Gay and Bisexual Men's Health
CDC Programs At-A-Glance
CDC has various activities and programs to address the health and well-being of gay and bisexual men. Below is a description of some of the activities for gay and bisexual men’s health across the agency.
In fiscal year (FY) 2013, approximately 41 percent of CDC’s Division of HIV/AIDS Prevention’s Extramural Prevention Program Budget was targeted to HIV prevention activities for gay and bisexual men. The CDC's approach to addressing the HIV epidemic among gay and bisexual men involves three areas of commitment:
- Engaging gay, bisexual, and other MSM communities and strategic partners;
- Expanding effective prevention strategies and programs; and
- Evaluating and disseminating information on strategies and programs.
HIV Prevention Communication
CDC is committed to increase HIV prevention awareness among gay and bisexual men.
The CDC's Testing Makes Us Stronger campaign and Act Against AIDS Leadership Initiative (AAALI) are two notable activities to address the epidemic among black/African American MSM.
- Reasons/Razones aims to increase HIV testing among Latino gay and bisexual men ages 18 to 49. The campaign’s message emphasizes family and partner relationships and normalizes HIV testing through positive messages.
- Start Talking Stop HIV was created for all openly gay and bisexual men ages 18-64, with an emphasis on those 18-29. The campaign’s messages emphasize HIV-related communication between intimate partners, knowledge about HIV prevention strategies (e.g., Condoms, ART, PrEP, PEP) for intimate partners, HIV-related information-seeking behaviors, and increase positive norms about HIV-related communication
- Testing Makes Us Stronger focuses on increasing HIV testing among 18-to-44-year-old black/African American gay & bisexual men. The campaign’s messages emphasize that HIV testing is a source of strength, not a reason for fear.
- To foster community leadership and engagement, the CDC supports the Act Against AIDS Leadership Initiative (AAALI). Two AAALI organizations focused primarily on black/African American gay and bisexual men are the Black Men’s Xchange-National and the Center for Black Equity. AAALI members are responsible for coordinating outreach events, facilitating HIV testing, and engaging local affiliates across the country in HIV prevention activities.
- The CDC partnered with the Northwest Portland Area Indian Health Board to create We R Native, focusing on sexual identity; and consult on the Red Talon Project, which works to achieve a more coordinated national and Northwest tribal response to STDs/HIV.
- The CDC collaborated with National Association of State and Territorial AIDS Directors to release an Issue Brief: Native Gay Men and Two Spirit People HIV/AIDS and Viral Hepatitis Programs and Services
National HIV/AIDS Awareness Days
Working together with state and local public health agencies, community-based organizations (CBOs), and other partners, CDC supports National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD). These Awareness Days urge individuals to have open dialogue about HIV with partners, peers, and families.
Programs for Youth
Young Men Who Have Sex with Men (YMSM) Project
CDC's Division of Adolescent and School Health (DASH) provides funding and support through a 5-year cooperative agreement for the Young Men Who Have Sex with Men (YMSM) Project to three local education agencies and a national non-profit organization to implement multi-component, school-centered HIV prevention activities for teen MSM ages 13-19. Recipients of the competitive funding are the School Board of Broward County, Los Angeles Unified School District, San Francisco Unified School District, and Advocates for Youth. The project is guided by the National HIV/AIDS Strategy.
Reduce HIV and other STDs among black and Latino young men who have sex with men (YMSM) through school and community-based partnerships by:
- Increasing the number of teen YMSM who are tested and treated for HIV and other STDs
- Decreasing sexual risk behaviors among teen YMSM
- Reducing absenteeism and school drop-out among teen YMSM
- Implement or expand HIV and other STD testing and treatment in schools and school-based health centers
- Increase collaboration in order to support referrals to HIV and other STD testing, treatment, and evidence-based educational interventions
- Develop systems in schools to support student referrals to HIV and other STD testing and treatment
- Assess state and district education policies and their implementation related to HIV and other STD testing, treatment, and prevention
- Promote safe school and school-based health center environments
- Provide evidence-based education interventions tailored for black and Latino YMSM
- Implement social marketing that promotes the core strategies
Sexually Transmitted Diseases
CDC’s Division of Sexually Transmitted Diseases Prevention (DSTDP) is concentrating its efforts on four priority areas to guide STD prevention, maximize long term impact, and reduce health disparities:
- Adolescents and young adults
- Men Who Have Sex with Men (MSM)
- Multidrug-resistant gonorrhea
- Congenital syphilis infection
The approach to STD control in the U.S. has remained the same since 1937, with a strong focus on:
- Health education, promotion, and behavior change;
- Identification and treatment of infected individuals through the screening of asymptomatic persons and linking them to care (usually in state-funded STD clinics);
- Individually-based interventions (e.g., health department-delivered partner notification and partner treatment;
- Public sector responsibility; and
- Specialty clinics and Disease Intervention Specialist focus.
