Sexual Risk, Substance Use and Undiagnosed Seropositivity among Men Who Have Sex with Men and Women in Miami, Florida

This paper utilizes the National HIV Behavioral Surveillance data in Miami for the men who have sex with men cycle (NHBS-MSM2) in 2008. We analyzed sexual risk, substance use and undiagnosed seropositivity in a diverse sample of men who have sex with men and women (MSMW) and compared them with MSM. Of 152 MSMW, 15.1% tested HIV positive with 73.9% previously undiagnosed. Almost half (44.1%) of the MSMW reported unprotected sex with male and female partners in the past year. More MSMW than MSM had undiagnosed HIV infection, exchanged sex for money or drugs, used crack and cocaine, been high during sex, and had not received HIV treatment if HIV positive. Undiagnosed HIV infection among MSMW was associated with Black race, older age, non-alcohol use and Ecstasy use. Our findings indicate that MSMW represent a unique population at risk of acquiring and transmitting HIV in Miami

Trends in the HIV Epidemic among Men Who Have Sex with Men in Miami-Dade County, Florida, 2004-2014

Miami, Florida has a large population of Hispanic and black men who have sex with men (MSM), a population more likely to become HIV infected than white MSM. We present here HIV behavioral trends in this population that reflect the effects of public health prevention in Miami over a 10-year period. Using National HIV Behavioral Surveillance (NHBS) data of MSM in Miami-Dade County, Florida, in 2004-05, 2008, 2011 and 2014, chi-square trend analyses were used to assess the epidemiologic trends related to HIV infection rates, HIV testing rates, undiagnosed HIV infection, use antiretroviral therapy (ART) and access to HIV care. Of 258, 527, 511, and 536 MSM, HIV rates have remained steady between 22.5% (95% CI 17.4-27.6) in 2004-05 to a high of 25.9% (95% CI 22.2-29.6) in MSM4 in 2014, with no significant trend. There was an increase in HIV testing in the past six months between 2004 (48.4%;95% CI 41.8-55.0) and 2014 (55.8;95% CI 51.3-60.3), p \u3c .001; and a decrease in unrecognized HIV infection from 48.3% (95% CI 35.4- 61.2) in 2004 to 31.4% (95% CI 23.7-39.1) in 2014, p = .004, over the same period. Being currently on ART and knowledge of pre-exposure prophylaxis (PrEP) also increased significantly during this 10-year period. HIV surveillance is providing valuable information, notably, as HIV testing rates have gone up unrecognized infections have decreased. Continued use of the NHBS system should provide insights into the epidemic and assist in reaching public health goals for the control of HIV infections