developed to help inform the phase and will provide ongoing technical input for additional campaign planning, implementation, and evaluation efforts.
The Act Against AIDS campaign also will include a men who engage in sex with men of all races (MSM-AR) phase, which will be designed to promote HIV prevention, awareness, and education among MSM-AR. This phase will focus on men ages 18 to 44. The phase will consist of message dissemination through traditional channels as well as new media including a large social media and mobile component. Creative materials will be crafted to incorporate various racial and ethnic groups as well as subgroups within the U.S. MSM population.
The Act Against AIDS Leadership Initiative (AAALI)—A component of the Act Against AIDS Campaign, AAALI includes partnerships with organizations that have a history of communities that have been disproportionately impacted by HIV including serving men who have sex with men. CDC is specifically partnering with two organizations that have demonstrated, effective leadership, reach, credibility, influence, and a history of service to the MSM community. These organizations have a demonstrated a willingness to integrate HIV awareness, prevention, testing, and stigma reduction into existing outreach and their day-to-day program activities.
Capacity Building Assistance to address the HIV prevention needs of Racial/Ethnic Minorities and other Individuals at High Risk for HIV Infection—This project provides support to 30 national and regional organizations that seek to build the capacity of the nation’s HIV prevention workforce, with a focus on capacity building for organizations that serve racial and ethnic minorities and other individuals at high risk for HIV infection, including MSM.
National Medical Association Partnership—CDC works with the National Medical Association to identify health care providers in high-prevalence HIV/STD areas who serve young African-American MSM. The partnerships evaluates the effectiveness and utility of routinizing sexual history tools on a large scale in order to increase HIV and STD testing and delivery of counseling messages.
Expansion of Effective Prevention—Highlights
The Diffusion of Effective Behavioral Interventions (DEBI)—The DEBI project was designed to bring science-based, community, group, and individual-level HIV prevention interventions to community-based service providers and state and local health departments. The goal is to enhance the capacity to implement effective interventions at the state and local levels, to reduce the spread of HIV and STDs, and to promote healthy behaviors. There are 26 interventions now available. More than 10,000 people and nearly 5,000 agencies have been trained through the DEBI project. CDC and its DEBI partners continue to train staff from over 150 community-based agencies directly funded by CDC to implement science-based interventions diffused under the DEBI project. Interventions for gay and bisexual men include the following:
- d-up: Defend Yourself!
- Healthy Relationships
- Many Men, Many Voices
- Popular Opinion Leader
- See all Effective Behavioral Interventions (DEBIs)
STD/HIV Prevention Training Centers (PTC)—The four PTCs are funded to provide training for health departments and CBOs on the following interventions: VOICES/VOCES, Healthy Relationships, 3MV and Mpowerment, Community Promise, RESPECT, CRCS, and several CBA program support courses. In addition, the PTCs are primary providers of training on key MSM-focused DEBIs such as 3MV and MPowerment. The PTCs also provide general programmatic training and technical assistance to MSM-serving CBOs and health department programs (e.g., training for counseling, testing and referral services, and group facilitation). This assistance is available to organizations and/or program staff who provide HIV prevention services to MSM.
HIV Prevention by Health Departments and Community-Based Organizations (CBOs)—Currently, CDC funds 65 jurisdictions at the state and city level to support HIV prevention efforts and programs for people living with HIV and people at risk for HIV, including gay and bisexual men. CDC also directly funds CBOs that work to decrease HIV acquisition and transmission by conducting HIV prevention services for high-risk persons. Services consist of health education and risk reduction, counseling and testing, and public information services. Many jurisdictions and CBOs implement evidence-based interventions included in CDC's Compendium of HIV Prevention Interventions with Evidence of Effectiveness.
HIV Prevention for Young Men Who Have Sex With Men and Young Transgender Persons of Color—This cooperative agreement supports 29 organizations across the United States to provide effective HIV prevention services to young men of color who have sex with men (YMCSM) and young transgender (YTG) persons of color and their partners who are at high-risk for acquiring or transmitting HIV infection.
