Trends in the HIV Epidemic among African American Men Who Have Sex with Men, San Francisco, 2004-2011

African American men who have sex with men have been disproportionately affected by the HIV epidemic in the United States and remain to this day one of the groups with highest HIV prevalence and incidence. 

Our goal was to clarify the current state of HIV risk, sexual behaviors, and structural/network-network level factors that affect black MSM's population risk of HIV, enabling the formulation of targeted and up-to-date public health messages/campaigns directed at this vulnerable population. 

Our approach maximized the use of local data through a process of synthesis and triangulation of multiple independent and overlapping sources of information that are sometimes separately published and often not examined side-by-side. 

Among African American MSM, we observed stable HIV incidence despite increases in reported individual risk behavior and STDs. An increasing proportion of African American MSM are reporting HIV testing in the past 6 months and seroadaptive behaviors, which may play a role in this observed decline in HIV among MSM in San Francisco, California. 

Our analysis suggests that currently the HIV epidemic is stable among African American MSM in San Francisco. However, we suggest that the observed stability is due to factors prohibiting expansion of new infections rather than decreasing risks for HIV infection among African American MSM.

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By:  Fuqua V1, Scott H1, Scheer S1, Hecht J2, Snowden JM3, Raymond HF4,5.

• 1San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA, 94102, USA.
• 2San Francisco AIDS Foundation, San Francisco, CA, USA.
• 3Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA.
• 4San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA, 94102, USA. hfisher.raymond@sfdph.org.
• 5Epidemiology and Biostatistics, University of California, San Francisco, USA. hfisher.raymond@sfdph.org. 

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Seroadaptive Behaviors of Men Who Have Sex with Men in Myanmar

Serosorting (i.e., choosing partners of the same HIV serostatus to reduce the risk of transmission with unprotected sex) and other forms of seroadaptation (i.e., engaging in diverse behaviors according to a hierarchy of risk by type of sex and partner serostatus) are phenomena widely described for men who have sex with men (MSM) in the developed world. We assessed seroadaptive behaviors among MSM surveyed in Yangon, Myanmar in 2013-2014. 

Among HIV-negative MSM, 

• 43.1 % engaged in some form seroadaptation including 
• serosorting (21.8 %), 
• using condoms with potentially serodiscordant anal sex (19.3 %), and 
• seropositioning (1.7 %). 

Among HIV-positive MSM,

• 3.5 % engaged in serosorting, 
• 36.0 % in using condoms with potentially serodiscordant anal sex, 
• 7.0 % in seropositioning, and 
• 46.5 % in any form of seroadaptation. 

For HIV-negative and HIV-positive MSM, seroadaptation was more common than consistent condom use (38.0 and 26.7 %, respectively). MSM in Myanmar are engaging in seroadaptive behaviors in magnitude and ways similar to MSM in industrialized countries.

Purchase full article at: http://goo.gl/4Txc1a

By: Aung T1, Thein ST1, McFarland W2,3.

• 1Population Services International-Myanmar, Yangon, Myanmar.
• 2San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA, 94102-6033, USA. willi_mcfarland@hotmail.com.
• 3University of California, San Francisco, San Francisco, CA, USA. willi_mcfarland@hotmail.com.

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