Brian Dodge1, Jessie V Ford2, Na Bo3, Wanzhu Tu3, John Pachankis4, Debby Herbenick1, Kenneth Mayer5, Mark L Hatzenbuehler2. 1. Department of Applied Health Science, Indiana University School of Public Health, Center for Sexual Health Promotion, Bloomington, IN. 2. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY. 3. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN. 4. Department of Social and Behavioral Sciences, Yale University School of Public Health, Social and Behavioral Sciences, New Haven, CT. 5. The Fenway Institute, Harvard University School of Medicine, Boston, MA.
Abstract
BACKGROUND: Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples. SETTING: A probability-based cohort of GBM (N = 502) from 45 states and Washington, DC. METHODS: Cross-sectional survey. RESULTS: Among HIV-negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two-thirds (63.3%) of PrEP users reported daily adherence in the past week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, whereas an additional 8.9% reported testing positive for at least one other sexually transmitted infection after their most recent test. All HIV-positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the past month. A majority of HIV-negative/unknown/untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary health care provider. CONCLUSIONS: Our findings present a decidedly mixed picture regarding the success of the US National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM.
BACKGROUND: Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples. SETTING: A probability-based cohort of GBM (N = 502) from 45 states and Washington, DC. METHODS: Cross-sectional survey. RESULTS: Among HIV-negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two-thirds (63.3%) of PrEP users reported daily adherence in the past week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, whereas an additional 8.9% reported testing positive for at least one other sexually transmitted infection after their most recent test. All HIV-positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the past month. A majority of HIV-negative/unknown/untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary health care provider. CONCLUSIONS: Our findings present a decidedly mixed picture regarding the success of the US National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM.
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