Estimates suggest that 4.2% of young (under-25s) men who have sex with men are living with HIV.
This is more common in countries where HIV prevalence among the whole men who have sex with men population is quite high.16 One study carried out in Bangkok found HIV incidence was more than twice as high among men aged 18 to 21 years compared to men over 30 years of age.17 Young men who have sex with men often find it harder to access HIV services, due to age of consent laws or unsociable opening times.
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Data on other sexually transmitted infections among gay men and other men who have sex with men are further evidence of inconsistent use of condoms.11 Likewise, access to HIV testing services is low among this group - ranging between 25% and 54% across the world.12 A study in India found that only 30% of a cohort of more than 1,000 men who have sex with men living with HIV were aware of their HIV-positive status.13 Not testing for HIV, means that many men who have sex with men are unaware of their HIV status and may be unaware of the need to take protective measures to prevent onwards transmission to others.
The drugs of interest - namely GHB (gamma-hydoxybutyrate), methamphetamine and methedrone - are used to facilitate sexual sessions lasting many hours or even days with multiple partners.
Healthcare professionals are particularly concerned with the high-risk behaviours that these drugs induce; a lack of physical inhibition and awareness often means a participant is exposed to multiple partners without protection or to shared drug taking equipment which increases the risk of HIV transmission.
In cases where sexual activity is prolonged there is also a concern that participants living with HIV may forget to take ART medication, or that those who are HIV negative will miss the 72-hour window to be eligible for receiving post-exposure prophylaxis (PEP) after suspected exposure to HIV.
15 Men who have sex with men living with HIV often become HIV-positive while still young.