Running in Place: Implications of HIV Incidence Estimates among Urban Men Who Have Sex with Men in the United States and Other Industrialized Countries
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Attempts to document changing HIV incidence rates among MSM are compromised by issues of generalizability and statistical power. To address these issues, this paper reports annualized mean HIV incidence rates from the entire published incidence literature on MSM from Europe, North America and Australia for the period 1995–2005. Publications that met the entry criteria were coded for region of the world, sampling method and year of study. From these reports, we calculated a mean incidence rate with confidence intervals for these variables. Although no differences in mean incidence rates were found for MSM from 1995 to 2005, HIV incidence rates are lower in Australia than either North America or Europe. We calculated a mean incidence rate of 2.39% for MSM in the United States, which if sustained within a cohort of MSM, would yield HIV prevalence rate of approximately 40% at age 40. These extrapolations overlap published HIV prevalence rates for MSM younger than age 40 in the United States. HIV incidence rates in the 2–3% range will adversely affect the health of gay male communities for decades to come. This analysis suggests that greater attention should be devoted to the question of how best to design prevention interventions that will lower HIV incidence rates among gay men.
KeywordsMen who have sex with men HIV/AIDS Epidemiology Prevention
This research was supported in part by grants MH080648, “Longitudinal Internet Research Investigating Health Outcomes in Adolescence” (Dr. Friedman), DA022936 “Long Term Health Effects of Methamphetamine Use in the MACS” (Drs. Stall and Guadamuz), AA015100 “Parent Alcoholism Among ADHD Youth: A Longitudinal Study” (Dr. Marshal). This paper is dedicated to the memory of Mr. Hank Wilson, a long-time AIDS activist in San Francisco whose life work was devoted to improving health and well-being among gay men.
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