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J Acquir Immune Defic Syndr. 2019 Sep 11. doi: 10.1097/QAI.0000000000002151. [Epub ahead of print]

HIV Risk and Prevention Outcomes in a Probability-Based Sample of Gay and Bisexual Men in the United States.

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Indiana University School of Public Health, Center for Sexual Health Promotion, Bloomington, Indiana.
Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, New York.
Indiana University School of Medicine, Department of Biostatistics, Indianapolis, Indiana.
Yale University School of Public Health, Social and Behavioral Sciences, New Haven, Connecticut.
The Fenway Institute/Harvard University School of Medicine, Boston, Massachusetts.



While gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States (U.S.), nearly all evidence on their HIV risk and prevention outcomes derive from non-probability samples.


A probability-based cohort of GBM (N=502) from 45 states and Washington, D.C.


Cross-sectional survey.


Among HIV negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two thirds (63.3%) of PrEP users reporting daily adherence in the last week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (STI) (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, while an additional 8.9% reported testing positive for at least one other STI following their most recent test. All HIV positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the last month. A majority of HIV negative/unknown/untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary healthcare provider.


Our findings present a decidedly mixed picture regarding the success of the U.S. National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM.

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