Adjusted prevalence^a of current ARV treatment by race/ethnicity among MSM—NHBS, 2008 and 2011.

<p>Adjusted prevalences from a model adjusted for year, current age, annual household income, current insurance, venue type where recruitment occurred, and city (random effect) show that the percent of blacks currently on antiretroviral therapy is significantly less than the percent of whites currently on antiretroviral therapy in both years. ^<b>a</b>Adjusted prevalence estimated from the following model: current ARV = α + β1*race + β 2*age + β 3*current insurance + β 4*income + β 5*venue type + β 6*year + β 7*race*year + β 8*age*year + β 9*current insurance*year + β 10*income*year; city is included as a random effect; adjusted prevalence ratio based on combined 2008, 2011 data comparing whites to blacks was 1.09 (CI: 1.02–1.16); ^<b>b</b>Hispanics can be of any race; ^<b>c</b>Includes MSM reporting American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, other race, or multiple races.</p

Prevalence and awareness of HIV status among MSM.

<p>(A) HIV prevalence of MSM interviewed in 2008 and 2011 by race/ethnicity. Compared to white MSM, black MSM were nearly twice (PR: 1.99) as likely to be HIV positive. (B) Awareness of HIV infection among MSM interviewed in 2008 and 2011 by race/ethnicity. Compared to white MSM, black MSM were 40% (PR: 0.60) less likely to be aware of their HIV infection status. *PRs (prevalence ratios) based on combined 2008, 2011 data. Separate analysis of 2008 and 2011 data produced similar results for prevalence and awareness in both 2008 and 2011 (not shown). CI: 95% confidence interval.</p

Response rates of men who have sex with men– National HIV Behavioral Surveillance System, 20 Cities, United States, 2008 and 2011.

a<p>All men were eligible for participation in NHBS in 2008.</p>b<p>Only men who reported ever having sex with another man were eligible for interview in NHBS in 2011.</p>c<p>Limited to men who reported sex with a man in the past 12 months, had a valid HIV test result, and provided valid interview data.</p

Characteristics of men who have sex with men– National HIV Behavioral Surveillance System, 20 Cities, United States, 2008 and 2011.

a<p>Includes: American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, other race, or multiple races.</p>b<p>Participants were asked if they had ever told anyone they were attracted to other men (Yes or No).</p>c<p>Venue type refers to the type of venue the participant was recruited from.</p>d<p>Other venues include gyms, restaurants, parks, street locations, social organizations, and other places where MSM congregate.</p

Increases in HIV Testing among Men Who Have Sex with Men — National HIV Behavioral Surveillance System, 20 U.S. Metropolitan Statistical Areas, 2008 and 2011

<div><p>In 2011, 62% of estimated new HIV diagnoses in the United States were attributed to male-to-male sexual contact (men who have sex with men, MSM); 39% of these MSM were black or African American. HIV testing, recommended at least annually by CDC for sexually active MSM, is an essential first step in HIV care and treatment for HIV-positive individuals. A variety of HIV testing initiatives, designed to reach populations disproportionately affected by HIV, have been developed at both national and local levels. We assessed changes in HIV testing behavior among MSM participating in the National HIV Behavioral Surveillance System in 2008 and 2011. We compared the percentages tested in the previous 12 months in 2008 and 2011, overall and by race/ethnicity and age group. In unadjusted analyses, recent HIV testing increased from 63% in 2008 to 67% in 2011 overall (<i>P</i><0.001), from 63% to 71% among black MSM (<i>P</i><0.001), and from 63% to 75% among MSM of other/multiple races (<i>P</i><0.001); testing did not increase significantly for white or Hispanic/Latino MSM. Multivariable model results indicated an overall increase in recent HIV testing (adjusted prevalence ratio [aPR] = 1.07, <i>P</i><0.001). Increases were largest for black MSM (aPR = 1.12, <i>P</i><0.001) and MSM of other/multiple races (aPR = 1.20, <i>P</i><0.001). Among MSM aged 18–19 years, recent HIV testing was shown to increase significantly among black MSM (aPR = 1.20, <i>P</i> = 0.007), but not among MSM of other racial/ethnic groups. Increases in recent HIV testing among populations most affected by HIV are encouraging, but despite these increases, improved testing coverage is needed to meet CDC recommendations.</p></div

Sample characteristics by year among men who have sex with men — National HIV Behavioral Surveillance System, 20 U.S. cities, 2008 and 2011.

<p>Percentages may not add to 100, due to rounding or missing values.</p><p>*Hispanics/Latinos can be of any race; categories are mutually exclusive.</p><p>Sample characteristics by year among men who have sex with men — National HIV Behavioral Surveillance System, 20 U.S. cities, 2008 and 2011.</p

Number of HIV tests in a two-year period among MSM in 2008 and 2011.

<p>During the interview, NHBS participants were asked to report their HIV testing frequency in the two years before interview. Testing twice in a two-year period was used as a proxy for annual testing. The distribution of HIV testing frequency among MSM during the 2 years before interview, shown here, changed from 2008 to 2011 (P<0.001). The percentage of men who tested one time or less in the 2 years before interview (less than annually) decreased from 40% in 2008 to 34% in 2011. The percentage who tested twice in two years (annually) was similar (23% to 22%), while the percentage of men who tested three or more times in two years (more than annually) increased from 37% to 44%.</p

HIV testing in previous 12 months, stratified by race/ethnicity and age group, among men who have sex with men — National HIV Behavioral Surveillance System, 20 U.S. cities, 2008 and 2011.

<p>aPR  =  Adjusted Prevalence Ratio and CI  =  Confidence Interval.</p><p>*Unadjusted <i>P</i>-value.</p>†<p>Adjusted for race/ethnicity, age group, education, income, MSA, race/ethnicity by interview year, age group by interview year, race/ethnicity by age group, and race/ethnicity by age group by interview year; aPR presented for the three-way interaction term, race/ethnicity by age group by interview year.</p>§<p>Hispanics/Latinos can be of any race; categories are mutually exclusive.</p><p>HIV testing in previous 12 months, stratified by race/ethnicity and age group, among men who have sex with men — National HIV Behavioral Surveillance System, 20 U.S. cities, 2008 and 2011.</p

Estimated proportion of persons who injected drugs (PWID) in the past year, by survey and combined by meta-analysis, United States.

<p>*Q₂ = 11.7, p<0.01, I² = 82.9.</p><p>NSDUH  =  National Survey of Drug Use and Health (2002–2009); NHANES = National Health and Nutrition Examination Survey (1999–2008); NSFG = National Survey of Family Growth (2002 and 2006–2008).</p

Diagnoses of HIV infection among persons who inject drugs (PWID), by sex- - United States, 2011.

<p>Note. Data include persons age 13 years and older with a diagnosis of HIV infection regardless of stage of disease at diagnosis. CI = confidence interval.</p><p>* Number of cases diagnosed with HIV infection or living with HIV infection was statistically adjusted to account for reporting delays and missing risk factor information, but not for incomplete reporting.</p><p>**Per 100,000 PWID.</p