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. 2001 Jun;91(6):907-14.
doi: 10.2105/ajph.91.6.907.

The continuing HIV epidemic among men who have sex with men

J A Catania  1 , D Osmond, R D Stall, L Pollack, J P Paul, S Blower, D Binson, J A Canchola, T C Mills, L Fisher, K H Choi, T Porco, C Turner, J Blair, J Henne, L L Bye, T J Coates
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The continuing HIV epidemic among men who have sex with men

J A Catania et al. Am J Public Health. 2001 Jun.

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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