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Changes in Disparities in Estimated HIV Incidence Rates Among Black, Hispanic/Latino, and White Men Who Have Sex With Men (MSM) in the United States, 2010–2015

McCree, Donna Hubbard, PhD, MPH, RPha; Williams, Austin M., PhDb; Chesson, Harrell W., PhDb; Beer, Linda, PhDa; Jeffries, William L. IV, PhD, MPH, MAa; Lemons, Ansley, MPHa; Prather, Cynthia, PhDa; Sutton, Madeline Y., MD, MPHa; McCray, Eugene, MDa

JAIDS Journal of Acquired Immune Deficiency Syndromes: May 1, 2019 - Volume 81 - Issue 1 - p 57–62
doi: 10.1097/QAI.0000000000001977
Prevention Research
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Background: During 2008–2015, the estimated annual HIV incidence rate in the United States decreased for each transmission risk category, except for men who have sex with men (MSM). Racial/ethnic disparities exist, with higher incidence rates for Black and Hispanic/Latino MSM.

Setting: This analysis examines changes, 2010–2015, in disparities of HIV incidence among Black, Hispanic/Latino and White MSM.

Methods: We compared results from the rate ratio, rate difference, weighted and unweighted index of disparity, and population attributable proportion. We calculated incidence rates for MSM using HIV surveillance data and published estimates of the MSM population in the United States. We generated 95% confidence intervals for each measure and used the Z statistic and associated P values to assess statistical significance.

Findings: Results from all but one measure, Black-to-White rate difference, indicate that racial/ethnic disparities increased during 2010–2015; not all results were statistically significant. There were statistically significant increases in the Hispanic/Latino-to-White MSM incidence rate ratio (29%, P < 0.05), weighted index of disparity with the rate for White MSM as the referent group (9%, P < 0.05), and the population attributable proportion index (10%, P < 0.05). If racial/ethnic disparities among MSM had been eliminated, a range of 55%–61% decrease in overall MSM HIV incidence would have been achieved during 2010–2015.

Conclusions: A large reduction in overall annual HIV incidence among MSM can be achieved by eliminating racial/ethnic disparities among MSM. Removing social and structural causes of racial/ethnic disparities among MSM can be effective in reducing overall annual HIV incidence among MSM.

aDivision of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, Georgia; and

bDivision of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA.

Correspondence to: Donna Hubbard McCree, PhD, MPH, RPh, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE MS D-21, Atlanta, GA 30333 (e-mail: zyr1@cdc.gov).

The authors have no funding or conflicts of interest to disclose.

Received October 17, 2018

Accepted January 04, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.