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

Parastu Kasaie; Cameron Stewart; Elizabeth Humes; Lucas Gerace; Jinbing Zhang; Michael J Silverberg; Michael A Horberg; Peter F Rebeiro; Emily P Hyle; Viviane D Lima; Cherise Wong; M John Gill; Kelly Gebo; Richard Moore; Mari M Kitahata; Keri N Althoff

doi:10.1016/j.annepidem.2021.08.021

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.

Authors

Affiliations

¹ Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: pkasaie@jhu.edu.
² Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
⁴ Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA.
⁵ Department of Medicine, Divisions of Infectious Diseases & Epidemiology; Department of Biostatistics; Vanderbilt University School of Medicine, Nashville, TN, USA.
⁶ Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Harvard University Center for AIDS Research, Boston, MA, USA.
⁷ Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Global Patient Safety, Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA.
⁹ Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
¹⁰ Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
¹¹ Department of Medicine, University of Washington, Seattle, WA, USA.

Abstract

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

Abstract

Publication types

MeSH terms

Grants and funding