Men diagnosed with HIV who reported sex with both men and women – analysis of HIV case surveillance data in the United States
M. Campsmith, X. Hu
Centers for Disease Control and Prevention, HIV Incidence and Case Surveillance Branch, Atlanta, United States
Background: The predominant HIV transmission category in the United States (U.S.) is male-to-male sex; included in this category are men who reported sex with both men and women (MSMW). We analyzed surveillance data to determine the characteristics of MSMW among recent diagnoses of HIV infection.
Methods: Analysis of new HIV diagnoses from 2005-2008 among adults/adolescents (>=13 years of age) from 37 states with mature name-based HIV reporting. Summary analyses were stratified by sex, race/ethnicity, and HIV transmission category. Case reports from MSMW were analyzed by race/ethnicity. Data were adjusted for reporting delay but not for missing HIV risk information. To assess differences, chi-square tests were conducted.
Results: A total of 156,812 persons were diagnosed with HIV from 2005-2008 in 37 states; 115,994 (74%) were men. Racial/ethnic distribution for men was 45% black/African American, 34% white, 19% Hispanic/Latino, and 1% or less each for other racial/ethnic groups. After removing case reports that did not indicate HIV risk factors, 76% (63,052/82,851) of men were classified with an HIV transmission category of male-to-male sex. White men had a higher percentage with HIV transmission category of male-to-male sex (85%) compared to Hispanic/Latino men (74%) and black/African American men (69%) (all P< 0.001). Among male-to-male sex transmission cases, 17,457 (28%) were MSMW; white men had a lower percentage of MSMW (20%) compared to Hispanic/Latino men (28%) or black/African American men (37%) (all P< 0.001).
Conclusions: Compared to white men, lower percentages of black/African American men and Hispanic/Latino men had an HIV transmission risk of male-to-male sex; however, these populations had a greater percentage reporting MSMW. The large and diverse population of HIV-positive MSMW in the U.S. indicates the need for accurately ascertaining HIV risk behaviors; such information could be used to develop focused HIV prevention activities for this population with unique HIV transmission opportunities.
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