Estimation of HIV Prevalence,Risk Factors,and Testing Frequency among Sexually Active Men Who Have Sex with Men,Aged 18–64 Years—New York City, 2002 |
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Authors: | Susan E Manning Lorna E Thorpe Chitra Ramaswamy Anjum Hajat Melissa A Marx Adam M Karpati Farzad Mostashari Melissa R Pfeiffer Denis Nash |
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Institution: | (1) Massachusetts Department of Public Health, Bureau of Family and Community Health, 250 Washington Street, 4th Floor, Boston, MA 02108, USA |
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Abstract: | Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with
men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two
population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing
patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of
living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected
males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey
were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated
using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4%
overall (95% confidence interval CI] = 7.5–9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black
(12.6%, 95% CI = 9.8–17.6), aged 35–44 (12.6%, 95% CI = 10.4–15.9), or 45–54 years (13.1%, 95% CI = 10.2–18.3), and residents
of Manhattan (17.7%, 95% CI = 14.5–22.8). Overall, 37% (95% CI = 32–43%) of MSM reported using a condom at last sex, and 34%
(95% CI = 28–39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning
a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates
(11.0–13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence
of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the
epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population,
condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related
information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom
use and encouraging safer sex practices among all sexually active MSM, particularly those groups with low levels of condom
use and multiple sex partners
At the time this work was conducted, Manning and Marx were with the Epidemic Intelligence Service, Office of Workforce and
Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA; Thorpe, Ramaswamy, Hajat, Marx, Karpati,
Mostashari, and Pfeiffer are with the New York City Department of Health and Mental Hygiene, New York, NY, USA; Nash is with
the Department of Epidemiology and International Center for AIDS Care and Treatment Programs, Columbia Mailman School of Public
Health, New York, NY, USA; Manning is with the Massachusetts Department of Public Health, Bureau of Family and Community Health,
Boston, MA, USA. |
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Keywords: | Condom use HIV prevalence HIV testing Human immunodeficiency virus Men who have sex with men |
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