157008 Race, risk, and HIV: An evolving epidemic among young men in North Carolina

Monday, November 5, 2007

Elizabeth A. Torrone, MSPH , School of Public Health, Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Christopher B. Hurt, MD , School of Medicine- Division of Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Kelly A. Green, MPH, MA , The University of North Carolina at Chapel Hill, Chapel Hill, NC
Peter A. Leone, MD , School of Medicine- Division of Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Lisa B. Hightow-Weidman, MD, MPH , School of Medicine- Division of Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: The human immunodeficiency virus (HIV) epidemic in the southeastern United States (US) continues to spread, with a disproportionate impact on young men. In order to develop effective intervention policies, a clear picture of changing trends in demographics and risk factors is needed.

Study objectives: Our goal is to describe the temporal trends in demographics and reported risk behaviors of young men newly diagnosed with HIV in North Carolina (NC).

Methods: We reviewed demographic and behavioral information collected by the NC Department of Health on all men, aged 18-30, with a new HIV diagnosis between 1/1/2000 and 12/31/2005 (n=1,457). Temporal trends in the data were determined using Cochran-Armitage Trend tests.

Results: Racial disparities continued to increase (p=0.02) with the proportion of African American cases increasing from 62.3% to 67.3% and the epidemic began to shift into rural areas (p=0.01). Drug use increased overall (p<0.001), with a sharp rise in club drug use (p=0.02), including crystal methamphetamine; crack use decreased (p=0.04). New venues for meeting sexual partners, such as the Internet, appeared (p<0.001) – while reports of traditional risk factors, such as exchanging sex for money, decreased (p=0.004).

Conclusions: Similar to other regions, use of the Internet to meet sex partners and expansion of club drug use, including crystal methamphetamine, are behaviors becoming more prevalent among newly diagnosed HIV infected men in this southeastern state. By characterizing and understanding changing temporal trends in demographics and risk factors, new intervention strategies can be designed and implemented.

Learning Objectives:
1. Describe the changing demographics of the HIV epidemic among young men in a southeastern US state. 2. Describe trends in risk behaviors reported by newly diagnosed young men, including increasing Internet sex-seeking and club drug use. 3. Recognize the use of routinely collected HIV surveillance data for developing HIV prevention intervention strategies.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: HIV Risk Behaviors among Men: Sexuality, Culture, and Context
See more of: HIV/AIDS