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HIV Risk and Prevention Outcomes in a Probability-Based Sample of Gay and Bisexual Men in the United States

Dodge, Brian PhDa; Ford, Jessie V. PhDb; Bo, Na MSc; Tu, Wanzhu PhDc; Pachankis, John PhDd; Herbenick, Debby PhD, MPHa; Mayer, Kenneth MDe; Hatzenbuehler, Mark L. PhDb

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1, 2019 - Volume 82 - Issue 4 - p 355–361
doi: 10.1097/QAI.0000000000002151
Prevention Research

Background: Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples.

Setting: A probability-based cohort of GBM (N = 502) from 45 states and Washington, DC.

Methods: Cross-sectional survey.

Results: Among HIV-negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two-thirds (63.3%) of PrEP users reported daily adherence in the past week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, whereas an additional 8.9% reported testing positive for at least one other sexually transmitted infection after their most recent test. All HIV-positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the past month. A majority of HIV-negative/unknown/untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary health care provider.

Conclusions: Our findings present a decidedly mixed picture regarding the success of the US National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM.

aDepartment of Applied Health Science, Indiana University School of Public Health, Center for Sexual Health Promotion, Bloomington, IN;

bDepartment of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY;

cDepartment of Biostatistics, Indiana University School of Medicine, Indianapolis, IN;

dDepartment of Social and Behavioral Sciences, Yale University School of Public Health, Social and Behavioral Sciences, New Haven, CT; and

eThe Fenway Institute, Harvard University School of Medicine, Boston, MA.

Correspondence to: Brian Dodge, PhD, Indiana University School of Public Health, Center for Sexual Health Promotion, SPH 116, Bloomington, IN 47405 (e-mail:

Supported by The National Institute of Mental Health (R01 MH112384, MPI: Hatzenbuehler/Dodge). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Received April 08, 2019

Accepted July 25, 2019

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