  
Antiretroviral therapy underused among some HIV-infected men who have sex with men
Last Updated: 2001-04-30 16:03:43 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - In a survey of four major US cities, most HIV-infected men who have sex with men (MSM) use antiretroviral therapies, according to a report published in the May issue of the American Journal of Public Health. However, certain MSM subpopulations were less likely to use antiretrovirals, the authors note.
Dr. Ron Stall, from the Centers for Disease Control and Prevention in Atlanta, and colleagues interviewed 2881 HIV-positive MSM living in Chicago, Los Angeles, New York, and San Francisco, specifically focussing on antiretroviral use.
The researchers found that 74% and 51% of MSM with CD4+ cell counts below and above 500 cells/µL, respectively, used antiretroviral therapies.
Men who were younger and who had been aware of their HIV status for a shorter period of time reported less use of recommended therapies. "It is striking that in a sample with very high rates of antiretroviral therapy use at recommended levels, relative youth was a barrier to care, an association also reported among injection drug users," the authors point out.
Men who had had sexual relations with a women in the previous 5 years, or who were only moderately affiliated with the gay community and who felt the gay community was exclusive or nonaccepting were also less likely to follow treatment recommendations.
The investigators note that "the associations with sexual orientations other than homosexual and having a higher perception of exclusivity on the part of the gay community both suggest that social support found within the gay community helps motivate seropositive men to obtain recommended antiretroviral therapies."
The researchers emphasize that "the most effective strategy to ensure that MSM receive appropriate levels of AIDS care is that of making sure that these individuals are never infected with HIV in the first place." They add that "this point assumes even greater importance during an era of increasing risk of HIV transmission among urban MSM."
Am J Public Health 2001;91:767-773.
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