New HIV diagnoses trended downward among US men who have sex with men (MSM) from 2008 through 2014, according to a Centers for Disease Control and Prevention (CDC) analysis . But new diagnoses rose significantly in Hispanic MSM and MSM 13 to 34 years old.
To explore trends in HIV diagnoses among subgroups of US MSM nationally and by state, CDC investigators analyzed National HIV Surveillance System data collected through June 2016 for people at least 13 years old at diagnosis and with infection attributed to sex between men. The analyses considered all MSM and subgroups defined by race/ethnicity and age. To chart changes in diagnosis rates, the CDC team calculated estimated annual percent change (EAPC) for each group.
Among all US MSM, the number of new HIV diagnoses fell from 27,026 in 2008 to 26,637 in 2014, a nonsignificant change (EAPC -0.4, P < 0.1). New diagnoses among Hispanic MSM rose significantly from 6071 in 2008 to 6907 in 2014 (EAPC +2.0, P < 0.0001) while falling significantly in white MSM from 9280 to 7950 (EAPC -2.6, P < 0.0001) and staying flat in black MSM.
From year to year new HIV diagnoses climbed significantly in 13-to-24-year-olds (EAPC +2.6, P < 0.0001) and 25-to-34-year-olds (EAPC +2.8, P < 0.0001). But the rate dropped significantly in 35-to-44-year-olds (EAPC -6.9, P < 0.0001) and 45-to-54-year olds (EAPC -3, P < 0.0001) while not changing significantly in older men.
Among the 50 states and Washington, DC, 12 states had significantly decreasing HIV diagnoses among all MSM and 7 had significantly increasing diagnoses. States with significant declines in new HIV diagnoses among all MSM were spread across the country: California, Colorado, Washington, DC, Delaware, Florida, Georgia, Idaho, Maryland, Missouri, New York, North Carolina, and Washington state. States with significant increases in new diagnoses among all MSM were all in the South or Southwest: Alabama, Arkansas, Arizona, Louisiana, Nevada, South Carolina, and Texas.
For Hispanic MSM 7 states had significant increases in HIV diagnoses and none had significant decreases. For white MSM 1 state had a significant increase and 14 had significant decreases. Numbers of states with significant diagnosis increases and decreases were 16 and 3 for the 13-to-24 group, 18 and 1 for the 25-to-35 group, 0 and 23 for the 35-to-44 group, and 0 and 7 for the 45-to-54 group.
The researchers noted that analyzing HIV diagnosis trends at the national level "obscures important geographic variability." For example, even states with overall drops in diagnoses did not have significant drops among Hispanic MSM. California and Florida has significant declines in HIV diagnoses among all MSM but significant gains among Hispanic MSM.
- Oster AM, Tang T, Hall HI. Trends in HIV infection diagnoses among men who have sex with men, overall and by state, United States, 2008-2014. 9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris. Abstract TUPEC0790.