Correlates of HIV Acquisition in a Cohort of Black Men Who Have Sex with Men in the United States: HIV Prevention Trials Network (HPTN) 061

• Type of Material: Article
• Authors: Beryl A. Koblin, New York Blood Center; Kenneth H. Mayer, Fenway Health and Beth Israel Deaconess Hospital; Susan H. Eshleman, Johns Hopkins University; Lei Wang, Fred Hutchinson Cancer Research Center; Sharon Mannheimer, Columbia University; Carlos Del Rio, Emory University; Steven Shoptaw, University of California; Manya Magnus, George Washington University; Susan Buchbinder, San Francisco Department of Public Health; Leo Wilton, Binghamton University; Ting-Yuan Liu, Fred Hutchinson Cancer Research Center; Vanessa Cummings, Johns Hopkins University; Estelle Piwowar-Manning, Johns Hopkins University; Sheldon D. Fields, Florida International University; Sam Griffith, FHI 360, Research Triangle Park; Vanessa Elharrar, Clinical Prevention Research Branch/PSP/DAIDS/NIAID/NIH; Darrell Wheeler, Loyola University Chicago
• Language: English
• Date: 2013-07-26
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2013 Koblin et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0070413
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 8
• Issue: 7
• Start Page: e70413
• End Page: e70413
• Grant/Funding Information: Additional site funding - Fenway Institute Clinical Research Site (CRS): Harvard University CFAR (P30 AI060354) and CTU for HIV Prevention and Microbicide Research (UM1 AI069480); George Washington University CRS: District of Columbia Developmental CFAR (P30 AI087714); Harlem Prevention Center CRS and NY Blood Center/Union Square CRS: Columbia University CTU (5U01 AI069466) and ARRA funding (3U01 AI069466-03S1); Hope Clinic of the Emory Vaccine Center CRS and The Ponce de Leon Center CRS: Emory University HIV/AIDS CTU (5U01 AI069418), CFAR (P30 AI050409) and CTSA (UL1 RR025008); San Francisco Vaccine and Prevention CRS: ARRA funding (3U01 AI069496-03S1, 3U01 AI069496-03S2); UCLA Vine Street CRS: UCLA Department of Medicine, Division of Infectious Diseases CTU (U01 AI069424).; The funder had a role in the design of the study by providing input into the design.; The funder did not have a role in the data collection and analysis, decision to publish, or preparation of the manuscript.; HPTN 061 grant support provided by the National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA) and National Institute of Mental Health (NIMH): Cooperative Agreements UM1 AI068619, UM1 AI068617, and UM1 AI068613.
• Keywords: SYPHILIS; Science & Technology; Multidisciplinary Sciences; INFECTION; Science & Technology - Other Topics; MORTALITY; DISPARITIES; RISK
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background:Black men who have sex with men (MSM) in the United States (US) are affected by HIV at disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts.Methods:From July 2009 to October 2010, Black MSM reporting unprotected anal intercourse with a man in the past six months were enrolled and followed for one year in six US cities for a feasibility study of a multi-component intervention to reduce HIV infection. HIV incidence based on HIV seroconversion was calculated as number of events/100 person-years. Multivariate proportional hazards modeling with time-dependent covariates was used to identify correlates of HIV acquisition.Results:Of 1,553 Black MSM enrolled, 1,164 were HIV-uninfected at baseline and included in follow-up. Overall annual HIV incidence was 3.0% (95% confidence interval (CI): 2.0, 4.4%) and 5.9% among men ≤30 years old (95% CI: 3.6, 9.1%). Men ≤30 years old reported significantly higher levels of sexual risk and were more likely to have a sexually transmitted infection diagnosed during follow-up. Younger men also were more likely to not have a usual place for health care, not have visited a health care provider recently, and to have unmet health care needs. In multivariate analysis, age ≤30 years (hazard ratio (HR): 3.4; 95% CI: 1.4, 8.3) and unprotected receptive anal intercourse with HIV-positive or unknown status partners (HR: 4.1; 95% CI: 1.9, 9.1) were significantly associated with HIV acquisition.Conclusion:In the largest cohort of prospectively-followed Black MSM in the US, HIV incidence was high, particularly among young men. Targeted, tailored and culturally appropriate HIV prevention strategies incorporating behavioral, social and biomedical based interventions are urgently needed to lower these rates.