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Uptake of Testing for HIV and Syphilis Among Men Who Have Sex with Men in Baltimore, Maryland: 2004–2011

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Abstract

Men who have sex with men (MSM) in Baltimore are at disproportionately high risk for HIV and syphilis infection. Testing and diagnosis are important first steps in receiving treatment and reducing transmission. We analyzed cross-sectional data collected in 2004–2005, 2008, and 2011 among MSM not reporting a previous positive HIV test (n = 1268) in Baltimore, Maryland as part of the National HIV Behavioral Surveillance System to determine the proportion of men tested for HIV and/or syphilis within the previous 12 months and examine the extent to which opportunities for testing were being missed in health care settings. Within the previous 12 months, 54 % of men had received an HIV test; 31 % had received a syphilis test; and only 23 % of men had received testing for both. Among 979 men who did not receive both tests, 72 % had seen a health care provider in the past year, suggesting missed testing opportunities.

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Notes

  1. Houses are a collective of persons, frequently young gay or transgender black or Hispanic/Latino persons, who function as a kinship system and are often associated with balls, which are social events in which houses and individual persons engage in dance and performance competitions [39].

References

  1. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2010. HIV Surveillance Report Supplemental Report 2012; 17(3 Part A):1–27. http://www.cdc.gov/hiv/library/reports/surveillance/2010/surveillance_report_vol_17_no_3.html. Accessed 20 May 2014.

  2. Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007—2010. HIV Surveillance Report Supplemental Report 2012;17(4):1–26. http://www.cdc.gov/hiv/pdf/statistics_hssr_vol_17_no_4.pdf. Accessed 20 May 2014.

  3. Centers for Disease Control and Prevention. HIV surveillance—United States, 1981–2008. MMWR Morb Mortal Wkly Rep. 2011;60:689–93.

    Google Scholar 

  4. Centers for Disease Control and Prevention. Rates of diagnoses of HIV infection among adults and adolescents, by area of residence, 2011—United States and 6 dependent areas. HIV surveillance report, 2011;23:1-84. http://www.cdc.gov/hiv/pdf/statistics_2011_hiv_surveillance_report_vol_23.pdf. Accessed 22 May 2015.

  5. Maryland Department of Health and Mental Hygiene (DHMH), Center for HIV Surveillance, Epidemiology and Evaluation. Center for HIV Surveillance, Epidemiology and Evaluation. Infectous Disease Bureau. Prevention and Health Promotion Administration. Baltimore-Towson Metropolitan Statistical Area (MSA) HIV/AIDS epidemiological profile. Baltimore, MD: DHMH; 2011. http://phpa.dhmh.maryland.gov/OIDEOR/CHSE/Shared%20Documents/Baltimore-Towson%20MSA%20HIV%20AIDS%20Epidemiological%20Profile%2012-2011.pdf. Accessed 20 May 2014.

  6. Wejnert C, Le B, Rose CE, Oster AM, Smith AJ, Zhu J. HIV infection and awareness among men who have sex with men—20 cities, United States, 2008 and 2011. PLoS One. 2013;8:e76878.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Lieb S, Prejean J, Thompson DR, et al. HIV prevalence rates among men who have sex with men in the southern United States: population-based estimates by race/ethnicity. AIDS Behav. 2011;15:596–606.

    Article  PubMed  Google Scholar 

  8. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39:446–53.

    Article  PubMed  Google Scholar 

  9. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Granich R, Crowley S, Vitoria M, et al. Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update. Curr Opin HIV AIDS. 2010;5:298–304.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One. 2010;5:e11068.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57.

    Article  PubMed  Google Scholar 

  13. Dieffenbach CW, Fauci AS. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009;301:2380–2.

    Article  CAS  PubMed  Google Scholar 

  14. Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52:793–800.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Branson BM, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recommend Rep. 2006;55(RR-14):1–17.

    Google Scholar 

  16. German D, Sifakis F, Maulsby C, et al. Persistently high prevalence and unrecognized HIV infection among men who have sex with men in Baltimore: the BESURE study. J Acquir Immune Defic Syndr. 2011;57:77–87.

