Linkage and retention in HIV care among men who have sex with men in the United States

Abstract

Men who have sex with men (MSM) continue to be disproportionately affected by human immunodeficiency virus (HIV) infection. While the MSM population does better than other HIV infection risk groups with regard to linkage to and retention in care, little is known about engagement in care outcomes for important subpopulations of MSM. There is also a dearth of research on engagement in care strategies specific to the MSM population. Key MSM subpopulations in the United States on which to focus future research efforts include racial/ethnic minority, young, and substance-using MSM. Health care systems navigation may offer a promising engagement in care strategy for MSM and should be further evaluated. As is the case for HIV-infected populations in general, future research should also focus on identifying the best metrics for measuring engagement in care.

Figure 1.

The continuum of engagement in human immunodeficiency virus (HIV) care, as represented by the Health Resources and Services Administration (HRSA). Reprinted from Cheever [27] with permission from the University of Chicago Press.

Figure 2.

The behavioral model for vulnerable populations. The model has been adapted by the authors, with additional components that influence health behaviors and outcomes shown in bold italics. Adapted with permission from Gelberg et al [36] and Ulett et al [19].