Twenty-three percent of men who tested positive for HIV at three North Carolina STD clinics initially hid the fact that they had sex with other men, according to a report published Sept. 25 in Morbidity and Mortality Weekly Reports.
As part of a prospective study assessing HIV diagnosis at 12 STD clinics in New York City, San Francisco, and North Carolina, 113 men being tested at the North Carolina sites were first asked about their sexual partners during pretest counseling and were then asked again during a partner services interview after their HIV-positive diagnosis. Most of these men were young (median age, 24 years) and African American (85%), noted Dr. Hsiu Wu, an epidemic intelligence service officer at the Centers for Disease Control and Prevention, Atlanta, and her associates.
Twenty-six of these men did not disclose having male sex partners at the initial visit but did so at the subsequent visit. Compared with men who did initially disclose their sexual contact with other men, these 26 men were over four times more likely to have reported having at least one female partner (30.8% vs. 6.9%). Other studies have shown that men who identify as bisexual or heterosexual are less likely than are those who identify as homosexual to report same-sex behaviors, the investigators said (MMWR 2015;64[37]:1037-41).
The 26 men reported having the same number of sexual partners as did the men who initially disclosed their homosexual activity, and many of them “shared sexual networks with other participants ... who also had newly diagnosed HIV infection.” This suggests there were missed opportunities to deliver effective prevention services. It also “highlights the importance of accurately identifying risks among this population, which remains the population most affected by HIV infection,” Dr. Wu and her associates reported.
They suggested that HIV prevention programs implement strategies to assess risk more accurately by customizing certain testing venues for young African American men who have sex with men, using technology such as mobile devices or tablet computers to administer more private risk screening, and educating the public about the benefits of new HIV prevention strategies such as PrEP.