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.
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.
Harawa
Nina T
NT
County of Los Angeles, Department of Health Services, Los Angeles, CA 90005, USA. nharawa@dhs.co.la.ca.us
Greenland
Sander
S
Bingham
Trista A
TA
Johnson
Denise F
DF
Cochran
Susan D
SD
Cunningham
William E
WE
Celentano
David D
DD
Koblin
Beryl A
BA
LaLota
Marlene
M
MacKellar
Duncan A
DA
McFarland
William
W
Shehan
Douglas
D
Stoyanoff
Sue
S
Thiede
Hanne
H
Torian
Lucia
L
Valleroy
Lucia A
LA
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