Abstract
BackgroundAmerican Black men who have sex with men (MSM) are disproportionately affected by HIV, but the factors associated with this concentrated epidemic are not fully understood.MethodsBlack MSM were enrolled in 6 US cities to evaluate a multi-component prevention intervention, with the current analysis focusing on the correlates of being newly diagnosed with HIV compared to being HIV-uninfected or previously diagnosed with HIV.ResultsHPTN 061 enrolled 1553 Black MSM whose median age was 40; 30% self-identified exclusively as gay or homosexual, 29% exclusively as bisexual, and 3% as transgender. About 1/6th (16.2%) were previously diagnosed with HIV (PD); of 1263 participants without a prior HIV diagnosis 7.6% were newly diagnosed (ND). Compared to PD, ND Black MSM were younger (p<0.001); less likely to be living with a primary partner (p<0.001); more likely to be diagnosed with syphilis (p<0.001), rectal gonorrhea (p = 0.011) or chlamydia (p = 0.020). Compared to HIV-uninfected Black MSM, ND were more likely to report unprotected receptive anal intercourse (URAI) with a male partner in the last 6 months (p<0.001); and to be diagnosed with syphilis (p<0.001), rectal gonorrhea (p = 0.004), and urethral (p = 0.025) or rectal chlamydia (p<0.001). They were less likely to report female (p = 0.002) or transgender partners (p = 0.018). Multivariate logistic regression analyses found that ND Black MSM were significantly more likely than HIV-uninfected peers to be unemployed; have STIs, and engage in URAI. Almost half the men in each group were poor, had depressive symptoms, and expressed internalized homophobia.ConclusionsND HIV-infected Black MSM were more likely to be unemployed, have bacterial STIs and engage in URAI than other Black MSM. Culturally-tailored programs that address economic disenfranchisement, increase engagement in care, screen for STIs, in conjunction with safer sex prevention interventions, may help to decrease further transmission in this heavily affected community.
Highlights
In the United States (US), sex between men is the most common mode of HIV transmission, and, Black men who have sex with men (MSM) have the highest HIV prevalence and incidence, compared to any other US subpopulation [1,2]
The current analysis was designed to evaluate the interactions of these different factors, by comparing their prevalence among participants who were newly diagnosed with HIV, to those were previously diagnosed with HIV, and those who were HIV-uninfected at enrollment, in order to better understand contemporary potentiators of the disproportionate spread of HIV among Black MSM
Compared to men who were HIV-uninfected at enrollment, men who were newly diagnosed with HIV were less likely to be working (21% vs. 35%, p = 0.011), less likely to have college education (35% vs. 46%, p = 0.049), and were less likely to report not having enough money for rent, food, or utilities (14% vs. 25%, p = 0.030)
Summary
In the United States (US), sex between men is the most common mode of HIV transmission, and, Black men who have sex with men (MSM) have the highest HIV prevalence and incidence, compared to any other US subpopulation [1,2]. For prevention interventions to be successful, public health officials and clinicians need to better understand specific contextual factors that are contributing to this concentrated epidemic. Previous studies have often evaluated how specific sociobehavioral factors (such as partner mixing patterns, use of drugs during sex), structural factors (such as poverty, homelessness), or biological factors (such as concomitant sexually transmitted infections) each contribute to the disproportionate rates of HIV among Black MSM. The current analysis was designed to evaluate the interactions of these different factors, by comparing their prevalence among participants who were newly diagnosed with HIV, to those were previously diagnosed with HIV, and those who were HIV-uninfected at enrollment, in order to better understand contemporary potentiators of the disproportionate spread of HIV among Black MSM. American Black men who have sex with men (MSM) are disproportionately affected by HIV, but the factors associated with this concentrated epidemic are not fully understood
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
