Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
REVIEW (Open Access)

Global travel and HIV/STI epidemics among men who have sex with men: what does the future hold?

Veronica C. Lee A , Patrick S. Sullivan A C and Stefan D. Baral B
+ Author Affiliations
- Author Affiliations

A Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, 4th Floor GCR Building, Atlanta, GA 30322, USA.

B Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Room E7146, Baltimore, MD 21205, USA.

C Corresponding author. Email: pssulli@emory.edu

Sexual Health 14(1) 51-58 https://doi.org/10.1071/SH16099
Submitted: 31 May 2016  Accepted: 27 September 2016   Published: 6 January 2017

Abstract

Infectious disease epidemics occur within dynamic systems and environments that shape risk and, ultimately, the spread of infectious diseases. Gay men and other men who have sex with men (MSM) are disproportionately impacted by HIV everywhere in the world. Several emerging trends present risks for sustained or increased HIV acquisition and transmission, and the growth of global travel in the context of emerging online platforms for social/sexual networking is discussed here. Four factors associated with travel that could potentiate HIV transmission are highlighted: different patterns of sexual risk behaviours during travel; the growth of online tools to meet sex partners more efficiently; the global heterogeneity of HIV strains; and the potential for diassortative mixing of men from high- and low-HIV prevalence areas. Prevention tools and services must rise to these challenges, and innovative mobile applications and programs have played, and will continue to play, an important role in supporting MSM at risk for or living with HIV during their periods of travel.


References

[1]  World Travel Markets. WTM global trends report 2014. 2014. Available online at: http://www.wtmlondon.com/RXUK/RXUK_WTMLondon/2015/documents/WTM-Global-Trends-2014.pdf [verified 26 May 2016].

[2]  Community Marketing and Insights. 20th annual survey on LGBT tourism and hospitality: U.S. overview report. 2015. Available online at: http://communitymarketinginc.com /20th-annual-lgbt-tourism-hospitality-survey/ [verified 26 May 2016].

[3]  Drame FM, Peitzmeier S, Lopes M, et al Gay men and other men who have sex with men in West Africa: evidence from the field. Cult Health Sex 2013; 15 7–21.
Gay men and other men who have sex with men in West Africa: evidence from the field.CrossRef |

[4]  Poteat T, Diouf D, Drame FM, et al HIV risk among MSM in Senegal: a qualitative rapid assessment of the impact of enforcing laws that criminalize same sex practices. PLoS One 2011; 6 e28760
HIV risk among MSM in Senegal: a qualitative rapid assessment of the impact of enforcing laws that criminalize same sex practices.CrossRef | 1:CAS:528:DC%2BC38Xis1SisQ%3D%3D&md5=8699eb667e61d6b9c3d4978b2abfc9a5CAS |

[5]  Richens J. Sexually transmitted infections and HIV among travellers: a review. Travel Med Infect Dis 2006; 4 184–95.
Sexually transmitted infections and HIV among travellers: a review.CrossRef |

[6]  Memish ZA, Osoba AO. International travel and sexually transmitted diseases. Travel Med Infect Dis 2006; 4 86–93.
International travel and sexually transmitted diseases.CrossRef |

[7]  Benotsch EG, Martin AM, Espil FM, Nettles CD, Seal DW, Pinkerton SD. Internet use, recreational travel, and HIV risk behaviors in men who have sex with men. J Commun Healthc 2011; 36 398–405.
Internet use, recreational travel, and HIV risk behaviors in men who have sex with men.CrossRef |

[8]  Benotsch EG, Mikytuck JJ, Ragsdale K, Pinkerton SD. Sexual risk and HIV acquisition among men who have sex with men travelers to Key West, Florida: a mathematical modeling analysis. AIDS Patient Care STDS 2006; 20 549–56.
Sexual risk and HIV acquisition among men who have sex with men travelers to Key West, Florida: a mathematical modeling analysis.CrossRef |

