142nd APHA Annual Meeting and Exposition

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313747
Differential Rates in Acute HIV Infection Diagnosis in Men who Have Sex with Men at a Community-based Organization in Los Angeles, California

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Matthew Beymer, MPH , Fielding School of Public Health, L.A. Gay & Lesbian Center and University of California, Los Angeles, Los Angeles, CA
Robert Bolan, MD , Los Angeles Gay and Lesbian Center, Los Angeles, CA
Risa Flynn, BA , L.A. Gay & Lesbian Center, Los Angeles, CA
  
Background: Over 22% of all HIV infections in the United States are diagnosed in African-American MSM. African-American MSM bear the largest disparity in HIV infection compared to other groups at risk with over six times the rate experienced by White MSM. The objective of this study was to determine if there were disparities in diagnosis of early/acute HIV infection by race.

Methods: Data were analyzed for all HIV positive diagnoses given to MSM at the L.A. Gay & Lesbian Center between January 2011 and January 2014 (n=618). Acute HIV infections were defined as a negative result for an HIV antibody test paired with a positive result for a HIV nucleic acid amplification test (NAAT). Acute HIV infections were compared to non-acute HIV infections in a multivariate logistic regression by race, age group and education level.

Results: The proportion of acute HIV diagnoses was 16.3% in White MSM but only 4.6% in African-American MSM. A multivariate logistic regression showed that African-American MSM had 74% lower odds of acute HIV infection diagnosis when compared to White MSM (p=0.04, OR: 0.26; CI: 0.11-0.66), controlling for age group and education level.

Discussion: African-American MSM in this study accounted for a significantly lower proportion of acute HIV infections than other racial groups. This study demonstrates that African-American MSM have lower rates of early HIV detection, potentially contributing to increased HIV transmission. NAAT testing should be more actively promoted in the African-American MSM community of Los Angeles as a tool for early HIV detection.

Learning Areas:

Public health or related public policy

Learning Objectives:
Identify racial disparities in early/acute identification of HIV Describe methods for early detection of HIV in the most high-risk populations

Keyword(s): HIV Risk Behavior, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PhD student in Public Health at the University of California, Los Angeles. In addition, I have worked for the past three years as the epidemiologist for the L.A. Gay & Lesbian Center with a specialization in the epidemiology of sexually transmitted infections including HIV.
Any relevant financial relationships? No

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.

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