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As we celebrate the progress we have made in HIV prevention and treatment among gay and bisexual men, we must also acknowledge the challenges we still face. Racism, poverty, stigma, and homophobia serve as barriers to care and prevention, and continue to drive inequities that cause gay and bisexual men—particularly African Caribbean Black (ACB) men—to be overrepresented in the HIV epidemic.

We continue to work together during the ongoing COVID-19 pandemic and recent MPX (formerly known as monkeypox) outbreak, we strengthen our commitment to ending the HIV epidemic by expanding HIV testing, prevention, and treatment, and reducing HIV stigma. To succeed, we will need to increase efforts supporting ACB gay and bisexual men, who bear the greatest burden of new HIV infections. The disruption of traditional HIV testing services over the last 2 years has made self-testing a great option for some people to take an HIV test, learn their status, and get the benefits of today’s prevention and treatment tools. In March 2021, GetaKit by Black CAP was launched in to deliver HIV self-tests to ACB men seeking HIV testing, with marketing focused on gay and bisexual men. These men who know their HIV status, positive or negative, can take steps to keep themselves healthy. If their test is negative, they can be linked to prevention services, including pre-exposure prophylaxis (PrEP). If their test is positive, they can be linked to care and start treatment to keep themselves healthy and prevent transmission to their sexual partners. This “status neutral” approach facilitates the integration of prevention and treatment services so that both become part of the fabric of comprehensive primary care and address the needs of the whole person while mitigating HIV-related stigma.

Antiretroviral therapy, especially early initiation of treatment, significantly reduces the transmission of HIV to sexual partners. When men living with HIV are not diagnosed, do not start on HIV treatment or fail to remain on treatment, it jeopardizes not only their own health, but also the well-being and prospects of their partners, households, extended families and communities. The failure to reach greater numbers of men with HIV testing and early treatment, combined with the limited impact that other prevention interventions have on the risk of men acquiring or transmitting HIV, is driving ongoing cycles of HIV transmission in high-prevalence settings. One of the most effective tools we have to address ongoing challenges in HIV prevention is pre-exposure prophylaxis (PrEP). Unfortunately, not everyone who can benefit from PrEP has access to it. Current PrEP data reflect racial and regional disparities driven by structural challenges such as stigma, racism, and mistrust in the healthcare system. Improving the utilization of HIV prevention, testing and treatment services by ACB men and adolescent boys is a complex but feasible challenge.

As partners in HIV prevention, we each play an essential role in ending HIV in this country. Our commitment and ongoing work can reduce stigma, ensure health equity, and raise awareness about HIV testing, prevention, and treatment. Its success also depends on a holistic approach to the various parts of the syndemic, including STIs, viral hepatitis, substance use and mental health disorders, stigma and discrimination, and social and structural determinants of health. Each community and stakeholder brings a unique perspective and plays a critical role in preventing and responding to HIV.

Together we can make a difference.

Garfield Durrant (He/Him/His)
Men’s Prevention Specialist (Lead)