XIX International AIDS Conference

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MOAC0102 - Oral Abstract Session


Racial disparities in antiretroviral therapy use and viral suppression among sexually active HIV-positive men who have sex with men receiving medical care: United States, Medical Monitoring Project, 2009 data collection cycle

Presented by Linda Beer (United States).

L. Beer, A. Oster, C. Mattson, J. Skarbinski


U.S. Centers for Disease Control and Prevention, Atlanta, United States

Background: In the United States, black men who have sex with men (MSM) are substantially more likely to acquire HIV than white MSM. Given highly racially homogeneous sexual networks, lower levels of viral suppression in HIV-infected black MSM (due to differences in antiretroviral [ART] use), might contribute to racial disparities in HIV infection. We present the first nationally representative data on disparities in ART use and viral suppression among sexually active black and white MSM receiving care.
Methods: We used interview and medical record data collected June 2009-May 2010 from the Medical Monitoring Project (MMP), a national probability sample of HIV-infected adults receiving medical care January-April 2009. We estimated the prevalence of self-reported current ART use and clinical documentation of viral suppression (most recent viral load ≤200 copies/ml) among sexually active non-Hispanic black MSM and white MSM. Analyses accounted for clustering, unequal selection probabilities, and non-response.
Results: Of 4,217 eligible participants, 313 black MSM and 691 white MSM were identified. Estimated national prevalence of ART use and viral suppression for these subpopulations is shown in the Figure. Black MSM were significantly less likely than white MSM to report ART use (p< .001) and be virally suppressed (p< .01).

Beer et al IAC 2012 figure
[Beer et al IAC 2012 figure ]


Conclusions: Among sexually active MSM receiving care, there are substantial racial disparities in ART use and viral suppression. One-fifth of black MSM were not on ART and almost one-third were not virally suppressed. These differences may contribute to the racial disparity in new infections among MSM. Narrowing gaps in ART use and viral suppression between HIV-infected black and white MSM will reduce morbidity among HIV-infected black MSM and might contribute to reducing new HIV infections among uninfected black MSM.


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