Abstract
The prevalence of HIV infection is disproportionately higher in both racial/ethnic minority men who have sex with men (MSM) and in men under the age of 25, where the leading exposure category is homosexual contact. Less is known, however, about patterns of HIV prevalence in young racial/ethnic minority MSM. We analyzed data from the Young men’s Survey (YMS), an anonymous, corss-sectional survey of 351 MSM in Baltimore and 529 MSM in New York City, aged 15–22, to determine whether race/ethnicity differences exist in the prevalence of HIV infection and associated risk factors. Potential participants were selected systematically at MSM-identified public venues. Venues and associated time periods for subject selection were selected randomly on a monthly basis. Eligible and willing subjects provided informed consent and underwent an interview, HIV pretest counseling, and a blood draw for HIV antibody testing. In multivariate analysis, adjusted for city of recruitment, and age, HIV seroprevalence was highest for African Americans [adjusted odds ratio (AOR)=12.5], intermediate for those of “other/mixed” race/ethnicity (AOR=8.6), and moderately elevated for Hispanics (AOR=4.6) as compared to whites. Stratified analysis showed different risk factors for HIV prevalence in each ethnic group: for African Americans, these were history of sexually transmitted diseases (STDs) and not being in school; for Hispanics, risk factors were being aged 20–22, greater number of male partners and use of recreational drugs; and for those of “other/mixed” race/ethnicity, risk factors included injection drug use and (marginally) STDs. These findings suggest the need for HIV prevention and testing programs which target young racial/ethnic, minority MSM and highlight identified risk factors and behaviors.
Keywords: Adolescents, Drug use, HIV prevalence, Men who have sex with men, Race ethnicity, Sexual behavior
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References
- 1.Karon JM, Fleming PL, Steketee RW, Cock KM. HIV in the United States at the turn of the century: an epidemic in transition. Am J Public Health. 2001;91:1060–1068. doi: 10.2105/ajph.91.7.1060. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.HIV/AIDS Surveillance Report. Atlanta, GA: CDC; 2002. pp. 20–20. [Google Scholar]
- 3.Ciesielski CA. Sexually transmitted diseases in men who have sex with men: an epidemiologic review. Curr Infect Dis Rep. 2003;5:145–152. doi: 10.1007/s11908-003-0051-5. [DOI] [PubMed] [Google Scholar]
- 4.Fox KK, Rio C, Holmes KK, et al. Gonorrhea in the HIV era: a reversal of trends among men who have sex with men. Am J Public Health. 2001;91:959–964. doi: 10.2105/ajph.91.6.959. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Centers for Disease Control and Prevention. 2003 STD surveillance report. Available at: http://www.cdc.gov/std/stats/trends2003.htm#5. Accessed May 3, 2005.
- 6.Centers for Disease Control and Prevention Increases in HIV diagnoses-29 states, 1999–2002. MMWR Morb Mortal Wkly Rep. 2003;52:1145–1148. [PubMed] [Google Scholar]
- 7.Lemp GF, Hirozawa AM, Givertz D, et al. Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. JAMA. 1994;272:449–454. doi: 10.1001/jama.272.6.449. [DOI] [PubMed] [Google Scholar]
- 8.Dean L, Meyer I. HIV prevalence and sexual behavior in a cohort of New York City gay men (aged 18–24) J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8:208–211. [PubMed] [Google Scholar]
- 9.Osmond DH, Page K, Wiley J, et al. HIV infection in homosexual and bisexual men 18–29 years of age: the San Francisco Young Men’s Health Study. Am J Public Health. 1994;84:1933–1937. doi: 10.2105/ajph.84.12.1933. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Stall RD, Hays RB, Waldo CR, Ekstrand M, McFarland W. The gay ’90s: a review of research on sexual behavior and HIV risk among men who have sex with men. AIDS. 2000;14:S101–S114. doi: 10.1097/00002030-200001070-00019. [DOI] [PubMed] [Google Scholar]
- 11.Mansergh G, Marks G. Age and risk of HIV infection in men who have sex with men. AIDS. 1998;12:1119–1128. doi: 10.1097/00002030-199810000-00003. [DOI] [PubMed] [Google Scholar]
- 12.Centers for Disease Control and Prevention HIV/AIDS among racial/ethnic minority men who have sex with men- United States, 1989–1998. MMWR Morb Mortal Wkly Rep. 2000;49:4–11. [PubMed] [Google Scholar]
- 13.Catania JA, Osmond D, Stall R, et al. The continuing HIV epidemic among men who have sex with men. Am J Public Health. 2001;91:907–914. doi: 10.2105/ajph.91.6.907. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Torian LV, Makki HA, Menzies IB, et al. HIV infection in men who have sex with men, New York City Department of Health Sexually Transmitted Disease, Clinics, 1990–1999: a decade of serosurveillance finds that racial disparities and associations between HIV and gonorrhea persist. Sex Transm Dis. 2002;29:73–78. doi: 10.1097/00007435-200202000-00002. [DOI] [PubMed] [Google Scholar]
- 15.Valleroy LA, MacKellar DA, Karon JM, et al. HIV prevalence and associated risks in young men who have sex with men. JAMA. 2000;284:198–204. doi: 10.1001/jama.284.2.198. [DOI] [PubMed] [Google Scholar]
- 16.Harawa NT, Greenland S, Bingham TA, et al. Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States. J Acquir Immune Defic Syndr. 2004;35:526–536. doi: 10.1097/00126334-200404150-00011. [DOI] [PubMed] [Google Scholar]
- 17.Sifakis F, Hylton J, Flynn C, et al. High rates of HIV prevalence and incidence among young men who have sex with men. Predictors of prevalence and prior HIV testing in the Baltimore Young Men’s Survey. Paper presented at: 128th APHA Conference; Nov. 7–11, 2000; Boston, MA. Abstract session 3116.
