HIV diagnoses surge in young black men who have sex with men (MSM) in Milwaukee, WI: A need to revisit local public health strategies and community approach?

Issue: In Fall of 2009, the Centers for Disease Control and Prevention (CDC) conducted an Epi-Aid Investigation in Milwaukee, WI associated with a documented 144% increase in HIV diagnoses in young black Men Who Have Sex with Men (MSM) in Milwaukee County during 2000-2008^1. (1. CDC 2011) Description: As a result of Epi-Aid investigation, the Wisconsin Division of Public Health (WDPH) and City of Milwaukee Health Department (MHD) revisited state and local planning related to prevention and intervention strategies aimed at reducing HIV infection incidence in young minority MSM populations within Milwaukee. The MHD contracted with a community organization to begin a multi-phase approach to engage community members, gay and bisexual youth and healthcare providers in developing a coordinated and comprehensive plan for HIV reduction. Lessons Learned: The Epi-Aid investigation concluded that the increase in HIV diagnoses among young MSM could not be fully explained by increased social network testing and likely reflected a real increase in HIV transmission and infection within Milwaukee during the study period. In addition, interviews conducted by the CDC with young MSM suggested various socio-environmental factors that may play a role in the observed increase including community stigmatization, internalized homophobia and high risk sexual networks. Recommendations: The MHD and WDPH are pursuing a number of new initiatives to address the documented increase in HIV diagnoses including development of a public awareness campaign directed at young MSM populations; dialogue with faith-based leadership; increasing testing opportunities and pursuit of funding for sustainment of community-based partnerships and interventions.