[9]  Cheung DH, Lim SH, Guadamuz TE, Koe S, Wei C. The potential role of circuit parties in the spread of HIV among men who have sex with men in Asia: a call for targeted prevention. Arch Sex Behav 2015; 44 389–97.
The potential role of circuit parties in the spread of HIV among men who have sex with men in Asia: a call for targeted prevention.CrossRef |

[10]  Fisher MP, Ramchand R, Bana S, Iguchi MY. Risk behaviors among HIV-positive gay and bisexual men at party-oriented vacations. J Stud Alcohol Drugs 2013; 74 158–67.
Risk behaviors among HIV-positive gay and bisexual men at party-oriented vacations.CrossRef |

[11]  Vanden Berghe W, Nostlinger C, Hospers H, Laga M. International mobility, sexual behaviour and HIV-related characteristics of men who have sex with men residing in Belgium. BMC Public Health 2013; 13 968
International mobility, sexual behaviour and HIV-related characteristics of men who have sex with men residing in Belgium.CrossRef |

[12]  Grov C, Rendina HJ, Breslow AS, Ventuneac A, Adelson S, Parsons JT. Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA. Sex Transm Infect 2014; 90 26–32.
Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA.CrossRef |

[13]  Truong HM, Fatch R, Grasso M, et al Gay and bisexual men engage in fewer risky sexual behaviors while traveling internationally: a cross-sectional study in San Francisco. Sex Transm Infect 2015; 91 220–5.
Gay and bisexual men engage in fewer risky sexual behaviors while traveling internationally: a cross-sectional study in San Francisco.CrossRef |

[14]  Colfax GN, Mansergh G, Guzman R, et al Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: a venue-based comparison. J Acquir Immune Defic Syndr 2001; 28 373–9.
Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: a venue-based comparison.CrossRef | 1:STN:280:DC%2BD3MnovVOqtg%3D%3D&md5=1fedd023d923d69a53fb090e97e9b467CAS |

[15]  Mansergh G, Colfax GN, Marks G, Rader M, Guzman R, Buchbinder S. The Circuit Party Men’s Health Survey: findings and implications for gay and bisexual men. Am J Public Health 2001; 91 953–8.
The Circuit Party Men’s Health Survey: findings and implications for gay and bisexual men.CrossRef | 1:STN:280:DC%2BD3MzhvVyqsQ%3D%3D&md5=96998a6555adcb52b4d4c546da2afba8CAS |

[16]  UN World Tourism Organization. Global report on LGBT tourism. 2012. Available online at: http://www.e-unwto.org/doi/pdf/10.18111/9789284414581 [verified 29 May 2016].

[17]  Grindr. Grindr fact sheet. 2015. Available online at: http://www.grindr.com/press/ [verified 25 May 2016].

[18]  Hornet. Hornet acquires Vespa to become #1 gay App. 2016. Available online at: http://love.hornetapp.com/blog/2016/7/5/hornet-acquires-vespa-to-become-1-gay-app [verified 8 September 2016].

[19]  Tinder. About Tinder. 2016. Available online at: https://www.gotinder.com/press [verified 25 May 2016].

[20]  Stahlman S, Nowak RG, Liu H, et al Online sex-seeking among men who have sex with men in Nigeria: implications for online intervention. AIDS Behav 2016;
Online sex-seeking among men who have sex with men in Nigeria: implications for online intervention.CrossRef |

[21]  Nguyen H, Nguyen HQ, Colby DJ. HIV knowledge and risks among Vietnamese men who have sex with men travelling abroad. Int J STD AIDS 2014; 25 643–9.
HIV knowledge and risks among Vietnamese men who have sex with men travelling abroad.CrossRef |

[22]  Stahlman S, Grosso A, Ketende S, et al Characteristics of men who have sex with men in Southern Africa who seek sex online: a cross-sectional study. J Med Internet Res 2015; 17 e129
Characteristics of men who have sex with men in Southern Africa who seek sex online: a cross-sectional study.CrossRef |

[23]  Holloway IW, Rice E, Gibbs J, Winetrobe H, Dunlap S, Rhoades H. Acceptability of smartphone application-based HIV prevention among young men who have sex with men. AIDS Behav 2014; 18 285–96.
Acceptability of smartphone application-based HIV prevention among young men who have sex with men.CrossRef |

