HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men - United States

Abstract

The burden of human immunodeficiency virus (HIV) is high among gay, bisexual, and other men who have sex with men (MSM). High HIV prevalence, lack of awareness of HIV-positive status, unprotected anal sex, and increased viral load among HIV-positive MSM not on antiretroviral treatment contribute substantially to new infections among this population. CDC analyzed data from the National HIV Surveillance System (NHSS) to estimate the percentage of HIV diagnoses among MSM by area of residence and data from the National HIV Behavioral Surveillance System (NHBS) to estimate unprotected anal sex in the past 12 months among MSM in 2005, 2008, and 2011; unprotected discordant anal sex at last sex (i.e., with a partner of opposite or unknown HIV status) in 2008 and 2011; and HIV testing history and the percentage HIV-positive but unaware of their HIV status by the time since their last HIV test in 2011. This report describes the results of these analyses. In all but two states, the majority of new HIV diagnoses were among MSM in 2011. Unprotected anal sex at least once in the past 12 months increased from 48% in 2005 to 57% in 2011 (p<0.001). The percentage engaging in unprotected discordant anal sex was 13% in 2008 and 2011. In 2011, 33% of HIV-positive but unaware MSM reported unprotected discordant anal sex. Among MSM with negative or unknown HIV status, 67% had an HIV test in the past 12 months. Among those tested recently, the percentage HIV-positive but unaware of their infection was 4%, 5%, and 7% among those tested in the past ≤3, 4-6, and 7-12 months, respectively. Expanded efforts are needed to reduce HIV risk behaviors and to promote at least annual HIV testing among MSM.

FIGURE 1

Estimated percentage of persons diagnosed with HIV with infection attributed to male-to-male contact or male-to-male contact and injection drug use, by area of residence — National HIV Surveillance System, United States, 2011

FIGURE 2

Time since last human immunodeficiency virus (HIV) test among men who have sex with men who reported negative or unknown HIV status,* — National HIV Behavioral Surveillance System, United States, 2011^† * Includes respondents who reported their last HIV test result was negative, indeterminate, did not receive test results, did not know the results, or had never been tested. ^† N = 7,312; excludes 76 respondents missing data for time of HIV test.

FIGURE 3

Percentage who were human immunodeficiency virus (HIV)-positive unaware among men who have sex with men who reported negative or unknown HIV status, by time since last HIV test — National HIV Behavioral Surveillance System, United States, 2011* * N = 7,312; excludes 76 respondents missing data for time of HIV test. Bars represents percentage testing positive in the survey among men who have sex with men who reported having had an HIV test at each time interval.