HIV/AIDS Backgrounder: Gay, bisexual men and other men who have sex with men (MSM)

Key Messages

HIV infection rates remain high among gay, bisexual, and other men who have sex with men (MSM) in Toronto. In 2009, gay men accounted for 69% of HIV positive test results in Toronto,. Overall, gay men account for 71% of people living with HIV/AIDS in Toronto.

While most gay men practice safer sex, a number of psycho-social factors put them at increased risk for HIV transmission. Research in Ontario indicates that most gay men do practice safer sex every time — or nearly every time — they have sex. Gay men have the highest rates of condom use amongst any community. However, some men do have unsafe sex and others who are usually safe will occasionally take risks at times in their lives when they are experiencing difficulties, such as loss of a relationship or a job. Racism, ageism, and HIV-stigma within the gay community can also affect men's sexual decision-making.

Societal homophobia contributes to the spread of HIV among gay, bisexual men and other MSM. Although attitudes towards homosexuality have improved, religious, cultural and other negative views towards same gendered sex persist. As a result, gay men are often bombarded with subtle and not-so-subtle messages that they are not valued. Young gay and bisexual men receive little or no sexual health education that speaks to their sexual health needs, or affirms their lives. Consequently, few gay men are equipped with the skills, information, and strong social networks that contribute to positive health outcomes.

In spite of these barriers and challenges, gay men have shown tremendous resilience in the face of HIV. Gay men responded in the early years of HIV/AIDS by caring for one and other, advocating for funding for and access to supportive HIV services and treatment, and undertaking education and outreach to reduce the spread of HIV.

Community building is the key to reducing the spread of HIV among gay men. While most gay men have high levels of HIV knowledge, there is the need for continued education and community development initiatives that reduce the multiple factors that contribute to HIV transmission: both within gay communities and within society, government, health and social service sectors. At the same time, there is a need to develop programs that build individual and community resilience in the face of the ongoing impact of HIV within gay male communities. ACT is a founding member of the Ontario Gay Men's Sexual Health Alliance (GMSH) which brings together service providers, researchers and policy makers to develop resources that promote the sexual health of gay and bisexual men.