HIV Diagnoses Up Among Younger MSM

HIV diagnoses among younger men who have sex with men (MSM) increased in recent years compared with other age groups, researchers found.

From 2008 to 2016, the annual number of diagnoses of HIV infection among MSM ages 13-29 increased 3%, but declined 4% among ages 30-49, and remained stable for MSM ages ≥50, reported Andrew Mitsch, MPH, of the CDC, and colleagues.

Moreover, the number of HIV diagnoses among MSM ages 13-29 was four times the number of those ≥50, the authors wrote in the Morbidity and Mortality Weekly Report.

CDC HIV Surveillance Reports estimated that two-thirds of diagnosed HIV infections in the U.S. in 2016 were due to male-to-male sexual contact, and the CDC recommends that sexually active MSM at risk of HIV infection be tested at least once a year. Those who test positive should be linked and retained in care, the authors said, while those who test negative should be provided HIV prevention services, including pre-exposure prophylaxis.

For the study, the researchers analyzed data from the National HIV Surveillance System for MSM ages ≥13 in 50 states and the District of Columbia. Overall, about 236,000 MSM were diagnosed with HIV from 2008-2016, with the large majority of diagnoses among men ages 13-50 (45% ages 13-29, 43% ages 30-49, and 12% ages ≥50).

Not surprisingly, these diagnoses varied by racial and ethnic group, with younger black/African Americans accounting for 49% of all HIV diagnoses among MSM ages 13-29 during the study period, with Hispanic/Latinos comprising 25% of diagnoses and whites, 19%. By contrast, black and Hispanic/Latinos each accounted for 28% of diagnoses among MSM ages 30-49 and black MSM accounted for 25% of the diagnoses among MSM ages ≥50.

However, the largest percentage increases in HIV diagnoses among MSM ages 13-29 were among American/Indians Alaskan Natives (14.8 annual percent change), Asians (12.0), and residents of the South (3.7), the authors said.

From 2008-2015, the number of MSM living with a diagnosed HIV infection increased by 4.5% per year. There was a 7.7% annual increase among ages 13-29, a 0.4% decrease among ages 30-49, and an almost 11% increase per year among MSM ages ≥50. Nine of 10 states with the highest percentages of MSM living with diagnosed HIV infection ages 13-29 were in the South.

The authors hypothesized that the increased number of diagnoses in this age group could be due to increased HIV testing in addition to ongoing transmission, and that testing is particularly important among this younger age group because "they account for the highest percentage of MSM with undiagnosed HIV infection." The authors added that given racial and ethnic disparities, more "widespread implementation of interventions" to target those at highest risk, such as black and Hispanic/Latino MSM, is needed.