title: Incidence and Predictors of HIV Infection Among Men Who Have Sex with Men Attending Public Sexually Transmitted Disease Clinics, New York City, 2007-2012.
abstract: We examined five annual cohorts (2007-2011) of men who have sex with men (MSM) attending New York City STD clinics who had negative HIV-1 nucleic acid amplification tests (NAATs) on the day of clinic visit. Annual HIV incidence was calculated using HIV diagnoses within 1 year of negative NAAT, determined by matching with the citywide HIV registry. Predictors (demographic; behavioral; bacterial STD from citywide STD registry match) of all new HIV diagnoses through 2012 were calculated from Cox proportional hazards models. Among 10,487 HIV NAAT-negative MSM, 371 had an HIV diagnosis within 1 year. Annual incidence was 2.4/100 person-years, and highest among non-Hispanic black MSM (4.1/100 person-years) and MSM aged <20 years (5.7/100 person-years). Characteristics associated with all 648 new HIV diagnoses included: black race (aHR 2.2; 95 % CI 1.6-3.1), condomless receptive anal sex (aHR 2.1; 95 % CI 1.5-2.8), condomless insertive anal sex (aHR 1.3; 95 % CI 1.1-1.8), and incident STD diagnosis (aHR 1.6; 95 % CI 1.3-1.9). MSM attending STD clinics have substantial HIV incidence and report risk behaviors that are highly associated with HIV acquisition. Increased uptake of effective interventions, e.g., pre- and post-exposure prophylaxis, is needed.
authors.affiliation: Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th Street, Queens, New York, 11101-4132, NY, USA. ppathela@health.nyc.gov.
authors.forename: Preeti
authors.identifier: http://orcid.org/0000-0001-9745-6079
authors.initials: P
authors.lastname: Pathela
authors.affiliation: Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th Street, Queens, New York, 11101-4132, NY, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Jamison
authors.affiliation: Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Braunstein
authors.affiliation: Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th Street, Queens, New York, 11101-4132, NY, USA.|Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Schillinger
authors.affiliation: Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.affiliation: Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th Street, Queens, New York, 11101-4132, NY, USA.|Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Blank
mesh_terms: D000328:Adult; D001741:Black or African American; D044383:Black People; D015331:Cohort Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D015497:HIV-1 / Q000302:isolation & purification*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control
keywords: HIV incidence; Men who have sex with men; STD clinics