[24]  Kubicek K, Carpineto J, McDavitt B, Weiss G, Kipke MD. Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men. Arch Sex Behav 2011; 40 803–16.
Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men.CrossRef |

[25]  Rice E, Holloway IW, Winetrobe H, et al Sex risk among young men who have sex with men who use Grindr, a smartphone geosocial networking application. J AIDS Clin Res 2012; S4 005
Sex risk among young men who have sex with men who use Grindr, a smartphone geosocial networking application.CrossRef |

[26]  Lewnard JA, Berrang-Ford L. Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies. Sex Transm Infect 2014; 90 290–6.
Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies.CrossRef |

[27]  Jenness SM, Neaigus A, Hagan H, Wendel T, Gelpi-Acosta C, Murrill CS. Reconsidering the internet as an HIV/STD risk for men who have sex with men. AIDS Behav 2010; 14 1353–61.
Reconsidering the internet as an HIV/STD risk for men who have sex with men.CrossRef |

[28]  Wei C, Lim SH, Guadamuz TE, Koe S. Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia? AIDS Behav 2014; 18 1428–35.
Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia?CrossRef |

[29]  Beyrer C, Baral SD, van Griensven F, et al Global epidemiology of HIV infection in men who have sex with men. Lancet 2012; 380 367–77.
Global epidemiology of HIV infection in men who have sex with men.CrossRef |

[30]  Gifford RJ, de Oliveira T, Rambaut A, et al Phylogenetic surveillance of viral genetic diversity and the evolving molecular epidemiology of human immunodeficiency virus type 1. J Virol 2007; 81 13050–6.
Phylogenetic surveillance of viral genetic diversity and the evolving molecular epidemiology of human immunodeficiency virus type 1.CrossRef | 1:CAS:528:DC%2BD2sXhtl2jtbrF&md5=f179b8b90d5ccb86d2d2d5b3ace44852CAS |

[31]  Li H, Bar KJ, Wang S, et al High multiplicity infection by HIV-1 in men who have sex with men. PLoS Pathog 2010; 6 e1000890
High multiplicity infection by HIV-1 in men who have sex with men.CrossRef |

[32]  Wagner GA, Pacold ME, Kosakovsky Pond SL, et al Incidence and prevalence of intrasubtype HIV-1 dual infection in at-risk men in the United States. J Infect Dis 2014; 209 1032–8.
Incidence and prevalence of intrasubtype HIV-1 dual infection in at-risk men in the United States.CrossRef | 1:CAS:528:DC%2BC2cXktl2ksbg%3D&md5=9aed1d648e91623b211a1733de43b7f1CAS |

[33]  Angelis K, Albert J, Mamais I, et al Global dispersal pattern of HIV Type 1 subtype CRF01_AE: a genetic trace of human mobility related to heterosexual sexual activities centralized in Southeast Asia. J Infect Dis 2015; 211 1735–44.
Global dispersal pattern of HIV Type 1 subtype CRF01_AE: a genetic trace of human mobility related to heterosexual sexual activities centralized in Southeast Asia.CrossRef |

[34]  Huang SW, Wang SF, Cowo AE, et al Molecular epidemiology of HIV-1 infection among men who have sex with men in Taiwan in 2012. PLoS One 2015; 10 e0128266
Molecular epidemiology of HIV-1 infection among men who have sex with men in Taiwan in 2012.CrossRef |

[35]  Hemelaar J. The origin and diversity of the HIV-1 pandemic. Trends Mol Med 2012; 18 182–92.
The origin and diversity of the HIV-1 pandemic.CrossRef |

[36]  Hemelaar J. Implications of HIV diversity for the HIV-1 pandemic. J Infect 2013; 66 391–400.
Implications of HIV diversity for the HIV-1 pandemic.CrossRef |

