Multilevel risk factors for greater HIV infection of black men who have sex with men in New York City

Alan Neaigus, Kathleen H. Reilly, Samuel M. Jenness, Travis Wendel, David M. Marshall, Holly Hagan

Research output: Contribution to journalArticle

Abstract

BACKGROUND: There is a large and disproportionate burden of HIV in black men who have sex with men (MSM) which is not adequately explained by racial/ethnic differences in risk behaviors. However, social factors may account for this disparity in HIV infection. We examine the extent to which both individual risk behaviors and social factors reduce the effect of black race and may account for the disparity in HIV infection of black MSM. METHODS: In a cross-sectional study in New York City in 2011, MSM were venue sampled, interviewed, and HIV tested. Variables associated (P < 0.10) both with black race and testing HIV positive were analyzed using multivariate logistic regression. RESULTS: Of 416 participants who were HIV tested and did not self-report being positive, 19.5% were black, 41.1% were Hispanic, 30.5% were white, and 8.9% were of other race/ethnicity. Overall, 8.7% tested positive (24.7% of blacks, 7.6% of Hispanics, 1.0% of whites, and 5.4% of other). The effect of black race versus non-black race/ethnicity with testing HIV positive declined by 49.2%, (crude odds ratio, 6.5 [95% confidence interval, 3.2-13.3] vs. adjusted odds ratio, 3.3 [95% confidence interval, 1.5-7.5]), after adjustment for having a black last sex partner, not having tested for HIV in the past 12 months, Brooklyn residency, and having an annual income less than US$20,000. CONCLUSIONS: Greater HIV infection risk of black MSM may result from social factors and less frequent HIV testing than from differences in risk behaviors. To reduce the disparity in HIV infection of black MSM, multilevel interventions that both ameliorate social risk factors and increase the frequency of HIV testing are needed.

Original languageEnglish (US)
Pages (from-to)433-439
Number of pages7
JournalSexually Transmitted Diseases
Volume41
Issue number7
DOIs
StatePublished - 2014

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HIV Infections
HIV
Risk-Taking
Hispanic Americans
Odds Ratio
Confidence Intervals
Internship and Residency
Self Report
Cross-Sectional Studies
Logistic Models

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

Multilevel risk factors for greater HIV infection of black men who have sex with men in New York City. / Neaigus, Alan; Reilly, Kathleen H.; Jenness, Samuel M.; Wendel, Travis; Marshall, David M.; Hagan, Holly.

In: Sexually Transmitted Diseases, Vol. 41, No. 7, 2014, p. 433-439.

Research output: Contribution to journalArticle

Neaigus, Alan ; Reilly, Kathleen H. ; Jenness, Samuel M. ; Wendel, Travis ; Marshall, David M. ; Hagan, Holly. / Multilevel risk factors for greater HIV infection of black men who have sex with men in New York City. In: Sexually Transmitted Diseases. 2014 ; Vol. 41, No. 7. pp. 433-439.
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abstract = "BACKGROUND: There is a large and disproportionate burden of HIV in black men who have sex with men (MSM) which is not adequately explained by racial/ethnic differences in risk behaviors. However, social factors may account for this disparity in HIV infection. We examine the extent to which both individual risk behaviors and social factors reduce the effect of black race and may account for the disparity in HIV infection of black MSM. METHODS: In a cross-sectional study in New York City in 2011, MSM were venue sampled, interviewed, and HIV tested. Variables associated (P < 0.10) both with black race and testing HIV positive were analyzed using multivariate logistic regression. RESULTS: Of 416 participants who were HIV tested and did not self-report being positive, 19.5{\%} were black, 41.1{\%} were Hispanic, 30.5{\%} were white, and 8.9{\%} were of other race/ethnicity. Overall, 8.7{\%} tested positive (24.7{\%} of blacks, 7.6{\%} of Hispanics, 1.0{\%} of whites, and 5.4{\%} of other). The effect of black race versus non-black race/ethnicity with testing HIV positive declined by 49.2{\%}, (crude odds ratio, 6.5 [95{\%} confidence interval, 3.2-13.3] vs. adjusted odds ratio, 3.3 [95{\%} confidence interval, 1.5-7.5]), after adjustment for having a black last sex partner, not having tested for HIV in the past 12 months, Brooklyn residency, and having an annual income less than US$20,000. CONCLUSIONS: Greater HIV infection risk of black MSM may result from social factors and less frequent HIV testing than from differences in risk behaviors. To reduce the disparity in HIV infection of black MSM, multilevel interventions that both ameliorate social risk factors and increase the frequency of HIV testing are needed.",
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