The odds of detecting HIV infection in African-American men vary according to the type of testing approach used, according to a new study.

CDC recently reported that men who have sex with men accounted for 61 percent of all new HIV infections in 2009. African Americans, who represent just 14 percent of the population, comprised 44 percent of all new HIV infections that year. In the new study, the authors -- from New York University, CDC, and Harlem United Community AIDS Center -- said black MSM accounted for 38 percent of new HIV diagnoses in New York City.

The team used data from the New York City setting of a multi-site study to evaluate the effectiveness of three testing strategies for detecting previously undiagnosed HIV infection in 18- to 64-year-old African-American MSM.

The three strategies were:

• Partner services. This involved identifying, locating and interviewing HIV-positive persons to learn the names and contact information of their sexual and needle-sharing partners; notifying those partners of their exposure to HIV; and providing HIV counseling, testing and referrals to the partners.
• Alternative venue testing. This involved offering rapid-result HIV testing in locations such as bars, churches and mobile units.
• Social networks strategy. In this approach, testers engaged either HIV-positive individuals or those at high risk as recruiters, who then were trained in how to encourage others in their social networks to undergo testing.

The percentage of men testing HIV-positive was 19.3 in the social networks approach, 14.3 in the partner services approach and 6.3 in the alternative venue approach.

"The odds for detection of HIV-positive MSM were 3.6 times greater for the social networks strategy and 2.5 times greater for partner services than alternative venue testing," the authors reported. The MSM who tested at alternative venues were younger and more likely to self-identify as gay than those tested through social networks. The men who tested through social networks reported taking more sexual risks than the MSM tested at alternative venues.

"Findings suggest differential effectiveness of testing strategies," the authors concluded. "Given differences in the individuals accessing testing across strategies, a multi-strategic testing approach may be needed to most fully identify undiagnosed HIV-positive African-American MSM."

The report, "Evaluation of the Relative Effectiveness of Three HIV Testing Strategies Targeting African-American Men Who Have Sex with Men (MSM) in New York City," was published in Annals of Behavioral Medicine (2011;17(42)).

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