HIV and AIDS among men of color who have sex with men and men of color who have sex with men and women: an epidemiological profile.

Abstract

In the United States, more than half of the cumulative total of adult male AIDS cases are among men who have sex with men (MSM) (Centers for Disease Control and Prevention [CDC], 2001). Even with an increase in reported AIDS cases among injection drug users (IDUs) and heterosexual men in the past decade, MSM continue to constitute the largest proportion of annually reported AIDS cases in this country. In the most recent CDC report, a total of 31,901 adult male AIDS cases were reported. Of these, the largest proportion of cases (42%) was among MSM compared with 16% among IDUs, 9% among heterosexuals, 5% among MSM IDUs, and 28% whose risk was not reported (CDC, 2001). A similar pattern exists in HIV infection rates among males. Cumulative rates of HIV infection for MSM exceed those of IDUs and heterosexuals (CDC, 2001). Even with new HIV infections, MSM are still the largest subgroup among males (CDC, 2001). In the United States, however, the AIDS epidemic has had a disproportional impact on racial and ethnic populations. Today, it is people of color who carry the burden of this disease. In 2000, for example, the U.S. AIDS rate among non-Hispanic Blacks was 57 per 100,000, among Hispanic/Latinos the rate was 22 per 100,000, among Asian-Pacific Islanders (APIs) the rate was 3 per 100,000, and among Whites the rate was 6 per 100,000 (CDC, 2002; U.S Census Bureau, 2002). As we enter the 3rd decade of this epidemic, MSM of color represent the largest number of persons living with AIDS in this country. In communities of color, the impact of AIDS is even more uneven across ethnic groups in large urban epicenters such as Chicago, Miami, New York, San Francisco, and Los Angeles. In Chicago, for example, HIV disease disproportionately affects non-Hispanic Blacks compared with other ethnic groups. Since 1990, non-Hispanic Blacks have had the highest annual AIDS incidence rates in the city. The most recently reported AIDS rate for non-Hispanic Blacks was 54 per 100,000 compared with 18 per 100,000 for Hispanics/Latinos, and 14 per 100,000 for Whites (Chicago Department of Health, 2002). In other parts of the country, such as Miami, non-Hispanic AIDS Education and Prevention, 15, Supplement A, 1–6, 2003 © 2003 The Guilford Press