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

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Background: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.Setting:A probability-based cohort of GBM (N=502) from 45 states and Washington, D.C.Methods:Cross-sectional survey.Results: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.Conclusion: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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