title: HIV among Black men who have sex with men (MSM) in the United States: a review of the literature.
abstract: In 2006, Millett published a seminal literature review that examined 12 hypotheses to explain the high rates of HIV among black MSM. This paper augments Millett's article by reviewing the recent literature on behavioral, biomedical, structural, social contextual, psychosocial, and social network factors that affect HIV rates among black MSM. We searched three databases: PubMed, Scopus, and Google Scholar. First we searched all articles that included black or African American and MSM and HIV. We then searched the following terms for each area: behavioral (drug use during sex, crack cocaine use, and serosorting); biomedical (circumcision, STDs, and STIs); structural (access to care, HIV care, ART, HAART, patient-provider communication, HIV quality of care); social contextual (stigma, discrimination, internalized homophobia, internalized heterosexism, medical mistrust, social isolation, and incarceration); psychosocial (peer support and mental health); and social network (sexual mixing, partner characteristics, and social networks) factors. We identified 39 articles to include in this review. We found inconclusive evidence that incarceration, stigma, discrimination, social isolation, mental health disparities, or social networks explain the elevated rates of HIV among black MSM. We found evidence that the differences in rates of HIV between black and white MSM may be explained by differences in STIs, undiagnosed seropositivity, access to care and treatment services, and use of HAART. There is an overwhelming need for HIV testing, linkage to care, retention in care, and adherence programs for black MSM.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, STE 904C, Baltimore, MD, 21205, USA, cmaulsby@jhsph.edu.
authors.forename: Cathy
authors.initials: C
authors.lastname: Maulsby
authors.forename: Greg
authors.initials: G
authors.lastname: Millett
authors.forename: Kali
authors.initials: K
authors.lastname: Lindsey
authors.forename: Robin
authors.initials: R
authors.lastname: Kelley
authors.forename: Kim
authors.initials: K
authors.lastname: Johnson
authors.forename: Daniel
authors.initials: D
authors.lastname: Montoya
authors.forename: David
authors.initials: D
authors.lastname: Holtgrave
mesh_terms: D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015438:Health Behavior; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D054625:Healthcare Disparities; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008605:Mental Health Services; D012307:Risk Factors; D012747:Sexual Partners; D063508:Social Discrimination; D012934:Social Isolation; D057545:Social Stigma; D012944:Social Support; D014481:United States / Q000453:epidemiology