You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.
 

Table 1.  

Characteristic

Diagnosed HIV infection (2019)*

Tested in past 12 mos (2017)

Missed opportunity for testing in past 12 mos (2017)†,§

No. % (95% CI) No. % (95% CI) No. % (95% CI)
Total 692,900 > 84.8 (84.1–85.5) 7,577 78.6 (77.1–80.0) 1,181 77.8 (73.9–81.7)
Race/Ethnicity
American Indian/Alaska Native 53 69.0** (53.1–84.8) †† ††
Asian 194 81.0 (73.3–88.7) 35 88.6 (78.0–99.1)
Black/African American 219,200 82.6 (81.4–83.9) 1,965 80.7 (78.1–83.4) 283 73.6 (65.3–82.0)
Hispanic/Latino §§ 186,800 80.3 (79.0–81.7) 2,098 77.3 (74.8–79.9) 315 75.6 (68.4–82.9)
Native Hawaiian/Other Pacific Islander 35 85.1** (65.7–100.0) †† ††
White 239,600 90.0 (88.7–91.3) 2,804 78.0 (75.5–80.5) 481 78.6 (72.5–84.7)
Multiple races ¶¶ 387 81.2 (75.2–87.2) 48 82.7** (64.9–100.0)
Age group, yrs
13–24 37,100 55.1 (52.8–57.6) —*** —*** —*** —***
18–24 —*** —*** 1,359 79.7 (76.5–83.0) 197 77.0 (67.8–86.2)
25–34 164,600 71.2 (70.0–72.4) 3,266 81.3 (79.2–83.4) 372 80.9 (74.6–87.1)
35–44 135,200 84.0 (82.8–85.3) 1,397 79.3 (76.1–82.4) 200 74.7 (65.2–84.2)
45–54 155,300 92.4 (91.4–93.5) 999 71.8 (67.6–76.0) 220 71.9 (62.6–81.2)
≥55 200,600 96.1 (95.0–97.2) 556 65.0 (58.2–71.9) 192 82.5 (73.0–91.9)

TABLE 1. Percentage of HIV infections diagnosed, percentage of persons receiving HIV testing in the past 12 months, and percentage of missed opportunities for HIV testing in the past 12 months among gay, bisexual, and other men who have sex with men, by race/ethnicity and age group — United States, 2017 and 2019

* Based on data reported through December 2020 to the National HIV Surveillance System for year-end 2019. Percentages are estimated based on a CD4 depletion model. Defined as the number of persons who received an HIV diagnosis divided by the estimated number of persons with HIV (diagnosed and undiagnosed).

Based on data collected by National HIV Behavioral Surveillance in 2017 in 23 U.S. urban areas (Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Denver, Colorado; Detroit, Michigan; Houston, Texas; Los Angeles, California; Memphis, Tennessee; Miami, Florida; Nassau and Suffolk counties, New York; New Orleans, Louisiana; New York City, New York; Newark, New Jersey; Philadelphia, Pennsylvania; Portland, Oregon; San Diego, California; San Francisco, California; San Juan, Puerto Rico; Seattle, Washington; Virginia Beach, Virginia; and Washington, DC). Excludes persons who tested HIV-positive >12 months ago.

§ Defined as visiting a health care provider in the past 12 months without being offered an HIV test. Excludes persons who tested HIV-positive >12 months ago and who tested in the past 12 months.

Estimates are not available because of high relative standard errors.

** Estimates have a CI width >30 and should be interpreted with caution.

†† Estimates are not available because denominator sample sizes are <30.

§§ Hispanic/Latino men who have sex with men could be any race.

¶¶ Represents persons identified as having multiple race categories selected.

*** National HIV Behavioral Surveillance did not collect data from persons aged 13–17 years. Data from the National HIV Surveillance System are presented for persons aged 13–24 years.

Table 2.  

Characteristic

Discussed PrEP with health care provider in past 12 mos*

Used PrEP in past 12 mos*

No. % (95% CI) No. % (95% CI)
Total 4,466 51.5 (49.1–53.9) 4,466 35.5 (33.0–38.0)
Race/Ethnicity
American Indian/Alaska Native
Asian 111 61.1 (48.3–74.0) 111 47.4 (34.1–60.6)
Black/African American 962 47.2 (42.5–51.8) 962 27.2 (22.7–31.7)
Hispanic/Latino 1,250 45.2 (41.2–49.2) 1,250 31.3 (27.5–35.2)
Native Hawaiian/Other Pacific Islander
White 1,841 58.5 (54.9–62.0) 1,841 42.2 (38.4–46.0)
Multiple races § 230 45.9 (36.0–55.7) 230 30.1 (21.5–38.7)
Age group, yrs
18–24 837 43.6 (38.3–49.0) 837 26.7 (22.2–31.2)
25–34 2,073 52.6 (49.2–56.0) 2,073 36.8 (33.3–40.3)
35–44 845 59.9 (55.0–64.8) 845 44.7 (39.7–49.8)
45–54 480 48.8 (41.4–56.1) 480 35.7 (28.4–42.9)
≥55 231 46.4 (36.9–56.0) 231 23.7 (15.1–32.3)

