| Objectives. Researchers have long suspected that young men who have sex with men (MSM) did not follow the risk-reduction efforts of their older counterparts and ascribe to HIV risk behaviors at very high levels. The purpose of this study was to describe HIV prevalence and associated risks, estimate HIV incidence, and investigate racial disparities among young MSM.;Methods. The Young Men's Survey (YMS) was a cross-sectional, venue-based survey conducted in Baltimore (1996--2000). MSM (15--29 years old) were recruited from public venues. Data collection included a questionnaire and serologic testing. HIV incidence was calculated by the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS). Correlates of HIV seropositivity, prior HIV testing, recent unprotected anal intercourse (UAI), and drug-use during recent sexual encounters were ascertained by multivariate logistic regression.;Results. Among 843 participants, overall HIV prevalence was 12.1%, yet 27.1% among African Americans. HIV seropositivity was associated with: being 26--29 years old, African American, of Other/mixed race, having had 5--19 and over 20 lifetime male partners, and a history of STD. The prevalence of prior HIV testing was 78.9%. Adjusting for age, race, and HIV serostatus, having had 5--19 and over 20 lifetime male partners, male anal intercourse, and history of STD were independently associated with prior HIV testing, whereas recent UAI was not. Overall HIV incidence was 4.15% per year (95% CI: 1.76, 8.56), yet 11.02% per year (95% CI: 4.10, 24.13) among African Americans. The following were independent predictors of recent UAI: more than four male sexual partners in the last six months and drug-use during sex.;Conclusions. The HIV epidemic greatly affects young MSM and in particular minorities, both in terms of disease burden and number of new infections. Prevention services have successfully attracted those with riskier behaviors, yet may lack the ability to change such practices. The effects of drug-use during sex and increasing numbers of male partners are a core concern regarding practice of UAI. With rates of drug-use during sex and UAI comparable to other ethnicities, African Americans seem to have significantly higher HIV incidence rates potentially due to their sexual mixing patterns. |
