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. 2021 Feb:54:52-63.
doi: 10.1016/j.annepidem.2020.09.004. Epub 2020 Sep 18.

Trajectories of and disparities in HIV prevalence among Black, white, and Hispanic/Latino men who have sex with men in 86 large U.S. metropolitan statistical areas, 1992-2013

Leslie D Williams  1 , Ronald Stall  2 , Barbara Tempalski  3 , Kevin Jefferson  4 , Justin Smith  4 , Umedjon Ibragimov  4 , H Irene Hall  5 , Anna Satcher Johnson  5 , Guoshen Wang  5 , David W Purcell  5 , Hannah L F Cooper  4 , Samuel R Friedman  6
Affiliations

Trajectories of and disparities in HIV prevalence among Black, white, and Hispanic/Latino men who have sex with men in 86 large U.S. metropolitan statistical areas, 1992-2013

Leslie D Williams et al. Ann Epidemiol. 2021 Feb.

Abstract

Purpose: The challenges of producing adequate estimates of HIV prevalence among men who have sex with men (MSM) are well known. No one, to our knowledge, has published annual estimates of HIV prevalence among MSM over an extended period and across a wide range of geographic areas.

Methods: This article applies multilevel modeling to data integrated from numerous sources to estimate and validate trajectories of HIV prevalence among MSM from 1992 to 2013 for 86 of the largest metropolitan statistical areas in the United States.

Results: Our estimates indicate that HIV prevalence among MSM increased, from an across-metropolitan statistical area mean of 11% in 1992 to 20% in 2013 (S.D. = 3.5%). Our estimates by racial/ethnic subgroups of MSM suggest higher mean HIV prevalence among black and Hispanic/Latino MSM than among white MSM across all years and geographic regions.

Conclusions: The increases found in HIV prevalence among all MSM are likely primarily attributable to decreases in mortality and perhaps also to increasing HIV incidence among racial/ethnic minority MSM. Future research is needed to confirm this. If true, health care initiatives should focus on targeted HIV prevention efforts among racial/ethnic minority MSM and on training providers to address cross-cutting health challenges of increased longevity among HIV-positive MSM.

Keywords: HIV prevalence; Men who have sex with men (MSM); Metropolitan statistical areas; Racial/ethnic disparities.

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Conflict of interest statement

The authors have no Conflicts of Interest to report.

Figures

Figure 1.
Figure 1.
Mean Trajectory of HIV Prevalence among Men who Have Sex with Men across 86 Metropolitan Statistical Areas, 1992–2013
Figure 2.
Figure 2.
Estimated HIV Prevalence among Subgroups of MSM by Race/Ethnicity, Over Time (1992–2013) among 42 Metropolitan Statistical Areas
Figure 3.
Figure 3.
Estimated HIV Prevalence among Subgroups of MSM by Race/Ethnicity, Over Time (1992–2013) among MSAs for which at Least Two Subgroups Were Computed
Figure 4.
Figure 4.
Estimated Trajectories of HIV Prevalence among MSM by Geographic Region, Over Time (1992–2013)
Figure 5.
Figure 5.
Estimated Trajectories of HIV Prevalence among MSM by Racial/Ethnic Subgroup, for Each Geographic Region, Over Time (1992–2013)
Figure 5.
Figure 5.
Estimated Trajectories of HIV Prevalence among MSM by Racial/Ethnic Subgroup, for Each Geographic Region, Over Time (1992–2013)
See this image and copyright information in PMC

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