Men Who have Sex with Men: Racial/Ethnic Disparities in Estimated HIV/AIDS Prevalence at the State and County Level, Florida

Abstract

Population-based HIV/AIDS prevalence estimates among men who have sex with men (MSM) have been unavailable, but have implications for effective prevention efforts. Prevalent (living) Florida HIV/AIDS cases reported through 2006 (numerators) were stratified by race/ethnicity and HIV exposure category. Based on previous research, MSM populations were posited as 4-10% of all males aged > or =13 years in each subgroup (denominators). At the estimated lower and upper plausible bounds, respectively, HIV/AIDS prevalence per 100,000 MSM was significantly higher among black (8,292.6-20,731.4); Hispanic (5,599.5-13,998.7); and Asian/Pacific Islander, American Indian or multi-racial (4,942.6-12,356.8) MSM than among white MSM (3,444.9-8,612.3). HIV/AIDS prevalence among all MSM was 13.8-36.9 times that among all other males. Across 19 high-morbidity counties, MSM HIV/AIDS prevalence was highest among those in the most populous counties and highest among blacks. This methodology, adaptable by other states, facilitates calculation of plausible MSM HIV/AIDS prevalence to guide HIV prevention/care community planners and MSM.

HIV Prevalence Rates Among Men Who Have Sex with Men in the Southern United States: Population-Based Estimates by Race/Ethnicity

“…Compelling data, presented credibly and clearly, can increase awareness of the dire situation in the South [34,35]. Our estimates of HIV prevalence rates among racial/ethnic MSM populations across the South could help guide comprehensive recommendations for primary and secondary HIV prevention.…”

The Disproportionality of HIV Transmission Among Black Men Who Have Sex with Men (BMSM): Recommendations for an Effective Prevention Model

“…The true prevalence is difficult to obtain however, as convenience and snowball sampling dominates attempts to define the population and may not reach those that wish to conceal their sexual behavior (Cole, 2006). Statewide studies report prevalence to be 4-10%, taking into consideration that MSM estimates vary between urban, suburban, and rural areas (Gasiorowicz & Stodola, 2011;Lieb et al, 2009;Lieb et al, 2011;Magnus et al, 2011). Despite the Black population composing around 15% of the U.S. population, they represent nearly 50% of known cases .…”

Estimating Populations of Men Who Have Sex with Men in the Southern United States

“…8,10,12,13,25,26 Others have used models based on HIV testing data, 7 census data, 9 statistical components, 11 Internet convenience sampling, 19 and HIV/AIDS surveillance data. [14][15][16] Definitions of MSM were not consistent across these studies, as they tended to use different age ranges, as well as different criteria for nature and degree of same-sex behavior or gayidentification, leading to possible under-or overestimates. As with our present study, ascertainment bias was a common concern of these studies because some men do not candidly disclose same-sex behavior or sexual orientation, leading to underestimates.…”

“…Populations of MSM have previously been estimated, [7][8][9][10][11][12][13][14][15][16][17][18][19] but estimation models and survey sampling schemes have tended to be complex and/or costly to apply and apparently have been utilized by few planning agencies. Surveys to measure the prevalence of male-male sexual orientation and behavior in male populations have been conducted at the national level and in selected locales, but have limited implications for effective targeting of primary and secondary HIV prevention initiatives at the state level.…”