Expanded safety trial of tenofovir (TDF) as pre-exposure prophylaxis (PREP) among MSM in the United States—The goal of this project is to assess the safety and efficacy of daily oral tenofovir as pre-exposure chemoprophylaxis to prevent HIV acquisition. Approximately 400 MSM who engage in high-risk sexual practices will participate at three clinical trials sites, where they will receive either TDF or placebo. All participants will be followed on a quarterly basis for two years.
Surveillance, Research, and Evaluation—Highlights
Overview of Behavioral Research Activities on MSM Health - CDC supports a range of research, evaluation, and practice activities to foster innovative behavioral health interventions that promote physical, sexual, and mental well-being among the MSM community. Read more about CDC's Behavioral Research Activities on Gay, Bisexual, and MSM Health.
The Monitoring and Evaluation of Mpowerment (MEM)-This project funds three community-based organizations to monitor and evaluate the implementation of Mpowerment, a community-level intervention that uses a combination of outreach, discussion group, creation of safe spaces, social opportunities, and social marketing to disseminate HIV prevention, safer sex, and risk reduction messages to young gay men. The main goals of this evaluation project are to determine if participation in the intervention is associated with risk reduction and positive psychosexual outcomes, assess the degree to which the behaviors/norms/attitudes of young gay men in the community are also affected by intervention messages, and identify agency- and intervention-level factors that are associated with successful program implementation.
Evaluating Recruitment Strategies for Improving the Effectiveness of HIV Testing Programs among MSM-CDC is currently evaluating the relative effectiveness of different recruitment strategies for reaching and motivating MSM with undiagnosed HIV infection for testing and referrals to medical services. This study is funding for sites providing HIV CTR services in Atlanta, Baltimore, Washington D.C., and New York City to evaluate three different recruitment strategies—alternative venue testing, social networks, and partner services—for reaching African American MSM.
Behavioral Assessment and Rapid Testing (BART) Project—This project focuses on behavioral assessments and rapid HIV testing at events attracting large numbers of African Americans, including black gay pride events. The specific goals of this project are as follows: 1) determine the risk behaviors of persons attending gay pride events, minority gay pride events, black college spring break events, social or cultural events attended by a large number of African Americans, and other events; 2) increase the knowledge of HIV serostatus and behavioral risks among persons attending these events; 3) evaluate new models for rapid HIV testing at these events; and 4) link persons who are identified to be infected with HIV to health care and supportive services.
Community-based Organization Behavioral Outcomes Project—Many Men, Many Voices (CBOP-3 MV)–This project funds three community-based organizations to monitor and evaluate outcomes and assess behavior changes after participation in Many Men, Many Voices (3 MV), a multi-session, group-level intervention program to prevent HIV and sexually transmitted diseases among black men who have sex with men who may or may not identify themselves as gay. CBOP-3 MV is an outcome monitoring study designed to assess changes in clients’ self-reported HIV risk behaviors after participating in 3MV. CBOs will collect data from 600 clients prior to their participation in 3MV and at two post-intervention follow-up points (90-day and 180-day). In addition to client-level data, CBOs will collect agency and intervention data to provide context for the behavioral outcome findings.
HIV/AIDS Surveillance—The goal of this program is to monitor the number and characteristics of persons who have been diagnosed with HIV and HIV-related morbidity including mortality by demographic, geographic, and risk/behavior characteristics of affected populations. The program also provides reliable and scientifically valid estimates of the number of newly acquired infections at the local, state, territorial, and national level. Although this program is not MSM-specific, it is a core source of data and knowledge about the HIV/AIDS epidemic among MSM.
Medical Monitoring Project (MMP)—The project entails a behavioral survey of persons living with HIV, including MSM, and a medical record review of care and treatment services received by these persons. The project aims to provide supplemental surveillance of HIV-infected persons receiving care in the United States. The project will produce population-based state and national measures of clinical outcomes and quality of care for HIV infection. Information on access to and use of HIV care and treatment services, access to and use of HIV prevention services, and levels of ongoing risk behaviors among persons living with HIV infection are collected.