Rapid HIV Testing Among Racial/Ethnic Minority Men at Gay

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5. O’Leary DR, Marfin AA, Montgomery SP, et al. The HIVtestingconductedat11eventsinnine a more comprehensive questionnaire ad- epidemic of West Nile virus in the United States, 2002. Vector Borne Zoonotic Dis. 2004;4(1):61-70. U.S.citiesduring2004-2006;mostofthese ministered by local staff using hand- 6. CDC. West Nile virus activity—United States, 2001. events were attended primarily by MSM held personal computers during 2005- MMWR Morb Mortal Wkly Rep. 2002;51 (23):497-501. fromracial/ethnicminoritygroups.Atotal 2006. The assessment questionnaires 7. Davidson AH, Traub-Dargatz JL, Rodeheaver RM, of 543 attendees who participated in the included questions about demographic et al. Immunologic responses to West Nile virus in vac- assessments reported at the time of the characteristics, sexual behavior, illicit cinated and clinically affected horses. J Am Vet Med Assoc. 2005;226(2):240-245. event that they had not had HIV infection drug use, HIV status, history of testing

*A sample of mosquitoes (usually no more than 50) diagnosedpreviously.Ofthese,133(24%) for HIV and other sexually transmitted of the same species and sex, collected within a de- were tested for HIV during the event, and diseases (STDs), and access to HIV and fined sampling area and period. eight(6%)ofthosetestedduringtheevent STD prevention services. After complet- †Additional information available at http://www.cdc .gov/ncidod/dvbid/westnile/surv&control.htm. had a positive rapid test result. All eight ing the questionnaire, respondents who were subsequently confirmed to be HIV said they were HIV negative or did not positive by Western blot testing. Testing know their HIV status were offered rapid Rapid HIV Testing at gay pride events provides an opportu- HIV testing using the OraQuick௡ Ad- Among Racial/Ethnic nitytoidentifynewHIVinfectionsamong vance™ Rapid HIV-1/2 Antibody Test MSM outside of health-care settings, par- (OraSure Technologies, Inc., Bethle- Minority Men at Gay ticularly those from racial/ethnic minor- hem, Pennsylvania). Because a positive ity groups. rapid HIV test is considered to be a pre- Pride Events—Nine As part of an initiative to reduce racial/ liminary result, persons with prelimi- U.S. Cities, 2004-2006 ethnic disparities in HIV infection, the nary positive results were asked to pro- U.S. Conference of Mayors, through a vide an oral fluid or blood specimen for MMWR. 2007;56:602-604 cooperative agreement with CDC, pro- confirmatory Western blot testing. Rapid 1 table omitted vided funding to CBOs and health HIV testing at the 11 events was per- departments to conduct behavioral as- formed in diverse settings, including IN THE UNITED STATES, HUMAN IMMUNO- sessments at gay pride events attended tents, mobile testing units, community deficiency virus (HIV) and acquired im- primarily by MSM from racial/ethnic mi- centers, churches, bars, and hotel rooms. munodeficiencysyndrome(AIDS)dispro- nority groups. CDC provided on-site Of 627 male respondents aged Ն18 portionately affect men from racial/ethnic technical assistance to the CBO and years who self-identified as being from minority groups.1 Approximately half of health department staff, including de- a racial/ethnic minority group and as the HIV/AIDS cases among non-Hispanic veloping assessment questionnaires, being either gay or bisexual, 543 re- black and Hispanic males reported by 33 training interviewers, and coordinating ported that they were HIV negative or did states using name-based HIV surveillance HIV testing and questionnaire admin- not know their HIV status. Of these, 133 during 2001-2005 were among men who istration. During 2004-2006, CBOs and (24%) were tested for HIV at an event. havesexwithmen(MSM).1 Eachyear,ap- health departments were funded to con- Of the 133 respondents who were tested, proximately 100 gay pride events are held duct assessments and HIV testing at (1) eight (6%) had preliminary positive test in cities across the United States to cel- black gay pride events in Detroit, Michi- results. All eight were subsequently con- ebrate diversity, demonstrate solidarity of gan (2004 and 2005), Baltimore, Mary- firmed to be HIV positive by Western blot the gay community, and heighten aware- land(2004),Jackson,Mississippi(2005), testing. The median age of the eight HIV- ness of topics of importance to the gay Charlotte, North Carolina (2006), St. positive respondents was 36 years (range: community. These events are attended by Louis, Missouri (2006), and the District 21-43 years), and