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UNAIDS POLICY BRIEF: HIV and sex between men
Hommes ayant des rapports sexuels avec des hommes (HSH)

UNAIDS POLICY BRIEF: HIV and sex between men

Sex between men occurs in every culture and society, though its extent and public acknowledgement vary from place to place. In terms of HIV, sex between men is significant because it can involve anal sex, which when unprotected carries a very high risk. At least 5–10% of HIV infections worldwide are estimated to occur through sex between men, though this figure varies considerably between countries and regions. As men who have sex with men may also have sex with women, if infected they can transmit the virus to their female partners or wives. Although sex between men is often associated with a discrete HIV epidemic, it should also be regarded as linked to the epidemic in the general population.

In a project in Senegal (Dakar), 88% of men who had sex with men also reported vaginal sex, and 20% reported anal sex with a woman. In a study in China, half the men who have sex with men reported having sex with a woman, and one third of them were married. In some cities in central and eastern Europe, one third of men in gay venues reported having both male and female partners.

Sex between men occurs in diverse circumstances and among men whose experiences, lifestyles, behaviours and associated risks for HIV vary greatly. It encompasses a range of sexual and gender identities among people in various sociocultural contexts. It may involve men who identify as homosexual, gay, bisexual, transgendered or heterosexual. Men who have sex with men are often married, particularly where discriminatory laws or social stigma of male sexual relations exist. Sex between adolescent males can also be a part of sexual experimentation. In places where men spend long periods in all-male environments, such as prisons or boarding schools, sex between men can be common regardless of sexual identity and may be coerced.

Policy position
The 2001 UN General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/ AIDS adopted by all UN Member States emphasized the importance of “addressing the needs of those at the greatest risk of, and most vulnerable to, new infection as indicated by such factors as […] sexual practices.” At the 2006 High Level Meeting on AIDS, the Member States and civil society members reiterated the commitment.

In this context, UNAIDS recommends actions for governments, for civil society and for international partners. (2006)

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