- 18.Koblin BA, Torian LV, Guilin V, Ren L, MacKellar DA, Valleroy LA. High prevalence of HIV infection among young men who have sex with men in New York City. AIDS. 2000;14:1793–1800. doi: 10.1097/00002030-200008180-00015. [DOI] [PubMed] [Google Scholar]
- 19.MacKellar DA, Valleroy LA, Karon J, Lemp G, Janssen R. The Young Men’s Survey: methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. Public Health Rep. 1996;111:138–144. [PMC free article] [PubMed] [Google Scholar]
- 20.Ascher DP, Roberts C. Determination of the etiology of seroreversals in HIV testing by antibody fingerprinting. J Acquir Immune Defic Syndr. 1993;6:241–244. [PubMed] [Google Scholar]
- 21.Bingham TA, Harawa NT, Johnson DF, Secura GM, MacKellar DA, Valleroy LA. The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men’s Survey, Los Angeles 1999–2000. AIDS Educ Prev. 2003;15:39–52. doi: 10.1521/aeap.15.1.5.39.23613. [DOI] [PubMed] [Google Scholar]
- 22.Morris M, Zavisca J, Dean L. Social and sexual networks: their role in the spread of HIV/AIDS among gay men. AIDS Educ Prev. 1995;7:24–35. [PubMed] [Google Scholar]
- 23.Strathdee SA, Hogg RS, Martindale SL, et al. Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;19:61–66. doi: 10.1097/00042560-199809010-00010. [DOI] [PubMed] [Google Scholar]
- 24.Myers HF, Javabakht M, Martinez M, Obediah S. Psychosocial predictors of risky sexual behaviors in African American men: implications for prevention. AIDS Educ Prev. 2003;15:66–79. doi: 10.1521/aeap.15.1.5.66.23615. [DOI] [PubMed] [Google Scholar]
- 25.Stueve A, O’Donnel L, Duran R, et al. Being high and taking sexual risks: findings from a multisite survey of urban young men who have sex with men. AIDS Educ Prev. 2002;14:482–495. doi: 10.1521/aeap.14.8.482.24108. [DOI] [PubMed] [Google Scholar]
- 26.Woody GE, Donnell D, Seage GR, et al. Non-injection substance use correlates with risky sex among men having sex with men: data from HIVNET. Drug Alcohol Depend. 1999;53:197–205. doi: 10.1016/S0376-8716(98)00134-3. [DOI] [PubMed] [Google Scholar]
- 27.Torian LV, Weisfuse IB, Makki HA, et al. Trends in HIV seroprevalence in men who have sex with men: New York City Department of Health Sexually Transmitted Disease Clinics, 1988–1993. AIDS. 1996;10:187–192. doi: 10.1097/00002030-199602000-00009. [DOI] [PubMed] [Google Scholar]
- 28.Ford K, Norris A. Sexual networks of African-American and Hispanic youth. Sex Transm Dis. 1997;24:327–333. doi: 10.1097/00007435-199707000-00004. [DOI] [PubMed] [Google Scholar]
- 29.Stall R. How to lose the fight against AIDS among gay men: declare victory and leave the field. BMJ. 1994;309:685–686. doi: 10.1136/bmj.309.6956.685. [DOI] [PMC free article] [PubMed] [Google Scholar]