HIV infection and awareness among men who have sex with men-20 cities, United States, 2008 and 2011

Abstract

Over half of HIV infections in the United States occur among men who have sex with men (MSM). Awareness of infection is a necessary precursor to antiretroviral treatment and risk reduction among HIV-infected persons. We report data on prevalence and awareness of HIV infection among MSM in 2008 and 2011, using data from 20 cities participating in the 2008 and 2011 National HIV Behavioral Surveillance System (NHBS) among MSM. Venue-based, time-space sampling was used to recruit men for interview and HIV testing. We analyzed data for men who reported ≥ 1 male sex partner in the past 12 months. Participants who tested positive were considered to be aware of their infection if they reported a prior positive HIV test. We used multivariable analysis to examine differences between results from 2011 vs. 2008. HIV prevalence was 19% in 2008 and 18% in 2011 (p = 0.14). In both years, HIV prevalence was highest among older age groups, blacks, and men with lower education and income. In multivariable analysis, HIV prevalence did not change significantly from 2008 to 2011 overall (p = 0.51) or in any age or racial/ethnic category (p>0.15 in each category). Among those testing positive, a greater proportion was aware of their infection in 2011 (66%) than in 2008 (56%) (p<0.001). In both years, HIV awareness was higher for older age groups, whites, and men with higher education and income. In multivariable analysis, HIV awareness increased from 2008 to 2011 overall (p<0.001) and for all age and racial/ethnic categories (p<0.01 in each category). In both years, black MSM had the highest HIV prevalence and the lowest awareness among racial/ethnic groups. These findings suggest that HIV-positive MSM are increasingly aware of their infections.

Figure 1. Prevalence and awareness of HIV status among MSM.

(A) HIV prevalence of MSM interviewed in 2008 and 2011 by race/ethnicity. Compared to white MSM, black MSM were nearly twice (PR: 1.99) as likely to be HIV positive. (B) Awareness of HIV infection among MSM interviewed in 2008 and 2011 by race/ethnicity. Compared to white MSM, black MSM were 40% (PR: 0.60) less likely to be aware of their HIV infection status. *PRs (prevalence ratios) based on combined 2008, 2011 data. Separate analysis of 2008 and 2011 data produced similar results for prevalence and awareness in both 2008 and 2011 (not shown). CI: 95% confidence interval.