Today, CDC released a new study of HIV prevalence and unrecognized infection among men who have sex with men (MSM) in 21 major U.S. cities, based on an analysis of data from the 2008 National HIV Behavioral Surveillance System (NHBS). Overall, researchers found that approximately one in five (19 percent) MSM was infected with HIV and nearly half (44 percent) of those men were unaware of their infection.

The study, published in the September 24 issue of CDC’s Morbidity and Mortality Weekly Report, found that young MSM and MSM of color were least likely to know of their infection. Fifty-nine percent of black MSM, and 46% of Hispanic MSM were unaware of their infection, compared to 26% of white MSM. Furthermore, young MSM (aged 18-29) – especially young MSM of color – were far more likely to be unaware of their HIV infection than their older counterparts.

HIV prevalence in the 21 cities varied greatly. Six percent of MSM in Atlanta had HIV, while a staggering 38% were infected in Baltimore.

Moreover, the study found a strong link between socioeconomic status and HIV among MSM—prevalence increased as income and education decreased, and awareness of HIV status was higher among MSM with greater education and income. These findings echo similar disparities seen in recent NHBS research among heterosexuals.

Clearly, HIV remains a serious health threat among gay and bisexual men in America’s major cities—especially among young MSM and MSM of color. We must reduce its devastating toll. It’s time to invigorate the response to HIV among public health professionals and community leaders across the United States; September 27, National Gay Men’s HIV/AIDS Awareness Day provides a focus for us to renew our promise to educate the community and protect health in the United States.

• For CDC, HIV prevention for MSM of all races remains a top priority. We are working to find new ways to reach MSM with HIV prevention messages and services. We have recently expanded a successful HIV testing initiative to reach more MSM in the areas most affected in the United States. We are researching new approaches to prevention. Moreover, we are funding organizations throughout the nation to implement evidence-based prevention programs to reduce high risk behavior among MSM. Those proven behavioral interventions include: d-up!, Many Men, Many Voices, Mpowerment, Popular Opinion Leader, and PROMISE. And just this week, we launched a new website on MSM Health.
• For gay community leaders, it is critical that together we engage and make HIV education, prevention, and testing of the highest priority. We must ensure that HIV is not a rite of passage for young MSM. We can rekindle a sense of urgency and action in the gay community to again embrace the work needed to drive down new infections. Now is the time to act.
• African American and Latino leaders also need to be engaged and to recognize and support HIV prevention efforts in their communities. We must ensure we effectively protect the health and reduce the toll of HIV among African American and Latino MSM.
• State and local health departments and community-based organizations should ensure that program and funding decisions prioritize the urgent needs of MSM.

As called for in the National HIV/AIDS Strategy at least once a year, and those at increased risk (e.g., those with multiple or anonymous sex partners, or who use drugs during sex) should be tested more often. Knowing your HIV status is the first step to protecting your health and the health of your partners, as well as the gateway to accessing treatment and prevention services.