Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track C: Epidemiology and Public Health

Tu.C.2405 - Tu.C.2409

Results: Gay men reported more steady partners than did bise>m....t,. (,i 1 J--3.82,
p<.001). Bisexual men reported more casual partners than did gay i.sit (5 j- 270,
p<.01), although this difference was not significant when men who.,ern a n r ady relationship with a man were excluded from the analysis. Gay men sere-, i k than bisexual men to have engaged in the receptive role for both anal (OR=-r; 9. 1 C I1.54-3.33)
and oral sex (OR= 1.73; 95%CI- 1.02 --2.91); no differences for inset cive oie i differences
in rates of condom use if overall rates of receptive anal sex ar-e c,-,5t i,ii '3' ren, compared to bisexual men, were less self-homophobic, saw others a,,,.... l.)tit, of homosexual behavior, and were more likely to have disclosed their atti, i;I t In to others
(all ps<.00I).There were no group differences in normative belie: I,.,.at tdom use, perceived vulnerability to HIV/AIDS, and attitudes toward condoms.
Conclusions: HIV preventive interventions are needed for both.. - c br e, l men.
Attitudinal differences regarding homosexuality suggest that gay-or.,d inerventions are
unlikely to be successful with bisexual men. Community level inter,: nt i:,,. it c.lding media
campaigns, are needed to increase awareness of and acceptance oI bi.ixur,,:iity and to
encourage condom use.
Joseph Stokes. Psychology (mc 285), UIC, 1007 W Harrison St., Cht i. ii -.
Telephone: [phone]; fax: [phone] I 22; email: JSTOKESoUIC Eii t
Tu.C.2405
CURRENT TRENDS IN AIDS INCIDENCE AMONG YOUNG MEN WHO HAVE SEX
WITH MEN- UNITED STATES
Denning, Paul,Ward J, Chu S, Fleming P Centers for Disease Co,.trol ntd Prevention
(CDC), Atlanta, Georgia, U.S.A.
Objective: To describe current trends in AIDS incidence among yourng men wi have sex
with men (YMSM).
Methods: We analyzed AIDS surveillance data from 1989 to 1994. 1SM.rgd I 25 years
at AIDS diagnosis were defined asYMSM. Data were adjusted for repq ring deir s, unreported HIV risks, and for the estimated incidence ofAIDS indicaor rc.r iti ns in men diagnosed with AIDS based on CD4+ criteria.
Results: Of 167,159 MSM diagnosed with AIDS from 1989 to 1991, 8.450 ( ) were
YMSM. AIDS incidence amongYMSM declined slightly ( 8%) betwci 1989 and 1994, but
trends in AIDS incidence varied greatly by race/ethnicity While AIDS incidene decreased
34% in white YMSM, it increased 19% in blacks and 24% in Hispanics. A a result, fiom 1989
to 1994, the proportion ofYMSM who were white declined fronm 53% to 38% whereas the
proportion who were black increased from 30% to 39% and Hispanic, ii itn 15% to 21%.
The proportions who were Asian/Pacific Islander or American Indian/Alaskan Native
remained relatively constant at 1% each.Twenty metropolitan statistical areas (lSAs)
accounted for most (5 I%) of the YMSM with AIDS f-om 1989 to 1994; AIDS incidence
decreased in 16 of these MSAs (median decrease=-20%, range -5% to- 49%) and increased
in only 4 (median increase= 15%, range 3% to 33%).Trends in incidence aso differed by
MSA size. Between 1989 and 1994,AIDS incidence fell 12% in MSAs ~irtl populations(_ l
million persons and 4% in MSAs with 250,000-999,999 persons. In contlrast. incidence rose
3% in MSAs with <250,000 persons and 4% in nonmetropolitan (o-r r uat areis.
Conclusions: Overall, AIDS incidence among YMSM has remained relative!y stible since the
late 1980s. However, the demographics ofYMSM with AIDS have changed coin,,iderably
Because of increases in AIDS incidence among racial/ethnic minorities dun; g 1989 94, these
YMSM now account for most YMSM with AIDS. In addition, the epidemic continues to
spread from the largest MSAs to smaller nonurban areas.The persiste It growth in AIDS
incidence among certain populations ofYMSM underscores the need to expand HIV prevention programs targeted toward these young men.
Paul Denning. CDC, Mail Stop E-47, I 600 Clifton Road, Atlanta, GA 30333, IS.A.
