Estimating the Population Size of Men Who Have Sex with Men in the United States to Obtain HIV and Syphilis Rates§
David W Purcell*, 1, Christopher H Johnson 1, Amy Lansky 1, Joseph Prejean 1, Renee Stein 1, Paul Denning 1, Zaneta Gau11, Hillard Weinstock 1, John Su 2, Nicole Crepaz 1
Identifiers and Pagination:Year: 2012
Issue: Suppl 1
First Page: 98
Last Page: 107
Publisher ID: TOAIDJ-6-98
Article History:Received Date: 26/4/2011
Revision Received Date: 18/8/2011
Acceptance Date: 20/9/2011
Electronic publication date: 7/9/2012
Collection year: 2012
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
CDC has not previously calculated disease rates for men who have sex with men (MSM) because there is no single comprehensive source of data on population size. To inform prevention planning, CDC developed a national population size estimate for MSM to calculate disease metrics for HIV and syphilis.
We conducted a systematic literature search and identified seven surveys that provided data on same-sex behavior in nationally representative samples. Data were pooled by three recall periods and combined using meta-analytic procedures. We applied the proportion of men reporting same-sex behavior in the past 5 years to U.S. census data to produce a population size estimate. We then calculated three disease metrics using CDC HIV and STD surveillance data and rate ratios comparing MSM to other men and to women.
Estimates of the proportion of men who engaged in same-sex behavior differed by recall period: past year = 2.9% (95%CI, 2.6–3.2); past five years = 3.9% (3.5–4.4); ever = 6.9% (5.1–8.6). Rates on all 3 disease metrics were much higher among MSM than among either other men or women (38 to 109 times as high).
Estimating the population size for MSM allowed us to calculate rates for disease metrics and to develop rate ratios showing dramatically higher rates among MSM than among other men or women. These data greatly improve our understanding of the disproportionate impact of these diseases among MSM in the U.S. and help with prevention planning.