The Young Men's Survey phase II: hepatitis B immunization and infection among young men who have sex with men.

OBJECTIVES: We measured the prevalence of hepatitis B virus (HBV) immunization and HBV infection among men aged 23 to 29 years who have sex with men. METHODS: We analyzed data from 2834 men who have sex with men in 6 US metropolitan areas. Participants were interviewed and tested for serologic markers of immunization and HBV infection in 1998 through 2000. RESULTS: Immunization prevalence was 17.2%; coverage was 21.0% among participants with private physicians or health maintenance organizations and 12.6% among those with no source of health care. Overall, 20.6% had markers of HBV infection, ranging from 13.7% among the youngest to 31.0% among the oldest participants. Among those susceptible to HBV, 93.5% had regular sources of health care, had been tested for HIV, or had been treated for a sexually transmitted disease. CONCLUSIONS: Although many young men who have sex with men have access to health care, most are not immunized against HBV. To reduce morbidity from HBV in this population, providers of health care, including sexually transmitted disease and HIV prevention services, should provide vaccinations or referrals for vaccination.

HIV testing patterns and unrecognized HIV infection among young Asian and Pacific Islander men who have sex with men in San Francisco.

The HIV epidemic is rising in Asian and Pacific Islander men who have sex with men (API MSM), who are often first diagnosed with HIV at a late stage of disease. We investigated the HIV testing patterns, correlates of prior testing, and awareness of HIV infection of 495 API MSM aged 18-29 years recruited from venues in San Francisco, using standardized face-to-face interviews. One quarter of participants had never tested for HIV, citing reasons such as perceived low risk, fear of results, and fear of needles. Older age, gay sexual orientation, history of sexually transmitted disease, higher lifetime number of sexual partners, and higher acculturation were significantly and independently associated with prior testing. Thirteen (2.6%) tested HIV-positive, of whom eight were unaware of their infection, five perceived themselves to be at low risk for HIV, and five reported recent UAI. These findings underscore the need to increase access to culturally appropriate and targeted HIV testing and to change perceptions of risk in this population.

HIV risk factors reported by two samples of male bathhouse attendees in Los Angeles, California, 2001-2002.

BACKGROUND: We aimed to describe the use of voluntary HIV counseling and testing services, risk behaviors, and risk factors for unprotected anal sex (UAS) among men who have sex with men (MSM) who attended a bathhouse in Los Angeles during 2001-2002. METHODS: Using 2 cross-sectional study samples, we compared (in order below) 458 of 640 MSM who used voluntary HIV counseling and testing in the bathhouse with 398 MSM surveyed upon exit. Within each group, logistic regression identified factors associated with UAS at their most recent bathhouse visit. RESULTS: Of 640 MSM, 71 (11%) tested HIV-positive for the first time. Of the 50 HIV-positive MSM who completed a survey, 50% tested because of the convenient services. Similar proportions of MSM in both survey samples reported UAS (7%-8%) during their recent bathhouse visit. Risk factors associated with UAS in both survey samples were UAS with men outside the bathhouse and greater numbers of partners within the bathhouse. CONCLUSIONS: Comprehensive prevention services provided within bathhouses may reduce undiagnosed HIV infections among MSM, and targeting HIV prevention at the bathhouse may reduce risks with partners both inside and outside the bathhouse.

HIV prevention services received at health care and HIV test providers by young men who have sex with men: an examination of racial disparities.

We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.