Despite overall progress in HIV prevention and treatment, the condition continues to disproportionately affect men who have sex with men (MSM), when compared with other populations in the US, explains Donna Hubbard McCree, PhD, MPH, RPh. Racial/ethnic disparities persist as well, with 67% of the estimated incident infections among MSM in 2015 occurring among African Americans and Latinos. While monitoring changes in disparities among MSM is a national HIV prevention goal, studies specifically examining these changes over time are lacking.
For a study published in JAIDS, Dr. McCree and colleagues examined changes between 2010 and 2015 in disparities of HIV incidence among African-American, Latino, and Caucasian MSM through results from the rate ratio, rate difference, weighted and unweighted index of disparity, and population attributable proportion. The study team calculated incidence rates for MSM using HIV surveillance data and published estimates of the MSM population in the US.
“Our results show that racial/ethnic disparities in HIV incidence increased among the study populations during the study period, despite overall HIV incidence rates in the US decreasing during the same period,” says Dr. McCree. Statistically significant increases were observed in the Latino-to-Caucasian MSM incidence rate ratio (29%), weighted index of disparity with the rate for Caucasian MSM as the referent group (9%), and the population attributable proportion index (10%). “Eliminating racial/ethnic disparities in HIV incidence among gay and bisexual men would have substantially reduced (55%-61%) overall HIV incidence in this population,” adds Dr. McCree. “These results provide further confirmation that effective HIV prevention and treatment efforts are not adequately reaching those who could most benefit from them.”
To that end, Dr. McCree makes note of steps taken by the CDC to help address the prevention needs of those most affected by HIV, including African-American and Latino MSM. “CDC is investing resources in high-impact prevention strategies to maximize every prevention dollar,” she adds. “This includes substantial efforts to reach African-American and Latino MSM with HIV testing, linkage to care, referrals, and education about pre-exposure prophylaxis and other critical prevention services. Additionally, the federal initiative to eliminate America’s HIV epidemic will help to close HIV prevention and treatment gaps and supplement and accelerate these efforts over the next 10 years.”
Changes in Disparities in Estimated HIV Incidence Rates Among Black, Hispanic/Latino, and White Men Who Have Sex With Men (MSM) in the United States, 2010–2015