HIV incidence rising in young men, MSM of colour
A US study suggests that expanding HIV screening to reduce undiagnosed infections and increasing access to care and treatment to achieve viral suppression are important to lessen HIV transmission. It is also imperative that prevention methods, such as condoms and pre-exposure prophylaxis, be easily accessed, particularly among young men who have sex with men (MSM) and MSM of colour.
There was a 14.8-percent decrease in modeled HIV incidence (from 45,200 infections in 2008 to 38,500 in 2015) overall and among all transmission risk groups, except MSM.
HIV incidence rose by 3.1 percent (95 percent CI, 1.6–4.5 percent) per year among Hispanic/Latino MSM (from 6,300 infections in 2008 to 7,900 in 2015), decreased by 2.7 percent (–3.8 to –1.5 percent) per year among white MSM (from 8,800 infections in 2008 to 7,100 in 2015) and remained stable among black MSM at about 10,000 infections.
While HIV incidence decreased by 3.0 percent (–4.2 percent to –1.8 percent) and 4.7 percent (–6.2 to –3.1 percent) per year among MSM aged 13–24 years and those aged 35–44 years, respectively, it increased by 5.7 percent (4.4–7.0 percent) per year (from 6,900 infections in 2008 to 10,000 in 2015) among MSM aged 25–34 years.
“The percentage of undiagnosed HIV infections was higher among black, Hispanic/Latino, and younger MSM than white and older MSM, respectively,” the investigators said.
Individuals aged ≥13 years with diagnosed HIV infection were included in this cross-sectional analysis. The investigators used data on HIV diagnoses and the first CD4 test result after diagnosis to model HIV incidence and prevalence as well as the percentage of undiagnosed HIV infections from 2008 to 2014 based on a well-characterized CD4 depletion model.
The study was limited by the assumptions of the CD4 depletion model and variability of CD4 values, according to the investigators.