seven were non- several hundred to several hundred thou- of Columbia (2005); (2) Hispanic gay Hispanic blacks. Four of the eight newly sand MSM. Certain gay pride events are pride events in Oakland (2004) and San identified HIV-positive respondents re- focusedoncelebratingsolidarityinthemi- Francisco, California (2005); and (3) gay ported having had a negative HIV test re- nority gay community and are attended pride events in Oakland, California sult during the preceding year, one had primarily by MSM from racial/ethnic mi- (2004), and Chicago, Illinois (2006). never been tested for HIV, and the test- nority groups. These events offer an op- Both volunteer and paid interviewers ing histories of three were unknown. portunity for community-based organi- were stationed in multiple places at event Of the 169 persons who were willing zations (CBOs) and health departments sites. Interviewers approached and in- to be tested at a 2005 or 2006 event, 105 toprovideHIV-preventioneducationand vited adult attendees to participate in a (62%) were tested; data for 2004 were outreach. In 2004, CBOs and health de- behavioral assessment. At some events, unavailable. Although the reasons will- partments, with technical assistance from attendees were offered nonmonetary in- ing respondents were not tested were not CDC, began conducting rapid behavioral centives (typically valued at Յ$10) to in- collected systematically, anecdotal re- assessments at gay pride events and at mi- crease participation. Assessments were ports from staff at events suggest that the nority gay pride events.2 This report de- conducted using a two-page, self- primary reasons were that respondents scribestheresultsofassessmentsandrapid administered questionnaire in 2004 and did not report to testing locations after

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completing the behavioral assessment or, not know their HIV status during the as- able, 74% had visited a health-care pro- if they did report to testing locations, they sessment and who were tested at gay viderduringtheprecedingyear;however, chose not to wait until staff were avail- pride events, 6% had positive HIV test only 41% had been offered HIV testing by able to administer a test. results. This result is comparable to the a provider during the preceding year. To Data on health-care–seeking behav- 7% of minority MSM with a positive HIV decrease the number of missed opportu- iors were available from the 2005 as- test result in 2004 at CDC-supported nities for HIV testing, in 2006, CDC rec- sessments only. Of the 229 respon- testing sites, which included hospitals, ommended that HIV testing for patients dents in 2005 who reported that they public health and STD clinics, prisons aged 13-64 years become a routine part were HIV negative or did not know their and jails, drug treatment centers, and out- ofmedicalservicesusingavoluntary,opt- HIV status, 23 (10%) had received a re- reach settings.6 Four of the eight men outapproach.CDCfurtherrecommended ferral for HIV testing from a health- who were newly identified as infected that persons likely to be at high risk for care provider or outreach worker dur- with HIV had received negative HIV test HIV infection, including sexually active ing the preceding year, and 169 (74%) results during the preceding year. Men MSM, be tested at least annually.9 respondents had visited a health-care who mistakenly believe that they are HIV Future analyses of outreach activi- provider during the preceding year. Of negative, even those who have this be- ties such as the ones described in this these 169 respondents, 70 (41%) had lief based on a recent negative HIV test, report can be used to understand bar- been offered an HIV test by their health- represent an important risk group for riers to HIV testing among MSM and care provider. HIV transmission. For example, 47 (7%) help determine the cost-effectiveness of of the 723 MSM in the Young Men’s Sur- such activities for health departments Reported by: T Dowling, MA, MPH, O Macias, D Sebesta, PhD, San Francisco Dept of Public Health, E vey who had received negative HIV test and CBOs. Expansion of HIV testing op- Antonio, Mission Neighborhood Health Center, C results during the preceding year and dis- portunities for racial/ethnic minori- Emerson, Tenderloin Health, San Francisco; L Hino- josa, Alameda County Office of AIDS Admin, Oak- closed that they were HIV negative to ties outside of health-care settings, com- land, California. P LaKosky, MA, Chicago Dept of Pub- their sex partners were unaware that they bined with culturally appropriate lic Health, Chicago, Illinois. C