July 25, 2012
In the U.S., black men who have sex with men (MSM) are less likely to be on antiretroviral treatment and less likely to be virally suppressed than white MSM, according to a U.S. Centers for Disease Control and Prevention study presented earlier this week at the XIX International AIDS Conference in Washington, D.C.
Although African Americans make up only 11% of the U.S. male population, they account for 37% of new HIV infections among MSM. The study, presented by Linda Beer, Ph.D., set out to determine whether behavioral or clinical differences contributed to this racial disparity.
The researchers analyzed data between June 2009 and May 2010 from the Medical Monitoring Project, a surveillance project designed to learn more about the experiences and needs of people who are receiving care for HIV. Their study population included 691 white MSM and 313 black MSM, all in HIV care.
White MSM were more likely to be on antiretroviral therapy than black MSM (91% vs. 80%), and more likely to be virally suppressed (83% vs. 69%). Viral suppression meant their most recent viral load was less than 200 copies/mL.
In terms of durable viral suppression (i.e., all viral load measurements in the past year were less than 400 copies/mL), only 51% of black MSM met this criterion compared to 73% of white MSM. Since lower viral load decreases the likelihood of HIV transmission, lower rates of viral suppression among black MSM may contribute to higher HIV incidence among this group.
In terms of sexual behaviors, the researchers did not find any significant difference between black and white MSM when it came to unprotected anal sex with an HIV-uninfected partner or partner of unknown status. But they did note that white MSM were 9% more likely to report having more than four sexual partners in the past year.
Beer noted that the study population was limited to those in care, and suggested that the racial disparities in the entire HIV-infected MSM community are likely higher, since studies have shown African Americans are less likely to be linked to and retained in care.
"Our measure was whether or not they had continuous health coverage over the entire previous 12 months," Beer said. "We did find higher prevalence of not having continuous health care coverage among black MSM compared to white MSM, which hopefully the ACA [Affordable Care Act ] will be able to address."
The researchers are beginning to explore how adherence and choice of HIV regimen contribute to the differences in viral suppression.
A similar study finding higher HIV rates in young African-American MSM was also presented at the conference.
Watch Beer's presentation:
Warren Tong is the research editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
Copyright © 2012 Remedy Health Media, LLC. All rights reserved.