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Heterosexual men

opinion

Fu, Amy Nunn, Curt G. In the United States, the human immunodeficiency virus HIV epidemic among heterosexual men disproportionately affects individuals involved with the criminal justice system, injection drug and other substance users, and racial and ethnic minorities. These overlapping populations confront similar social and structural disparities that contribute to HIV risk and limit access to HIV testing, treatment, and care.

In this review, we discuss barriers to linkage to comprehensive HIV care for specific subpopulations of heterosexual men and examine approaches for enhancing linkage to care for this diverse population.

HIV-infected men are also more likely to receive a diagnosis late in the course of infection Heterosexual men 3 ] and have lower CD4 cell counts when care is initiated [ 4 ]. Significant racial and ethnic disparities in HIV infection persist. Racial and ethnic minorities are Heterosexual men disproportionately represented among late diagnoses and are significantly more likely to experience delayed linkage to care [ 5—11 ].

Modes of HIV transmission among men have changed during the last decade [ 12 ]. Increasing rates of heterosexual HIV transmission underscore the potential for a more generalized heterosexual HIV epidemic, and studies in Washington, DC, and Baltimore, Maryland, have identified this trajectory in marginalized urban communities [ 1213 ].

Figure 1 depicts the proportion of heterosexual men Heterosexual men the total number of persons with HIV infection in the United Heterosexual men between and [ 214—20 ]. Estimated proportion of human immunodeficiency virus HIV infection among Heterosexual men in the United States, by transmission "Heterosexual men," — In the United States, "Heterosexual men" HIV epidemic among heterosexual men disproportionately affects individuals involved with the criminal justice system, injection drug users IDUsother substance users, and racial and ethnic minorities.

In describing these disparities and risks, clinicians and researchers need to be particularly cautious about protecting sensitive health information, such as drug use and sexual risk-taking behaviors. Other studies have used technology such as audio computer-assisted self-interviews to improve rates of reporting of sensitive behaviors and to reduce socially desirable responding [ 23—26 ].

In this review, we discuss barriers to linking specific subpopulations of heterosexual men to comprehensive HIV care and examine approaches for enhancing the linkage to care for this diverse population. During the past 2 decades, there has been a significant decline in IDU-related HIV infections [ 27—29 ], probably in part because of increases in HIV prevention programs Heterosexual men to IDUs, including syringe exchange programs [ 3031 ].

Heterosexuality is romantic attraction, sexual...

Despite these declines, IDU-related HIV transmission continues to affect racial and ethnic minorities at disproportionate rates, particularly African American men [ 32 ]. Among African Americans in high-risk communities in Houston, Texas, Risser et al found that individuals reporting both IDU and heterosexual anal intercourse had 6. These findings demonstrate the need Heterosexual men coordinated efforts between researchers, policymakers, and outreach and community-based organizations to address late HIV diagnoses among IDUs and to target interventions to the needs of specific IDU subpopulations.

Booth et al found that crack cocaine smokers and crack cocaine—smoking IDUs were more likely to report Heterosexual men multiple sexual partners and exchanging sex for drugs or money than those who only injected [ 36 ]. McCoy et al found that, compared with neighborhood controls, crack cocaine smokers were 2.

Adimora et al also found a statistically significant Heterosexual men between sexual concurrency and crack cocaine smoking in a sample of rural African Americans with recent heterosexually acquired HIV infection [ 37 ].

Alcohol use has also been shown to be an important mediator of high-risk sexual behavior among men [ 3839 ], with additional studies finding strong associations between alcohol use and HIV incidence [ 4041 ]. Methamphetamine use is yet another emerging risk factor for HIV infection among heterosexual men [ 4243 ]. Understanding risk factors among men who have sex with men and women MSMW and adapting "Heterosexual men" prevention interventions should be Heterosexual men, given the potential of MSMW to bridge the epidemics between sexes.

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