Examining HIV risk and prevention behaviors among men who have sex with men in Ending the HIV Epidemic states in the Western US region between 2017 and 2021: a serial-cross-sectional analysis of the American Men's Internet Survey.

Background: The Western region of the US has received comparatively less attention in HIV research despite housing several Ending the HIV Epidemic priority areas. Understanding HIV risk and prevention behaviors among men who have sex with men (MSM) in this region is critical. This study examines dif...

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Publicado en:Sexual Health (14485028) Vol. 23; no. 2; pp. 1 - 15
Autores principales: Algarin, Angel B., Portle, Sarah, Sanchez, Travis H.
Formato: research tables/charts Journal Article
Publicado: CSIRO Publishing 2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Examining HIV risk and prevention behaviors among men who have sex with men in Ending the HIV Epidemic states in the Western US region between 2017 and 2021: a serial-cross-sectional analysis of the American Men's Internet Survey.
      aug:
        au:
          Algarin, Angel B.
          Portle, Sarah
          Sanchez, Travis H.
        affil: Arizona State University Edson College of Nursing and Health Innovation, Center for Health Promotion and Disease Prevention, Phoenix, AZ, USA.
      sug:
        subj:
          HIV Infections Risk Factors
          HIV Infections Prevention and Control
          Men Who Have Sex With Men Psychosocial Factors
          Americans Psychosocial Factors
          Health Behavior Evaluation
          Sexual Health
          Risk Assessment
          Funding Source
          United States
          Human
          Male
          Adolescence
          Adult
          Cross Sectional Studies
          Secondary Analysis
          Internet
          Surveys
          Poisson Distribution
          Odds Ratio
          Confidence Intervals
          P-Value
          Data Analysis Software
          Descriptive Statistics
          Risk Taking Behavior
          Condoms
          Unsafe Sex
          Anal Intercourse
          Substance Use Disorders
          Sexually Transmitted Diseases
          Health Screening
          Pre-Exposure Prophylaxis
          Health Knowledge
          Health Status Disparities
          Health Services Accessibility
          Sexual Behavior
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
      ab: Background: The Western region of the US has received comparatively less attention in HIV research despite housing several Ending the HIV Epidemic priority areas. Understanding HIV risk and prevention behaviors among men who have sex with men (MSM) in this region is critical. This study examines differences in HIV risk and prevention behaviors among MSM in the Pacific (CA, WA) and Mountain (AZ, NV) sub-regions. Methods: We conducted a serial cross-sectional analysis using 2017–2021 data from the American Men's Internet Survey. The sample included MSM with HIV-negative or unknown status. Key outcomes included condomless anal intercourse, substance use, STI diagnoses, HIV/STI testing, and PrEP awareness, willingness and use. Poisson regression models with robust standard errors estimated prevalence ratios and 95% confidence intervals, adjusting for sociodemographics. Results: Among 7423 MSM, 81.3% resided in the Pacific sub-region, 53.0% were aged <30 years and 50.8% were white. Condomless anal intercourse rates were similar across sub-regions, but STI diagnoses (13.0% vs 10.1%, P < 0.05) and substance use were higher in the Pacific compared with the Mountain sub-region. HIV testing (55.5% vs 59.8%, P < 0.05) and STI testing (39.2% vs 45.7%, P < 0.001) were lower in the Mountain sub-region compared with the Pacific sub-region. PrEP awareness was similar, but usage was lower (17.2% vs 23.1%, P < 0.001) despite higher willingness (51.8% vs 44.5%, P < 0.001) in the Mountain compared with the Pacific sub-region. Conclusions: HIV risk was similar across sub-regions, but disparities in prevention engagement highlight regional barriers. Expanding PrEP access and HIV/STI testing in the Mountain sub-region is critical to achieving Ending the HIV Epidemic goals. HIV infections in the United States have declined overall, but important regional differences remain, especially in the West, which has received far less attention than the South. Analyzing survey data from more than 7400 men who have sex with men in four Western states, we found that sexual risk behaviors were similar across regions, yet men in Arizona and Nevada were less likely to be tested for sexually transmitted infections and less likely to use preventive medication, despite being more willing to try it. These findings suggest that gaps in healthcare access, rather than differences in behavior, are driving prevention shortfalls and point to where targeted investments could help end the HIV epidemic in the West.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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