Addressing Social Determinants of Health Among HIV Positive Men Who Have Sex with Men (MSM): The Need for Synergy

Document Type

Book Section

Publication Title

Understanding Prevention for HIV Positive Gay Men

Publication Date


Date Added



The incongruence between HIV rates and the estimated population size of MSM highlights the need to consider other factors—beyond individual risk taking—that may be driving HIV infections for MSM. Much of the HIV prevention and treatment research has examined individual-level factors such as an individual’s self-reports of unprotected anal sex. However, investigators have recently begun to explore the relationship between structural-level factors such as social determinants of health and sexual decision-making. Though sexual decision-making occurs on the individual level, individuals make these decisions within a larger social context. Consequently, researchers are broadening their efforts to not only identify direct (individual-level) causes for sexual decision-making but also indirect (structural-level) causes. In an effort to explore this relationship among MSM, we will first examine why it is important to consider social determinants of health (not just individual behavior) when discussing health behaviors, particularly risk behaviors for HIV infection. Next, we will review the pertinent current research on the role of structural-level factors in the lives of MSM. Then, we will highlight two federal-level programs which are currently underway to help overcome these structural-level factors. Finally, we will end our discussion with actions that can be taken on two emerging structural-level factors to improve the health of HIV positive MSM.


978-1-4419-0202-3 978-1-4419-0203-0




Social Work


Springer New York