[37]  Truong HM, Kellogg T, Schwarcz S, et al Frequent international travel by men who have sex with men recently diagnosed with HIV-1: potential for transmission of primary HIV-1 drug resistance. J Travel Med 2008; 15 454–6.
Frequent international travel by men who have sex with men recently diagnosed with HIV-1: potential for transmission of primary HIV-1 drug resistance.CrossRef |

[38]  Gao F, Morrison SG, Robertson DL, et al Molecular cloning and analysis of functional envelope genes from human immunodeficiency virus type 1 sequence subtypes A through G. The WHO and NIAID Networks for HIV Isolation and Characterization. J Virol 1996; 70 1651–67.
| 1:CAS:528:DyaK28XpvFamsA%3D%3D&md5=3d24c97dc415dd569c9dccc9efd2991aCAS |

[39]  Gordon M, De Oliveira T, Bishop K, et al Molecular characteristics of human immunodeficiency virus type 1 subtype C viruses from KwaZulu-Natal, South Africa: implications for vaccine and antiretroviral control strategies. J Virol 2003; 77 2587–99.
Molecular characteristics of human immunodeficiency virus type 1 subtype C viruses from KwaZulu-Natal, South Africa: implications for vaccine and antiretroviral control strategies.CrossRef | 1:CAS:528:DC%2BD3sXpvVGmug%3D%3D&md5=718b7d3e5d01590c37a220bf109bf2c0CAS |

[40]  Yu RX, Yin Y, Wang GQ, et al Worldwide susceptibility rates of Neisseria gonorrhoeae isolates to cefixime and cefpodoxime: a systematic review and meta-analysis. PLoS One 2014; 9 e87849
Worldwide susceptibility rates of Neisseria gonorrhoeae isolates to cefixime and cefpodoxime: a systematic review and meta-analysis.CrossRef |

[41]  Kirkcaldy RD, Kidd S, Weinstock HS, Papp JR, Bolan GA. Trends in antimicrobial resistance in Neisseria gonorrhoeae in the USA: the Gonococcal Isolate Surveillance Project (GISP), January 2006-June 2012. Sex Transm Infect 2013; 89 iv5–10.
Trends in antimicrobial resistance in Neisseria gonorrhoeae in the USA: the Gonococcal Isolate Surveillance Project (GISP), January 2006-June 2012.CrossRef |

[42]  Kirkcaldy RD, Zaidi A, Hook EW, et al Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005–2010. Ann Intern Med 2013; 158 321–8.
Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005–2010.CrossRef |

[43]  Centers for Disease Control and Prevention Fluoroquinolone-resistant Neisseria gonorrhoeae–San Diego, California, 1997. MMWR Morb Mortal Wkly Rep 1998; 47 405–8.

[44]  Baker KS, Dallman TJ, Ashton PM, et al Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. Lancet Infect Dis 2015; 15 913–21.
Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study.CrossRef |

[45]  Rosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in US States, metropolitan statistical areas, and counties, 2012–2013. JMIR Public Health Surveill 2016; 2 e22
Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in US States, metropolitan statistical areas, and counties, 2012–2013.CrossRef |

[46]  Sullivan PS, Jones JS, Baral SD. The global north: HIV epidemiology in high-income countries. Curr Opin HIV AIDS 2014; 9 199–205.
The global north: HIV epidemiology in high-income countries.CrossRef |

[47]  Kelley CF, Vaughan AS, Luisi N, et al The effect of high rates of bacterial sexually transmitted infections on HIV incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia. AIDS Res Hum Retroviruses 2015; 31 587–92.
The effect of high rates of bacterial sexually transmitted infections on HIV incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia.CrossRef |

[48]  Sullivan PS, Grey JA, Simon Rosser BR. Emerging technologies for HIV prevention for MSM: what we have learned, and ways forward. J Acquir Immune Defic Syndr 2013; 63 S102–7.
Emerging technologies for HIV prevention for MSM: what we have learned, and ways forward.CrossRef |

[49]  Goldenberg T, McDougal SJ, Sullivan PS, Stekler JD, Stephenson R. Preferences for a mobile HIV prevention app for men who have sex with men. JMIR Mhealth Uhealth 2014; 2 e47
Preferences for a mobile HIV prevention app for men who have sex with men.CrossRef |

[50]  Goldenberg T, McDougal SJ, Sullivan PS, Stekler JD, Stephenson R. Building a mobile HIV prevention app for men who have sex with men: an iterative and community-driven process. JMIR Public Health Surveill 2015; 1 e18

[51]  Grindr. Grindr – World AIDS Day 2015. 2015. Available online at: http://www.grindr.com/blog/world-aids-day-2015/ [verified 25 May 2016].

