Mistaken Assumptions and Missed Opportunities: Correlates of Undiagnosed HIV Infection Among Black and Latino Men Who Have Sex With Men

The authors of the current study sought to identify the correlates of being HIV-positive but unaware among black and Latino men who have sex with men. These men were compared with HIV-negative MSM in bivariate and multivariate analyses.

Participants in three cities completed a computer-assisted interview and were tested for HIV. Of 1,208 MSM (597 black; 611 Latino) tested, 11 percent were unaware they were HIV-positive (18 percent black; 5 percent Latino).

Multivariate analysis showed being Latino HIV-positive unaware was associated with non-gay identity, high perceived risk of being HIV-positive, and belief that sex with other Latino MSM reduces HIV risk. Among black MSM, being HIV-positive unaware was associated with gay identity, moderately higher income, having health insurance, disclosure of sexuality to health care provider, fewer than three lifetime HIV tests, high perceived risk of being HIV-positive, and belief that sex with other black MSM reduces HIV risk.

"HIV prevention efforts should address misperceptions among those black and Latino MSM who believe assortative (i.e., intra-racial) sexual mixing reduces risk of HIV infection," the authors suggested. "Our findings also revealed missed opportunities to diagnose black MSM with HIV infection who were already engaged in care and had disclosed their sexuality to their health care provider. Clinicians should offer HIV testing to all MSM, particularly black MSM who disclose engaging in recent sex with other men, to facilitate earlier diagnosis of HIV infection and reduce transmission risk to sexual partners."

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