Increased HIV and primary and secondary syphilis diagnoses among young men--United States, 2004-2008

National data document increases in HIV and syphilis diagnoses in young black men who have sex with men (MSM), but trends could be driven by increases in a few large areas. We describe the extent to which metropolitan areas of varying population sizes have reported increases in HIV and syphilis diagnoses in young MSM.

We examined trends in HIV and primary and secondary syphilis case reports from 2004 to 2008 in metropolitan areas having more than 500,000 persons and at least 500 black men aged 13-24 years (n = 73). We examined differences by age at diagnosis, race/ethnicity, and area size.

Comparing 2004/2005 with 2007/2008, HIV diagnoses increased in 85% (n = 62) of areas among black MSM aged 13-24 years; primary and secondary syphilis diagnoses in young black men increased in 70% of areas (n = 51). Areas had an average percentage increase of 68.7% (Interquartile range: 25.0-103.1) in HIV diagnoses among young black MSM and an average increase of 203.5% (interquartile range: 0.0-192.7) in primary and secondary syphilis. Across area size strata, the youngest group of black men had the highest average percentage increase in diagnoses of HIV and syphilis and the highest percentage of areas with increases in diagnoses.

HIV and syphilis diagnoses increased among young black men in almost all areas, suggesting widespread increases across metropolitan areas of different sizes. Findings highlight the need for continued prevention efforts for young MSM, particularly young black MSM.