The Georgia Department Of Public Health Fact Sheet NATIONAL HIV BEHAVIORAL SURVEILLANCE SYSTEM: MEN WHO HAVE SEX WITH MEN Ongoing HIV Risk Behaviors in Metropolitan Atlanta: Preliminary Data from the National HIV Behavior Surveillance (NHBS) System, Men who have Sex with Men (MSM2) What is NHBS? The Georgia Department of Public Health collaborated with Emory University and the Centers for Disease Control and Prevention (CDC) in conducting a behavioral surveillance system within the Metropolitan Statistical Area (MSA) of Atlanta; among three specific and distinct populations at heightened risk for HIV infection. This system represents one of 21 sites nationally that comprise the integrated monitoring system; participating MSAs were selected based on high prevalence of people living with HIV/ AIDS. NHBS activities include assessing and monitoring trends in HIV risk, HIV testing behaviors and access to preventive services among these populations at highest risk for infection: Men who have Sex with Men (MSM), Injection Drug Users (IDU), and Heterosexuals at increased risk of HIV infection (HET). Activities are implemented in one-year cycles that are repeated among the three at-risk groups every three years. Findings will be used to enhance understanding of risk and testing behaviors, and to develop and evaluate HIV prevention programs for ongoing improvement of services among these groups in reducing this risk for HIV/AIDS infection. Atlanta MSA Counties Bartow Pickens Dawson Cherokee Forsyth Paulding Cobb Gwinnett Barrow Haralson Carroll DeKalb Walton Douglas Fulton Rockdale Clayton Newton Fayette Henry Coweta Heard Jasper Spaulding Butts Pike Lamar Meriwether *MSA counties: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, Dekalb, Douglas, Fayette, Forsyth,Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, Walton Who are the participants? Data collection for the second MSM cycle was conducted between September and December 2008. Venue based sampling was the methodology used in recruiting the MSM population; participants completed an anonymous survey Racial distribution of MSM population in the Atlanta MSA region for the NHBS_MSM2 cycle 2008. interview and HIV test. Of 382 eligible participants ranging Others in age from 18 to 69 in the MSM2 cycle, the mean age was 1% Others 35 years. The Atlanta MSM population consisted of 93% homosexual or gay identified and 6% bisexual men. The Multiple races 1%Hispanic 12% Hispanic majority of participants identified either as White (50%) or 3%Multiple races 12% Hispanic Black (34%). Participant education level consisted of 40% 3% with a Bachelor's degree and 24% having some college or associate's degree. Seventy-four percent (277) were employed full-time, 12% (45) were employed part-time andWhite-NH 10% (36) reported being unemployed. Sixty-one percent 50% White-NH (226) of participants reporting having health insurance at 50% the time of the interview. Black-NH 34% Black-NH 34% Black-NHHispanic White-NHBlack-NH Multiple rWacheitse-NH Others Multiple races Others 2 Peachtree Street, Atlanta, Ga 30303 w www.health.state.ga.us August 2011 NATIONAL HIV BEHAVIORAL SURVEILLANCE SYSTEM: MEN WHO HAVE SEX WITH MEN Risk Behaviors of MSMs in the Atlanta MSA MSM reported their last MSM sex partner was a main sex partner (74%) rather than with a casual (23%) or exchange partner (3%). Of 157 MSM who reported having insertive anal sex during their last sexual encounter, 45% (71) did not use condoms. Of the 55% (86) who reported using condoms during insertive anal sex, 22% (19) did not use a condom the entire time. Of 180 MSM who reported engaging in receptive anal sex at last sexual encounter, 49% (88) did not use a condom or if a condom was initiated, 22% (40) did not continue use during the entire encounter. MSM revealed that 35% (114) met their last sexual partner at a bar/club and 23% (74) met over the internet. What prevention services are MSM accessing in the Atlanta MSA? Fifty-four percent of MSM participants stated they had seen a doctor in the last 12 months and 29% (100) did not report their sexual identity to their health care provider. Thirty-nine percent reported their health care provider offered an HIV test. Almost 94% of MSM participants stated they had not talked to a counselor about HIV prevention methods in the past year. In the past 12 months, 93% (346) had not had an STD test for Syphilis. In the past 12 months, MSM reported their STD diagnoses as: Herpes 1%(4), Gonorrhea 9%(34), Syphilis 7%(24) and Chlamydia 9% (33). Of the MSM participants, 74% (264) stated they had not received free condoms in the past 12 months. Of the 29% (109) who had received free condoms, 83% (90) reported using the free condoms during sexual behavior. Ever tested for HIV AIDS vs Race & Ethnicity among MSM population of GA for MSM2 cycle 2008 Hispanic Black Non-Hispanic White Non-Hispanic Multiple races Yes No. (%) 29 (67) 111 (86) 186 (98) 11 (84) No No. (%) 14 (32) 18 (14) 4 (2) 2 (16) Disclosure of sexual orientation associated with MSM population in Georgia Sexual Identity # % Straight/Heterosexual 2 <1 Homosexual/Gay 346 93 Bisexual 25 6 Outness among Gay identified respondents No 25 7 Yes 346 93 Gay Identified: Told Friends who are not Gay No 48 14 Yes 298 86 Gay Identified: Told Family members No 126 36 Yes 220 64 Gay Identified: Told health Care providers No 100 29 Yes 246 71 HIV rates among MSM2 participants? Percentage of condom usage in the MSM From the participants in MSM2, 90% (335) reported having population in Atlanta MSA region for the NHBS- an HIV test in their lifetime. Of the 382 tested, 6% (24) were HIV positive and one was indeterminate. The HIV positive 24M%SM2 cycle 2008 racial breakdown consisted of 12 Whites, 10 Blacks and 2 Hispanics. Only 3 of the MSMs tested were unaware of Did not receive free Condoms their HIV positive status. 5% Received free Condoms, but did not use 24% 71% Received free Condoms and used Did not rec For additional information about NHBS Condoms Jianglan White, MD, MPH, NHBS Principal Investigator (404) 657-2601 | jzwhite@dhr.state.ga.us 5% Received f but did not Received f Jeffery Todd, MA, and used NHBS Team Leader 71% (404) 657-2603 | jdtodd@dhr.state.ga.us