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HIV Prevention Efforts Need Sexual Behavior Reality Check

Effect of concurrent sexual partnerships and homophobia is underestimated

WEDNESDAY, Nov. 26 (HealthDay News) -- A reluctance by the Secretariat of the Joint United Nations Programme on HIV/AIDS (UNAIDS) to accept the role of concurrent sexual relationships in Africa's AIDS epidemic has undermined HIV/AIDS prevention efforts, while homophobia and the criminalization of homosexuality in certain countries is hampering HIV/AIDS prevention among men who have sex with men, according to two articles published online Nov. 25 in BMJ.

Bob Roehr, a freelance medical journalist from New York City, writes that men who have sex with men, whether they term themselves homosexual or not, are central to the HIV epidemic all around the world, and that their likelihood of becoming infected with HIV is 19 times that of the general population, yet they are frequently missing in surveillance systems because of negative attitudes and laws against homosexuality.

Helen Epstein, an independent consultant on public health in developing countries, from New York City, writes that UNAIDS has not taken on research showing that partner reduction can reduce the prevalence of HIV, and did not include information on long-term concurrency, typically undertaken without use of condoms as relationships are stable and therefore mistakenly deemed to be low-risk, in its reports until 2006.

"Multiple concurrent partnerships provide a compelling, if partial, resolution of the apparent paradox of Africa's high HIV infection rates," Epstein writes. "This pattern of behavior gives rise to an interlocking network of sexual relationships that creates a superhighway for HIV."

Abstract - Roehr
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Abstract - Epstein
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