title: Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States.
abstract: Using data from a multisite venue-based survey of male subjects aged 15 to 22 years, we examined racial/ethnic differences in demographics, partner type, partner type-specific condom use, drug use, and HIV prevalence in 3316 US black, multiethnic black, Latino, and white men who have sex with men (MSM). We further estimated associations of these factors with HIV infection and their influence on racial/ethnic disparities in HIV prevalence. HIV prevalences were 16% for both black and multiethnic black participants, 6.9% for Latinos, and 3.3% for whites. Paradoxically, potentially risky sex and drug-using behaviors were generally reported most frequently by whites and least frequently by blacks. In a multiple logistic regression analysis, positive associations with HIV included older age, being out of school or work, sex while on crack cocaine, and anal sex with another male regardless of reported condom use level. Differences in these factors did not explain the racial/ethnic disparities in HIV prevalence, with both groups of blacks experiencing more than 9 times and Latinos experiencing approximately twice the fully adjusted odds of infection compared with whites. Understanding racial/ethnic disparities in HIV risk requires information beyond the traditional risk behavior and partnership type distinctions. Prevention programs should address risks in steady partnerships, target young men before sexual initiation with male partners, and tailor interventions to men of color and of lower socioeconomic status.
authors.affiliation: County of Los Angeles, Department of Health Services, Los Angeles, CA 90005, USA. nharawa@dhs.co.la.ca.us
authors.forename: Nina T
authors.initials: NT
authors.lastname: Harawa
authors.forename: Sander
authors.initials: S
authors.lastname: Greenland
authors.forename: Trista A
authors.initials: TA
authors.lastname: Bingham
authors.forename: Denise F
authors.initials: DF
authors.lastname: Johnson
authors.forename: Susan D
authors.initials: SD
authors.lastname: Cochran
authors.forename: William E
authors.initials: WE
authors.lastname: Cunningham
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.forename: Marlene
authors.initials: M
authors.lastname: LaLota
authors.forename: Duncan A
authors.initials: DA
authors.lastname: MacKellar
authors.forename: William
authors.initials: W
authors.lastname: McFarland
authors.forename: Douglas
authors.initials: D
authors.lastname: Shehan
authors.forename: Sue
authors.initials: S
authors.lastname: Stoyanoff
authors.forename: Hanne
authors.initials: H
authors.lastname: Thiede
authors.forename: Lucia
authors.initials: L
authors.lastname: Torian
authors.forename: Lucia A
authors.initials: LA
authors.lastname: Valleroy
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology; D006306:Health Surveys; D006630:Hispanic or Latino; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D044465:White People