Introduction
Recent years have seen an increase in the number of new HIV infections among MSM in the US, even though overall HIV prevalence has remained relatively stable over the past decade. Even though they only make up 3.9% of adult males and 2.2% of the US population, Higa et al. (2020) argue that MSM is responsible for 72% of HIV cases. When infected with HIV, immune cells are destroyed, and their functions are suppressed, making them unable to generate a proper immune response (Kuppan et al., 2021). HIV medicine, Antiretroviral therapy (ART), should be started as soon as possible for MSM living with HIV. Adherence to ART, a key part of US HIV/AIDS policy and an essential part of the HIV care dynamic process, can improve health outcomes for MSM living with HIV and stop HIV from spreading (Hogg, 2018). Taking ART as directed drastically lowers the amount of HIV in the body (viral load), which helps to maintain a healthy immune system and fight off illnesses. This is considered viral suppression. After using ART, some people achieve what is known as an undetectable viral load, meaning that their viral load is so low that a test cannot detect it. Since its introduction, ART has altered the progression of the disease and saved numerous lives. Since it was first used in 1996, complex treatment plans have helped HIV become a chronic illness that can be managed.
Maintaining an HIV viral load below the detection limit is the best model for HIV-positive health. Lowering the amount of virus in the body also helps stop the spread of the infection through sexual contact or shared needles. The term “treatment as prevention” is occasionally used to describe this approach. Continuous use of antiretroviral therapy (ART) is essential for HIV treatment. New infections among MSM in the US have increased at an average annual rate of 8% since 2001, as reported by Eluwa et al. (2019). Successful HIV therapy for MSM mostly depends on patients adhering to their ART regimen. With the development of new, potent ARTs and their compositions, such as “once daily” medication, the regimens have become more manageable, and the side effects have decreased.
With the availability of ART, the fight against HIV in MSM populations could be greatly facilitated. Maintaining regular ART treatment reduces the risk of HIV transmission among MSM who are HIV positive. When used as prescribed, ART successfully eradicates the virus (Rodger et al., 2016). The solution is appropriate now because adherence to ART is connected with fewer HIV-related health complications, a longer lifespan, and a better quality of life (Benator et al., 2015). This research paper argues that simplifying current regimens, psychological therapy, and text reminders can increase ART adherence rates.
Overview
The first known cases of AIDS were reported in 1981. During that time, the disease spread quickly and always led to death. It was not until 2000 that the long-term use of ART became clear, thanks to the thorough implementation of treatment plans for various ARV drugs (Jacob et al., 2017). The development of ART was a big step toward treating HIV/AIDS as a long-term disease that can be managed. HIV can be spread sexually through body fluid and semen if it is not suppressed with ART medication (Bhattacharjee et al., 2020). HIV treatment for MSM usually involves several ART regimens to slow the disease’s progression and stop it from spreading (Cohen et al., 2019). In order to improve health outcomes for HIV-positive MSM and reduce rates of HIV transmission, regular adherence to ART is an essential factor.
Treatment with ART has cut down on deaths caused by HIV, turning it from a disease that killed quickly into a long-term illness that can be managed. Rodger et al. (2019) show that ART can reduce viral load to a point where the risk of transmission is very low or nonexistent. Even so, the number of people who adhere to ART is low, ranging from 27 to 80% in different populations and studies, when the needed level is 95% (Jacob et al., 2017). To reduce HIV-related death and illness, the CDC recommends that all MSM with HIV start ART immediately, no matter how many CD4 cells (white blood cells responsible for fighting infections) they have. With proper treatment, Wing (2016) claims that the survival rates of HIV-positive MSM are on par with those of HIV-negative individuals. However, Jacob et al. (2017) argue that neither the efficiency of the medications nor the refined ART principles can substitute the high adherence to ART, despite the reduction in death and transmission risk. It is therefore expected that HIV patients require an adherence level of 95% or higher to attain undetectable viral levels (Cohen et al., 2019). This is because maintaining viral suppression while on ART is essential for HIV-positive MSM. The risk of HIV transmission is decreased, according to Rodger et al. (2019), since ART lowers HIV in the blood. This indicates that an MSM who is HIV-negative does not need to take HIV medication before or after having intercourse with someone who is on ART because of the decreased risk of transmission.
ART reduces HIV spread among MSM (Cohen et al., 2019). According to Cohen et al. (2019), ART programs have greatly decreased HIV infections in various groups. In countries where ART is widely available, HIV-related illness and death have gone down. Even though the overall number of people with HIV has gone down in many countries because there is more access to HIV testing and ART and less focus on prevention, there are still many MSM groups where the virus is spreading at an alarming rate because of things like the number of pills they have to take, the negative side effects of ART, and forgetfulness. Bezabhe et al. (2016) found that about 63% of HIV-positive MSM patients had high rates of ART adherence. This is less than the 90% goal that UNAIDS set and Levi et al. (2016) mentioned. To prevent the spread of HIV, Rodger et al. (2019) stressed the need to maintain treatment adherence and undergo routine viral load testing and HIV status. The complex nature of ART adherence issues and the necessity of continual monitoring only add to the difficulty of addressing them. The current ways to solve this problem are challenging to understand, which is a setback. Even among compliant MSM, keeping an eye on their adherence levels is crucial. This is because strict adherence to ART is crucial for achieving optimal results.
Chaillon et al. (2018) looked into whether increasing the dosage of existing ART medications affects the amount of virus still in the body after treatment. They found that ART increasing dosage did not affect the amount of virus still in the body, suggesting that new methods are needed if HIV infection is to be cured. A coordinated bundle of services can be delivered to lower transmission risks in situations where conventional approaches have failed. Rodger et al. (2019) found that HIV did not spread from the HIV-positive partner to the HIV-negative partner when the HIV-positive partner’s viral load was undetectable or very low. This highlights the significance of HIV testing and treatment for those at risk of contracting the virus and the need for strong adherence to ART and regular monitoring of viral load for HIV-positive MSM.
To conclude, this article examines the concept of MSM ART adherence, the limitations of antiretroviral treatment, and the strategies that might be implemented locally to promote adherence. Analysis of populations at high risk for HIV infection, such as MSM, is emphasized because they are the current epidemic’s frontline. This problem should be addressed now because achieving and maintaining maximum ART adherence is crucial for better patient health outcomes and the complete elimination of new infections.
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