Researchers at ICAP’s Harlem Prevention Center joined the HIV Prevention Trials Network (HPTN) at the XIX International AIDS Conference to announce study results that showed alarmingly high rates of new HIV infections occurring among black gay and bisexual black men in the US (also known as men who have sex with men, or MSM), with rates particularly high among 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 US. 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 US white MSM. The overall infection rate among black MSM in this US 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 US cities, and the first to determine the rate of new HIV infection among such a large prospective cohort of US black MSM (referred to as HIV incidence).
“The HPTN 061 study findings are a sobering wake-up call,” said Wafaa El-Sadr, ICAP director. “These results, and others to be garnered from further analysis of the study, highlight the enormity of the challenges ahead and offer important insights into how to design research studies and programs for prevention of HIV among black MSM.”
HPTN 061 enrolled a total of 1,553 men in six US cities: Atlanta, GA, Boston, MA, New York, NY, Los Angeles, CA, San Francisco, CA, and Washington, D.C. The Harlem Prevention Center, ICAP at Columbia University’s community-based clinical research site that is dedicated to addressing the impact of HIV in New York City’s medically underserved communities, was one of two New York City sites conducting the study. The Harlem Prevention Center enrolled 154 participants with excellent follow-up of participants for the 12-month duration of the study.
The HIV incidence results from HPTN 061, presented at the XIX International AIDS Conference in Washington, DC 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 men who indicated that they were HIV-negative or were unaware of their HIV status at the time of enrollment in the study and who agreed to have an HIV test at time of enrollment, 12% were HIV-positive. This finding suggests that not enough men in this population are receiving HIV testing.
During the study, all HIV-infected study participants were referred for HIV care and treatment services. All participants were also 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 referrals, risk reduction counseling, and other standard HIV prevention services.
The success of the HPTN 061 in recruiting and retaining black MSM in a year-long study, including a 97% uptake of HIV testing, accomplished a primary objective of the study, and paves the way for future HIV prevention research in this population.
Sharon Mannheimer, who directed the study at the Harlem Prevention Center, said, “These results are an opportunity to understand how to address critical issues in this community. Moving forward, it is especially important that we consider social and societal factors that contribute to HIV risk, such as poverty and unemployment.”
While further analysis of data from the study is ongoing to assess how HIV risk among black MSM might be affected by factors such as childhood experiences, social and sexual networks, discrimination, and barriers to health care, these findings can be used to help inform decisions by local policy and public health officials when HIV prevention resources are allocated in major US cities. This study also provides support for future programs to be developed that address multi-level factors including individual, community, and structural influences that have an impact on black MSM.
The HPTN 061 study was conducted between 2009 and 2011, and is funded by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH).
