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Missed opportunities in HIV diagnosis among black, Latino MSM
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BOSTON — Clear racial disparities exist among black and Latino men who have sex with men who are unaware of their HIV-positive status, according to Gregorio Millett, PhD.
“There have been several studies that found that about 20% of the population in the US are unaware of their HIV status,” Millet, of the CDC and senior policy advisor in the Office of National AIDS Policy, said during a presentation here. “Among MSM, there are clear racial disparities in those men who are unaware of their HIV-positive status, particularly among black and Latino MSM. There are surprisingly few studies, if any, which look at correlates of unrecognized HIV infection [in this population.]”
Between May 2005 and April 2006, the researchers recruited 1,208 black (n=597) and Latino MSM (n=611) for chain-referral sampling from New York City, Philadelphia and Los Angeles. Men were given a short questionnaire about sexual risk behaviors and psychosocial factors, and were tested for HIV.
Demographic, behavioral and psychological variables associated with unrecognized HIV-infection among black and Latino MSM were assessed. Men who were HIV-positive, but were unaware of their HIV status were compared with men who were HIV-negative.
Among black men, 105 had unrecognized HIV and 492 were HIV-negative. Of Latino men, 33 had unrecognized HIV and 578 were HIV-negative. Unrecognized HIV infection was more prevalent among black MSM vs. Latino MSM (18% vs. 5%; P<.001). The prevalence for HIV infection differed by city among blacks (24% in New York City vs. 13% in Philadelphia; P<.001) and Latinos (10% in Los Angeles vs. 3% in New York City; P<.001).
According to Millett, some men who were infected with HIV believed that having sex with men of the same race or ethnicity reduced their risk for infection. This belief was associated with being HIV-positive-unaware for both black and Latino MSM. Black MSM were 86% more likely to hold this belief and be HIV-positive-unaware; Latino MSM were 47% more likely to hold this belief and be HIV-positive-unaware. Moreover, men who were HIV-positive-unaware were more likely to have health insurance and have disclosed sexuality to health care providers.
“Previous studies have found that being HIV-positive-unaware was less likely among men who had access to care, and though that is true, what we found in our study, is that there are men who do have access to care — particularly black MSM — who are not being diagnosed for HIV,” Millet said. “Routine HIV testing is essential to reduce HIV transmission and connect HIV-positive MSM with care, and we need to make sure that we have some sort of cues for doctors of those men who disclose their sexuality, and make sure that doctors are actually testing those men for HIV.” – by Ashley DeNyse
For more information:
- Millet G. #131LB. Presented at: 18th Conference on Retroviruses and Opportunistic Infections; Feb. 27-March 2, 2011; Boston.
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