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DECREASED HIV DIAGNOSES AMONG MSM OF COLOR IN THRIVE-FUNDED JURISDICTIONS, 2014-2018
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CROI 2021 March 6-10 reported by Jules Levin
Kashif Iqbal1, Xueyuan Dong2, Weiming Zhu1, Kenneth L. Dominguez1, Mary Tanner1, Athena Kourtis1, Sonia Singh1, Karen W. Hoover1
1Centers for Disease Control and Prevention, Atlanta, GA, USA, 2ICF International, Atlanta, GA, USA
Background: While the total number of HIV diagnoses decreased in the United States from 2014-2018, diagnoses increased among young men who have sex with men (MSM) of color. THRIVE was a demonstration project that funded 7 health departments from 2015-2020 to develop community collaboratives to provide comprehensive HIV prevention and care services for MSM of color. Twenty-eight Metropolitan Statistical Area (MSA) jurisdictions were eligible for THRIVE funding because they had the highest rates of HIV diagnoses among Black/African American (Black) MSM and/or Hispanic/Latino MSM in 2014. This study evaluated trends in HIV diagnoses among MSM in jurisdictions awarded THRIVE funding compared to jurisdictions eligible for THRIVE but not awarded funding.
Methods: Data from the National HIV Surveillance System were analyzed to determine the number of HIV diagnoses from 2014-2018 among White, Black, and Hispanic/Latino MSM for: 1) 7 THRIVE-eligible jurisdictions that were awarded THRIVE funding, 2) 11 THRIVE-eligible jurisdictions that were not awarded THRIVE funding, and 3) and overall for United States and Puerto Rico. The Estimated Annual Percent Change (EAPC) and 95% confidence interval (CI) were used to evaluate trends for each of the three groups stratified by age group and race/ethnicity.
Results: From 2014-2018, 130,508 MSM were diagnosed with HIV infection in the U.S.; 8.4% were in THRIVE jurisdictions and 26% in unfunded THRIVE- eligible jurisdictions. During 2014-2018 in THRIVE jurisdictions, HIV diagnoses significantly decreased among Black MSM (EAPC -4.4 [95% CI -6.0, -2.7]) and White MSM (-9.4 [-12.1, -6.6]), but EAPC for Hispanics/Latino MSM was insignificant (-1.0 [ -4.3, 2.4]). In comparison, HIV diagnoses in the unfunded THRIVE-eligible jurisdictions and the United States show White MSM experienced a decrease but to a lesser extent than THRIVE jurisdictions; Black MSM and Hispanic/Latino MSM did not see either a decline or an increase (Table). For most age groups, HIV diagnoses decreased in THRIVE jurisdictions among Black MSM, White MSM, and Hispanic/Latino MSM but increased in both unfunded THRIVE-eligible jurisdictions and the United States for Black MSM aged 25-34 years.
Conclusion: Findings suggest that successful implementation of HIV testing and PrEP in THRIVE contributed to decreases in HIV diagnoses among Black
and White MSM. Barriers to HIV prevention for Hispanic/Latino MSM in THRIVE communities need to be understood to inform interventions for HIV prevention in this population.
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