title: Unmet HIV service needs among Black men who have sex with men in the United States.
abstract: The National HIV/AIDS Strategy (NHAS) clearly emphasized the need to provide services to black men who have sex with men (MSM). However, there are no estimates of the unmet HIV-related service delivery needs among black MSM. We estimate that of 195,313 black MSM living with HIV in the US, 50,196 were not yet diagnosed, and 145,118 were aware of their seropositivity (of whom 67,625 were not linked to care and 77,493 were linked to care). Also, of those already diagnosed, ~43,390 had undetectable viral load and 101,728 had detectable viral load. Approximately 19,545 of diagnosed black MSM engage in unprotected risk behavior in serostatus-discordant partnerships. The cost of delivering services needed to meet the NHAS goals is ~$2.475 billion in 2011 U.S. dollars. Mathematical modeling suggests that provisions of these services would avert 6213 HIV infections at an economically favorable cost of $20,032 per quality-adjusted life year saved.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA, dholtgra@jhsph.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Holtgrave
authors.forename: J Janet
authors.initials: JJ
authors.lastname: Kim
authors.forename: Chris
authors.initials: C
authors.lastname: Adkins
authors.forename: Cathy
authors.initials: C
authors.lastname: Maulsby
authors.forename: Kali D
authors.initials: KD
authors.lastname: Lindsey
authors.forename: Kim M
authors.initials: KM
authors.lastname: Johnson
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Montoya
authors.forename: Robin T
authors.initials: RT
authors.lastname: Kelley
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D006679:HIV Seropositivity; D006301:Health Services Needs and Demand / Q000191:economics*; D054625:Healthcare Disparities; D018451:Homosexuality, Male; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012747:Sexual Partners; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex; D019562:Viral Load; D055815:Young Adult