MOAC0104 - Oral Abstract
Trends in HIV prevalence and HIV testing among young MSM: five United States cities, 1994-2008
Presented by Alexandra Oster (United States).
A. Oster, C. Johnson, B. Le, T. Finlayson, A. Balaji, A. Lansky, J. Mermin, L. Valleroy, D. MacKellar, S. Behel, G. Paz-Bailey, YMS and NHBS Study Groups
Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, United States
Background: During 2006-2009, HIV incidence surveillance estimated that new infections increased 34% among men ages 13-29y who have sex with men in the United States. To better understand this trend, we examined HIV prevalence and testing during 1994-2008 among young men who have sex with men (MSM).
Methods: The Young Men's Survey (1994-1998, ages 15-22y, and 1998-2000, ages 23-29y) and the National HIV Behavioral Surveillance System (2004-2005 and 2008, ages 18y+) conducted interviews and HIV testing among MSM recruited by venue-based sampling. We analyzed data of MSM ages 18-29y from Baltimore, Los Angeles, Miami, New York City, and San Francisco. We used logistic regression to assess if interview year was associated with HIV prevalence and testing for MSM ages 18-22y and 23-29y, after adjusting for city, race/ethnicity, and education (ages 23-29y only). We also calculated model-adjusted prevalence of HIV infection and testing by year.
Results: Overall, HIV prevalence was 11% and 16% among MSM ages 18-22y and 23-29y, respectively. Multivariable analysis demonstrated no change in HIV prevalence over time among MSM ages 18-22y (p=0.6, figure 1). However, there was an increase in HIV prevalence among MSM ages 23-29y of borderline significance (p=0.07). HIV testing increased substantially (p< 0.0001 for both age groups, figure 2). However, the proportion (78%) of HIV-infected MSM previously unaware of their infection did not change over time; among these, 47% had been tested in the past 12 months.
Conclusions: Among young MSM, high HIV prevalence and proportion previously unaware of their infection are consistent with national trends. Gains in HIV testing among young MSM are encouraging, but stable proportions unaware of their infections suggest that more, and perhaps more frequent, HIV testing is needed, consistent with CDC guidelines. Getting more young MSM tested, aware of their infection, and into appropriate care would help prevent ongoing transmission.
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