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HIV Risk and Treatment Disparities Persist in US Hispanic vs White MSM
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AIDS 2020: 23rd International AIDS Conference Virtual, July 6-10, 2020
Mark Mascolini
Although US Hispanic men who have sex with men (MSM) lowered rates of HIV risk and improved rates of HIV awareness and viral suppression once treatment begins, Hispanic men still trail whites in several important measures, according to a systematic review by the Centers for Disease Control and Prevention (CDC) [1]. Similar high proportions of Hispanic and white MSM get an antiretroviral prescription after HIV diagnosis.
Hispanic MSM have become the only US racial/ethnic group with a growing rate of new HIV infection, according to the CDC. To get a better understanding of HIV risk, awareness, and treatment in Hispanic men, CDC investigators collated recent relevant data from several sources, including online publication and abstract databases, the CDC HIV Resource Library, Ryan White HIV/AIDS Program Data Reports, and Atlas Plus. They aimed to assess four major outcomes: (1) high-risk sex among HIV-negative MSM, (2) knowledge of HIV status, (3) whether they received antiretroviral therapy (ART), and (4) viral suppression among ART-treated men.
A higher proportion of HIV-negative Hispanic MSM than white MSM had condomless sex with an HIV-positive or status-unknown partner without taking PrEP. The proportion of Hispanic MSM with this risk trait appeared to decline modestly over recent years (15% in 2011, 15% in 2014, 12% in 2017) but never reached levels reported in white MSM (11% in 2011, 11% in 2014, and 9% in 2017).
In the first half of the last decade, a consistently lower proportion of Hispanic than white MSM knew their HIV status, although proportions inched upward for both Hispanic MSM (77% in 2011, 77% in 2012, 78% in 2013, 79% in 2014, 79% in 2015, 80% in 2016) and white MSM (86% in 2011, 87% in 2012, 87% in 2013, 88% in 2014, 88% in 2015, 89% in 2016).
Similar high proportions of Hispanic and white MSM diagnosed with HIV and in care reported having an ART prescription in the past 12 months: 92% and 93% in 2011, 91% and 92% in 2012, and 94% and 95% in 2013.
Among MSM in care for HIV infection, the proportion of Hispanics reporting viral suppression in the past 12 months rose gradually in the last decade but never equaled the proportion in whites: 76% versus 79% in 2011, 78% versus 81% in 2012, 81% versus 84% in 2013, 84% versus 87% in 2014, 86% versus 88% in 2015, 87% versus 89% in 2016, and 88% versus 90% in 2017.
The CDC researchers stress the persisting need to identify and address social and structural factors that underlie high-risk sex, serostatus unawareness, and unsuppressed viral load in US Hispanic men at risk for or with HIV infection.
Reference
1. Crepaz N, Mullins M, Higa D, et al. Trends in HIV risk behavior and care outcomes among Hispanic/Latino MSM in the United States: A systematic review of national surveillance data. AIDS 2020: 23rd International AIDS Conference Virtual. July 6-10, 2020. Abstract PEC0740.
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