Variables Associated with Less Concern for HIV Given Effective Treatment in an Era of Increasing HIV Prevention Methods Among Black/African American and Latino MSM in Three US Cities

Background: Black and Latino MSM continue to be at disproportional risk for HIV infection in the United States. It is important to better understand perceptions of HIV disease in order to effectively address HIV prevention messaging among these men. This analysis examines the association of less concern for HIV given effective treatment among black and Latino MSM in an era of increasing HIV prevention methods (e.g., HIV pre-exposure prophylaxis).

Methods: Data from the 2014 Messages4Men Study were used for analysis. Black and Latino MSM were recruited online and in person in Chicago, Fort Lauderdale, and Kansas City. Self-reported STD in the past year and demographic variables of HIV status, race/ethnicity, education, age, and city were analyzed for associations with reporting less concern for transmitting (for HIV-positive men) or acquiring (for HIV-negative men) HIV given effective treatment for HIV infection.  

Results: Overall, 39% of the sample (n=845) reported less concern for HIV given effective treatment, less concern being more prevalent for HIV-positive vs. HIV-negative men (54% vs. 32% respectively, p<.05). Nearly a quarter (22%) reported having an STD in the past year, and those reporting (vs. not reporting) an STD reported less concern for HIV (49% vs. 37%, p<.05), as did Latino (vs. black) men (48% vs. 31%, p<.05). In multivariable regression analysis controlling for recent STD, HIV status, and demographic variables above, HIV-positive status was associated with less concern for HIV (AOR=3.14, 95% CI=2.24-4.39) as was younger age (p<.05), but having an STD (p=.076) and Latino identification (p=.086) were not.    

Conclusions: Less concern for HIV transmission/acquisition given effective HIV treatment was associated with an HIV-positive status and younger age among black and Latino MSM. Effective primary prevention messaging in an era of effective HIV treatment and now chemo-prophylaxis continues to be challenging, particularly among younger MSM.