TABLE 2. Percentage of gay, bisexual, and other men who have sex with men with a likely indication for preexposure prophylaxis who discussed preexposure prophylaxis with a health care provider in the past 12 months or used preexposure prophylaxis in the past 12 months, by race/ethnicity and age group — United States, 2017

Abbreviations: MSM = men who have sex with men; NHBS = National HIV Behavioral Surveillance; PrEP = preexposure prophylaxis.

* Based on data collected by NHBS in 2017 in 23 U.S. urban areas (Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Denver, Colorado; Detroit, Michigan; Houston, Texas; Los Angeles, California; Memphis, Tennessee; Miami, Florida; Nassau and Suffolk counties, New York; New Orleans, Louisiana; New York City, New York; Newark, New Jersey; Philadelphia, Pennsylvania; Portland, Oregon; San Diego, California; San Francisco, California; San Juan, Puerto Rico; Seattle, Washington; Virginia Beach, Virginia; and Washington, DC). Restricted to MSM with likely clinical indications for PrEP, who had a negative NHBS HIV test result after the NHBS interview, had a male sex partner who was HIV-positive or two or more male sex partners in the past 12 months, and had condomless anal sex with a male sex partner or a sexually transmitted infection (i.e., syphilis, gonorrhea, or chlamydia) in the past 12 months.

Hispanic/Latino MSM could be any race.

§ Represents persons identified as having multiple race categories selected.

Estimates not available because denominator sample sizes are <30.

Table 3.  

Characteristic

ART adherence (2018)*

Viral suppression (2019)

HIV-related stigma score (2018)§

No. % (95% CI) No. % No. Median (95% CI)
Total 1,869 58.3 (54.9–61.7) 528,606 68.1 1,873 29.3 (28.0–30.5)
Race/Ethnicity
American Indian/Alaska Native 1,538 64.7
Asian 9,779 71.7
Black/African American 503 48.3 (40.2–56.3) 161,072 61.6 528 32.8 (29.3–36.3)
Hispanic/Latino** 440 58.7 (53.4–64.1) 135,301 66.6 436 32.0 (29.6–34.3)
Native Hawaiian/Other Pacific Islander 590 66.2
White 784 64.1 (59.4–68.9) 195,335 73.5 770 26.1 (24.0–28.2)
Multiple races †† 104 55.7 (44.8–66.7) 24,643 74.5 103 30.4 (24.2–36.6)
American Indian/Alaska Native, Asian, or Native Hawaiian/Other Pacific Islander §§ 38 60.2 ¶¶ (40.2–80.2) §§ §§ 36 20.3 (12.0–28.7)
Age group, yrs
13–24 —*** —*** 19,520 66.2 —*** —***
18–24 53 44.6 ¶¶ (29.5–59.6) —*** —*** 56 39.3 (30.0–48.7)
25–34 319 47.7 (39.7–55.7) 105,957 65.0 332 33.6 (30.6–36.6)
35–44 346 53.7 (47.5–59.9) 101,620 66.1 353 31.5 (29.7–33.4)
45–54 523 55.7 (50.3–61.1) 140,157 69.3 517 28.7 (26.8–30.6)
≥55 628 69.6 (64.9–74.4) 161,352 70.6 615 25.4 (23.5–27.3)

TABLE 3. Among gay, bisexual, and other men who have sex with men with diagnosed HIV infection, percentage with antiretroviral therapy adherence, percentage with viral suppression, and median HIV-related stigma scores, by race/ethnicity and age group — United States, 2018 and 2019

Abbreviations: ART = antiretroviral therapy; MSM = men who have sex with men; NHBS = National HIV Behavioral Surveillance; PrEP = preexposure prophylaxis.

* Based on data collected by the Medical Monitoring Project during June 2018–May 2019. ART adherence was defined as taking 100% of ART doses in the past 30 days among MSM currently taking ART.

Based on data reported through December 2020 to the National HIV Surveillance System for year-end 2019. Viral suppression was defined as the number of MSM with a viral load test result of <200 copies of HIV RNA per mL at last test divided by the number of MSM with diagnosed HIV infection.

