Most gay and bisexual men living with HIV are on treatment and cannot transmit the virus - study

HSE SHCPP Press Release: Thursday, 3rd October 2019

 Study finds that most gay and bisexual men living with HIV are on effective treatment, have an undetectable viral load and cannot transmit HIV

Today, (Thursday, 3rd October 2019), a national report from the European Men who have Sex with Men Internet Survey 2017 (EMIS-2017 Ireland) was launched by Minister Catherine Byrne T.D., Minister of State, at the Department of Health with responsibility for Health Promotion and the National Drugs Strategy1.

The EMIS-2017 Ireland report presents information from 2,083 gay, bisexual and other men who have sex with men (MSM) who responded to an online survey about their sexual health and wellbeing. The study is part of an international online behavioural surveillance survey designed to generate data useful for planning HIV and STI prevention and care programmes2 The Irish report was led by the HSE Health Protection Surveillance Centre (HPSC) in partnership with the Gay Health Network (GHN) and was supported by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP)3.

Launching the EMIS-2017 Ireland survey report, Minister Catherine Byrne TD said; “I welcome the publication of this important survey and I want to thank all of those men who took part. The information they have provided is key to informing our continued work and improvements in the area of sexual health. Some of the key findings of this report show where more work is needed but there is also good news. The report found that there is a higher than average usage and awareness of PrEP in Ireland compared to the European average 4. This is very encouraging as we prepare for the introduction of the PrEP programme in Ireland. Working in partnership with the Gay Health Network and the HSE, we will continue to promote positive sexual health and wellbeing across all communities.”

The study finds that 7% of respondents to the survey were living with HIV; and of these the vast majority were engaged in care and on treatment (94%) and had an undetectable viral load (97%). 

Dr Fiona Lyons, Consultant in Genitourinary and HIV Medicine, GUIDE Clinic, St. James’s Hospital said, “This is very welcome as it shows that the vast majority of men who reported that they are living with HIV are on effective treatment. In Ireland, it is recommended that everyone diagnosed with HIV starts treatment as soon as possible. Effective and timely HIV treatment keeps people with HIV healthy and prevents transmission to other.” 5

Mick Quinlan, Gay Health Network (GHN) said, “The U=U message6 is becoming more prevalent and MSM living with HIV can feel confident that if they have an undetectable viral load and are having their HIV monitored, they will not pass HIV on to their sexual partner. 6 However, just over 40% of all respondents in this study were not aware of this important information. This highlights the need for targeted health promotion messaging; to arrange for people who have been diagnosed with HIV to take-up treatment as soon as possible, and for MSM to test for HIV and to have regular testing if at risk of acquiring HIV.”

The study also reports findings on the prevalence of HIV and STI testing, indications of anxiety and depression, alcohol use, drug use, and condom use among the community. 

Dr Derval Igoe, HSE Health Protection Surveillance Centre and the Irish study’s Principal Investigator, said: “The proportion of men testing for HIV and sexually transmitted infections (STIs) has been increasing in recent years, which is very welcome. This reflects work being undertaken by statutory and non-statutory organisations in encouraging testing and providing more options for where testing can be carried out, such as in community setting.7 However, 23% of MSM overall have never tested for HIV, rising to 47% in young men between 17 and 24 years of age. A sustained focus on reducing HIV stigma, on highlighting the benefits to the individual and the population in knowing your HIV status and on expanding options and opportunities for testing are all required”.

Mick Quinlan continued, “EMIS 2017 Ireland shows some concerning findings from the community.  Twenty-nine per cent of men were found to have possible alcohol dependency, compared to 18% in the European study.  Forty-one per cent used at least one illicit drug with cannabis, cocaine and ecstasy among the top three. Also worrying are the findings relating to the prevalence of anxiety and depression and experience of homophobic verbal assaults or attacks. These findings emphasise that further work is needed to develop specific health and wellbeing messaging and interventions for the community. The Gay Health Network will continue to work in partnership with the HSE to develop and promote wider health promoting messages via the Man2Man.ie programme”8.

Helen Deely, Acting Assistant National Director, HSE Health and Wellbeing, Strategic Planning and Transformation said, “This study contains valuable information from the MSM community. The data suggests some positive improvements in the area of HIV and STI testing and treatment, however it raises many concerning findings relating to mental health, alcohol and drug-use. The study will be used to inform the work of the SHCPP and the broader Health and Wellbeing Programme over the coming years in the context of the National Sexual Health Strategy and the Healthy Ireland Framework9.  We look forward to maintaining and strengthening our partnership with the Gay Health Network and with NGOs that have worked closely with us in recent years in developing primary prevention interventions, information and support.” 

Notes to Editors:

  1. The EMIS-2017 Ireland report can be found at http://gayhealthnetwork.ie/research/
  2. The EMIS 2017 European Report can be found here http://sigmaresearch.org.uk/files/EMIS-2017_The_European_MSM_Internet_Survey_-_findings_from_50_countries.pdf
  3. The Health Protection Surveillance Centre (HPSC) is Ireland's specialist agency for the surveillance of communicable diseases. www.hpsc.ie

The HSE Sexual Health and Crisis Pregnancy Programme is a national programme tasked with implementing Ireland’s first framework for sexual health and wellbeing, the National Sexual Health Strategy 2015 – 2020. www.sexualwellbeing.ie

The Gay Health Network is a network of organisations and individuals in Ireland that serve as an expert network for the promotion of HIV prevention and of sexual health and wellbeing among gay men, bisexual men and MSM. www.ghn.ie

4. PrEP is medication that can be taken before exposure to HIV (including before sex) to prevent HIV infection. PrEP is used by HIV negative people to prevent them from becoming HIV positive. PrEP is best used in combination with other HIV prevention measures.  For more information https://www.sexualwellbeing.ie/sexual-health/sexually-transmitted-infections/information-on-hiv/

5. HSE Position on Antiretroviral Therapy for all people living with HIV can be found here: https://www.sexualwellbeing.ie/sexual-health/sexually-transmitted-infections/information-on-hiv/hse-position-on-antiretroviral-therapy_vfeb2018.pdf

6. U=U: Undetectable = Untransmittable. This signifies that individuals with HIV who receive antiretroviral therapy (ART) and have achieved and maintained an undetectable viral load cannot sexually transmit the virus to others. This message has been spearheaded by community movements such as preventionaccess.org. A landmark study published in the Lancet in May 2019 provides conclusive evidence that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext

7. Community HIV testing is implemented by four NGO’s in Dublin, Cork, Limerick and Galway - HIV Ireland, Dublin; the Sexual Health Centre, Cork; GOSSH, Limerick and Aids West, Galway. Funding for 2019 was provided by the Department of Health as part of the Fast Track Cities fund, and was administered and managed by the HSE Sexual Health and Crisis Pregnancy Programme.

8. Log onto www.man2man.ie for information in English, French, Portuguese and Spanish about HIV; STIs & sexual health; drugs and alcohol; where to get Tested, Vaccinated; Condoms; PEP and PrEP and Support

9. The National Sexual Health Strategy 2015 – 2020 is available here: https://www.sexualwellbeing.ie/about/corporate-publications/national-sexual-health-strategy/national-sexual-health-strategy.pdf The Healthy Ireland Framework is available here: https://health.gov.ie/wp-content/uploads/2014/03/HealthyIrelandBrochureWA2.pdf

Last updated on: 03 / 10 / 2019