Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer.
Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Ann Epidemiol. 2018 Dec;28(12):865-873. doi: 10.1016/j.annepidem.2018.04.008. Epub 2018 Apr 30.
Men who have sex with men (MSM) bear a disproportionate burden of new and existing HIV infections in the United States, with black and Hispanic MSM facing the highest rates. A lack of data on MSM population sizes has precluded the understanding of state-level variations in these rates.
Using a recently developed model for estimating state-level population sizes of MSM by race that synthesizes data from the American Community Survey and the National Health and Nutrition Examination Survey, in conjunction with Centers for Disease Control and Prevention-based HIV diagnosis data, we estimated rates of living with an HIV diagnosis (2013) and new diagnosis among MSM (2014) by state and race.
Nationally, state-level median prevalence of living with an HIV diagnosis was 10.6%. White MSM had lower prevalence in all but five states; black MSM were higher in all but three. Hispanic MSM had highest concentrations in Northeast and Mississippi Delta states. Patterns were similar for new diagnoses rates.
Results suggest that racial disparities in HIV infection among MSM are more prominent than geographic ones. Interventions should be differentially tailored to areas of high proportionate and absolute burden. Continued efforts to understand and address racial differences in HIV infection are needed.
在美国,男男性行为者(MSM)承担着不成比例的新的和现有的艾滋病毒感染负担,其中黑人和西班牙裔 MSM 的感染率最高。由于缺乏关于 MSM 人口规模的数据,因此无法了解这些比率在各州的差异。
利用最近开发的一种按种族估算 MSM 州级人口规模的模型,该模型综合了美国社区调查和国家健康和营养检查调查的数据,并结合疾病控制和预防中心基于艾滋病毒诊断数据,我们按州和种族估计了 MSM 携带艾滋病毒诊断(2013 年)和新诊断(2014 年)的比率。
在全国范围内,州级 HIV 诊断的中位数为 10.6%。除了五个州外,白人 MSM 的流行率较低;除了三个州外,黑人 MSM 的流行率较高。西班牙裔 MSM 主要集中在东北部和密西西比三角洲州。新诊断率的模式也类似。
结果表明,MSM 中的艾滋病毒感染的种族差异比地理差异更为突出。干预措施应根据高比例和绝对负担的地区进行有区别的调整。需要继续努力了解和解决艾滋病毒感染方面的种族差异。