    Article  PubMed  Google Scholar 

  17. MacKellar DA, Valleroy LA, Secura GM, Behel S, Bingham T, Celentano DD, et al. Unrecognized HIV infection, risk behaviors, and perceptions of risk among young men who have sex with men: opportunities for advancing HIV prevention in the third decade of HIV/AIDS. J Acquir Immune Defic Syndr. 2005;38:603–14.

    Article  PubMed  Google Scholar 

  18. Centers for Disease Control and Prevention. HIV incidence among young men who have sex with men—seven U.S. cities, 1994–2000. MMWR Morb Mortal Wkly Rep. 2001;50:440–4.

    Google Scholar 

  19. Chen M, Rhodes PH, Hall IH, Kilmarx PH, Branson BM, Valleroy LA. Prevalence of undiagnosed HIV infection among persons aged ≥13 years—National HIV Surveillance System, United States, 2005–2008. MMWR Morb Mort Wkly Rep. 2012;61(Suppl):57–64.

    Google Scholar 

  20. Chin T, Hicks C, Samsa G, McKellar M. Diagnosing HIV infection in primary care settings: missed opportunities. AIDS Patient Care STDS. 2013;27:392–7.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Centers for Disease Control and Prevention. Missed opportunities for earlier diagnosis of HIV infection—South Carolina, 1997–2005. MMWR Morb Mortal Wkly Rep. 2006;55:1269–72.

    Google Scholar 

  22. Dorell CG, Sutton MY, Oster AM, et al. Missed opportunities for HIV testing in health care settings among young African American men who have sex with men: implications for the HIV epidemic. AIDS Patient Care STDs. 2011;25:657–64.

    Article  PubMed  Google Scholar 

  23. Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recommend Rep. 2010;59(RR-12):1–110.

    Google Scholar 

  24. Paz-Bailey G, Meyers A, Blank S, et al. A case-control study of syphilis among men who have sex with men in New York City: association with HIV infection. Sex Transm Dis. 2004;31:581–7.

    Article  PubMed  Google Scholar 

  25. Centers for Disease Control and Prevention. Notes from the field: repeat syphilis infection and HIV coinfection among men who have sex with men—Baltimore, Maryland, 2010–2011. MMWR Morb Mortal Wkly Rep. 2013;62:649–50.

    Google Scholar 

  26. Stamm WE, Handsfield HH, Rompalo AM, Ashley RL, Roberts PL, Corey L. The association between genital ulcer disease and acquisition of HIV infection in homosexual men. JAMA. 1988;260:1429–33.

    Article  CAS  PubMed  Google Scholar 

  27. Mehta SD, Ghanem KG, Rompalo AM, Erbelding EJ. HIV seroconversion among public sexually transmitted disease clinic patients: analysis of risks to facilitate early identification. J Acquir Immune Defic Syndr. 2006;42:116–22.

    Article  PubMed  Google Scholar 

  28. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2011. Atlanta, GA: US Department of Health and Human Services; 2012. http://www.cdc.gov/std/stats11/Surv2011.pdf. Accessed 20 May 2014.

  29. Gallagher KM, Sullivan PS, Lansky A, Onorato IM. Behavioral surveillance among people at risk for HIV infection in the U.S.: the National HIV Behavioral Surveillance System. Public Health Rep. 2007;122(Suppl 1):32–8.

    PubMed Central  PubMed  Google Scholar 

  30. Centers for Disease Control and Prevention. HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men—five U.S. cities, June 2004–April 2005. MMWR Morb Mortal Wkly Rep. 2005;54(24):597–601.

    Google Scholar 

  31. Finlayson TJ, Le B, Smith A, Bowles K, Cribbin M, Miles I, et al. HIV risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008. MMWR Morb Mortal Wkly Rep Surveill Summ. 2011;60(14):1–34.

