Increases in HIV testing among men who have sex with men--National HIV Behavioral Surveillance System, 20 U.S. Metropolitan Statistical Areas, 2008 and 2011.

Laura A Cooley,Charles E Rose,Gabriela Paz-Bailey,Binh C Le,Alexandra M Oster,Cyprian Wejnert,Joan A Caylà

doi:10.1371/journal.pone.0104162

Abstract

In 2011, 62% of estimated new HIV diagnoses in the United States were attributed to male-to-male sexual contact (men who have sex with men, MSM); 39% of these MSM were black or African American. HIV testing, recommended at least annually by CDC for sexually active MSM, is an essential first step in HIV care and treatment for HIV-positive individuals. A variety of HIV testing initiatives, designed to reach populations disproportionately affected by HIV, have been developed at both national and local levels. We assessed changes in HIV testing behavior among MSM participating in the National HIV Behavioral Surveillance System in 2008 and 2011. We compared the percentages tested in the previous 12 months in 2008 and 2011, overall and by race/ethnicity and age group. In unadjusted analyses, recent HIV testing increased from 63% in 2008 to 67% in 2011 overall (P<0.001), from 63% to 71% among black MSM (P<0.001), and from 63% to 75% among MSM of other/multiple races (P<0.001); testing did not increase significantly for white or Hispanic/Latino MSM. Multivariable model results indicated an overall increase in recent HIV testing (adjusted prevalence ratio [aPR] = 1.07, P<0.001). Increases were largest for black MSM (aPR = 1.12, P<0.001) and MSM of other/multiple races (aPR = 1.20, P<0.001). Among MSM aged 18–19 years, recent HIV testing was shown to increase significantly among black MSM (aPR = 1.20, P = 0.007), but not among MSM of other racial/ethnic groups. Increases in recent HIV testing among populations most affected by HIV are encouraging, but despite these increases, improved testing coverage is needed to meet CDC recommendations.

Highlights

1.1 million people in the United States are living with HIV [1], and an estimated 50,000 new infections occur each year [2]
Unadjusted prevalence of recent HIV testing in 2008 and 2011, as shown in Table 2, demonstrates an increase from 63% in 2008 to 67% in 2011 overall (P,0.001), from 63% to 71% among black MSM (P,0.001), and from 63% to 75% (P,0.001) among MSM of other/multiple races
Consistent with the unadjusted results, the adjusted increases in testing were significant for black MSM and MSM of other/ multiple races (Table 2)

Summary

Introduction

1.1 million people in the United States are living with HIV [1], and an estimated 50,000 new infections occur each year [2]. While MSM represent only an estimated 4% of the male population in the United States [3], they accounted for approximately 79% of estimated new HIV diagnoses among adult and adolescent males and approximately 62% of estimated new HIV diagnoses overall in the United States in 2011 [4]. From 2008 to 2011, adult and adolescent MSM were the only group among whom the annual number of new HIV diagnoses increased [4]. Despite representing approximately 13% of the U.S population [5], blacks accounted for 47% of estimated new HIV diagnoses in 2011 [4].

Methods

Results

Discussion

Conclusion