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. 2014 Jan 1;65(1):115-21.
doi: 10.1097/QAI.0b013e3182a98bae.

Age, race/ethnicity, and behavioral risk factors associated with per contact risk of HIV infection among men who have sex with men in the United States

Hyman M Scott  1 , Eric Vittinghoff, Risha Irvin, Darpun Sachdev, Albert Liu, Marc Gurwith, Susan P Buchbinder
Affiliations

Age, race/ethnicity, and behavioral risk factors associated with per contact risk of HIV infection among men who have sex with men in the United States

Hyman M Scott et al. J Acquir Immune Defic Syndr. .

Abstract

Objective: Young men who have sex with men (MSM) and MSM of color have the highest HIV incidence in the United States. To explore possible explanations for these disparities and known individual risk factors, we analyzed the per contact risk (PCR) of HIV seroconversion in the early highly active antiretroviral therapy era.

Methods: Data from 3 longitudinal studies of MSM (HIV Network for Prevention Trials Vaccine Preparedness Study, EXPLORE behavioral efficacy trial, and VAX004 vaccine efficacy trial) were pooled. The analysis included visits where participants reported unprotected receptive anal intercourse (URA), protected receptive anal intercourse, or unprotected insertive anal intercourse (UIA) with an HIV seropositive, unknown HIV serostatus, or an HIV seronegative partner. We used regression standardization to estimate average PCRs for each type of contact, with bootstrap confidence intervals.

Results: The estimated PCR was highest for URA with an HIV seropositive partner (0.73%; 95% bootstrap confidence interval [BCI]: 0.45% to 0.98%) followed by URA with a partner of unknown HIV serostatus (0.49%; 95% BCI: 0.32% to 0.62%). The estimated PCR for protected receptive anal intercourse and UIA with an HIV seropositive partner was 0.08% (95% BCI: 0.0% to 0.19%) and 0.22% (95% BCI: 0.05% to 0.39%), respectively. Average PCRs for URA and UIA with HIV seropositive partners were higher by 0.14%-0.34% among younger participants and higher by 0.08% for UIA among Latino participants compared with white participants. Estimated PCRs increased with the increasing number of sexual partners, use of methamphetamines or poppers, and history of sexually transmitted infection.

Conclusions: Susceptibility or partner factors may explain the higher HIV conversion risk for younger MSM, some MSM of color, and those reporting individual risk factors.

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Figures

Figure 1
Figure 1
Per contact risk of unprotected anal intercourse and mean number of reported contacts with a HIV seropositive partner stratified by (A) age, (B) race/ethnicity, (C) number of sexual partners, and (D) other risk factors . PCR estimates for the controls not reporting the other risk factors in (D) were uniformly lower than for the exposed (data not shown). URA - Unprotected receptive anal intercourse UIA - Unprotected insertive anal intercourse STI- Self-reported Sexually Transmitted Infection (includes gonorrhea, syphilis, and chlamydia) * 95% bootstrap confidence interval for difference from reference group excludes 0 † - Any Use ‡ - Heavy Use
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References

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