Telephone: [phone] Fax: [phone] E-mail: pbd0@cidhiv I.et.cdc ov
Tu.C.2406
AGE AND ETHNICITY IN RELATION TO HIV RISK BEHAVIOR LEVELS IN A DIVERSE
COMMUNITY SAMPLE OF MEN WHO HAVE SEX WITH MEN
Rompa, David I., Kalihman S.C. & Kelly J.A. Centerfor AIDS Intervs it- (u R5 serar ch (CAIR),
Medical College of Wisconsin, Miwauikee, WI
Objectives: Although incidence of new HIV infections has leveled cm to g day and bisexual
men as a whole, numerous epidemiological studies show still-ineasini h isncidenc e among
young and ethnic minority men who have sex with men (MSM).Althoth the ris igincidence of F-IVy infection among this population segment is well-krnown, there h.rae been few
studies which systematically explain behavioral patterns related to riesk arneng young and
minority gay or bisexual men. We sought to delineate differences in HIVr t i. behavior patterns and characteristics related to age and ethnicity in a commurii s npie of MSM in
Milwaukee, WI who were recruited through outreach to enroll in an ItV prevention
research project.
Methods: A detailed risk behavior and risk characteristic assessm t r eiasure wans administy), and group differences were analyzed.
Results:Young men were higher" than older men in sensation seeki-ig pri tarry dispositions and had a larger number of unprotected anal intercourse pitrtneor s lf. ehvior rates,
especially involving anal sex, were highest among young ethnic mrs.orita Fin5 A s imilar pattern was observed for substance use in relation to sex. Risk betav io sslionas were
highest among ethnic minority hSm.
Conclusions: D,fferent I-tIV risk behavior patterns and profiles mrtalr.tt hI r1ge
community samrple of MSM, and those differences were especrall. pr, urn, ri/ dor young
and ethnic minority men. Active and culturally-focused outreach-ba.e d r HlV pl, C:viirtion
approaches are urgently needed for this population.
David J. Rompa, Center for AIDS Intervention Research (CAIR), I, li r s
Wisconsin, 1201 N. Prospect Ave., Milwaukee, WI 53202, U.S.A. ihoe. i C,8' 1680, Fax:
414 287-4683

Tu.C.2407
HIV AND RISK BEHAVIOuR PREVALENCE AMONG YOUNG MEN WHO HAVE SEX
WITH MEN SAMPLED IN SIX URBAN COUNTIES IN THE U.S.A.
Valleroy,. Linda A*, MacKellar D*, Janssen R*, Jacobs T*. and the Young Men's Survey Team *
Centers for Disease Control and Prevention, Atlanta, GA, USA
Objective: To determine the prevalence of HIV and related risk behaviours among young
men who have sex with men (ymsm) from community-based samples in 6 urban counties
across the United States (US).
Methods: The Young Men's Survey (YMS) is a multi-stage probability survey of the prevalence and determinants of HIV and related risk behaviours among 15- to 22 year-old ymsm.
Ymsm are sampled at public venues frequented by ymsm, (e.g., street locations, dance clubs,
and bars). Participants are interviewed, counseled, and tested for HIV in a nearby van. In
1994 1996,YMS sampled ymsm at venues in 6 urban counties: Dade (Miami), FL; Dallas,TX;
and Alameda, Los Angeles, San Francisco, and Santa Clara, CA.The following are preliminary
results firom the ongoing survey For HIV and each risk behaviou, we present the crude
prevalence from the county sample with the median prevalence (median), and the range of
prevalence flom all county samples (range). All denominators are > =-48. Final results will
estimate prevalence among source populations of ymsm who attended venues in these 6
counties, and factors associated with HIV prevalence.
Results: As of 1/96, we had compiled data on 178 I ymsm from the 6 county samples
(median n=219, range 140-518); I125 ymsm were HIV infected (median 7%, range 5-9%).
Median HIV prevalence varied by age and race/ethnicity: 5% (I-6%) among 15-19-year-olds;
9% (6 I 1%) among 20-22-year-olds; 4% (4-6%) among whites; 7% (5-9%) among Hispanics;
and I 1% (8- I 3%) among African Americans. Median prevalence of reported sexual behaviour with nen in the past 6 months was: 9 1% (83-94%) for oral or anal sex with > -I
man, 38% (27-48%) for any unprotected anal sex, and 27% (20-37%) for unprotected
receptive anal sex.
Conclusions: HIV prevalence is very high among these ymsm, compared with general populations of CiS youth.The prevalence of unprotected anal sex is alarming, given that these
ymsm grew up in an era of HIV/AIDS awareness. Prevention programs must intensify
efforts to target and reach ymsm and to reduce their risk behaviour.
