Background National surveillance data document increases in HIV and syphilis diagnoses in young black men who have sex with men (MSM), but trends could be driven by increases in a few large areas. We assessed the extent to which metropolitan areas of varying population sizes have reported increases in HIV diagnoses among MSM and in syphilis diagnoses among men.
Methods We examined trends in HIV and primary and secondary syphilis case report data in metropolitan areas with greater than 500 000 people, at least 500 black men aged 13–24 years, and with mature HIV reporting systems as of 2004 (n=73). We compared the average number of case reports in 2004–2005 and 2007–2008 and examined differences by age at diagnosis (13–24 years, 25–29 years, ≥30 years), race/ethnicity (white, black, and Hispanic), and area population size (500 000–999 999, 1 000 000–2 499 999, and ≥2 500 000 persons).
Results Among MSM aged 13–24 years, observed increases in HIV diagnoses were larger among blacks (average percent increase=68.7%) compared with Hispanics (36.7%) and whites (41.7%). Increases in HIV diagnoses were observed in more areas for black MSM aged 13–24 years (85% of areas) than for Hispanic MSM aged 13–24 years (62% of areas), or white MSM aged 13–24 years (58% of areas), or older MSM of any race/ethnicity (range—44%–62% of areas). (Abstract P1-S2.35 figure 1) Among men aged 13–24 years, primary and secondary syphilis diagnoses increased on average 203.5% among blacks, 99.7% among Hispanics, and 43.7% among whites, and increases were observed in more areas for blacks (70% of areas) than for Hispanics (44% of areas) or whites (59% of areas). (Abstract P1-S2.35 figure 1) The majority of areas (63%) had increases in both HIV and syphilis in black men aged 13–24 years. Across area size strata, the youngest group of black men had the highest average percent increase in diagnoses of HIV and syphilis as well as the highest percentage of areas with increases in diagnoses.
Conclusions HIV and syphilis diagnoses have increased among young black men in almost all areas, suggesting that national trends are not driven by increases in a few large areas. Findings highlight the need for improved prevention efforts for young MSM, particularly young black MSM.
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