Stuck in the Middle: Longitudinal HIV-Related Health Disparities Among Men Who Have Sex with Men and Women (MSMW)

Published: March 21, 2014

Abstract

INTRODUCTION:
Men who have sex with men and women (MSMW) have been shown in cross-sectional studies to suffer HIV-related health disparities above and beyond those found among men who have sex with men only (MSMO). We conducted a secondary data analysis over a 7-year time frame of participants in the Multicenter AIDS Cohort Study (MACS), a longstanding prospective cohort study, to examine whether MSMW had persistently higher rates of depression symptoms, polydrug use, and (among HIV positive MSM) HIV viral load levels compared with MSMO.
 
METHODS:
Men were behaviorally defined as bisexual if they reported sexual activity with at least one male and one female partner between study waves 38-50. We used generalized mixed modeling with repeated measures to test differences in CES-D score, polydrug use, and viral load between sexually active MSMO (n=111) and MSMW (n=1514), adjusting for age, income, and race/ethnicity, and recent seroconversion.
 
RESULTS:
MSMW were significantly more likely than MSMO to have higher CES-D scores, polydrug use, and viral load levels (all p-values <.01). Outcome trajectories did not differ significantly over time between these groups. Black and Hispanic HIV positive MSMW had higher viral load levels relative to White HIV positive MSMW (p-values<.01).
 
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