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Meta-Analysis
. 2014 Jan 30;9(1):e87139.
doi: 10.1371/journal.pone.0087139. eCollection 2014.

HIV infection and sexual risk among men who have sex with men and women (MSMW): a systematic review and meta-analysis

M Reuel Friedman  1 , Chongyi Wei  2 , Mary Lou Klem  3 , Anthony J Silvestre  1 , Nina Markovic  4 , Ron Stall  5
Affiliations
Meta-Analysis

HIV infection and sexual risk among men who have sex with men and women (MSMW): a systematic review and meta-analysis

M Reuel Friedman et al. PLoS One. .

Abstract

Objectives: To estimate the number of men who have sex with men and women who are HIV-positive in the United States, and to compare HIV prevalence rates between men who have sex with men and women, men who have sex with men only, and men who have sex with women exclusively.

Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports referencing HIV prevalence and men who have sex with men and women. We searched PubMed and Ovid PsycINFO for peer-reviewed, U.S.-based articles reporting on HIV prevalence among men who have sex with men and women. We conducted event rate, effect size, moderation and sensitivity analyses.

Results: We estimate that 1.0% of U.S. males are bisexually-behaving, and that 121,800 bisexually-behaving men are HIV-positive. Men who have sex with men and women are less than half as likely to be HIV-positive as men who have sex with men only (16.9% vs. 33.3%; OR = 0.41, 95% CI: 0.31, 0.54), but more than five times as likely to be HIV-positive as men who have sex with women exclusively (18.3% vs. 3.5%; OR = 5.71, 95% CI: 3.47, 9.39). They are less likely to engage in unprotected receptive anal intercourse than men who have sex with men only (15.9% vs. 35.0%; OR = 0.36, 95% CI: 0.28, 0.46). Men who have sex with men and women in samples with high racial/ethnic minority proportions had significantly higher HIV prevalence than their counterparts in low racial/ethnic minority samples.

Conclusions: This represents the first meta-analysis of HIV prevalence in the U.S. between men who have sex with men and women and men who have sex with men only. Data collection, research, and HIV prevention and care delivery specifically tailored to men who have sex with men and women are necessary to better quantify and ameliorate this population's HIV burden.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow diagram of included and excluded records.
Figure 2
Figure 2. HIV prevalence among MSMW, compared to MSMO, U.S.
Figure 3
Figure 3. HIV prevalence among MSMW, compared to MSWE, U.S.
See this image and copyright information in PMC

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