HIV gains lag for Black, Hispanic and young MSM in US
Between 2014 and 2018, HIV diagnoses among men who have sex with men (MSM) decreased 2.3% per year overall in the United States, and MSM also experienced improvements in linkage to care and viral suppression, study findings in MMWR showed.
Black, Hispanic/Latino and younger MSM — those aged 13 to 19 years — experienced more limited decrease in HIV diagnoses, researchers reported, although all ethnic and racial groups saw gains in linkage to care and viral suppression.
The report was published ahead of National Gay Men’s HIV/AIDS Awareness Day, which is Sept. 27.
“MSM account for two-thirds of annual diagnoses of HIV infection,” William L. Jeffries IV, PhD, associate chief for science in the CDC’s Division of HIV/AIDS Prevention, and colleagues wrote. “Increased linkage to care and viral suppression among MSM with HIV infection can prevent transmission.”
HIV disproportionately affects Black, Hispanic/Latino and younger MSM, who are also less likely to be linked to care and virally suppressed, according to Jeffries and colleagues. For their study, they analyzed data from 33 U.S. jurisdictions reported to the National HIV Surveillance System from 2014 to 2018 by ethnicity/race and age.
The analysis demonstrated that the number of HIV diagnoses among all MSM decreased 2.3% per year (95% CI, 1.9-2.8) on average, from 19,789 to 18,034. Among Black MSM, diagnoses decreased 1.3% per year overall and 6% and 5.6% among those aged 20 to 24 and 45 to 54 years, respectively, but increased 2.2% annually among those aged 25 to 34 years, Jeffries and colleagues reported. Among Hispanic/Latino MSM, diagnoses decreased just 0.2% overall and 3.7% per year among patients aged 20 to 24 years but increased 2% among those aged 25 to 34 years. Among white MSM, diagnoses decreased 4.8% per year overall and 5.6%, 2.1%, 7.8%, and 9.3% among those aged 20 to 24, 25 to 34, 35 to 44, and 45 to 54 years, respectively.
The study found that annual percentages of linkage to care within 1 month and viral suppression within 6 months of diagnosis among all MSM increased 2.9% (95% CI, 2.4-3.5) and 6.8% (95% CI, 6.2-7.4) per year, respectively.
According to the researchers, among Black MSM, the percentage of patients linked to care increased 3.8% per year overall and increased specifically among those aged 13 to 34 years. Similarly, the percentage of patients linked to care increased 3.2% per year among Hispanic/Latino MSM overall, and increased among those aged 20 to 54 years. Additionally, among white MSM, the percentage linked to care increased 1.8% per year overall and increased among those aged 20 to 24 and 25 to 34 years.
The study also demonstrated that the percentage of Black MSM who achieved viral suppression within 6 months increased 9.4% per year overall and specifically increased among those aged 13 to 54 years. Among Hispanic/Latino MSM, the percentage who were virally suppressed increased 6.8% per year overall, and it increased among those aged 20 to 54 years. The percentage of white MSM who achieved viral suppression increased 4.4% per year overall and increased among those aged 13 to 54 years.
The authors noted that viral suppression did not significantly change among those aged 55 years and older in any of the three groups.
“CDC encourages use of interventions that address social determinants of health that underlie the high risk for HIV infection among MSM of all races/ethnicities and ages,” they wrote. “Such interventions might help prevent HIV infection and eliminate racial/ethnic disparities in HIV infection among MSM.”