Explaining Racial Disparities in HIV Incidence in a Prospective Cohort of Black and White Men Who Have Sex With Men in Atlanta, GA: A Prospective Observational Cohort Study

Annals of Epidemiology
Patrick S. Sullivan, Eli S. Rosenberg, Travis H. Sanchez, Colleen Kelley, Nicole Luisi,
Hannah Cooper, Ralph Diclemente, Paula Frew, Laura F. Salazar, Carlos del Rio, Mark J. Mulligan, John Peterson
Original Article:  bit.ly/1IATF3c



To describe factors associated with racial disparities in HIV incidence among men who have sex with men (MSM) in the United States.


In a longitudinal cohort of black and white HIV-negative MSM in Atlanta, HIV incidence rates were compared by race. Incidence hazard ratios (HR) between black and white MSM were estimated with an age-scaled Cox proportional hazards model. A change-in-estimate approach was used to understand mediating time-independent and -dependent factors that accounted for the elevated HR.


Thirty-two incident HIV infections occurred among 260 black and 302 white MSM during 823 person-years (PY) of followup. HIV incidence was higher among black MSM (6.5/100PY; 95% CI: 4.2, 9.7) than white MSM (1.7/100PY; CI: 0.7, 3.3), and highest among young (18-24 years) black MSM (10.9/100PY; CI: 6.2, 17.6). The unadjusted hazard of HIV infection for black MSM was 2.9 (CI: 1.3-6.4) times that of white MSM; adjustment for health insurance status and partner race explained effectively all of the racial disparity.


Relative to white MSM in Atlanta, black MSM, particularly young black MSM, experienced higher HIV incidence that was not attributable to individual risk behaviors. In a setting where partner pool risk is a driver of disparities, it is also important to maximize care and treatment for HIV-positive MSM.

Full text of article available at link below:  bit.ly/1IATF3c