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Very High HIV Incidence and Associated Risk Factors in a Longitudinal Cohort Study of Diverse Adolescent and Young Adult Men Who Have Sex with Men and Transgender Women

  • Brian MustanskiEmail author
  • Daniel T. Ryan
  • Michael E. Newcomb
  • Richard T. D’Aquila
  • Margaret Matson
Original Paper

Abstract

To report HIV incidence and associated factors among young men who have sex with men (YMSM) and transgender women (TW). Data were collected February 2015 to July 2018 in the RADAR longitudinal cohort study of YMSM/TW aged 16–29 years (N = 1093). Data included tests for HIV and rectal STIs and self-reported sexual behaviors and networks characteristics. HIV incidence rates were 2.91 per 100 person years (44 seroconversions among 1513 person years). Incidence was significantly higher in Black participants than white (IRR 8.81; 95% CI 2.72–45.26) and Latinx (IRR 3.15; 1.49–7.28) participants, but no significant differences by gender identity were found. Testing positive for rectal STIs (HR 2.50; 95% CI 1.27–4.92) and sex with a partner from a high HIV incidence community area (HR 2.46; 95% CI 1.19–5.07) were associated with higher incidence. HIV incidence was very high and Black YMSM/TW experienced higher HIV incidence attributable to partner race and geographic residence. Rectal STIs were associated with increased HIV incidence.

Keywords

HIV incidence Gay and bisexual men Young MSM Transgender women Adolescent 

Notes

Acknowledgements

This study was funded by the National Institute on Drug Abuse (U01DA036939). We acknowledge the support of the Third Coast Center for AIDS Research (P30AI117943) and the Northwestern University Clinical and Translational Sciences Institute (UL1TR001422). We thank the participants in the RADAR study for sharing their experiences. We acknowledge the contributions of the RADAR study staff, particularly Antonia Clifford, Justin Franz, Roky Truong, Christian Castro, and Hannah Hudson.

Funding

This study was funded by the National Institute on Drug Abuse (U01DA036939).

