Running Backwards: Consequences of Current HIV Incidence Rates for the Next Generation of Black MSM in the United States
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Black men who have sex with men (MSM) in the United States are disproportionately impacted by HIV. To better understand this public health problem, we reviewed the literature to calculate an estimate of HIV incidence among Black MSM. We used this rate to model HIV prevalence over time within a simulated cohort, which we subsequently compared to prevalence from community-based samples. We searched all databases accessible through PubMed, and Conference on Retroviruses and Opportunistic Infections abstracts for HIV incidence estimates among Black MSM. Summary HIV incidence rates and 95 % confidence intervals (CIs) were calculated using random effects models. Using the average incidence rate, we modeled HIV prevalence within a simulated cohort of Black MSM (who were all HIV-negative at the start) from ages 18 through 40. Based on five incidence rates totaling 2898 Black MSM, the weighted mean incidence was 4.16 % per year (95 % CI 2.76–5.56). Using this annual incidence rate, our model predicted that 39.94 % of Black MSM within the simulated cohort would be HIV-positive by age 30, and 60.73 % by 40. Projections were similar to HIV prevalence found in community-based samples of Black MSM. High HIV prevalence will persist across the life-course among Black MSM, unless effective prevention and treatment efforts are increased to substantially reduce HIV transmission among this underserved and marginalized population.
KeywordsHIV/AIDS Black MSM Epidemiology Prevention HIV incidence HIV prevalence
This study was partially supported by the National Institute for Nursing Research (R01NR013865), the National Institute for Mental Health (T32MH094174; R01MH094230), and the National Institute on Drug Abuse (F31DA037647). We thank Dr. Eli Rosenberg for his comments on an earlier version of this draft, the Center for Black Equity for partnering with us to implement POWER, and the hundreds of study participants who volunteered their time to contribute to this research. This article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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