The continuing HIV epidemic among men who have sex with men

Am J Public Health. 2001 Jun;91(6):907-14. doi: 10.2105/ajph.91.6.907.


Objectives: This study characterized the AIDS epidemic among urban men who have sex with men (MSM).

Methods: A probability sample of MSM was obtained in 1997 (n = 2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures.

Results: HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (32%), and less educated men (< high school, 37%). City-level HIV differences were non-significant once these other factors were controlled for. In comparing the present findings with historical data based on public records and modeling, HIV prevalence appears to have declined as a result of high mortality (69%) and stable, but high, incidence rates (1%-2%).

Conclusions: Although the findings suggest that HIV prevalence has declined significantly from the mid-1980s, current levels among urban MSM in the United States approximate those of sub-Saharan countries (e.g., 14%-25%) and are extremely high in many population subsegments. Despite years of progress, the AIDS epidemic continues unabated among subsegments of the MSM community.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Disease Outbreaks*
  • Ethnic Groups / statistics & numerical data
  • HIV Infections / epidemiology*
  • Health Surveys
  • Homosexuality, Male / statistics & numerical data*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Socioeconomic Factors
  • Substance-Related Disorders / epidemiology
  • United States / epidemiology
  • Urban Population / statistics & numerical data