Center For AIDS Research

May 17, 2016: Special Edition

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Special Edition: May 17, 2016
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Focus On... HIV among MSM in the South

Focus On...    

You know how the ATL is frequently referred to as the "Black San Francisco?" With today's release of information by Emory CAMP documenting that more than 15% of all Atlanta men who have sex with men (MSM) are infected with HIV (and that Black MSM bear an outsize share of that numerator), it is now definitively clear that channeling our inner San Francisco also means echoing that city's tragic history of decimation by HIV.

But as bad as things are in Atlanta, they are even worse in other parts of the South.

     Rates of Prevalent HIV Infection, Prevalent Diagnoses and New Diagnoses among MSM in US States, Metropolitan Statistical Areas, and Counties, 2012-2013

According to an Emory CAMP (Emory Coalition for Applied Modeling for Prevention) paper released today ("Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013"), every single one of the cities in the United States in which more than one in every four of its MSM citizens are infected with HIV -- Baton Rouge, LA (25.4%), Augusta, GA (26.6%), El Paso, TX (28.5%), Columbia, SC (29.7%), and Jackson, MS (39.5%) -- are found in the South.

Think about that for a moment. In Jackson Mississippi almost 2 of every 5 MSM have HIV. And that estimate is from 2012 data -- the situaiton is quite possibly even worse today.

Two questions:
1) Where is the data coming from?
2) How important is the science behind the data?

Answers: 1) From Emory CFAR members! 2) Exceptionally important!

Specifically, members of a 5-year Emory CAMP cooperative agreement between Emory and the CDC National Center for HIV, Viral Hepatitis, STD, and TB Prevention which received support from the CFAR Prevention Science Core and includes CFAR members Patrick Sullivan (PI), Eli Rosenberg (PD), Jeremy Gray, Travis Sanchez, David Purcell, and Jono Mermin -- have been doing some REALLY exciting work.

How exciting? Well, their paper ("Estimating the Population Sizes of Men Who Have Sex With Men in US States and Counties Using Data From the American Community Survey") describes a newly developed methodology for acurately estimating the population sizes of MSM in every single US county and metropolitan statistical area.

Think for a second about how foundational this work is! Until now there has been no scientifically defensible population figures for MSM in the US because the US census does not collect information on same-sex behavior. Which means that, until now, there has also been no scientifically defensible information on the relative impact of HIV among MSM in a given location.

But thanks to Patrick, Eli, Travis, Jono, Jeremy and other members of Emory CAMP, that's all changed now.

For the first time ever we can estimate rates of prevalent diagnoses, prevalent infection, and new HIV diagnoses among MSM at below-national scales.

Which is how we have come to learn that six southern states (and DC) are the only states in the US with prevalences of living with an HIV diagnosis above 15%. And that Georgia is the only US state with both >15,000 MSM cases and >15% prevalence of a diagnosis.

And that 21 of the top 25 high HIV diagnosis cities are located in the US South.

So what are the research lessons here?

How about these ...

1. CFAR Members Rock!
Emory CAMP is a partnership between CFAR members at Emory and the CDC. Three cheers for cross-Clifton collaborations.

2. Think Locally, Act Locally:
CFAR's very own back yard has an enormous magnitude of HIV infection, even in areas of low population (think: small cities and rural areas).

3. Use All Your Resources:
We need to seriously consider doubling down on research that focuses on HIV prevention and care resources -- which, thanks to this amazing group of CFAR members, we now can do with much more local precision than ever before.

As Jono Mermin puts it:

"By pinpointing where HIV strikes the hardest, we have a key piece of the puzzle highlighting the largest disparities within states and the South. We hope these data empower local public health officials, community-based organizations and everyone fighting HIV to bring resources to the gay and bisexual men who need them the most."

Go Team CFAR!

READ MORE ABOUT IT

Papers:
http://publichealth.jmir.org/2016/1/e14/
http://publichealth.jmir.org/2016/1/e22/
http://publichealth.jmir.org/2016/1/e26/
http://publichealth.jmir.org/2016/1/e25/

More information:
EmoryCAMP.org
Official Press Release
Maps and data downloads

Some press coverage so far:
ABC
POZ

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The Network News is a periodic email, detailing HIV/AIDS related events, funding opportunities, and achievements of CFAR members. If you have items that you wish to have included, please send them to us at cfar@emory.edu by Friday of each week. Please put "The Network News" in the subject line.

The Network News is distributed to CFAR members and fans by email every Tuesday. Except when it isn't.

Editor, Kimberley (Kimbi) Sessions Hagen, EdD

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