Incidence and Predictors of HIV Infection Among Men Who Have Sex with Men Attending Public Sexually Transmitted Disease Clinics, New York City, 2007–2012

Abstract

We examined five annual cohorts (2007-2011) of men who have sex with men (MSM) attending New York City STD clinics who had negative HIV-1 nucleic acid amplification tests (NAATs) on the day of clinic visit. Annual HIV incidence was calculated using HIV diagnoses within 1 year of negative NAAT, determined by matching with the citywide HIV registry. Predictors (demographic; behavioral; bacterial STD from citywide STD registry match) of all new HIV diagnoses through 2012 were calculated from Cox proportional hazards models. Among 10,487 HIV NAAT-negative MSM, 371 had an HIV diagnosis within 1 year. Annual incidence was 2.4/100 person-years, and highest among non-Hispanic black MSM (4.1/100 person-years) and MSM aged <20 years (5.7/100 person-years). Characteristics associated with all 648 new HIV diagnoses included: black race (aHR 2.2; 95 % CI 1.6-3.1), condomless receptive anal sex (aHR 2.1; 95 % CI 1.5-2.8), condomless insertive anal sex (aHR 1.3; 95 % CI 1.1-1.8), and incident STD diagnosis (aHR 1.6; 95 % CI 1.3-1.9). MSM attending STD clinics have substantial HIV incidence and report risk behaviors that are highly associated with HIV acquisition. Increased uptake of effective interventions, e.g., pre- and post-exposure prophylaxis, is needed.

Young Men Who Have Sex with Men at High Risk for HIV, Bangkok MSM Cohort Study, Thailand 2006–2014

“…This study included young men but most were not MSM. Our findings were similar to incidence estimates in YMSM cohorts in China, but were much higher than those found in western countries [3, 5, 9]. Despite significant progress reducing HIV rates among other key populations such as female sex workers and people who inject drugs [32], our results suggest that a high HIV incidence in a different key population, YMSM, is now driving the HIV epidemic in Thailand and may complicate efforts to reach the UNAIDS/WHO 90–90-90 targets.…”

“…Characteristics of sexual partnership have an impact upon risky behaviors and the majority of unprotected sex events occurring between steady/regular partners, this being associated with HIV seroincidence [22–24]. Anal sex roles also contribute to high risk of HIV seroconversion especially among YMSM who adopt the receptive anal sex role without a condom [5, 25]. Early age at first anal sex has been shown to be associated with HIV acquisition among MSM; studies also demonstrate early age at first anal sex is associated with sexual risk taking [26, 27].…”

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England

“…While these two studies employed a different methodology to estimate incidence, their results suggest that incidence has remained relatively stable and high over the past 10 years among men attending STI clinics [19]. Our estimates are also comparable with those for cohorts of MSM in Portugal (2.8 per 100 PY) [20], Spain (2.4 per 100 PY) [21], Germany (3.3%) [22] and the USA (2.4 per 100 PY) [23] but higher than that for clinic-attending MSM in Australia (1.3 per 100 PY) [24]. Different mathematical models have been developed to estimate HIV incidence among the general MSM population.…”

Internet-Based Sex-Seeking Behavior Promotes HIV Infection Risk: A 6-Year Serial Cross-Sectional Survey to MSM in Shenyang, China

“…We found IBM preferred receptive anal sexual roles and that more STD symptoms occurred in IBM. Both of these factors can significantly increase IBM's risk for acquiring HIV [19–22]. This study also was the first to show that there was a great increase in the Internet seeking behavior in Shenyang during the six-year survey, in which the proportion of IBM increased from 43.3% to 61.5%.…”