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. 2001 Jun;91(6):907–914. doi: 10.2105/ajph.91.6.907

The continuing HIV epidemic among men who have sex with men.

J A Catania 1, D Osmond 1, R D Stall 1, L Pollack 1, J P Paul 1, S Blower 1, D Binson 1, J A Canchola 1, T C Mills 1, L Fisher 1, K H Choi 1, T Porco 1, C Turner 1, J Blair 1, J Henne 1, L L Bye 1, T J Coates 1
PMCID: PMC1446467  PMID: 11392933

Abstract

OBJECTIVES: This study characterized the AIDS epidemic among urban men who have sex with men (MSM). METHODS: A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures. RESULTS: HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were non-significant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1%-2%). CONCLUSIONS: Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.

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Selected References

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  1. Anderson J. E., Nelson D. E., Wilson R. W. Telephone coverage and measurement of health risk indicators: data from the National Health Interview Survey. Am J Public Health. 1998 Sep;88(9):1392–1395. doi: 10.2105/ajph.88.9.1392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Catania J. A., Binson D., Stone V. Relationship of sexual mixing across age and ethnic groups to herpes simplex virus-2 among unmarried heterosexual adults with multiple sexual partners. Health Psychol. 1996 Sep;15(5):362–370. doi: 10.1037//0278-6133.15.5.362. [DOI] [PubMed] [Google Scholar]
  3. Catania J. A., Coates T. J., Stall R., Bye L., Kegeles S. M., Capell F., Henne J., McKusick L., Morin S., Turner H. Changes in condom use among homosexual men in San Francisco. Health Psychol. 1991;10(3):190–199. doi: 10.1037//0278-6133.10.3.190. [DOI] [PubMed] [Google Scholar]
  4. Choi K. H., Catania J. A., Dolcini M. M. Extramarital sex and HIV risk behavior among US adults: results from the National AIDS Behavioral Survey. Am J Public Health. 1994 Dec;84(12):2003–2007. doi: 10.2105/ajph.84.12.2003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cooley P. C., Myers L. E., Hamill D. N. A meta-analysis of estimates of the AIDS incubation distribution. Eur J Epidemiol. 1996 Jun;12(3):229–235. doi: 10.1007/BF00145410. [DOI] [PubMed] [Google Scholar]
  6. Ekstrand M. L., Stall R. D., Paul J. P., Osmond D. H., Coates T. J. Gay men report high rates of unprotected anal sex with partners of unknown or discordant HIV status. AIDS. 1999 Aug 20;13(12):1525–1533. doi: 10.1097/00002030-199908200-00013. [DOI] [PubMed] [Google Scholar]
  7. Fullilove M. T., Wiley J., Fullilove R. E., 3rd, Golden E., Catania J., Peterson J., Garrett K., Siegel D., Marin B., Kegeles S. Risk for AIDS in multiethnic neighborhoods in San Francisco, California. The population-based AMEN Study. West J Med. 1992 Jul;157(1):32–40. [PMC free article] [PubMed] [Google Scholar]
  8. Gail M. H., Rosenberg P. S., Goedert J. J. Therapy may explain recent deficits in AIDS incidence. J Acquir Immune Defic Syndr. 1990;3(4):296–306. [PubMed] [Google Scholar]
  9. Hahn R. A., Magder L. S., Aral S. O., Johnson R. E., Larsen S. A. Race and the prevalence of syphilis seroreactivity in the United States population: a national sero-epidemiologic study. Am J Public Health. 1989 Apr;79(4):467–470. doi: 10.2105/ajph.79.4.467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Holmberg S. D. The estimated prevalence and incidence of HIV in 96 large US metropolitan areas. Am J Public Health. 1996 May;86(5):642–654. doi: 10.2105/ajph.86.5.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. McFarland W., Busch M. P., Kellogg T. A., Rawal B. D., Satten G. A., Katz M. H., Dilley J., Janssen R. S. Detection of early HIV infection and estimation of incidence using a sensitive/less-sensitive enzyme immunoassay testing strategy at anonymous counseling and testing sites in San Francisco. J Acquir Immune Defic Syndr. 1999 Dec 15;22(5):484–489. doi: 10.1097/00126334-199912150-00009. [DOI] [PubMed] [Google Scholar]
