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1.  Age, Race/Ethnicity, and Behavioral Risk Factors Associated with Per-Contact Risk of HIV Infection Among Men Who Have Sex with Men in the United States 
Objective
Young men who have sex with men (MSM) and MSM of color have the highest HIV incidence in the US. To explore possible explanations for these disparities and known individual risk factors we analyzed the per-contact risk (PCR) of HIV seroconversion in the early highly active antiretroviral therapy era.
Methods
Data from three longitudinal studies of MSM, HIVNET Vaccine Preparedness Study, EXPLORE behavioral efficacy trial, and VAX004 vaccine efficacy trial were pooled. The analysis included visits where participants reported unprotected receptive anal intercourse (URA), protected receptive anal intercourse (PRA), or unprotective insertive anal intercourse (UIA) with an HIV seropositive, unknown HIV serostatus, or an HIV seronegative partner. We used regression standardization to estimate average PCRs for each type of contact, with bootstrap confidence intervals.
Results
The estimated PCR was highest for URA with an HIV seropositive partner (0.73%; 95%BCI 0.45%-0.98%) followed by URA with a partner of unknown HIV serostatus (0.49%; 95%BCI 0.32%-0.62%). The estimated PCR for PRA and UIA with an HIV seropositive partner was 0.08% (95%BCI 0.0%-0.19%) and 0.22% (95%BCI 0.05%-0.39%) respectively. Average PCRs for URA and UIA with HIV seropositive partners were higher by 0.14-0.34% among younger participants and higher by 0.08% for UIA among Latino participants compared to White participants. Estimated PCRs increased with increasing number of sexual partners, use of methamphetamines or poppers, and history of sexually transmitted infection.
Conclusions
Susceptibility or partner factors may explain the higher HIV conversion risk for younger MSM, some MSM of color, and those reporting individual risk factors.
doi:10.1097/QAI.0b013e3182a98bae
PMCID: PMC3894586  PMID: 24419067
HIV; MSM; USA; per contact risk
2.  Racial/ethnic and sexual behavior disparities in rates of sexually transmitted infections, San Francisco, 1999-2008 
BMC Public Health  2010;10:315.
Background
Racial/ethnic minorities and men who have sex with men (MSM) represent populations with disparate sexually transmitted infection (STI) rates. While race-specific STI rates have been widely reported, STI rates among MSM is often challenging given the absence of MSM population estimates. We evaluated the race-specific rates of chlamydia and gonorrhea among MSM and non-MSM in San Francisco between 1999-2008.
Methods
2000 US Census data for San Francisco was used to estimate the number of African-American, Asian/Pacific Islander, Hispanic, and white males. Data from National HIV Behavioral Surveillance (NHBS) MSM 1, conducted in 2004, was used to estimate the total number of MSM in San Francisco and the size of race/ethnic sub-populations of MSM. Non-MSM estimates were calculated by subtracting the number of estimated MSM from the total number of males residing in San Francisco. Rates of MSM and non-MSM gonorrhea and chlamydia reported between 1999 and 2008 were stratified by race/ethnicity. Ratios of MSM and non-MSM rates of morbidity were calculated by race/ethnicity.
Results
Between 1999-2008, MSM accounted for 72% of gonorrhea cases and 51% of chlamydia cases. Throughout the study period, African-American MSM had the highest chlamydia rate with 606 cases per 100,000 in 1999 increasing to 2067 cases per 100,000 in 2008. Asian/Pacific Islander MSM consistently had the lowest rate among MSM with1003 cases per 100,000 in 2008. The ratio of MSM/non-MSM for chlamydia was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0). Gonorrhea rates were similar for African-American, white, and Hispanic MSM between 2137-2441 cases per 100,000 in 2008. Asian/Pacific Islander MSM had the lowest gonorrhea rate with 865 cases per 100,000 in 2008. The ratio of MSM/non-MSM for gonorrhea was highest among whites 11.6 (95% CI: 8.8-14.4) and Asian/Pacific Islanders 8.6 (95% CI: 6.2-11), and lowest among African-Americans 1.53 (95% CI: 1.2-1.9) and Hispanics 4.43 (95% CI: 2.8-6.0).
Conclusions
For all racial/ethnic groups in San Francisco, MSM carried a substantially higher burden of STIs compared to non-MSM except among African-American men. These racial and sexual behavior disparities warrant further public health attention and resources.
doi:10.1186/1471-2458-10-315
PMCID: PMC2903517  PMID: 20525397

Results 1-2 (2)