1 in 5 Gay and Bisexual Men in Major Cities are HIV Positive, but Many Unaware of Status

Nearly 20% of gay and bisexual men in a survey of 21 large U.S. cities are infected with HIV, but more than 40% do not know their status, according to a report in the September 24, 2010 edition of the CDC's Morbidity and Mortality Weekly Report. HIV prevalence varied widely across cities -- from 6% to 38% -- and was highest among black men who have sex with men, at 28%, compared with 18% among Hispanic men and 16% among white men.

A. Smith and colleagues from the Centers for Disease Control and Prevention (CDC) Division of HIV/AIDS Prevention collected data about HIV prevalence rates among men who have sex with men (MSM) from the National HIV Behavioral Surveillance (NHBS) system.

MSM accounted for 57% of all new HIV infections in the U.S. in 2006, the report authors noted as background, despite making up only an estimated 10% or so of the population.

The analysis included more than 800 men in 21 metropolitan statistical areas surveyed during 2008. Anonymous interviews and blood tests were done at venues where MSM gather, such as bars, clubs, and social organizations. Researchers conducted interviews using a handheld computer and asked questions about sex, drug use, HIV testing, and use of HIV prevention services.

Eligible participants were age 18 or older and able to complete the interview in English or Spanish. Participants could self-identify as gay, bisexual, same-gender-loving, straight, or other, but had to have had sex with a man during the past 12 months.

A total of 28,468 men were approached, 12,325 were screened for participation, and 11,074 were found to be eligible for the survey. Of these, 2921 were excluded for various reasons including lack of consent, not having sex with a man within the 1-year time frame, and having an indeterminate HIV test result. This left a total of 8153 men in the final analysis.


"Because MSM represent the only group with increasing HIV incidence and comprise the largest proportion of new infections, it is critical to target resources and prevention strategies to MSM," the study authors wrote. "The National HIV/AIDS Strategy emphasizes the importance of improving the impact of HIV prevention efforts for MSM. "
"The high proportion of MSM unaware of their HIV infection continues to be a serious public health concern, because these MSM account for the majority of estimated new HIV transmissions in the United States," they continued. "Persons aware of their HIV infection often take substantial steps to reduce their risk behaviors, which could reduce HIV transmission."

The CDC recommends that sexually active MSM get tested for HIV at least once per year.

"Many gay and bisexual men do not get tested or retested regularly because they are afraid they may be infected, yet this hinders life-saving treatment and puts their partners at risk," said CDC Division of HIV/AIDS Prevention director Jonathan Mermin. "Stigma, homophobia, and discrimination are real issues that may prevent gay and bisexual men from accessing the prevention and treatment resources they need."



A Smith, I Miles, B Le, and others (Centers for Disease Control and Prevention). Prevalence and Awareness of HIV Infection Among Men Who Have Sex With Men -- 21 Cities, United States, 2008. Morbidity and Mortality Weekly Report 59(37): 1201-1207 (Abstract). September 24, 2010.

Other Sources

J Mermin. September 27, 2010 is National Gay Men's HIV/AIDS Awareness Day. CDC e-HAP Direct Update. September 24, 2010.

Kaiser Family Foundation. CDC: One In Five Gay Men HIV-Positive. Kaiser Daily Health Policy Report. September 24, 2010

D DeNoon. CDC Study Shows Gay/Bisexual African-Americans, Young Adults Least Aware of HIV Status. WebMD. September 23, 2010.

M Smith. HIV Prevalence Remains High Among Gay Men. MedPage Today. September 23, 2010.

D O'Neill. HIV Remains a Gay Disease. Washington Blade. September 23, 2010.