Bolden Calhoun, 7 Community Health Awareness Group, Detroit; L Ran- were HIV positive. Knowledge of being behavioral interventions, are impor- dall, PhD, Michigan Dept of Community Health. B infected with HIV has been associated tant components of ongoing CDC ac- Tucker, Women Accepting Responsibility, Inc., Balti- with reduction of high-risk behaviors.8 tivities to reduce HIV transmission and more; C Flynn, ScM, Maryland Dept of Health and Mental Hygiene. M Robinson, Pride of Mississippi, Inc., CBOs and health departments face eliminate disparities in the rates of HIV H Mangum, MSSW, Grace House Inc., Jackson; C several challenges when conducting infection by race and ethnicity. Thompson, Mississippi Dept of Health. D Wrigley, St. Louis City Health Dept, St. Louis, Missouri. M Buie, rapid HIV testing at gay pride events. The MA, D Bost, North Carolina Dept of Health and Hu- effectiveness of testing depends, in part, REFERENCES man Svcs. A Smith, MA, Whitman-Walker Clinic, Dis- trict of Columbia. E Begley, MPH, B Boyett, MS, H on the amount of resources that CBOs 1. CDC. Racial/ethnic disparities in diagnoses of HIV/ Clark, MPH, J Heffelfinger, MD, K Jafa-Bhushan, and health departments can dedicate to AIDS—33 states, 2001-2005. MMWR Morb Mortal MBBS, J Schulden, MD, B Song, MS, P Thomas, PhD, such events. The demand for rapid HIV Wkly Rep. 2007;56(9):189-193. P Sullivan, DVM, PhD, Div of HIV/AIDS Prevention, 2. Gallagher KM, Denning PD, Allen DR, Nakashima National Center for HIV/AIDS, Viral Hepatitis, STD, testing at several of the events de- AK, Sullivan PS. Use of rapid behavioral assessments and TB Prevention; A Voetsch, PhD, EIS Officer, CDC. scribed in this report exceeded the ca- to determine the prevalence of HIV risk behaviors in high-risk populations. Public Health Rep. pacity of CBO and health department 2007;122(Suppl 1):56-62. CDC Editorial Note: Of the estimated 1 staff to provide testing. Persons who 3. Glynn M, Rhodes P. Estimated HIV prevalence in the United States at the end of 2003. [Abstract] 2005 million persons living with HIV infection could not be tested during the event were National HIV Prevention Conference. Available at http: in the United States, approximately 25% referred for testing at a later date. Effec- //www.aegis.com/conferences/NHIVPC/2005 do not know their HIV status.3 In 2003, tiveness also depends on proper follow /T1-B1101.html. 4. CDC. Advancing HIV prevention: new strategies the CDC initiative Advancing HIV Pre- up of persons with newly diagnosed HIV. for a changing epidemic—United States, 2003. MMWR vention: New Strategies for a Changing Two of the eight MSM with newly diag- Morb Mortal Wkly Rep. 2003;52(15):329-332. 5. Spielberg F, Branson BM, Goldbaum GM, et al. Epidemic called for implementation of nosed and confirmed HIV infection were Choosing HIV counseling and testing strategies for out- new models for diagnosing HIV infec- not referred to medical care because they reach settings: A randomized trial. J Acquir Immune 4 Defic Syndr. 2005;38(3):348-355. tions. Rapid HIV testing can increase the could not be located after the event. HIV 6. CDC. HIV counseling and testing at CDC-supported number of persons who are willing to be testing at gay pride events is only one part sites—United States,1999-2004. Available at http: //www.cdc.gov/hiv/topics/testing/reports.htm. testedandtheproportionofpersonstested of a greater strategy to encourage HIV 7. MacKellar DA, Valleroy LA, Behel S, et al. Unin- 5 who receive their results. The findings testing among MSM. tentional HIV exposures from young men who have in this report suggest that rapid HIV test- HIV testing provided by CBOs and sex with men who disclose being HIV-negative. AIDS. 2006;20(12):1637-1644. ing of MSM in racial/ethnic minority health departments outside of the health- 8. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta- groups at gay pride events is a useful way care setting, such as at gay pride events, analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United to enable HIV-infected persons to learn isanimportantstrategytoreachMSMwho States: implications for HIV prevention programs. J Ac- their HIV status. might not regularly access health care. quir Immune Defic Syndr. 2005;39(4):446-453. 9. CDC. Revised recommendations for HIV testing of Overall, of the persons who reported Among persons for whom health-care– adults, adolescents, and pregnant women in health- that they were HIV negative or who did seeking behavior information was avail- care settings. MMWR. 2006;55(No. RR-14).

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