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Am Fam Physician. 2005;72(5):951

The Centers for Disease Control and Prevention (CDC) has released new data on trends for human immunodeficiencognizedy virus (HIV) testing among men who have sex with men. The report, “HIV Prevalence, Unrec Infection, and HIV Testing Among Men Who Have Sex with Men—Five U.S. Cities, June 2004–April 2005,” was published in the June 24, 2005, issue of Morbidity and Mortality Weekly Report and is available online athttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5424a2.htm.

The CDC analyzed data from five cities participating in the National HIV Behavioral Surveillance system. Of 1,767 men who had one or more male sex partners, 450 (25 percent) tested positive for HIV. Nearly one half of infected men did not know that they were HIV positive. The prevalence of previously undetected infections was highest among nonwhite men younger than 30 years.

Most men with previously undetected infections had been tested before for HIV (84 percent), but fewer than one half had been tested within the previous year (approximately 42 percent). The most common reason given for not being tested was fear of discovering that they were HIV positive. Other reasons included worry that others would find out or that their name would be reported to the government; fear of losing their job, family, or insurance coverage; and fear of needles. Nearly 20 percent of men with previously undetected HIV infections said they had not done anything to put themselves at risk for infection.

The CDC concludes that men who have sex with men should be encouraged to be tested for HIV at least annually, and prevention programs should focus on reaching persons who are unaware of their HIV status, especially in at-risk populations.

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