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HIV transmission among black college student and non-student men who have sex with men--North Carolina, 2003.
MMWR Morb Mortal Wkly Rep 2004 Aug 20;53(32):731-4.
Abstract
In the United States, young black men who have sex with men (MSM) and reside in urban settings have high rates of infection with human immunodeficiency virus (HIV), with incidence and prevalence as high as 14% and 32%, respectively. Few epidemiologic and behavioral studies have been conducted in this population, and even fewer data are available for black MSM from non-urban areas of the southern United States. In November 2002, the North Carolina Department of Health (NCDOH) identified two cases of acute HIV infection among non-Hispanic black male college students. A retrospective review of all men aged 18-30 years with HIV diagnosed during January 2000-May 2003 indicated an increase in HIV case reports in male college students, from two cases in 2000 to 56 during January 2001-May 2003. Of these 56, a total of 49 (88%) were black, and nearly all were MSM, including some men who had sex with both men and women. In August 2003, NCDOH invited CDC to assist with an epidemiologic investigation of young HIV-positive black MSM in North Carolina. This report summarizes the results of that investigation, which indicated that black MSM college students and non-students in North Carolina had high rates of HIV risk behaviors, underscoring the need for enhanced HIV-prevention programs in these populations.
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Reviewed by
Susa Coffey, MD
Commentary
In the United States, rates of HIV infection are higher in African American men than in white men. Young black men who have sex with men (MSM) are at particularly high risk for HIV infection. Recent reports from North Carolina of a sharp increase in HIV incidence in black MSM college students have heightened attention to the phenomenon of HIV transmission in young African American MSM. This article summarizes the investigation of behavioral risk factors for HIV infection in this population. It notes significant high-risk sexual behaviors in both the HIV-infected cases and the HIV-negative control groups. Among the black MSM college students, both HIV infected and HIV negative, a high proportion did not identify as gay, most did not disclose their sexual identity, and most did not perceive themselves to be at risk for infection with HIV; about 20% had recent female as well as male partners. The report highlights the need for more effective prevention interventions for young African American MSM and suggests possible new approaches for prevention strategies.
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