    Google Scholar 

  32. Centers for Disease Control and Prevention. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men—United States. MMWR Morb Mortal Wkly Rep. 2013;62(47):958–62.

    Google Scholar 

  33. Cooley LA, Oster AM, Rose CE, Wejnert C, Le BC, Paz-Bailey G, et al. Increases in HIV testing among men who have sex with men—National HIV Behavioral Surveillance System, 20 U.S. metropolitan statistical areas, 2008 and 2011. PLoS One. 2014;9(9):e104162.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Woodring JV, Kruszon-Moran D, Oster AM, McQuillan GM. Did CDC’s 2006 revised HIV testing recommendations make a difference? Evaluation of HIV testing in the US household population, 2003–2010. J Acquir Immune Defic Syndr. 2014;67(3):331–40.

    Article  PubMed  Google Scholar 

  35. Scott HM, Fuqua V, Raymond HF. Utilization of HIV prevention services across racial/ethnic groups among men who have sex with men in San Francisco, California, 2008. AIDS Behav 2013;Suppl 3:316–23.

  36. Cooley LA PM, Flynn C, Blythe D, Ross C, Hart-Cooper G, Morgan J, Oster AM. Low viral suppression and HIV: HIV diagnosis rate among MSM with syphilis—Baltimore, Maryland. Conference on Retroviruses and Opportunistic Infections, Boston, Massachusetts. 3–6 March 2014 .

  37. Cooley LA, Pearl ML, Ross C, Hart-Cooper G, Elmore K, Blythe D, et al. Low viral suppression and high HIV diagnosis rate among men who have sex with men with syphilis—Baltimore, Maryland. Sex Transm Dis. 2015;42(4):226–31.

    Article  PubMed  Google Scholar 

  38. Wolitski RJ, Fenton KA. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav. 2011;15(Suppl 1):S9–17.

    Article  PubMed  Google Scholar 

  39. Murrill CS, Liu KL, Guilin V, et al. HIV prevalence and associated risk behaviors in New York City’s house ball community. Am J Public Health. 2008;98:1074–80.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Chandran A, Fuller C, Morris-Compton S, Rodgers V, Barbot O. Healthy Baltimore 2015: An Interim Report. Baltimore City Health Department, October 2013. health.baltimorecity.gov/sites/default/files/HB2015InterimUpdateOct2015Optimized_1.pdf. Accessed 22 May 2015.

  41. Better World Advertising. Testing makes us stronger campaign launches in Baltimore. http://www.socialmarketing.com/news/testing_makes_us_stronger_campaign_launches_in_baltimore. Accessed 24 March 2015.

  42. Maryland Department of Health and Mental Hygiene (DHMH), Center for HIV Surveilllance, Epidemiology, and Evaluation, Infectious Disease Bureau, Prevention and Health Promotion Administration. Baltimore City HIV/AIDS epidemiological profile. Baltimore, MD: DHMH; 2011. http://phpa.dhmh.maryland.gov/OIDEOR/CHSE/SharedDocuments/BaltimoreCityHIVAIDSEpidemiologicalProfile12-2011.pdf. Accessed 22 May 2015.

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Acknowledgments

The National HIV Behavioral Surveillance System is funded by the Centers for Disease Control and Prevention. Baltimore activities are funded through a cooperative agreement with the Maryland Department of Health and Mental Hygiene, who contracts with the Johns Hopkins Bloomberg School of Public Health.

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None.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Maria A. Said & Laura A. Cooley

  2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Danielle German & Sabriya L. Linton

  3. Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA

    Maria A. Said, Colin Flynn & David Blythe

  4. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Laura A. Cooley, Alexandra B. Balaji & Alexandra M. Oster

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  1. Maria A. Said
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Correspondence to Maria A. Said.

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Said, M.A., German, D., Flynn, C. et al. Uptake of Testing for HIV and Syphilis Among Men Who Have Sex with Men in Baltimore, Maryland: 2004–2011. AIDS Behav 19, 2036–2043 (2015). https://doi.org/10.1007/s10461-015-1106-y

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