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Eli Rosenberg

Race and Age Disparities in HIV Incidence and Prevalence Among MSM in Atlanta, GA. Eli Rosenberg. Patrick Sullivan, Colleen Kelley, Travis Sanchez, Nicole Luisi, Carlos del Rio, Laura Salazar, Paula Frew, John Peterson Center for AIDS Research Emory University Atlanta, GA

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Eli Rosenberg

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  1. Race and Age Disparities in HIV Incidence and Prevalence Among MSM in Atlanta, GA Eli Rosenberg Patrick Sullivan, Colleen Kelley, Travis Sanchez, Nicole Luisi, Carlos del Rio, Laura Salazar, Paula Frew, John Peterson Center for AIDS Research Emory University Atlanta, GA CROI 2014 March 4, 2014 Emory University Center for AIDS Research

  2. Disclosures Dr. Rosenberg has no financial relationships with commercial entities to disclose.

  3. HIV and MSM • HIV prevalence among MSM is high and MSM continue to bear the burden of new infections in the US and Atlanta, GA • Black MSM (BMSM), particularly young BMSM, continue to be overrepresented among new HIV infections • Similar patterns for other sexually transmitted infections (STI) • Reasons for these racial disparities remain unclear • Prospective, racially comparative studies are needed

  4. Study Design • Prospective HIV/STI incidence cohort study: 2009-2014 • Sexually active black and white MSM in Atlanta • Ages 18 - 39 • Recruitment • Venue-time-space sampling, Facebook • Procedures • Testing: HIV, Chlamydia, Gonorrhea, Syphilis • Behavioral questionnaire • Enrollment • 803 men enrolled • 30% HIV-positive (BMSM: 44%, WMSM: 13%) • 562 HIV-negative MSM followed for 832 person-years • 79% retention at 24-months HIV/STI testing, Questionnaire Baseline HIV/STI testing, Questionnaire Month 3 HIV/STI testing, Questionnaire Month 6 HIV/STI testing, Questionnaire Month 12 HIV/STI testing, Questionnaire Month 18 HIV/STI testing, Questionnaire Month 24

  5. Demographic characteristics of cohort

  6. STI Incidence

  7. Log-Rank P = 0.0005 6.6 / 100 PY24 infections Cum. Inc. (2-yr): 11.3% 1.7 / 100 PY 8 infections Cum. Inc. (2-yr): 3.6% Proportion HIV Infected

  8. 12.1 / 100 PY 16 infections Cum. Inc(2-yr): 16.6% Log-Rank P < 0.0001 3.5 / 100 PY 8 infections Cum. Inc. (2-yr): 6.0% Proportion HIV Infected 1.9 / 100 PY 7 infections Cum. Inc. (2-yr): 4.5% 1.0 / 100 PY 1 infection Cum. Inc. (2-yr): 1.6%

  9. HIV incidence Social determinants Individual risk behaviors Partner pool / network

  10. HIV incidence Age-scaled Cox PH models Black vs. White HR (95% CI): HRRace= 3.3 (1.4, 7.5)(UAI) HRRace= 3.0 (1.3, 6.7) (Older partners) HRRace = 2.9 (1.3, 6.5) (no covariate adjustment) 2.6 HRRace= 2.6 (1.3, 6.5) (Health Ins.) HRRace= 1.6 (0.6, 4.2) (Black partners) HRRace= 1.5 (0.6, 3.9) (Black P, Health Ins.) HRRace = 1

  11. Conclusions • In Atlanta, MSM and BMSM face multiple high-incidence epidemics of HIV/STI • >1 in 10 YBMSM acquire HIV per year • Individual behavioral risk factors associated with HIV incidence, but do not account for race disparity • Partner pool/network and structural factors help to explain HIV race disparity STI-HIV EffectPoster #1028Thursday, P-W9

  12. Relevance Sexual network factors and social determinants may supersede individual characteristics and behaviors as drivers of HIV disparities.

  13. The InvolveMENt Team: • Investigators • Recruiters • Event staff • Retention specialists • Data team • Our participants Thank You! Eli Rosenberg esrose2@emory.edu Supported by NIH #: • R01-MH085600 (PI: Sullivan) • R01-HD067111 (PI: Sullivan) • P30 AI050409 (Emory CFAR, PI: Curran)

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