Statewide Estimation of Racial/Ethnic Populations of Men Who Have Sex with Men in the U.S

• Published in: Public health reports (1974) Vol. 126; no. 1; pp. 60 - 72
• Main Authors: Lieb, Spencer, Fallon, Stephen J., Friedman, Samuel R., Thompson, Daniel R., Gates, Gary J., Liberti, Thomas M., Malow, Robert M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Association of Schools of Public Health 01-01-2011; SAGE Publications; SAGE PUBLICATIONS, INC
• Subjects: Acquired immune deficiency syndrome; Adult; Advocacy; African Americans; African Americans - ethnology; African Americans - statistics & numerical data; AIDS; Asian Americans - ethnology; Asian Americans - statistics & numerical data; Behavioral Risk Factor Surveillance System; Blacks; Community Health Planning; Cross-Cultural Comparison; District of Columbia; Epidemiology; Ethnicity; European Continental Ancestry Group - ethnology; European Continental Ancestry Group - statistics & numerical data; Family Characteristics - ethnology; Gays & lesbians; Hispanic Americans - ethnology; Hispanic Americans - statistics & numerical data; Hispanics; HIV; HIV Infections - ethnology; HIV Infections - prevention & control; Homosexuality, Male - ethnology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Male; Men; Modeling; Models, Statistical; Population estimates; Population Surveillance; Public health; Race; Residence Characteristics - statistics & numerical data; Rural Population - statistics & numerical data; Sexual behavior; Suburban Population - statistics & numerical data; United States - epidemiology; Urban Population - statistics & numerical data; White people; United States; United States > US; USA, South Dakota; INE, USA, California; USA, Wyoming; INE, USA, Alaska
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/003335491112600110

Objectives. Men who have sex with men (MSM) bear the greatest burden of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in every state in the U.S., but their populations are poorly defined. We estimated and compared populations of MSM in 2007 by region, state, and race/ethnicity. Methods. We averaged findings from two statistical models we had previously developed to estimate the total state-specific percentage and number of males who were MSM. The models were based, respectively, on state-specific rural/suburban/urban characteristics and an index using state-specific household census data on same-sex male unmarried partners. A third model, based on racial/ethnic ratios from a nationally representative behavioral survey, partitioned these statewide numbers by race/ethnicity. Results. Of an estimated 7.1 million MSM residing in the U.S. in 2007, 71.4% (5.1 million) were white, 15.9% (1.1 million) were Hispanic, 8.9% (635,000) were black, 2.7% (191,000) were Asian, 0.4% (26,000) were American Indian/Alaska Native, 0.1% (6,000) were Native Hawaiian/other Pacific Islander, and 0.6% (41,000) were of multiple/unknown race/ethnicity. The overall U.S. percentage of males who were MSM (6.4%) varied from 3.3% in South Dakota to 13.2% in the District of Columbia, which we treated as a state. Estimated numbers of MSM ranged from 9,612 in Wyoming to 1,104,805 in California. Conclusions. Plausible estimates of MSM populations by state and race/ethnicity can inform and guide HIV/AIDS surveillance, allocation of resources, and advocacy. They can help in the planning, implementation, and evaluation of HIV prevention programs and other services. Using MSM numbers as denominators, estimates of population-based MSM HIV incidence, prevalence, and mortality rates could help clarify national and state-level epidemic dynamics. Until corroborated by other modeling and/or empirical research, these estimates should be used with caution.