Paper # 972 
High HIV Prevalence Despite Lower Rates of Sexual Risk Behaviors among MSM of Color in Washington, DC
Magnus Manya*1, I Kuo1, G Phillips II1, K Shelley1, A Rawls1, L Montanez1, J Peterson1, T West-Ojo2, S Hader2, and A Greenberg1
1George Washington Univ Sch of Publ Hlth and Hlth Svcs, Washington, DC, US and 2HIV/AIDS Admin, District of Columbia Dept of Hlth, US
Background: The District of Columbia (DC) has among
the highest HIV/AIDS rates in the US, with 3% of the adult population and 6.5%
of black men living with HIV/AIDS. Men who have sex with men (MSM) behavior are
the reported mode of transmission for 78% of white, 28% of black, and 49% of
Latino men. The purpose of this analysis was to assess HIV prevalence and
sexual risk behaviors in a diverse community-based sample of MSM.
Methods: Data for this study were obtained from the
National HIV Behavioral Surveillance (NHBS) system and collected from July 2008
to Dec 08 via venue-based sampling in DC. Males >18 years of age
disclosing MSM activity at least once in the past year were analyzed. HIV
status was assessed using OraQuick rapid test with a Western blot confirmation using
OraSure. Stata was used to characterize the sample and unadjusted and adjusted
characteristics associated with confirmed known and new HIV status using uni-,
bi-, and multivariable methods.
Results: Of 500 participants, 65% were 18 to 34
years of age; 48%, 32%, 5%, and 15% were white, black, Latino, and mixed
race/other, respectively; 85% self-identified as gay; and, 14% were HIV+
and 5% were newly diagnosed with HIV. Compared with white MSM, MSM of color were
significantly more likely to be HIV+ (20% vs 8%) and newly diagnosed
(8% vs 3%) [OR = 5.55 (95%CI 2.71 to 11.39, P <0.001) and OR =
8.84 (95%CI 2.50 to 31.29, P <0.001)] respectively). However,
white MSM were more likely than MSM of color to report >4 male sex
partners in the past 12 months (61% vs 42%, P <0.05), unprotected
anal intercourse (56% vs 31% receptive, P <0.05; 51% vs 30%
insertive, P <0.05), and to have ever engaged in barebacking
(sex with use of a condom) (73% vs 58%, P <0.05).
Discussion: Despite having significantly higher HIV
rates, MSM of color reported significantly lower rates of risk behaviors than
white MSM. These findings suggest that the primary risk of HIV infection in MSM
of color may be network-based and related to non-individual level risk
behaviors. These findings are critical in designing targeted HIV prevention
strategies for this high risk population.
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