Racial/ethnic and age disparities in HIV prevalence and disease progression among men who have sex with men in the United States.

Abstract

We examined HIV diagnosis rates and disease progression among men who have sex with men (MSM) according to race/ethnicity and age. Using data obtained from the national HIV/AIDS surveillance system, we examined trends in HIV diagnosis rates for 2001 through 2004 using Poisson regression. We used a standardized Kaplan-Meier method to determine differences in time of progression from HIV to AIDS and AIDS survival. HIV diagnosis rates were higher for Black and Hispanic than for White MSM, but trends within age groups from 2001 to 2004 did not differ by race/ethnicity. Diagnosis rates increased among MSM aged 13 to 19 years (14% per year), 20 to 24 years (13%), 25 to 29 years, and 40 to 54 years (3%-6%; P< or = .01 for each). The percentage of MSM who did not have AIDS 3 years after HIV diagnosis was lower among Black (66.8%; 95% confidence interval [CI]=66.1, 67.4) and Hispanic (68.1%; 95% CI=67.5, 68.8) than among White MSM (74.7%; 95% CI=74.2, 75.1). Three-year survival after AIDS diagnosis was lower for Black than for White or Hispanic MSM. HIV prevention efforts should target young and middle-aged MSM and must offer early diagnosis and treatment for all MSM.