§ Based on data collected by the Medical Monitoring Project during June 2018–May 2019. HIV-related stigma was measured using a 10-item scale that measures four dimensions of HIV stigma: personalized stigma during the past 12 months, current disclosure concerns, current negative self-image, and current perceived public attitudes about persons with HIV. The stigma score ranged from 0 to 100, with 0 indicating no stigma and 100 indicating highest stigma. A median score was calculated based on responses on a five-point Likert scale to each item. Median scores with nonoverlapping 95% CIs were considered to be meaningfully different. Median scores were interpreted in the context of the national goal of reducing HIV-related stigma by 2025 by at least 50% from the 2018 baseline median score of 31.

Estimates are not available because denominator sample sizes are <30.

** Hispanic/Latino MSM could be any race.

†† Represents persons identified as having multiple race categories selected.

§§ Viral suppression percentages are presented separately for American Indian or Alaska Native persons, Asian persons, and Native Hawaiian or Other Pacific Islander persons.

¶¶ Estimates have a CI width >30 and should be interpreted with caution.

*** The Medical Monitoring Project did not collect data from persons aged 13–17 years. Data from the National HIV Surveillance System are presented for persons aged 13–24 years.

CME / ABIM MOC / CE

Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex With Men — United States, 2010–2019

  • Authors: Marc A. Pitasi, MPH; Linda Beer, PhD; Susan Cha, PhD; Shacara Johnson Lyons, MSPH; Angela L. Hernandez, MD; Joseph Prejean, PhD; Linda A. Valleroy, PhD; Stacy M. Crim, MPH; Lindsay Trujillo, MPH; Dominique Hardman, MPA; Elizabeth M. Painter, PhD; Jacqueline Petty, MS; Jonathan H. Mermin, MD; Demetre C. Daskalakis, MD; H. Irene Hall, PhD
  • CME / ABIM MOC / CE Released: 4/4/2022
  • Valid for credit through: 4/4/2023
Start Activity

  • Credits Available

    Physicians - maximum of 0.50 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.50 ABIM MOC points

    Nurses - 0.50 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)

    Pharmacists - 0.50 Knowledge-based ACPE (0.050 CEUs)

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for public health officials, infectious disease clinicians, immunologists, hematologists, internists, and other clinicians caring for patients with HIV.

The goal of this activity is that learners will be better able to describe HIV prevention and treatment outcomes among gay, bisexual, and other men who have sex with men (MSM) in the United States during the years before implementation of the Ending the HIV Epidemic in the U.S. (EHE) initiative and the progress needed to reach EHE and other national goals, according to a Centers for Disease Control and Prevention (CDC) analysis of data from 3 national surveillance systems.

Upon completion of this activity, participants will:

  • Describe estimated number of new HIV infections and percentage of infections diagnosed among men who have sex with men (MSM) from 2010-2019, according to a Centers for Disease Control and Prevention (CDC) analysis of National HIV Surveillance System data
  • Determine uses of and barriers to prevention and treatment services among MSM, according to a CDC analysis of National HIV Behavioral Surveillance and Medical Monitoring Project data
  • Identify clinical and public health implications of HIV prevention and treatment outcomes among MSM in the United States during the years before implementation of the Ending the HIV Epidemic in the U.S. (EHE) initiative, and the progress needed to reach EHE and other national goals, according to CDC analysis of data from 3 national surveillance systems


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Medscape policies. Others involved in the planning of this activity have no relevant financial relationships.


Faculty

  • Marc A. Pitasi, MPH

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Marc A. Pitasi, MPH, has disclosed no relevant financial relationships.

  • Linda Beer, PhD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Linda Beer, PhD, has disclosed no relevant financial relationships.

  • Susan Cha, PhD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Susan Cha, PhD, has disclosed no relevant financial relationships.

  • Shacara Johnson Lyons, MSPH

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Shacara Johnson Lyons, MSPH, has disclosed no relevant financial relationships.

  • Angela L. Hernandez, MD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Angela L. Hernandez, MD, has disclosed no relevant financial relationships.

  • Joseph Prejean, PhD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Joseph Prejean, PhD, has disclosed no relevant financial relationships.

  • Linda A. Valleroy, PhD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Linda A. Valleroy, PhD, has disclosed no relevant financial relationships.

  • Stacy M. Crim, MPH

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Stacy M. Crim, MPH, has disclosed no relevant financial relationships.

  • Lindsay Trujillo, MPH

    ICF International
    Fairfax, Virginia

    Disclosures

    Disclosure: Lindsay Trujillo, MPH, has disclosed no relevant financial relationships.

