Estimated HIV Incidence, Prevalence, and Mortality Rates Among Racial/Ethnic Populations of Men Who Have Sex with Men, Florida

Florida Department of Health, Bureau of HIV/AIDS, Tallahassee, FL 32399-1715, USA.
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.56). 02/2010; 54(4):398-405. DOI: 10.1097/QAI.0b013e3181d0c165
Source: PubMed


Population-based HIV incidence, prevalence, and mortality rates among men who have sex with men (MSM) have been unavailable, limiting assessment of racial/ethnic disparities and epidemic dynamics.
Using estimated numbers of MSM aged >or=18 years by race/ethnicity as denominators, from models in our prior work, we estimated MSM HIV prevalence and mortality rates for 2006-2007 and HIV incidence rates for 2006 in Florida.
Overall, the estimated MSM HIV prevalence rates per 100,000 MSM were 7354.8 (2006), and 7758.3 (2007). With white MSM as the referent, MSM HIV prevalence rate ratios (RRs) equaled 3.7 for blacks in 2006 and 3.6 in 2007 and 1.7 for Hispanics in both years (all P < 0.001). Among all MSM with HIV, the mortality rates were 199.8 (2006) and 188.4 (2007), with RRs of 5.4 for blacks in 2006 and 4.9 in 2007, and 1.6 for Hispanics in 2006 and 1.4 in 2007 (all P < 0.001). In 2006, the estimated HIV incidence rate among all MSM was 656.1 per 100,000 MSM, with RRs of 5.5 (blacks) and 2.0 (Hispanics) (both P < 0.001). A sensitivity analysis indicated that error due to misclassification of minority MSM as males who are not MSM lowered rates and RRs for all the 3 indicators but racial/ethnic disparities persisted (all P < 0.001).
The impact of HIV by each measure was greater on black and Hispanic MSM than on white MSM. Quantifying estimates of HIV incidence, HIV prevalence, and mortality rates among MSM with HIV informs HIV surveillance, prevention, treatment, resource allocation, and community mobilization.

Download full-text


Available from: Daniel R Thompson
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Men who have sex with men (MSM) bear the greatest burden of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in every state in the U.S., but their populations are poorly defined. We estimated and compared populations of MSM in 2007 by region, state, and race/ethnicity. We averaged findings from two statistical models we had previously developed to estimate the total state-specific percentage and number of males who were MSM. The models were based, respectively, on state-specific rural/ suburban/urban characteristics and an index using state-specific household census data on same-sex male unmarried partners. A third model, based on racial/ethnic ratios from a nationally representative behavioral survey, partitioned these statewide numbers by race/ethnicity. Of an estimated 7.1 million MSM residing in the U.S. in 2007, 71.4% (5.1 million) were white, 15.9% (1.1 million) were Hispanic, 8.9% (635,000) were black, 2.7% (191,000) were Asian, 0.4% (26,000) were American Indian/Alaska Native, 0.1% (6,000) were Native Hawaiian/other Pacific Islander, and 0.6% (41,000) were of multiple/unknown race/ethnicity. The overall U.S. percentage of males who were MSM (6.4%) varied from 3.3% in South Dakota to 13.2% in the District of Columbia, which we treated as a state. Estimated numbers of MSM ranged from 9,612 in Wyoming to 1,104,805 in California. Plausible estimates of MSM populations by state and race/ethnicity can inform and guide HIV/AIDS surveillance, allocation of resources, and advocacy. They can help in the planning, implementation, and evaluation of HIV prevention programs and other services. Using MSM numbers as denominators, estimates of population-based MSM HIV incidence, prevalence, and mortality rates could help clarify national and state-level epidemic dynamics. Until corroborated by other modeling and/or empirical research, these estimates should be used with caution.
    Full-text · Article · Jan 2011 · Public Health Reports
  • Source

    Full-text · Article ·
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: States across the U.S. lack effective ways to quantify HIV prevalence rates among men who have sex with men (MSM). We estimated population-based HIV prevalence rates among MSM in the 17 southern states by race/ethnicity. Through 2007, estimated HIV prevalence rates per 100,000 MSM ranged from 2,607.6 among white (non-Hispanic) MSM in Maryland to 41,512.9 among black (non-Hispanic) MSM in the District of Columbia. Black MSM rates significantly exceeded Hispanic and white MSM rates in each state. Significant racial/ethnic disparities in rates persisted in a sensitivity analysis examining the possibility that minority MSM populations had been underestimated in each state. Compared with black, Hispanic, and white non-MSM males, respectively, rates at the regional level were 25.2 times higher for black MSM, 43.0 times higher for Hispanic MSM, and 106.0 times higher for white MSM. State-level analysis of racial/ethnic-specific MSM HIV prevalence rates can help guide resource allocation and assist advocacy.
    Full-text · Article · Apr 2011 · AIDS and Behavior
Show more