  12. Mills T. C., Stall R., Pollack L., Paul J. P., Binson D., Canchola J., Catania J. A. Health-related characteristics of men who have sex with men: a comparison of those living in "gay ghettos" with those living elsewhere. Am J Public Health. 2001 Jun;91(6):980–983. doi: 10.2105/ajph.91.6.980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Moss A. R., Osmond D., Bacchetti P., Chermann J. C., Barre-Sinoussi F., Carlson J. Risk factors for AIDS and HIV seropositivity in homosexual men. Am J Epidemiol. 1987 Jun;125(6):1035–1047. doi: 10.1093/oxfordjournals.aje.a114619. [DOI] [PubMed] [Google Scholar]
  14. Osmond D. H., Catania J., Pollack L., Canchola J., Jaffe D., MacKellar D., Valleroy L. Obtaining HIV test results with a home collection test kit in a community telephone sample. J Acquir Immune Defic Syndr. 2000 Aug 1;24(4):363–368. doi: 10.1097/00126334-200008010-00011. [DOI] [PubMed] [Google Scholar]
  15. Osmond D. H., Page K., Wiley J., Garrett K., Sheppard H. W., Moss A. R., Schrager L., Winkelstein W. HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study. Am J Public Health. 1994 Dec;84(12):1933–1937. doi: 10.2105/ajph.84.12.1933. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rosenberg P. S., Gail M. H., Carroll R. J. Estimating HIV prevalence and projecting AIDS incidence in the United States: a model that accounts for therapy and changes in the surveillance definition of AIDS. Stat Med. 1992 Sep 30;11(13):1633–1655. doi: 10.1002/sim.4780111302. [DOI] [PubMed] [Google Scholar]
  17. Schwartländer B., Stanecki K. A., Brown T., Way P. O., Monasch R., Chin J., Tarantola D., Walker N. Country-specific estimates and models of HIV and AIDS: methods and limitations. AIDS. 1999 Dec 3;13(17):2445–2458. doi: 10.1097/00002030-199912030-00017. [DOI] [PubMed] [Google Scholar]
  18. Service S. k., Blower S. M. HIV transmission in sexual networks: an empirical analysis. Proc Biol Sci. 1995 Jun 22;260(1359):237–244. doi: 10.1098/rspb.1995.0086. [DOI] [PubMed] [Google Scholar]
  19. Siegel D., Golden E., Washington A. E., Morse S. A., Fullilove M. T., Catania J. A., Marin B., Hulley S. B. Prevalence and correlates of herpes simplex infections. The population-based AIDS in Multiethnic Neighborhoods Study. JAMA. 1992 Oct 7;268(13):1702–1708. [PubMed] [Google Scholar]
  20. Sullivan P. S., Chu S. Y., Fleming P. L., Ward J. W. Changes in AIDS incidence for men who have sex with men, United States 1990-1995. AIDS. 1997 Nov;11(13):1641–1646. doi: 10.1097/00002030-199713000-00014. [DOI] [PubMed] [Google Scholar]
  21. Winkelstein W., Jr, Lyman D. M., Padian N., Grant R., Samuel M., Wiley J. A., Anderson R. E., Lang W., Riggs J., Levy J. A. Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study. JAMA. 1987 Jan 16;257(3):321–325. [PubMed] [Google Scholar]
  22. Winkelstein W., Jr, Samuel M., Padian N. S., Wiley J. A., Lang W., Anderson R. E., Levy J. A. The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86. Am J Public Health. 1987 Jun;77(6):685–689. doi: 10.2105/ajph.77.6.685. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Winkelstein W., Jr, Wiley J. A., Padian N. S., Samuel M., Shiboski S., Ascher M. S., Levy J. A. The San Francisco Men's Health Study: continued decline in HIV seroconversion rates among homosexual/bisexual men. Am J Public Health. 1988 Nov;78(11):1472–1474. doi: 10.2105/ajph.78.11.1472. [DOI] [PMC free article] [PubMed] [Google Scholar]

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