Epidemiological Profile of HIV/AIDS in Minnesota
Men who have Sex with Men (MSM)
HIV/AIDS Prevalence among MSM
Since the beginning of the HIV epidemic, the majority of HIV/AIDS cases in Minnesota have been among MSM. As of December 31st, 2013, MSM and those with the joint risk of MSM and IDU accounted for over half (56%) of the 7, 723 people living with HIV/AIDS in Minnesota.
Rate of HIV among MSM
Men who have sex with Men have the highest rate of persons living with and new diagnoses of HIV/AIDS than any other sub-group. In 2013, the estimated rate of people living with HIV/AIDS among MSM was 4,659 per 100,000 population. This is more than 60 times higher than the rate among non-MSM men (73.8 per 100,000 population). The estimated rate of new diagnoses among MSM in 2013 was 162.7 per 100,000 population. This is more than 40 times higher than the rate of diagnoses among non-MSM men (3.7 per 100,000 population). It’s important to note that MSM contains cases from all racial/ethnic categories and therefore cannot be directly compared to the rates by race/ethnicity.
HIV Diagnoses among MSM
MSM made up 50% of newly reported HIV cases in Minnesota in 2013. Over the past decade, the number of newly reported HIV infections among MSM has slowly trended upward, from 130 cases in 2003, to 151 in 2013 with a peak of 214 cases in 2009. In 2013, nearly half (49%) of MSM living with HIV/AIDS resided in Minneapolis, followed by 12% in St. Paul.
While the majority (61%) of new HIV infections diagnosed among MSM and MSM/IDU between 2011 and 2013 were white, the proportion of new diagnoses among men differs by race/ethnicity. Of the new HIV infections diagnosed among males between 2011 and 2013, MSM or MSM/IDU were estimated to account for 93% of cases among Hispanic males, 96% of cases among White males, 88% of cases among African American males, and 10% of cases among African-born males. During the same time period, 100% of all Asian males had MSM as their mode of exposure and 60% among American Indian males; however the number of new diagnoses during this time is too small to make further generalizations about risk.
Age at Diagnosis
The majority of MSM and MSM/IDU living with HIV in 2013 were over the age of 40 (73%). Youth (persons between the ages of 13 and 24) accounted for 4% of living MSM and MSM/IDU cases. Although young MSM make up a small percentage of all MSM living with HIV/AIDS, the number of new infections among this group more than quadrupled from 15 in 2001 to 74 in 2009. In 2013, the number of new infections among young MSM and MSM/IDU decreased to 34. However, young MSM or MSM/IDU still accounted for more than 1 out of 5newly reported MSM cases in 2013, and are still a population of concern. For more information about HIV infection in youth, please see the Adolescent and Young Adult section of this document.
The reason behind the increase in HIV infections among young MSM in Minnesota is somewhat unclear. However, 61% of young male cases were interviewed in 2009, and behaviors most commonly reported included anonymous sex, using technology (e.g., chat rooms), having multiple partners, and using condoms infrequently.
MSM/IDU represent a smaller number of cases, accounting for 5% of people living with HIV/AIDS in Minnesota and 3% of newly reported HIV infections in 2013. For more information about the demographics of MSM/IDU risk group please see the Injection Drug Use section of this document.
HIV Treatment Cascade among MSM and MDM/IDU
There were 3,783 HIV positive persons with MSM as their identified risk and 384 with MSM/IDU as their risk included in the HIV Treatment Cascade analyses. Compared to the overall HIV treatment cascade in Minnesota, people who have an identified HIV risk of MSM have slightly higher percentages of viral suppression. MSM have the highest percentage of viral suppression than any other risk group at 65%. MSM/IDU have lower percentages of retention in care as well as viral suppression as compared to the overall cascade for Minnesota.
There were 166 cases among MSM reported in 2012 that were included to calculate linkage to care. Ninety-three percent of MSM linked to care within three months of their initial HIV diagnosis in 2012. This is three percentage points higher than the overall cascade. There were 10 cases among MSM/IDU reported in 2012 included in the linkage to care calculation. Linkage to care among MSM/IDU was the same as the percentage in the overall treatment cascade. However, the number of cases among MSM/IDU included in the linkage to care calculation is small and should therefore be interpreted with caution.