HIV is hyperendemic among men who have sex with men in San Francisco: 10-year trends in HIV incidence, HIV prevalence, sexually transmitted infections and sexual risk behaviour

Abstract

Temporal trends in multiple biological and behavioural indicators over the past decade describe a hyperendemic state of HIV infection among MSM in San Francisco, whereby prevalence has stabilised at a very high level. In the absence of new, effective prevention strategies this state will persist.

Recent infection testing algorithm (RITA) applied to new HIV diagnoses in England, Wales and Northern Ireland, 2009 to 2011

“…Although HIV incidence fluctuated over the study period, there was no statistically significant trend over time [28]. In another study, HIV incidence amongst MSM attending an STI clinic in the same city was estimated at 4.9% (CI 2.3-8.3) in 1999, decreasing to 2.7% (CI 1.4-4.8) in 2006 (a non-significant trend) [34]. RITA testing among men with early syphilis using remnant samples from STI clinics in Atlanta, San Francisco and Los Angeles, resulted in annual estimates of HIV incidence of 9.5% (CI 3.9-15.1) among all men, increasing to 12.0% (CI 4.5-19.4) among MSM alone [35].…”

The HIV Epidemic: High-Income Countries

“…4). In 2009 surveillance, it is likely that such phenomena as "prevention fatigue," young MSM without a memory of AIDS in the pretreatment era, and minority MSM who are not reached by prevention messages targeting LGBTI communities (lesbian, gay, bisexual, transgender, intersex) are contributing to the worrisome trends in nations as diverse as the United States and China (Wolitski et al 2001;Rietmeijer et al 2003;Johnson et al 2008;Scheer et al 2008;Xu et al 2010;Hao et al 2011). Both behavior and biology are relevant to the MSM epidemic.…”

Transmen: The HIV Risk of Gay Identity

“…The San Francisco Department of Public Health recently included TMSM (transmen who have sex with non-trans men) within the larger HIV risk group MSM. HIV prevalence among MSM in San Francisco was recently estimated to be 24.3% (Scheer et al, 2008), and HIV was characterized as being hyperendemic in the gay community. The Centers for Disease Control and Prevention reported at the 2010 National STD Prevention Conference that gay men are 44 times more likely to acquire HIV than other men (Roehr, 2010).…”