A state-level analysis of social and structural factors and HIV outcomes among men who have sex with men in the United States

Andrew D. Forsyth, Ronald O. Valdiserri

Research output: Contribution to journalArticlepeer-review

Abstract

We apply a social determinants of health model to examine the association of select social and structural influences on AIDS diagnosis rates among men who have sex with men (MSM) in the U.S. states. Secondary data for key social and structural variables were acquired and analyzed. Standard descriptive and inferential statistics were used to examine bivariate and multivariate associations of selected social and structural variables with estimated rate of Stage 3 HIV infection (AIDS) per 100,000 MSM in 2010. We found that living in states with a higher demographic density of lesbian, gay, bisexual, and transgender persons is independently associated with lower AIDS diagnosis rates among MSM. In addition, we found that greater income inequality and higher syphilis rates among men were associated with greater AIDS diagnosis rates among MSM, which may be attributable to state policy environments that underinvest in social goods that benefit population health, and to the fact that ulcerative sexually-transmitted infections increase biological risk of HIV transmission and acquisition. To end the epidemic in the U.S., it will be critical to identify and address state-level social and structural factors that may be associated with adverse HIV outcomes for MSM.

Original languageEnglish (US)
Pages (from-to)493-504
Number of pages12
JournalAIDS Education and Prevention
Volume27
Issue number6
DOIs
StatePublished - Dec 2015
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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