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High HIV incidence among young black men who have sex with men: constructing a retrospective cohort from a community health programme
  1. M Reuel Friedman1,2,
  2. Nayck B Feliz3,
  3. Jess Netto4,
  4. Brian J Adams1,2,
  5. Derrick D Matthews1,2,
  6. Ron D Stall2,5,
  7. Ken S Ho6,
  8. Sarah E Krier1,2,
  9. Anthony J Silvestre1,2
  1. 1 Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2 Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  3. 3 Division of Adolescent Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  4. 4 Community Human Services, Inc., Pittsburgh, Pennsylvania, USA
  5. 5 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  6. 6 Pittsburgh AIDS Center for Treatment, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr M Reuel Friedman, P.O. Box 7319, Pittsburgh, PA 15213, USA; mrf9{at}


Objectives We sought to calculate HIV incidence in a retrospective cohort of young (13–29 years old) black men who have sex with men (YBMSM) accessing repeated HIV-antibody testing in a mid-size city in the USA.

Methods We aggregated site-specific HIV-antibody testing results from the project's inception among YBMSM who received an initial negative result and accessed at least one additional HIV-antibody test. From these data, we assessed number of seroconversions and person-years and calculated HIV incidence using a mid-P exact test to estimate 95% CIs.

Results Five seroconversions were documented over 42.3 person-years (the mean age at first onsite test: 19.7 years), resulting in an HIV incidence rate of 11.8% (95% CI 4.3% to 26.2%). The mean age at seroconversion was 20.4 (±3.0) years.

Conclusions Even in mid-size cities with low HIV prevalence rates in the general population, HIV incidence among YBMSM may be high. Community-based HIV-antibody testing organisations serving YBMSM should be encouraged and trained to track repeated HIV testing and calculate HIV incidence rates. Increased resources should be deployed to develop and encourage regular HIV testing in community health sites serving YBMSM.

  • HIV

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  • Handling editor Jackie A Cassell

  • Contributors MRF conducted the analyses and wrote the majority of the manuscript. NBF, JN, BJA and SEK assisted with design, data collection and manuscript refinement. DDM, RDS, KSH and AJS contributed to the introduction and discussion sections of the manuscript.

  • Funding National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (PS12-1201c). DDM and RDS were funded by the National Institutes of Health (R01 NR013865). Additional support was provided by Pennsylvania Department of Health and Allegheny County Health Department.

  • Competing interests None declared.

  • Ethics approval University of Pittsburgh IRB PRO12100115.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing is subject to brokered de-identification of data collected and a Data Use Agreement brokered between respective institutions.