Trends in AIDS incidence and survival among racial/ethnic minority men who have sex with men, United States, 1990-1999.
OBJECTIVE
We describe trends in AIDS incidence, survival, and deaths among racial/ethnic minority men who have sex with men (MSM).


METHODS
We examined AIDS surveillance data for men diagnosed with AIDS from 1990 through 1999, survival trends from 1993 through 1997, and trends in AIDS incidence and deaths from 1996 to 1999, when highly active antiretroviral therapy (HAART) was introduced.


RESULTS
The percentage of racial/ethnic minority MSM with AIDS increased from 33% of 26,930 men in 1990 to 54% of 17,162 men in 1999. From 1996 through 1998, declines in AIDS incidence were smallest among black MSM (25%, from 66.2 to 49.5 per 100,000) and Hispanic MSM (29%, from 39.3 to 27.8), compared with white MSM (41%, from 17.9 to 10.5). Declines in deaths of MSM with AIDS were also smallest among black MSM (53%, from 39.7 to 18.6 deaths per 100,000) and Hispanic MSM (61%, 21.6 to 8.4), compared with white MSM (63%, 12.3 to 4.5). Survival improved each year for all racial/ethnic groups but was poorest for black MSM in all years.


CONCLUSIONS
Since the introduction of HAART, a combination of factors that include relatively higher infection rates in more recent years and differences in survival following AIDS diagnosis contribute to observed differences in trends in AIDS incidence and deaths among racial/ethnic minority MSM. Increased development of culturally sensitive HIV prevention services, and improved access to testing and care early in the course of disease are needed to further reduce HIV-related morbidity in racial/ethnic minority MSM.
Blair
Janet M
JM
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. JBlair@cdc.gov
Fleming
Patricia L
PL
Karon
John M
JM
D015492:AIDS Serodiagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D023241:Antiretroviral Therapy, Highly Active; D015528:HIV Seroprevalence / Q000639:trends*; D006630:Hispanic or Latino; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014481:United States / Q000453:epidemiology