Gay and bisexual men having sex with men (MSM) are at greatest risk of HIV infection in southern states, researchers from Emory University, the Centers for Disease Control and Prevention (CDC), amfAR and the Louisiana Office of Public Health noted in a study published online today in JMIR Public Health and Surveillance.

MSM have higher rates of HIV infection, making up two-thirds of all diagnoses every year, according to data presented during a teleconference on the study today. Identifying “hotspots” of infection will help direct essential HIV treatment, prevention, and care resources to areas of greatest need, according to researchers in the conference.

Eli Rosenberg, PhD, assistant professor of Epidemiology at the Rollins School of Public Health at Emory University, together with the Centers for Disease Control and Prevention, the Louisiana Office of Public Healthand amfAR discussed the implications of a new analyses of rates of HIV in men having sex with men (MSM) within certain communities and throughout the United States.


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Dr Rosenberg explained that the American south has the highest rate of HIV in MSM, with 6 southern states and Washington DC having infection rates higher than 15%. Additionally, 21 of 25 metropolitan areas with the highest rates were found in the south, 6 of which had MSM infection rates of more than 25%. The study showed that in 2012, 25% of MSM were diagnosed with HIV in Jackson, MS; Columbia, SC; El Paso, TX; Augusta, GA; and Baton Rouge, LA. 

Following Dr Rosenberg, Jonathan Mermin, MD, MPH, Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC explained that this study did not look at HIV rates by race, but emphasized that minorities are disproportionately affected by the disease. “One in 6 of MSM will get HIV if current rates continue,” he said, adding that “no single remedy” will solve the crisis. He recommended a multipronged approach of testing, treatment, and behavioral risk reduction. He added that knowing the prevalence of HIV in a given area will help MSM make prevention choices.

DeAnn Gruber, PhD, LCSW, and STD/HIV Program Director at the Louisiana Office of Public Health spoke following Dr Mermin, and discussed strategies being used in Louisiana, which is one of the states with the highest rates of HIV. First, she said that it is necessary to reduce the number of people who are unaware that they are infected. Testing must be increased on many levels, including emergency departments, correctional facilities and community health settings. There must also be an increase in awareness of PrEP and its distribution.  Dr Gruber also added that the social determinants of health must be eliminated. Dr Gruber noted that stigma and discrimination among health care workers toward gay and bisexual men must be addressed through homophobia and transphobia workshops.

Gregorio Millett, MPH, Vice President and Director of Public Policy at amfAR said that “resources must follow the epidemic” and that this study offers guidance as to where attention needs to be focused.  He said that a “collective effort – not the federal government alone” is needed to combat the epidemic.

Reference

Rosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in US states, metropolitan statistical areas, and counties, 2012-2013. JMIR Public Health Surveill. 2016.