Abstract

Approximately 80% of new HIV infections in the United States occur in men. Four out of five men diagnosed with HIV infection are men who have sex with men (MSM), with an increasing proportion of young MSM (i.e. ≤24 years of age). We performed a retrospective analysis 11,873 cisgender men participating in a community based HIV screening program in San Diego between 2008 and 2014 to characterize the HIV prevalence and sexual risk behaviors among young men. In young heterosexual men HIV prevalence was lower compared to heterosexual men between 25 and 49 years of age (0.3% vs. 1.4%, p = 0.043). Among young MSM, HIV prevalence was 5.5%, per test positivity rate 3.6%, and HIV incidence 3.4 per 100 person years (95% CI 2.2–5.4). Per test positivity rate (p = 0.008) and incidence (p < 0.001) were significantly higher among young MSM than among MSM above 24-years of age. Young MSM diagnosed with HIV infection reported significantly more serodiscordant condomless anal intercourse, bacterial sexually transmitted infections, and higher rates of methamphetamine and gamma hydroxybutyrate use when compared to young MSM who tested negative. In conclusion, young MSM are particularly vulnerable to HIV infection and may represent ideal candidates for targeted prevention interventions that increase testing uptake and/or decrease the risk of acquiring HIV infection.

Highlights

  • Men account for about 80% of new HIV infections in the United States[1]

  • Young men who have sex with men (MSM) were more likely to report Hispanic ethnicity and less likely white race when compared to older MSM (p < 0.001)

  • Among young MSM, HIV prevalence was 5.5%, and per test positivity rate was 3.6%

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Summary

Introduction

Men account for about 80% of new HIV infections in the United States[1]. While most HIV infections are still diagnosed in men above 25 years of age, HIV incidence and prevalence among young MSM While a number of studies have evaluated prevalence and incidence of HIV infection among young MSM in settings where African Americans account for a significant proportion of the population[3,4,5,6,7,8,9,10], fewer studies have characterized HIV risk among young MSM in other settings of the United States[11]. The objective of this study was to examine prevalence and incidence of HIV, as well as racial disparities and risk behavior, all stratified by age, among men undergoing community-based testing in San Diego, where African Americans represent less than 7% of the population

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