Current progress and future directions
by Gregorio A. Millett, David Malebranche, and John L. Peterson
The social demography of the human immunodeﬁciency virus (HIV) epidemic among Black men in the United States has changed over thelast two decades. Black men who have sex with men (MSM) now account for the largest proportion (30%) of all Black men diagnosed with HIV (CDC, 2004a). Moreover, Black men constitute a sizable proportion (27%) of all MSM diagnosed with HIV (CDC, 2004a,b). Similarly, most studies of MSM have reported that rates of HIV infectionare higher among Black MSM than all other racial or ethnic MSM groups (Easterbrook et al., 1993; Lemp et al., 1994; Valleroy et al., 2000;CDC, 2001; Mansergh et al., 2002; Harawa et al., 2004).
Given the toll of the HIV epidemic on Black MSM, there is a pressing need to provide effective interventions that prevent HIV transmission and progression to the acquired immunodeﬁciency syndrome(AIDS). These interventions depend on the availability of sufﬁcient research that describes and explains the factors that inﬂuence HIVtransmission. Studies in public health and in the social or behavioralsciences provide evidence of potential factors that prevent HIV infection or an AIDS diagnosis among Black MSM. In primary prevention research, studies focus on factors associated with HIV serostatus, HIVrisk behaviors, and protective behaviors associated with the initial infection with HIV. Secondary prevention research focuses on the factors that affect disease progression among HIV-infected individuals.Both research areas may involve intervention research to determine the types of intervention approaches to prevent HIV transmission ordisease progression.