Racial/ethnic and age disparities in HIV prevalence and disease progression among men who have sex with men in the United States

Abstract

Objectives: We examined HIV diagnosis rates and disease progression among men who have sex with men (MSM) according to race/ethnicity and age.

Methods: Using data obtained from the national HIV/AIDS surveillance system, we examined trends in HIV diagnosis rates for 2001 through 2004 using Poisson regression. We used a standardized Kaplan-Meier method to determine differences in time of progression from HIV to AIDS and AIDS survival.

Results: HIV diagnosis rates were higher for Black and Hispanic than for White MSM, but trends within age groups from 2001 to 2004 did not differ by race/ethnicity. Diagnosis rates increased among MSM aged 13 to 19 years (14% per year), 20 to 24 years (13%), 25 to 29 years, and 40 to 54 years (3%-6%; P< or = .01 for each). The percentage of MSM who did not have AIDS 3 years after HIV diagnosis was lower among Black (66.8%; 95% confidence interval [CI]=66.1, 67.4) and Hispanic (68.1%; 95% CI=67.5, 68.8) than among White MSM (74.7%; 95% CI=74.2, 75.1). Three-year survival after AIDS diagnosis was lower for Black than for White or Hispanic MSM.

Conclusions: HIV prevention efforts should target young and middle-aged MSM and must offer early diagnosis and treatment for all MSM.

FIGURE 1—

Estimated rates of HIV diagnoses (per 100 000 male population), by race/ethnicity, among men who have sex with men aged (a) 13–19 years, (b) 20–24, (c) 25–29, (d) 30–34, and (e) 35–39: 33 US states, 2001–2004. Note. Lines are modeled rates; symbols are actual rates. Additional information regarding estimated rates of HIV diagnoses is available as a supplement to the online version of this article.