STD AAPPS (Assessment, Assurance, Policy Development, and Prevention Strategies)
The purpose of the STD AAPPS funding opportunity announcement is to strengthen STD prevention programs for eligible jurisdictions in order to reduce the burden of STDs in the United States. The funding for this flagship program is $90 million for STD and STD-related HIV prevention. The STD AAPPS promotes opportunities to:
- Align allocation of funds with burden of disease and at-risk populations;
- Prioritize prevention strategies and interventions;
- Provide more direction to focus on Core Public Health functions (strengthen surveillance and evaluation); and
- Increase flexibility for grantees in directing resources to address state and local needs and priorities.
Using a program science framework, the STD AAPPS provides critical resources for state and local programs to address the STD disparities among MSM.
Other Efforts to Support General Program Capacity Building
- STD Surveillance Network (SSuN)
- National Coalition of STD Directors Cooperative Agreement
- STD-Related Reproductive Health Training Assistance Centers (STDrRH TACs)
- National Network of STD/HIV Prevention Training Centers (NNPTCs)
- DIS Certification Project
Additional DSTDP Efforts Specifically Aimed at Reaching MSM
- Community Approaches for Reducing STDs (CARS) Project (Richmond, VA)
- Conducted 12 focus groups to better understand the needs of the community and the knowledge of providers about sexual health issues affecting the MSM and transgender community;
- Established a relationship with 3 House/Ball communities in Richmond City to implement strategies and events targeting the MSM community;
- Established a peer educator and advocate network for an MSM community utilizing House/Ball community leaders and members; and
- Implemented the d-up: Defend Yourself! intervention in Richmond City with Black MSMs between the ages of 18-29.
- CARS Funding Opportunity Announcement (F0A) #CDC-RFA-PS14-1406 – published on February 10, 2014
Populations of interest to this announcement include: Young MSM, MSM and other vulnerable populations seen in HIV care and other selected facilities, and adolescents and young adults diagnosed and reported with an STD of interest.
Integrating HIV-Viral Hepatitis Testing and Linkage to Care for At-risk Populations
The Minority AIDS Initiative is exploring the feasibility of integrating hepatitis B (HBV) and hepatitis C (HCV) screening into HIV testing services in order to improve health outcomes for racial/ethnic minorities living with HIV by addressing viral hepatitis co-infections. The three goals of the demonstration project are as follows:(1) Increase the proportion of racial/ethnic minorities living with HIV who aware of their HIV/viral hepatitis co-infection status; (2) Increase access to viral hepatitis prevention services for racial/ethnic minorities living with HIV; and (3) Increase the proportion of racial/ethnic minorities living with HIV/viral-hepatitis co-infections that are linked to care and treatment.
Three sites have been selected to conduct integrated HIV-viral hepatitis testing and linkage to care activities; one site to carry out integrated HIV-HBV testing of Asian and Pacific Islanders, and two sites for integrated HIV-HCV testing of racial/ethnic minorities that identify as MSM, persons who inject drugs, and other at-risk populations. Each site has integrated viral hepatitis testing and linkage to care activities into their HIV testing protocol and is providing feedback on integrated testing activities.
For this project, both qualitative and quantitative data are being collected. The qualitative data collection includes semi-structured interviews of staff members involved in various aspects of providing integrated HIV-viral hepatitis testing and linkage to care services. Quantitative testing and linkage to care data are collected via the EvaluationWeb® HepTLC system. Both the qualitative and quantitative data from this project will provide valuable insights into identifying successes, challenges, and creative solutions to address these challenges in providing integrated HIV and viral hepatitis testing services.