title: Mistaken assumptions and missed opportunities: correlates of undiagnosed HIV infection among black and Latino men who have sex with men.
abstract: OBJECTIVE
  To identify demographic, behavioral, and psychological variables associated with being HIV positive unaware among black and Latino men who have sex with men (MSM).
  
  
  METHODS
  Participants recruited in 3 cities completed a computer-assisted interview and were tested for HIV infection (OraSure Technologies, Bethlehem, PA). HIV-positive unaware MSM were compared with MSM who tested HIV negative in bivariate and multivariate analyses.
  
  
  RESULTS
  Of 1208 MSM (597 black and 611 Latino), 11% were HIV-positive unaware (18% black; 5% Latino). In multivariate analysis of the Latino MSM, being HIV-positive unaware was associated with nongay identity, high perceived risk of currently being HIV positive, and belief that sex with other Latino men reduces HIV transmission risk. Among black MSM, being HIV-positive unaware was associated with gay identity, moderately higher income, having health insurance, sexuality disclosure to a current health care provider, fewer than 3 lifetime HIV tests, high perceived risk of testing HIV positive, and belief that sex with other black men reduces HIV transmission risk.
  
  
  CONCLUSIONS
  HIV prevention efforts should address misperceptions among those black and Latino MSM who believe that assortative (ie, intraracial) sexual mixing reduces risk of HIV infection. Our findings also revealed missed opportunities to diagnose black MSM with HIV infection who were already engaged in care and had disclosed their sexuality to their health care provider. Clinicians should offer HIV testing to all MSM, particularly black MSM, who disclose engaging in recent sex with other men to facilitate earlier diagnosis of HIV infection and reduce transmission risk to sexual partners.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. gmillett@cdc.gov
authors.forename: Gregorio A
authors.initials: GA
authors.lastname: Millett
authors.forename: Helen
authors.initials: H
authors.lastname: Ding
authors.forename: Gary
authors.initials: G
authors.lastname: Marks
authors.forename: William L
authors.initials: WL
authors.lastname: Jeffries
authors.forename: Trista
authors.initials: T
authors.lastname: Bingham
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lauby
authors.forename: Christopher
authors.initials: C
authors.lastname: Murrill
authors.forename: Stephen
authors.initials: S
authors.lastname: Flores
authors.forename: Ann
authors.initials: A
authors.lastname: Stueve
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D021841:Safe Sex; D014481:United States / Q000453:epidemiology