The key to reining in this trend is to link this group to health services as early as possible. The key to linkage, in turn, is testing. A new study finds room for improvement in meeting CDC testing coverage recommendations.
The small percentage of gay, bisexual, and other men who have sex with men (MSM) account for about two-thirds of the estimated new HIV diagnoses in the United States, according to a newly released HIV surveillance report by the CDC on MSM in 20 US cities.
From 2008 to 2011, adult and adolescent MSM were the only group who showed an increase in the annual number of new HIV diagnoses. Black MSM, young ones in particular, are most affected. Despite representing about 13% of the US population, blacks accounted for nearly half of the estimated new HIV diagnoses in 2011.
“Considering the disproportionate burden of HIV among MSM and blacks, it is not surprising that the burden upon black MSM is also disproportionate,” stated the authors. More than one-third of estimated new HIV diagnoses among MSM in 2011 occurred among black MSM. More than half of MSM aged 13 to 24 years with a diagnosis of HIV infection in 2011 were black.
Achieving awareness of HIV infection through testing is an essential first step to linking HIV-positive patients to medical care and services, such as antiretroviral therapy, which can result in improved clinical outcomes. A variety of HIV testing initiatives, designed to reach populations disproportionately affected by HIV, have been developed at both the national and local levels. Research shows that once receiving a diagnosis of HIV, patients reduce risk behaviors, which, in combination with viral suppression, can reduce the likelihood of transmitting HIV to others, the researchers noted.
Currently, the CDC recommends that persons at increased risk for HIV infection, including sexually active MSM, should undergo HIV testing at least annually. Previous analyses suggested that more frequent HIV testing may be beneficial for all MSM, irrespective of their risk behavior.
The researchers, led by Laura Cooley Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, CDC, Atlanta, assessed changes in HIV testing behavior among MSM participating in the National HIV Behavioral Surveillance System in 2008 and 2011. They 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 significantly from 63% in 2008 to 67% in 2011 overall, from 63% to 71% among black MSM, and from 63% to 75% among MSM of other/multiple races. Testing did not increase significantly for white or Hispanic/Latino MSM.
A multivariable model indicated an overall increase in recent HIV testing. Increases were largest for black MSM and MSM of other/multiple races. Among MSM aged 18 to 19 years, recent HIV testing was shown to increase significantly among black MSM 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,” stated the authors.
The researchers reported their results in the September 02, 2014, issue of PLoSOne.
Cooley LA, Oster AM, Rose CE, et al, for the NHSB Study Group. 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. September 02, 2014. DOI: 10.1371/journal.pone.0104162,