Projecting the age-distribution of men who have sex with men receiving HIV treatment in the United States

Ann Epidemiol. 2022 Jan;65:46-55. doi: 10.1016/j.annepidem.2021.08.021. Epub 2021 Oct 7.


Background: The age-distribution of men who have sex with men (MSM) continues to change in the 'Treat-All' era as effective test-and-treat programs target key-populations. However, the nature of these changes and potential racial heterogeneities remain uncertain.

Methods: The PEARL model is an agent-based simulation of MSM in HIV care in the US, calibrated to data from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Results: PEARL projects a gradual decrease in median age of MSM at ART initiation from 36 to 31 years during 2010-2030, accompanied by changes in mortality among Black, White, and Hispanic MSM on ART by -8.4%, 42.4% and -19.6%. The median age of all MSM on ART is projected to increase from 45 to 47 years from 2010-2030, with the proportion of ART-users age ≥60y increasing from 6.7% to 28.0%. Almost half (49.7%) of White MSM ART-users are projected to age ≥60y by 2030, compared to 19.5% of Black and 17.2% of Hispanic MSM.

Conclusions: The overall age of US MSM in HIV care is expected to increase over the next decade, and differentially by race/ethnicity. As this population age, HIV programs should expand care for age-related causes of morbidity and mortality.

Keywords: Aging; Computer simulation; HIV; Hispanic ethnicity; People who inject drugs; Racial disparities; Sexual and Gender Minorities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Hispanic or Latino
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Racial Groups
  • Sexual and Gender Minorities*
  • United States / epidemiology

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