Online Program

Social Context and Human Immunodeficiency Virus (HIV) Risk for Black Men who Have Sex with Men (BMSM) in the Southeastern United States (U.S.), 2014

Sunday, November 1, 2015

DeMarc A. Hickson, PhD, MPH, Center for Research, Evaluation, Environmental and Policy Change, My Brother's Keeper, Inc., Jackson, MS
Leandro Mena, MD, MPH, School of Medicine, University of Mississippi Medical Center, Jackson, MS
Nhan Truong, PhD, Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS
NiKendrick Sturdevant, BS, Center for Research, Evaluation, Environmental and Policy Change, My Brother's Keeper, Inc., Jackson, MS
Neena Smith-Bankhead, MS, AID Atlanta, Atlanta, GA
June Gipson, PhD, EdS, Center for Community-Based Programs, My Brother's Keeper, Inc., Ridgeland, MS
Zaneta Gaul, MSPH, Division of HIV/AIDS Prevention, ICF International, CDC, Atlanta, GA
Madeline Sutton, MD, MPH, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Background: BMSM are disproportionately affected by HIV, especially in the southeastern U.S. Factors beyond individual-level risk behaviors that may explain variations in MSM populations, including policy barriers, are underexplored.  We examined several factors that may be associated with increased HIV risk for BMSM living in the southeast. 

Methods: We enrolled BMSM in two southeastern cities. Participants completed electronic surveys regarding demographics, social factors, and behaviors and were screened for HIV and other sexually transmitted infections (STI). We report adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the association between being HIV-positive and social, behavioral and clinical variables.

Results:To date, 328 BMSM have been enrolled: median age= 26 years; 69% identified as gay, 26% as bisexual.  HIV prevalence was 41% (n=134), with 37% (n=50) being newly diagnosed at enrollment or within 12 months before enrollment. Among all participants, 240 (73%) reported being circumcised, 125 (38%) had history of incarceration, and 180 (55%) had no healthcare coverage (previous 12 months).  Being HIV-positive was more likely among BMSM who were living at or below poverty (AOR 2.24, 95% CI 1.06-4.87) or who had a history of syphilis (AOR 3.26; 95% CI 1.41-7.58), and was less likely among younger BMSM (18-24 years) versus BMSM ≥ 35 years (AOR 0.12, 95% CI 0.05-0.27) and bisexual men versus gay men (AOR 0.19; 95% CI 0.08-0.45).

Conclusions: These findings suggest that several factors contribute to HIV risk for BMSM in the southeast. HIV interventions and policies that address poverty, healthcare coverage and strengthen routine HIV/STI screenings are warranted.

Learning Areas:

Diversity and culture
Public health or related public policy
Public health or related research

Learning Objectives:
Describe social factors that contribute to the disproportionate risk of HIV among Black men who have sex with men in the southeastern United States.

Keyword(s): HIV Interventions, Men’s Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Over 20 years working in public health and HIV prevention; multiple publications
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.