Background: Syphilis emerged as a health disparity in a recent outbreak in Indianapolis. The Marion County Health Department Bell Flower Clinicís (BFCís) electronic database was used to analyze risk among black MSM to determine what characteristics might assist in disease control.
Objectives: To identify characteristics of black MSM at risk for syphilis and other STDís for the development of more effective casefinding and prevention interventions.
Methods: Data was extracted from the clinic database maintained in Netsmart Technologiesí Insight from 10/04 to 9/09. MSM were defined by sexual behaviors. Latino men were grouped together and excluded from black and white racial groups. Analysis was performed using Microsoft Excel and Access. Statistical analysis of proportions used chi square tests.
Results: There were 39,078 male patient visits by 22,224 unique men during the study period. Of these, 650 were black MSM, 1254 white MSM and 110 Latino MSM. Black MSM were more likely to have sex with women (39%) than other MSM (Latino 23%, white 12.8%, p=. 0001). Black MSM were more likely to have gonorrhea diagnosed at a visit (14%) than white or Latino MSM (7% and 4% respectively)(p<. 0001). Both syphilis and HIV were seven times more common in exclusively gay black MSM compared to bisexual black MSM. Number of partners, cocaine, alcohol, anonymous partners and condom use did not explain differences among black and other MSM with regard to STD infection.
Conclusions: Analysis of existing data can reveal previously unknown characteristics of subpopulations at risk, including MSM. Behavioral characteristics donít account for more frequent STDís observed in black MSM attending BFC.
Implications for Programs, Policy, and/or Research: Continued study is needed to understand the health disparities that exist with regard to HIV and STDís.