African-American Men Who Have Sex With Men Show Higher HIV Rates Despite Less Sexually Risky Behavior

By Mariana Plazas-Mayorca and Courtney McQueen 
Published: Oct 1, 2010 9:30 am

Results of a recent study indicate that significantly more African-American men who have sex with men are HIV-positive than their Caucasian counterparts. However, the study also found that African-American men report lower levels of high-risk sexual behaviors.

The authors speculated that access to health care and health insurance, stigma, and reluctance to get HIV testing may play a role in higher HIV rates in African-American men.

The study took place in Washington, D.C., which has one of the highest rates of HIV/AIDS in the United States. An estimated 3 percent of the D.C. population is HIV-positive, a rate that is higher than in many African countries. Seven percent of African-American men in D.C. are living with HIV.

The reasons for increased rates of HIV in African-American men, particularly men who have sex with men (MSM), remain unclear. Previous research has not found higher rates of high-risk sexual behavior.

To see if this is true for men in Washington, D.C. as well, this study examined HIV status and risk behaviors for 500 Caucasian, African-American, and other minority men. The study participants were recruited at events geared primarily toward MSM in D.C.

Results showed that African-American men were more likely to be HIV-positive (26 percent) than Caucasian (8 percent) and Latino, Asian, and other minority men (6.5 percent).

However, African American MSM reported fewer risky sexual practices than their Caucasian counterparts. They had fewer male sex partners, were less likely to have ever engaged in intentional unprotected anal sex, and were more likely to have used condoms during their last anal sexual encounter. Rates of drug use or substance abuse with sex were similar.

On the other hand, African-American MSM were also less likely to have health insurance, disclose their MSM status to their health care providers, or have been tested for HIV. They were more likely to have had their MSM sexual debut at 18 years or younger.

For both groups, older age was associated with a greater chance of HIV infection.

The authors of the study suggested stigma against homosexuality and barriers to health care and HIV testing may play an important role in the observed racial disparity in HIV rates.

The authors indicated that routine HIV testing and increased access to health care may be particularly important for HIV prevention in African-American MSM.

They also noted that the results will need to be confirmed by further study. Participants were recruited specifically from events in Washington, D.C. where the attendees were expected to be primarily MSM. As a result, the study may not represent the MSM population in general.

For more information, please see the full article in the journal AIDS Patient Care and STDs.