The risk of HIV infection disproportionately affects certain groups of young people, including young men who have sex with men (YMSM). The term YMSM encompasses a diverse array of individuals, including:
- Young men who identify as gay, bisexual, or otherwise same-gender oriented in sexuality and sexual practice
- Young men who do not identify as same-gender oriented, but who have sex with other men because of economics (e.g., sex workers), environments (e.g., prisoners), or societal constraints (e.g., gender separation or gender norms)
- Male-to-female transgender individuals who are biologically male but self-identify as female
Young MSM are present in every country in the world, yet homophobia—and related stigma, denial, discrimination, violence, and criminalization—often prevent these young men from receiving critical HIV prevention and treatment information, services, and support. As a result, many YMSM are not equipped to protect themselves from becoming infected with HIV and other sexually transmitted infections. Additional risk factors resulting from the isolation often experienced by YMSM include homelessness, substance abuse, and multiple partners.
Also, the biological risk of HIV transmission is five times greater through anal intercourse than vaginal intercourse. For these reasons, MSM are on average 19 times more likely to be HIV-positive than the general population. The young age at which MSM often initiate sexual activity and the fact that many who become HIV-infected do not learn of their status until late in the course of infection highlight the urgency of addressing the needs of YMSM.
More research is needed to understand the unique needs of YMSM. The wide range of risk factors demonstrates the need for programs that address both individual behaviors and structural changes.