  • Dominique Hardman, MPA

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Dominique Hardman, MPA, has disclosed no relevant financial relationships.

  • Elizabeth M. Painter, PhD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Elizabeth M. Painter, PhD, has disclosed no relevant financial relationships.

  • Jacqueline Petty, MS

    Office of the Director
    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Jacqueline Petty, MS, has disclosed no relevant financial relationships.

  • Jonathan H. Mermin, MD

    Office of the Director
    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Jonathan H. Mermin, MD, has disclosed no relevant financial relationships.

  • Demetre C. Daskalakis, MD

    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: Demetre C. Daskalakis, MD, has disclosed no relevant financial relationships.

  • H. Irene Hall, PhD

    Division of HIV Prevention
    Division of HIV Prevention
    National Center for HIV, Viral Hepatitis, STD, and TB Prevention
    Centers for Disease Control and Prevention
    Atlanta, Georgia

    Disclosures

    Disclosure: H. Irene Hall, PhD, has disclosed no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Disclosure: Laurie Barclay, MD, has disclosed the following relevant financial relationships:
    Stock, stock options, or bonds: AbbVie (former)

Compliance Reviewer/Nurse Planner

  • Stephanie Corder, ND, RN, CHCP

    Associate Director, Accreditation and Compliance
    Medscape, LLC

    Disclosures

    Disclosure: Stephanie Corder, ND, RN, CHCP, has disclosed no relevant financial relationships.


Accreditation Statements



In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Contact This Provider

    For Nurses

  • Awarded 0.50 contact hour(s) of nursing continuing professional development for RNs and APNs; 0 contact hours are in the area of pharmacology.

    Contact This Provider

    For Pharmacists

  • Medscape designates this continuing education activity for 0.50 contact hour(s) (0.050 CEUs) (Universal Activity Number: JA0007105-0000-22-052-H02-P).

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

CME / ABIM MOC / CE

Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex With Men — United States, 2010–2019

Authors: Marc A. Pitasi, MPH; Linda Beer, PhD; Susan Cha, PhD; Shacara Johnson Lyons, MSPH; Angela L. Hernandez, MD; Joseph Prejean, PhD; Linda A. Valleroy, PhD; Stacy M. Crim, MPH; Lindsay Trujillo, MPH; Dominique Hardman, MPA; Elizabeth M. Painter, PhD; Jacqueline Petty, MS; Jonathan H. Mermin, MD; Demetre C. Daskalakis, MD; H. Irene Hall, PhDFaculty and Disclosures

CME / ABIM MOC / CE Released: 4/4/2022

Valid for credit through: 4/4/2023

processing....

Abstract

Background. Men who have sex with men (MSM) accounted for two thirds of new HIV infections in the United States in 2019 despite representing approximately 2% of the adult population.

Methods. CDC analyzed surveillance data to determine trends in estimated new HIV infections and to assess measures of undiagnosed infection and HIV prevention and treatment services including HIV testing, preexposure prophylaxis (PrEP) use, antiretroviral therapy (ART) adherence, and viral suppression, as well as HIV-related stigma.

Results. The estimated number of new HIV infections among MSM was 25,100 in 2010 and 23,100 in 2019. New infections decreased significantly among White MSM but did not decrease among Black or African American (Black) MSM and Hispanic/Latino MSM. New infections increased among MSM aged 25–34 years. During 2019, approximately 83% of Black MSM and 80% of Hispanic/Latino MSM compared with 90% of White MSM with HIV had received an HIV diagnosis. The lowest percentage of diagnosed infection was among MSM aged 13–24 years (55%). Among MSM with a likely PrEP indication, discussions about PrEP with a provider and PrEP use were lower among Black MSM (47% and 27%, respectively) and Hispanic/Latino MSM (45% and 31%) than among White MSM (59% and 42%). Among MSM with an HIV diagnosis, adherence to ART and viral suppression were lower among Black MSM (48% and 62%, respectively) and Hispanic/Latino MSM (59% and 67%) compared with White MSM (64% and 74%). Experiences of HIV-related stigma among those with an HIV diagnosis were higher among Black MSM (median = 33; scale = 0–100) and Hispanic/Latino MSM (32) compared with White MSM (26). MSM aged 18–24 years had the lowest adherence to ART (45%) and the highest median stigma score (39).

Conclusion. Improving access to and use of HIV services for MSM, especially Black MSM, Hispanic/Latino MSM, and younger MSM, and addressing social determinants of health, such as HIV-related stigma, that contribute to unequal outcomes will be essential to end the HIV epidemic in the United States.