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2015. HIV surveillance supplemental report web site. https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published 2018. Accessed 21 Sep 2018.
  2. 2.
    Hall HI, Song R, Szwarcwald CL, Green T. Brief report: time from infection with the human immunodeficiency virus to diagnosis, United States. J Acquir Immune Defic Syndr. 2015;69(2):248–51.CrossRefGoogle Scholar
  3. 3.
    Sharma A, Wang LY, Dunville R, Valencia RK, Rosenberg ES, Sullivan PS. HIV and sexually transmitted disease testing behavior among adolescent sexual minority males: analysis of pooled youth risk behavior survey data, 2005–2013. LGBT Health. 2017;4(2):130–40.CrossRefGoogle Scholar
  4. 4.
    Balaji AB, An Q, Smith JC, et al. High human immunodeficiency virus incidence and prevalence and associated factors among adolescent sexual minority males-3 cities, 2015. Clin Infect Dis. 2018;66(6):936–44.CrossRefGoogle Scholar
  5. 5.
    Singh S, Song R, Johnson AS, McCray E, Hall HI. HIV incidence, prevalence, and undiagnosed infections in U.S. men who have sex with men. Ann Intern Med. 2018;168(10):685–94.CrossRefGoogle Scholar
  6. 6.
    Garofalo R, Hotton AL, Kuhns LM, Gratzer B, Mustanski B. Incidence of HIV infection and sexually transmitted infections and related risk factors among very young men who have sex with men. J Acquir Immune Defic Syndr. 2016;72(1):79–86.CrossRefGoogle Scholar
  7. 7.
    Halkitis P, Kapadia F, Ompad D. Incidence of HIV infection in young gay, bisexual, and other YMSM: the P18 cohort study. J Acquir Immune Defic Syndr. 2015;69(4):466–73.CrossRefGoogle Scholar
  8. 8.
    Sullivan PS, Rosenberg ES, Sanchez TH, et al. Explaining racial disparities in HIV incidence in black and white men who have sex with men in Atlanta, GA: a prospective observational cohort study. Ann Epidemiol. 2015;25(6):445–54.CrossRefGoogle Scholar
  9. 9.
    Ackers ML, Greenberg AE, Lin CY, et al. High and persistent HIV seroincidence in men who have sex with men across 47 U.S. cities. PLoS ONE. 2012;7(4):e34972.CrossRefGoogle Scholar
  10. 10.
    Koblin BA, Mayer KH, Eshleman SH, et al. Correlates of HIV acquisition in a cohort of Black men who have sex with men in the United States: HIV prevention trials network (HPTN) 061. PLoS ONE. 2013;8(7):e70413.CrossRefGoogle Scholar
  11. 11.
    Mustanski B, Morgan E, D’Aquila R, Birkett M, Janulis P, Newcomb ME. Individual and network factors associated with racial disparities in HIV among young men who have sex with men: results from the RADAR cohort study. J Acquir Immune Defic Syndr. 2019;80(1):24–30.CrossRefGoogle Scholar
  12. 12.
    Mustanski B, Birkett M, Kuhns LM, Latkin CA, Muth SQ. The role of geographic and network factors in racial disparities in HIV among young men who have sex with men: an egocentric network study. AIDS Behav. 2015;19(6):1037–47.CrossRefGoogle Scholar
  13. 13.
    Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global epidemiology of HIV infection and related syndemics affecting transgender people. J Acquir Immune Defic Syndr. 2016;72(Suppl 3):S210–9.CrossRefGoogle Scholar
  14. 14.
    Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22.CrossRefGoogle Scholar
  15. 15.
    Nuttbrock L, Bockting W, Rosenblum A, et al. Gender abuse and incident HIV/STI among transgender women in New York City: buffering effect of involvement in a transgender community. AIDS Behav. 2015;19(8):1446–53.CrossRefGoogle Scholar
  16. 16.
    Mustanski B, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48(2–3):218–53.CrossRefGoogle Scholar
  17. 17.
    Schlusser KE, Pilcher C, Kallas EG, et al. Comparison of cross-sectional HIV incidence assay results from dried blood spots and plasma. PLoS ONE. 2017;12(2):e0172283.CrossRefGoogle Scholar
  18. 18.
    Leserman J. Sexual abuse history: prevalence, health effects, mediators, and psychological treatment. Psychosom Med. 2005;67(6):906–15.CrossRefGoogle Scholar
  19. 19.
    Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791–804.CrossRefGoogle Scholar
  20. 20.
    Adamson SJ, Kay-Lambkin FJ, Baker AL, et al. An improved brief measure of cannabis misuse: the Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Drug Alcohol Depend. 2010;110(1–2):137–43.CrossRefGoogle Scholar
  21. 21.
    Innovacon Inc. Drugs of abuse: one step drug screen test card: instruction sheet for single and multi drug screen test cards for any combination of the following drugs: AMP/BAR/BZO/COC/THC/MTD/mAMP/MDMA/MOP/OPI/OXY/PCP/PPX/TCA. In. San Diego, CA: CLIAwaived.com; n.d.Google Scholar
  22. 22.
    Substance abuse and mental health services administration. Clinical drug testing in primary care. In. 32 ed. Rockville, MD: Subst Abuse Mental Health Serv Adm.; 2012.Google Scholar
  23. 23.
    Li DH, Janulis P, Mustanski B. Predictors of correspondence between self-reported substance use and urinalysis screening among a racially diverse cohort of young men who have sex with men and transgender women. Addict Behav. 2018;88:6–14.CrossRefGoogle Scholar
  24. 24.
    Centers for disease control and prevention and association of public health laboratories. Technical update on HIV-1/2 differentiation assays. https://stacks.cdc.gov/view/cdc/40790. Published 2016. Accessed 11 Apr 2017.
  25. 25.
    Duong YT, Kassanjee R, Welte A, et al. Recalibration of the limiting antigen avidity EIA to determine mean duration of recent infection in divergent HIV-1 subtypes. PLoS ONE. 2015;10(2):e0114947.CrossRefGoogle Scholar
  26. 26.
    Kim AA, Rehle T. Assessing estimates of HIV incidence with a recent infection testing algorithm that includes viral load testing and exposure to antiretroviral therapy. AIDS Res Hum Retroviruses. 2018;34(10):863–6.CrossRefGoogle Scholar
  27. 27.
    Swann G, Newcomb ME, Mustanski B. Validation of the HIV risk assessment of sexual partnerships (H-RASP): comparison to a 2-month prospective diary study. Arch Sex Behav. 2018;47(1):121–31.CrossRefGoogle Scholar
  28. 28.
    Chicago Department of Public Health. HIV/STI surveillance report 2016. Chicago, IL2016.Google Scholar
  29. 29.
    World Health Organization and UNAIDS. Technical update on HIV incidence assays for surveillance and monitoring purposes: WHO HIV Incidence Assay Working Group Meeting. Barecelona, Spain: UNAIDS; 2015.Google Scholar
  30. 30.
    South African centre for epidemiological modeling and analysis: incidence estimation tools. http://www.incidence-estimation.org/page/tools. Published 2015. Accessed 3 Oct 2018.
  31. 31.
    Matthews DD, Herrick AL, Coulter RW, et al. Running backwards: consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS Behav. 2016;20(1):7–16.CrossRefGoogle Scholar
  32. 32.
    Beck EC, Birkett M, Armbruster B, Mustanski B. A data-driven simulation of HIV spread among young men who have sex with men: role of age and race mixing and STIs. J Acquir Immune Defic Syndr. 2015;70(2):186–94.CrossRefGoogle Scholar
  33. 33.
    Barbee LA, Khosropour CM, Dombrowksi JC, Golden MR. New human immunodeficiency virus diagnosis independently associated with rectal gonorrhea and chlamydia in men who have sex with men. Sex Transm Dis. 2017;44(7):385–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute for Sexual and Gender Minority Health and WellbeingNorthwestern UniversityChicagoUSA
  2. 2.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Division of Infectious Diseases, Department of Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Northwestern Institute for Sexual and Gender Minority Health and WellbeingChicagoUSA

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