Date of Award

1-9-2015

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Richard Rothenberg, MD, MPH

Second Advisor

Dr. Jane Kelly, MD

Abstract

Background: As of 2012, Georgia ranked fifth in the United States in the number of people diagnosed with HIV/AIDS. Given the high burden of disease among men who have sex with men (MSM), the HIV Care Continuum has become an important measure for keeping persons living with HIV in care and eventually reaching an undetectable viral load.

Methods: Data were extracted from the Enhance HIV/AIDS Reporting System (eHARS) using SAS version 9.3.A univariate analysis was then performed by cross tabulating variables such as linked to care, any care in 2012, retained in care and viral suppression (VS) for men who have sex with men only (MSMO) and men who have sex with men and women (MSMW), stratified by race/ethnicity and age.

Results: Among 20,676 males categorized as MSM, 14,316 (69%) were MSMO and 6,360 (31%) were MSMW. Among MSMO, 77% (N=772) were linked to care and 45% were virally suppressed and among MSMW, 75% (N=219) were linked to care and 40% were virally suppressed. Black men have the lowest percentages along the HIV Care Continuum when compared to other race/ethnicities of MSMO and Hispanic/Latino MSMW have the lowest linkage to care of any race/ethnicity for both subpopulations. In both MSMO and MSMW, linkage, any care, retention, and VS increase with increasing age.

Conclusion: MSM suffer are terribly affected by HIV and a substantial proportion of MSM also engage in sexual contact with women, who may not be aware of their partner’s HIV risk status. Much speculation can be drawn about what keeps both MSMO and MSMW from being linked to care or reaching an undetectable viral load. Possibilities may include greater perception of stigma, ambivalence about HIV care and increased denial affecting ART adherence for MSMW as compared to MSMO. In order to see a drop in HIV rates within this group, the outside factors that negatively influence a person’s progress along the HIV Care Continuum toward an undetectable viral load must be understood and addressed.

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