MOAC0106 - Oral Abstract
Correlates of HIV incidence among black men who have sex with men in 6 U.S. cities (HPTN 061)
Presented by Beryl Koblin (United States).
B. Koblin1, K. Mayer2, S. Eshleman3, L. Wang4, S. Shoptaw5, C. del Rio6, S. Buchbinder7, M. Magnus8, S. Mannheimer9,10, T.-Y. Liu4, V. Cummings3, E. Piwowar-Manning3, S. Fields11, S. Griffith12, V. Elharrar13, D. Wheeler14, HPTN 061 Study Team
1New York Blood Center, Laboratory of Infectious Disease Prevention, New York, United States, 2Fenway Health and Beth Israel Deaconess Hospital, Boston, United States, 3Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, United States, 4Fred Hutchinson Cancer Research Center, Vaccine and Infectious Disease Division, Seattle, United States, 5University of California, Los Angeles, Department of Family Medicine, Los Angeles, United States, 6Emory University Rollins School of Public Health, Department of Global Health, Atlanta, United States, 7San Francisco Department of Public Health, San Francisco, United States, 8George Washington University, School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington DC, United States, 9Harlem Hospital/ Columbia University, Department of Medicine, New York, United States, 10Columbia University Mailman School of Public Health, Department of Epidemiology, New York, United States, 11Florida International University-College of Nursing and Health Sciences, Miami, United States, 12FHI 360, Research Triangle Park, United States, 13NIAID, National Institutes of Health, Clinical Prevention Research Branch, Bethesda, United States, 14Loyola University Chicago, Graduate School of Social Work, Chicago, United States
Background: Black/ African American MSM (BMSM) in the United States are affected by HIV at dramatically disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts.
Methods: In 2009-10, HPTN 061 recruited BMSM in Atlanta, Boston, Los Angeles, New York City, San Francisco and Washington D.C. for a feasibility study of a multi-component intervention to reduce HIV infection. Participants reporting >1 episode of unprotected anal intercourse with a man in the past six months were evaluated at baseline, 6 and 12 months. HIV status at enrollment was based on real-time testing performed at study sites and confirmatory testing at the HPTN Network Laboratory. HIV incidence based on HIV seroconversion was calculated as number of events/person-years. Confidence intervals were calculated using exact methods.
Results: Of 1553 BMSM enrolled, 174 reported a prior HIV diagnosis and 46 refused HIV testing or a specimen was not available at baseline. Of those without a prior HIV diagnosis (n=1333), 1168 were HIV-uninfected, and 165 (12.4%) were newly diagnosed at baseline (including 3 with acute HIV infection). Among the 1168 HIV uninfected men at baseline, 26 acquired HIV infection during follow up for a 2.8% annual HIV incidence rate (95% CI:1.8-4.1%). HIV incidence was higher among men < 30 yrs (5.9%; 95% CI:3.6-9.1%) compared men >30 yrs (1.0%; 95% CI:0.4-2.2%), men identifying as exclusively gay/homosexual (5.0%; 95% CI:2.6-8.8%) compared to bisexual (1.5%; 95% CI:0.4-3.7%) and men reporting unprotected receptive anal sex (4.9%; 95% CI:3.0-7.4%) compared to those not (1.0%; 95% CI:0.3-2.4%).
Conclusions: In the largest cohort of prospectively-followed BMSM in the US, HIV incidence was high, particularly among young and gay-identified BMSM. Targeted and tailored culturally appropriate combination HIV prevention strategies incorporating behavioral, social and biomedical based interventions are urgently needed to lower these rates.
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