CDC Report Highlights 2021 Trends in HIV Testing, Treatment, Risk Behaviors Among MSM

The CDC recently released the report, “HIV Infection, Risk, Prevention, and Testing Behaviors Among Men Who Have Sex with Men,” a special report from the National HIV Behavioral Surveillance (NHBS) system.

This report highlights 2021 data regarding HIV infection and surveillance among men who have sex with men (MSM) in the United States, including percentages of MSM reporting specific behavioral risk factors, testing habits, and participation in prevention programs for HIV.

The report included data from 2241 MSM from 23 metropolitan areas that participated in NHBS in 2021. Of this group, 26% of participants were aged 29 years or younger, with most participants beings in their 30s. Additionally, 38% were Black, 27% were White, and 25% were Hispanic or Latino.

Preexposure prophylaxis (PrEP) awareness and use were highlighted in the report. While 89% of interviewed MSM without HIV knew what PrEP was in 2021, only 42% used it to prevent infection. Also, 57% of White MSM reported using PrEP in the past year, compared with 44% of Hispanic or Latino MSM and 24% of Black MSM.

The CDC recommends sexually active MSM get tested for HIV at least once per year, saying testing is the pathway toward engagement in HIV prevention and treatment services. According to the report, 76% of MSM without HIV had received testing in the past 12 months.

Of this group who had been tested, 72% said their most recent HIV test was performed in a clinical setting and 25% said it was in a nonclinical setting—HIV counseling and testing site, HIV street outreach program or mobile unit, syringe services program, or at home. Interviews revealed that Black and Hispanic or Latino MSM were more likely to have had their most recent HIV test conducted in a nonclinical setting compared with White MSM.

The report noted that 86% of participants had health insurance and 89% had visited a health care provider in general within 12 months prior to the interview, which may be related to the high levels of testing in clinical settings.

Importantly, HIV treatment rates are high among MSM with HIV.

According to the CDC report, 95% of MSM living with HIV 2021 were actively taking HIV antiretroviral treatment at the time of the interview. Additionally, 98% of MSM with HIV reported having ever visited a health care provider for HIV in 2021. Further, 69% did so within a month of receiving an HIV diagnosis, and 88% did so within 6 months prior to being interviewed.

The report also looked at differences in condom use based on HIV status.

Most (77%) MSM reported condomless anal sex with male partners, regardless of self-reported HIV status.

Men who did not have an HIV diagnosis were more likely to report condomless sex overall with female sex partners compared with MSM with HIV, though both percentages were low for this group. Men with HIV reported condomless anal sex with main (44%) and casual male partners (55%) at similar rates to MSM without an HIV diagnosis (50% and 53%, respectively).

Reference

Centers for Disease Control and Prevention. HIV infection risk, prevention, and testing behaviors among men who have sex with men—national HIV behavioral surveillance, 13 U.S. cities, 2021. HIV Surveillance Special Report 2023; 31. Published January 2023. Accessed February 1, 2023. https://www.cdc.gov/hiv/library/reports/hiv-surveillance-special-reports/no-31/index.html