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HIV-related risk behaviors fail to explain high rate of diagnoses among black MSM

More access to effective HIV prevention measures is needed for all young males who have sex with males, as there is no evidence that differences in risk behaviors alone are driving the higher number of diagnoses among those who are black, according to data published in Morbidity and Mortality Weekly Report.

“Most new HIV diagnoses among youths occur among males who have sex with males,” Laura Kann, PhD, of the CDC National Center of HIV/AIDS, Viral Hepatitis, STD and TB Prevention, and colleagues wrote. “Among all [males who have sex with males], young black [males who have sex with males] accounted for the largest number of new HIV diagnoses in 2014.”

To examine if the HIV-related risk behaviors among black males who have sex with males [MSM] in high school differed from those of white and Hispanic MSM students, the researchers analyzed data from 32 Youth Risk Behavior Surveys, which collected information from 17 large, urban school districts from 2009 to 2013.

Their data set included 1,681 records from MSM in grades nine through 12, who responded to questions regarding 17 risk behaviors related to HIV transmission. In the survey, two questions measured alcohol use, 10 questions addressed other drug use, and five questions were related to sexual behaviors in connection with HIV infection. Of the students included in the researcher’s sample, 13.6% were white, 40.6% were black and 45.8% were Hispanic.

According to the researchers, black MSM students had a lower or similar prevalence of most HIV-related risk behaviors compared with white and Hispanic MSM students. Among black MSM, 22.9% reported drinking five or more drinks of alcohol in a row compared to 38% of white MSM. That trend persisted regarding the use of inhalants (21.5% among black MSM compared to 35% among white MSM), heroin (16.5% vs 29.1%), ecstasy (19.6% vs 40%), taking prescription drugs without a prescription (31.4% vs 47.8%) and ingesting alcohol and drugs before last sexual intercourse (32.6% vs 72.6%). Similar trends were seen when comparing black MSM to Hispanic MSM.

In addition, black MSM students had a significantly higher prevalence than white MSM students (89.1% versus 67.4%), and Hispanic MSM students (89.1% versus 79.2%), of ever having sexual intercourse. Black MSM also had a higher prevalence of using a condom during their last sexual intercourse, among sexually active students, compared to white MSM students (47.4% versus 25.2%). According to the researchers, no other differences proved to be statistically significant.

“Although risk behaviors are necessary for HIV transmission, the findings in this report do not provide evidence that differences in HIV-related risk behaviors alone are driving the higher numbers of HIV diagnoses among young black MSM compared with young Hispanic and white MSM,” Kann and colleagues wrote. “Indeed, black male students who had sexual contact with males in this report often had a lower prevalence of HIV-related risk behaviors.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.

Editor’s note: On Feb. 17, the story was updated to clarify the rate of black MSM students having reported ever having sexual intercourse. The editors regret the error.