[52]  Ranosa T. Tinder adds HIV and STD testing locator on its website. 2016. Available online at: http://www.techtimes.com/articles/126756/20160122/tinder-adds-hiv-and-std-testing-locator-on-its-website.htm#sthash.KnVkt2Ma.dpuf [verified 25 May 2016].

[53]  Hornet. Find the closest HIV testing location with Hornet. 2014. Available online at: http://love.hornetapp.com/blog/2014/9/23/find-the-closest-hiv-testing-location-with-hornet [verified 26 May 2016].

[54]  Grant RM, Lama JR, Anderson PL, et al Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363 2587–99.
Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.CrossRef | 1:CAS:528:DC%2BC3MXit1ansg%3D%3D&md5=0341ee2cfaa1dd3a056b90f732e92218CAS |

[55]  Elsesser SA, Oldenburg CE, Biello KB, et al Seasons of risk: anticipated behavior on vacation and interest in episodic antiretroviral pre-exposure prophylaxis (PrEP) among a large national sample of U.S. men who have sex with men (MSM). AIDS Behav 2016; 20 1400–7.
Seasons of risk: anticipated behavior on vacation and interest in episodic antiretroviral pre-exposure prophylaxis (PrEP) among a large national sample of U.S. men who have sex with men (MSM).CrossRef |

[56]  McDougal SJ, Alexander J, Dhanireddy S, Harrington RD, Stekler JD. Non-occupational post-exposure prophylaxis for HIV: 10-year retrospective analysis in Seattle, Washington. PLoS One 2014; 9 e105030
Non-occupational post-exposure prophylaxis for HIV: 10-year retrospective analysis in Seattle, Washington.CrossRef |

[57]  Sullivan PS, Jones J, Kishore N, Stephenson R. The roles of technology in primary HIV prevention for men who have sex with men. Curr HIV/AIDS Rep 2015; 12 481–8.
The roles of technology in primary HIV prevention for men who have sex with men.CrossRef |

[58]  McCormack S, Dunn DT, Desai M, et al Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016; 387 53–60.
Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial.CrossRef |

[59]  Molina JM, Capitant C, Spire B, et al On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med 2015; 373 2237–46.
On-demand preexposure prophylaxis in men at high risk for HIV-1 infection.CrossRef | 1:CAS:528:DC%2BC28XntFSnsLc%3D&md5=e79e5715fed31994b8c74acf262635a6CAS |

[60]  Lewis JM, Volny-Anne A, Waitt C, Boffito M, Khoo S. Dosing antiretroviral medication when crossing time zones: a review. AIDS 2016; 30 267–71.
Dosing antiretroviral medication when crossing time zones: a review.CrossRef | 1:CAS:528:DC%2BC2MXitV2nsbjK&md5=5d501a211eaf91c96559f60b86632ac9CAS |

[61]  Koole O, Denison JA, Menten J, et al Reasons for missing antiretroviral therapy: results from a multi-country study in Tanzania, Uganda, and Zambia. PLoS One 2016; 11 e0147309
Reasons for missing antiretroviral therapy: results from a multi-country study in Tanzania, Uganda, and Zambia.CrossRef |

[62]  Oster AM, Brooks JT, Stryker JE, et al Interim guidelines for prevention of sexual transmission of Zika Virus – United States, 2016. MMWR Morb Mortal Wkly Rep 2016; 65 120–1.
Interim guidelines for prevention of sexual transmission of Zika Virus – United States, 2016.CrossRef |


Full Text PDF (544 KB) Export Citation Cited By (3)

View Altmetrics