Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates§

Abstract

Background:CDC has not previously calculated disease rates for men who have sex with men (MSM) because there is no single comprehensive source of data on population size. To inform prevention planning, CDC developed a national population size estimate for MSM to calculate disease metrics for HIV and syphilis.Methods:We conducted a systematic literature search and identified seven surveys that provided data on same-sex behavior in nationally representative samples. Data were pooled by three recall periods and combined using meta-analytic procedures. We applied the proportion of men reporting same-sex behavior in the past 5 years to U.S. census data to produce a population size estimate. We then calculated three disease metrics using CDC HIV and STD surveillance data and rate ratios comparing MSM to other men and to women.Results:Estimates of the proportion of men who engaged in same-sex behavior differed by recall period: past year = 2.9% (95%CI, 2.6–3.2); past five years = 3.9% (3.5–4.4); ever = 6.9% (5.1–8.6). Rates on all 3 disease metrics were much higher among MSM than among either other men or women (38 to 109 times as high).Conclusions:Estimating the population size for MSM allowed us to calculate rates for disease metrics and to develop rate ratios showing dramatically higher rates among MSM than among other men or women. These data greatly improve our understanding of the disproportionate impact of these diseases among MSM in the U.S. and help with prevention planning.

Population Size Estimates for Men who Have Sex with Men and Persons who Inject Drugs

“…Therefore, these data are not directly comparable to estimates that use behavior in the past 5 years 2,8 . However, we believe that the past 12 month estimates are appropriate for identifying populations who continue to be at risk of HIV acquisition.…”

“…To ensure adequate sample size, we included data from 1999-2010. We included adults aged 18-59 years in the analysis and examined prevalence of the following: (1) male-male sex-ever (i.e., among men, having ever had oral or anal sex with another man), (2) male-male sex-past 12 months (i.e., among men, having had oral or anal sex with another man during the past 12 months), (3) injection drug use-ever (i.e., ever injecting drugs not prescribed by a doctor), and (4) injection drug use-past 12 months (i.e., injecting drugs not prescribed by a doctor during the past 12 months). Prevalence estimates for male-male sex are presented with two different denominators: men only and all persons.…”

“…CDC recently published estimates of the population size of gay, bisexual, and other men who have sex with men (collectively referred to as MSM) in the USA 2 . Although these estimates allow calculation of disease rates for HIV, syphilis, and other infections at the national level, extrapolating this estimate to different geographic areas is problematic, as the proportion of the population who are MSM may vary by smaller geographic unit.…”

Estimating the Number of Young Black Men who have Sex with Men (YBMSM) on the South Side of Chicago: Towards HIV Elimination within US Urban Communities

“…2). [25][26][27] A standard method for estimating at-risk populations has not been developed. 4 We chose three approaches, each with their own set of limitations.…”

HIV-Prevention Opportunities With GPS-Based Social and Sexual Networking Applications for Men Who Have Sex With Men

“…MSM make up approximately 3% of the U.S. population (Purcell et al, 2012), yet account for 63% of all new HIV infections and 78% of new infections among men 13 years and older (Centers for Disease Control and Prevention [CDC], 2014). At the end of 2012, MSM accounted for 51% of persons living with an HIV diagnosis and 54% of those living with an AIDS diagnosis in the U.S. (CDC, 2014).…”