HIV infection in MSM causes and effects

HIV infection among MSM is one of the main public health concerns across countries, regardless their socio-economic status and prevalence rate of HIV among general population. Vulnerability of this population is a result of biological and social factors. Firstly, anal sexual intercourse greatly increases risk of HIV infection. Secondly, widespread structural barriers, stigma and discrimination faced by MSM in most of the countries as well as homophobia and state sanctions against homosexuality promote environment in which MSM are more liable to get infected and less likely to access safe, high quality and acceptable healthcare services, including HIV counseling and testing. Despite existing evidences, that persistent condom use and pre-exposure prophylaxis can significantly reduce individual risk of HIV acquisition among MSM population, effective HIV prevention for KAPs is still far from achieving the global targets to end HIV epidemic. In order to ensure effective prevention and control of the infection, combination prevention strategies including behavioural, biomedical and structural methods should be used by countries. Among the preventive methods, HIV testing and counselling (HTC) is one of the most effective interventions to prevent HIV infection. Apart from early diagnosis, it encourages people to modify behaviors in order to prevent HIV infection or transmission. Besides this, cost-effectiveness of HCT services has been proved and therefore, it has been widely promoted in low-middle income countries. The various individual and structural factors in- and outside the healthcare system influence on the utilization of HIV counseling and testing. On the one hand, individual factors, such as knowledge and perception of individual risks, as well as attitude towards and fear of HIV (in correlation with stigma and negative reactions to disclosure), on the other hand, healthcare factors, like acceptability and quality of services including provider-client relationship, service design alter individual’s behavior towards counseling and testing culture. Therefore, understanding the individual, local and socio-cultural aspect of HTC services utilization is useful for the programs in similar settings. It is imperative to explore the utilization of HTC among such vulnerable population.