Study results released today by the HIV Prevention Trials Network (HPTN) show disturbing rates of new HIV infections occurring among Black gay and bisexual men in the U.S. (also known as men who have sex with men, or MSM), particularly young Black MSM.
The HPTN 061 study showed that the overall rate of new HIV infection among Black MSM in this study was 2.8% per year, a rate that is nearly 50% higher than in white MSM in the U.S. Even more alarming, HPTN 061 found that young Black MSM—those 30 years of age and younger—acquired HIV infection at a rate of 5.9% per year, three times the rate among U.S. white MSM. The overall infection rate among Black MSM in this U.S study is comparable to the rate seen in the general populations of countries in sub-Saharan Africa hardest hit by the HIV epidemic. HPTN 061 was a large multi-site study of HIV and Black MSM conducted in six U.S. cities, and the first to determine the rate of new HIV infection among such a large prospective cohort of U.S. Black MSM (referred to as HIV incidence).
The Fenway Institute worked with the Multicultural AIDS Coalition to coordinate the Boston arm of HPTN 061, dubbed Project S.O.S. (Saving OurSelves), which enrolled 237 study participants over two years. Kenneth Mayer, MD, Medical Research Director at Fenway served as the Protocol Co-Chair for the multi-site study and was the Fenway site’s Principal Investigator and Ben Perkins, MDiV, served as the study’s Project Director at The Fenway Institute.
The HPTN 061 study results are part of an HIV prevention narrative that consistently continues to show that Black MSM are exceedingly vulnerable. The truth is that these troubling HIV infection rates are associated with underlying issues of stigma, discrimination, joblessness, homelessness, incarceration, and trauma. Any attempts to address the HIV problem will, therefore, by necessity, need to tackle these issues in order to make a real and lasting impact in the epidemic.
—Ben Perkins, MDiV, the study’s Project Director at The Fenway Institute
“These study results show that in proportion to their numbers, Black MSM are bearing the brunt of the HIV epidemic here in the United States, even in comparison to other groups of gay and bisexual men,” said Mayer. “We found that the men had many unmet medical and social service needs. There is an urgent need to focus resources to address these high rates of HIV infection as part of the larger national strategy to combat the AIDS epidemic.”
The HIV incidence results from HPTN 061, presented today at the XIX International AIDS Conference in Washington, D.C. are among the first findings to come out of the study. Other early analyses show that HIV infection in this study population was associated with very high rates of untreated sexually transmitted infections and with poverty. Of the self-reported HIV-negative or unknown HIV status study participants who agreed to be tested at time of enrollment, 12% were HIV-positive. This finding suggests low rates of HIV testing or delays in testing among Black MSM. All HIV-infected study participants were referred for HIV care and treatment services. During the study, all participants were offered the chance to work with “peer health navigators” to provide support and to assist them with access to needed services. In addition, they were provided with condoms, testing and referral treatment of sexually transmitted infections, risk reduction counseling and other standard HIV prevention services.
Further analysis of data from the study is ongoing to assess how HIV risk among Black MSM might be affected by childhood experiences, social and sexual networks, discrimination, homophobia, incarceration and barriers to health care. These findings will help inform future research and prevention efforts.