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Background: The U.S. National HIV/AIDS Strategy recommends intensification of prevention efforts in communities where HIV is most highly concentrated and establishes targets for reducing diagnoses among key populations, including men who have sex with men (MSM). Although trends in diagnoses among subgroups of MSM have been examined nationally, HIV risk, testing, and prevention behaviors vary geographically, and HIV prevention is typically delivered at a state or local level. We analyzed trends in HIV diagnoses among subgroups of MSM in the United States by state.
Methods: Using National HIV Surveillance System data submitted through June 2016 and adjusted for missing risk information, we determined the annual number of diagnoses among MSM during 2008-2014, overall and by race/ethnicity and age group. To examine trends, we calculated estimated annual percent change (EAPC) for each subgroup, nationally and for each state and the District of Columbia. We present significant increases or decreases (p< 0.05), given ≥12 diagnoses per year.
Results: The number of diagnoses among MSM decreased slightly during 2008-2014 (Table). Diagnoses increased among Hispanic/Latino MSM and MSM aged 13-24 y or 25-34 y and decreased among white MSM and MSM aged 35-44 y or 45-54 y. Findings were heterogeneous by state, with 7 states experiencing increases in diagnoses among MSM and 12 experiencing decreases. Notably, diagnoses among Hispanic/Latino MSM increased in 7 states and did not decrease in any states. Diagnoses among MSM aged 13-24 y and 25-34 y increased in 16 and 18 states, respectively.

Table.
[Table.]


Conclusions: Sub-national trends indicate that achieving national goals to reduce diagnoses will require intervention in a large number of states, with a focus on young, Hispanic/Latino, and black MSM. This analysis also identified states with successes in reducing HIV transmission, which may offer lessons learned.

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