HIV: new cases highest among young MSM in the South, Northeast

  • Jones J & al.
  • Open Forum Infect Dis
  • 1 Jun 2018

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Despite a wide variety of state- and regional-based HIV diagnoses in men who have sex with men (MSM), disproportionately high new diagnoses continue to be found in MSM aged 18-24 years.
  • Prevalence continues to grow; highest prevalence observed in MSM aged >45 years.

Why this matters

  • Increased promotion of viral suppression, prevention (i.e., preexposure prophylaxis [PrEP], condoms) recommended, especially in the South and Northeast U.S.
  • Design HIV prevention strategies based on age/audience.

Key results

  • Across states/age, increasing HIV prevalence observed with increasing age, ranging from 0.2% (18-24 years) to 36.4% (25-34 years).
    • Within-state prevalence rates increased through 45-54 years age group; West had highest rates in older MSM (standardized prevalence ratio 2.20; 95% CI, 2.17-2.23). 
    • Compared with the Midwest and South, Northeast had higher than expected prevalence rates.
  • Overall age-adjusted standardized diagnosis ratios [SDR] showed 70% higher than expected diagnoses in 18-24 years age group in the Northeast (SDR, 1.70; 95% CI, 1.65-1.75) and 74% in South (SDR, 1.74; 95% CI, 1.71-1.77) vs Midwest.

Study design

  • Epidemiological surveillance study estimating state-level MSM population size, rate of prevalent and new HIV diagnoses in 2013, 2016, respectively.
  • Funding: CDC.

Limitations

  • Race-stratified estimates lacking.
  • Misclassification errors.
  • Data restricted to weighted samples.
  • Self-report bias.
  • Inconsistent surveillance practices.

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