LAValleroy, MS E46, HIV/AIDS Div, CDC, 1600 Clifton Rd, Atlanta, GA. 30333, USA ATeI:
404 639-2084, Fax: [phone], email: lav0@cidhiv I.em.cdc.gov
Tu.C.2408
THE RELATIONSHIP BETWEEN PERCEIVED EXPOSURE TO HIV AND ACTUAL RISK
IN A COHORT OF GAY AND BISEXUAL MEN
MacQueen Kathleen M-I, Kay Kt, Bartholow BI, Buchbinder S2, McKirnan D3, Judson F4,
Douglas j. Division of HIV/AIDS Prevention, CDC, Atlanta, GA 2AIDS Office, Dept of
Public Health, San Francisco, CA 3Howard Brown Health Clinic, Chicago, IL 4Public Health
Dept. Denver, CO
Objective: To evaluate the extent to which perceived exposure to HIV reflects known risk
factors for seroconversion in a cohort of gay and bisexual men.
Methods: Risk assessments and HIV antibody tests were administered at 6 month intervals
to 1,267 gay and bisexual men in San Francisco, Chicago, and Denver; all men were HIV at
enrollment. At 6-, 12-, and 18-month follow-up visits, participants were asked if they thought
they had been exposed to HIV since their last interview and, if so, the perceived routes of
exposure Multiple logistic regression was used to determine whether previously identified
risks for HIV seroconversion (known HIV+ partner, gonococcal/non-gonococcal urethritis,
injection drug use, condom breakage or slippage, and unprotected receptive anal intercourse) were associated with perceived exposure to HIV. Perceived routes of exposure
were coded and code fi-equencies calculated for a 10% sample of participants at the 6-me.
follow up visit.
Results: Of identified risks for seroconversion, those reporting a known HIV+ partner were
more likely than those without such partners to perceive themselves as exposed (OR=2.3,
p<.000 I). In the 10% sample, men cited having an HIV+ partner (31% of sample), unprotected receptive anal intercourse (35%). condom breakage (7.7%), and injecting drugs (1%)
as risks for HIV; STDs were not cited. Other commonly cited exposures were oral intercourse (44%), unprotected insertive anal intercourse (29%), multiple partners (I 5%), and
anonymous partners (I 1%).
Conclusions: With the exception of those who knew that a partner was HIV+, participants
with factors that put them at significant risk of HIV seroconversion were no more likely to
consider themselves exposed to HIV than those without such risks. Participants who
thought they were exposed fequently cited factors that represented a substantially lower
risk of infectionThough the study participants were drawn from populations generally considered well informed about HIV, these results indicate a need to increase understanding of
the ctiors nost associated with HIV transmission among gaylbisexual men.
K.Si. MacQueen, CDC, 600 Clifton Rd Mailstop E-45, Atlanta, GA 30333 USATeI: 404 -639-6146 Fax: [phone] email: kmm3@cidhiv I.em.cdc.gov
Tu.C.2409
HIV SEROINCIDENCE AMONG PERSONS ATTENDING SEXUALLY TRANSMITTED
DISEASE (STD) CLINICS IN THE UNITED STATES, 1988-1995
Weinstock Hillard S., Sweeney S., Steinberg S., Gwinn M. Center s for Disease Control and
Preventiorn, Atlasta, GA
Objective: To estiate HIV seroincidenc e among heterosexuals r ane d nic who have sex
nttt n en (l'ISMI attending STD clinics in different regions of the United States.
Methods: We reviewed records of all patients reserving voluntary HIV tests in I10 STD dlieeIndvidurle who had a negative HIV test between n988 and 1995 and who returned to
rho clint. for at lcest one subsequent test were included in calculations of incidence.
Results: In thre 10 STD clinics, 96.692 persons received HIV testing, and I15,221I (I 6%) were
tested two or ts o tines. Of the 101 (0.66%) patients who seroconverted, 47 seroconartten: were MSS-1. Seroincndence among heterosexnals ranged by clinic fl-em 0.09 HIV
ietions pen I 00 perseon-years to 0,98 pen 100 person-years. No. significant differences me
encirlence vase found between heterosexuaml men red women. Anrong MSM, residence
ranged by limic fron 2. I per 100 person years to 9.8 per t00 person-years and was signifi
I)tly h igthnr (p < 0.001) than incidence among heterosexuals in each clinic.,sO
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