The continuing HIV epidemic among men who have sex with men.
OBJECTIVE
This study characterized the AIDS epidemic among urban men who have sex with men (MSM).


METHODS
A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures.


RESULTS
HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were non-significant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1%-2%).


CONCLUSIONS
Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.
Catania
J A
JA
Center for AIDS Prevention Studies, University of California, San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105, USA. jcatania@psg.ucsf.edu
Osmond
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Stall
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Pollack
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Paul
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Blower
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Binson
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Canchola
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Mills
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Fisher
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Choi
K H
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Porco
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Turner
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Blair
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Henne
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Bye
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Coates
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TJ
D000293:Adolescent; D000328:Adult; D004196:Disease Outbreaks; D005006:Ethnicity / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology*; D006306:Health Surveys; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data