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Early HIV Infections Among Men Who Have Sex with Men in Five Cities in the United States

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Abstract

We tested blood samples from men who have sex with men (MSM) to detect early HIV infection. Early HIV included both acute (infected past 30 days) and recent (estimated recency past 240 days). Acute infections were defined as screen immunoassay (IA) negative/NAAT-positive or IA-positive/Multispot-negative/NAAT-positive. Recent infections were defined as avidity index cutoff <30 % on an avidity-based IA and, (1) not reporting antiretroviral therapy use or, (2) HIV RNA >150 copies/mL. Of 937 samples, 26 % (244) were HIV-infected and of these 5 % (12) were early. Of early infections, 2 were acute and 10 recent; most (8/12) were among black MSM. Early infection was associated with last partner of black race [adjusted relative risk (ARR) = 4.6, confidence intervals (CI) 1.2–17.3], receptive anal sex at last sex (ARR = 4.3, CI 1.2–15.0), and daily Internet use to meet partners/friends (ARR = 3.3, CI 1.1–9.7). Expanding prevention and treatment for black MSM will be necessary for reducing incidence in the United States.

Resumen

Utilizamos muestras de sangre de hombres que tienen sexo con hombres (HSH) para detectar infección temprana de VIH. La infección temprana de VIH incluía tanto infecciones agudas (infectado en los 30 días anteriores) como recientes (infectado en los 240 días anteriores). Las infecciones agudas se definieron como: resultados de tamizaje por immunoensayo (IA, por sus siglas en inglés) negativo/NAAT-positivo, o IA-positivo/Multispot-negativo/NAAT-positivo. Las infecciones recientes se definieron como índice de avidez <30 % en un ensayo de avidez y, (1) participante no reporto estar en terapia antiretroviral o, (2) carga viral >150 copias/mL. De las 937 muestras, 26 % (244) estaban infectadas por VIH, y de estas 5 % (12) eran infecciones tempranas. De las infecciones tempranas, 2 eran agudas y 10 recientes; la mayoría (8/12) eran en HSH afroamericanos.Las infecciones recientes estaban asociadas con reportar ultima pareja sexual afroamericana (riesgo relativo ajustado [RRA] = 4.6, intervalo de confianza [IC]:1.2-17.3), sexo anal receptivo en la última relación sexual (RRA = 4.3, IC: 1.2-15.0), y uso diario del Internet para encontrar parejas sexuales/amigos (RRA = 3.3, IC: 1.1-9.7). Para reducir la incidencia de VIH es necesario expandir la prevención y el tratamiento en HSH afroamericanos en los Estados Unidos.

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Acknowledgements

We would like to thank Dr. Binh Le for his assistance and oversight during data analyses. We would like to acknowledge the contributions of the NHBS team and survey participants. Funding was provided by the Centers for Disease Control and Prevention.

Conflicts of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-46, Atlanta, GA, 30329, USA

    G. Paz-Bailey, A. Smith, S. Masciotra, C. E. Rose & S. M. Owen

  2. Dynamic Research Corporation, Atlanta, GA, USA

    W. Zhang

  3. Department of Public Health, Los Angeles County, CA, USA

    T. Bingham

  4. Maryland Department of Health & Mental Hygiene, Baltimore, MA, USA

    C. Flynn

  5. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA

    D. German

  6. Denver Public Health, Denver Health and Hospital Authority, Denver, CO, USA

    A. Al-Tayyib

  7. School of Public Health and Health Services, George Washington University, Washington, DC, USA

    M. Magnus

  8. Florida Department of Health, Tallahassee, FL, USA

    M. LaLota

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  1. G. Paz-Bailey
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  2. A. Smith
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Correspondence to G. Paz-Bailey.

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Paz-Bailey, G., Smith, A., Masciotra, S. et al. Early HIV Infections Among Men Who Have Sex with Men in Five Cities in the United States. AIDS Behav 19, 2304–2310 (2015). https://doi.org/10.1007/s10461-015-1011-4

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  • DOI: https://doi.org/10.1007/s10461-015-1011-4

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