13th Conference on Retroviruses and Opportunistic Infections Denver, Colorado - February 5-8, 2006

Conf Retrovir Opportunistic Infect 2006 Feb 5-8;13:abstract no. 28

Frangiscos Sifakis¹, C Flynn², R Montes De Oca¹, M Hilton¹, N Tomoyasu², and D Celentano^1
1Johns Hopkins Univ, Bloomberg Sch of Publ Hlth, Baltimore, MD, US and ²Maryland Dept of Hlth and Mental Hygiene, Baltimore, US

BACKGROUND: We examined HIV prevalence, incidence, and risk behaviors among MSM in Baltimore, Maryland.

METHODS: BESURE is part of the CDC-funded National HIV Behavioral Surveillance (NHBS) effort. It is a cross-sectional, community-based study of MSM 18 years or older who were actively recruited in public venues and reside in the Baltimore metropolitan area. A questionnaire was administered and blood specimens drawn for HIV testing between June 2004 and April 2005. HIV incidence was ascertained using the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) assay.

RESULTS: Of 1,013 men recruited, 891 (88.0%) had complete survey and HIV testing data. The study sample included 500 (56.1%) African American, 293 (32.9%) white, 41 (4.6%) Hispanic, and 57 (6.4%) other/mixed race/ethnicity participants. Overall HIV prevalence was 32.3%, but varied by race/ethnicity: 45.6% (n=228) among African Americans, 10.6% (n=31) among whites, 29.3% (n=12) among Hispanics, and 29.8% (n=17) among other/mixed race/ethnicity. After adjusting for age, education, sexual activity during last 12 months, sexual identity, prior HIV testing, and ever injected drugs in multivariate logistic regression analysis, African Americans (AOR=9.3; 95%CI:5.8,15.0), Hispanics (AOR=4.0; 95%CI:1.7,9.2), or other/mixed race (AOR=5.2; 95%CI:2.4,11.2) participants were significantly more likely to be HIV positive when compared to white participants. Of 288 HIV positive specimens, 27 were recent infections and the overall HIV incidence was 9.2 % per year (95% CI: 4.3, 17.4). HIV incidence was 15.4% per year (95%CI: 8.7, 25.2) among African Americans, 3.2% per year (95%CI: 0.7, 9.1) among whites, 0.0% per year (95%CI: 0.0, 3.7) among Hispanics, and 10.2% per year (95%CI: 4.9, 18.7) among mixed/other race/ethnicity. Among the 228 HIV positive African American men, 83 (36.4%) reported knowing they were HIV positive, 74 (32.5%) reported previously testing HIV negative, and 71 (31.1%) reported never before receiving an HIV test.

CONCLUSIONS: HIV prevalence (32.3%) and incidence (9.2% per year) are high among MSM in Baltimore and of particular concern among African American MSM (45.6% and 15.4% per year, respectively). Unrecognized infection among African American MSM remains high (63.4%). HIV prevention and education in Baltimore must promote HIV testing and better address the needs of African American MSM.

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2006-02-05
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