HIV risk and HIV testing among men who have sex with men only and men who have sex with men and women in Baltimore, Maryland

This study addresses gaps in the current HIV prevention literature by examining differences between two groups: men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). Cross-sectional self-report data on HIV related behaviors were collected from a racially diverse sample of 448 MSM (men who have sex with men) in 2008 in Baltimore, Maryland. The study used venue-based time space sampling and included an optional HIV test. We used stratified multivariate Poisson regressions to examine associations with HIV and associations with HIV testing. The following factors were associated with being HIV positive among MSMO: being African American, being over the age of 30, having had an STD in the last year, and having health insurance. Among MSMW, having more than three male sex partners and having diverse friendship networks were marginally associated with being HIV positive. Partner characteristics such as race of partner and concurrent partnerships were not associated with HIV for either MSMO or MSMW after adjusting for confounding. Among MSMO, being over the age of 30 and having a doctor recommend an HIV test were associated with having an HIV test in the past six months. Among MSMW, the following factors were associated with having an HIV test in the past six months: race, homelessness, a recent visit to doctor, HIV counseling that was not part of HIV testing, and having an African American male partner. MSMW and MSMO represent distinct populations. HIV prevention programs should address differences between MSMO and MSMW in program planning. HIV counseling might be a particularly important component of HIV prevention efforts for MSMW.