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Supplement Rates of prevalent HIV infection, prevalent diagnoses and new diagnoses among men who have sex with men (MSM) in US states, metropolitan statistical areas, and counties, 2012‐2013 Eli S. Rosenberg, PhD, Jeremy A. Grey, PhD, Travis H. Sanchez, DVM, Patrick S. Sullivan, PhD DVM Part 1. Number of MSM, 2012 This manuscript used estimates of the county‐level population sizes of men who have sex with men (MSM) in 2012 and 2013. The results for 2013 are included in the companion article on our method [1]. Here, we provide estimates for 2012 at the state and metropolitan statistical area (MSA) levels (also referred to as core‐based statistical area [CBSA] level in the companion article). Supplement Table 1. Estimated population size of men who have sex with men in 50 states and the District of Columbia, using housing and population estimates from the American Community Survey, 2008‐2012. Adult males MSM State N n % of males Alabama 1,739,878 40,812 2.3% Alaska 273,669 5,162 1.9% Arizona 2,357,342 107,515 4.6% Arkansas 1,068,010 18,909 1.8% California 13,810,868 785,954 5.7% Colorado 1,904,108 70,287 3.7% Connecticut 1,323,562 43,525 3.3% Delaware 331,320 13,193 4.0% District of Columbia 233,939 35,110 15.0% Florida 7,186,086 331,070 4.6% Georgia 3,478,235 130,214 3.7% Hawaii 527,813 15,751 3.0% Idaho 567,187 9,687 1.7% Illinois 4,701,376 201,596 4.3% Indiana 2,371,363 70,228 3.0% Iowa 1,136,654 20,774 1.8% Kansas 1,045,398 22,687 2.2% Kentucky 1,609,713 45,741 2.8% Louisiana 1,646,198 41,220 2.5% Maine 509,723 15,025 2.9% Maryland 2,109,864 82,629 3.9% Massachusetts 2,450,324 112,995 4.6% Michigan 3,658,367 112,434 3.1% Minnesota 1,982,819 79,645 4.0% Mississippi 1,055,795 19,151 1.8% Missouri 2,204,131 72,415 3.3% Montana 382,786 6,530 1.7% Nebraska 672,249 12,677 1.9% Nevada 1,025,612 51,429 5.0% New Hampshire 503,623 13,997 2.8% New Jersey 3,231,850 130,952 4.1% New Mexico 752,990 16,980 2.3% New York 7,184,245 373,806 5.2% North Carolina 3,486,140 101,062 2.9% North Dakota 264,770 3,969 1.5% Ohio 4,241,771 139,189 3.3% Oklahoma 1,380,741 37,671 2.7% Oregon 1,456,607 60,528 4.2% Pennsylvania 4,765,333 159,785 3.4% Rhode Island 394,203 23,182 5.9% South Carolina 1,703,151 33,896 2.0% South Dakota 305,101 5,411 1.8% Tennessee 2,332,882 74,852 3.2% Texas 9,007,898 365,088 4.1% Utah 944,257 32,522 3.4% Vermont 242,270 6,942 2.9% Virginia 2,989,024 111,842 3.7% Washington 2,552,526 112,627 4.4% West Virginia 712,946 12,556 1.8% Wisconsin 2,139,759 58,258 2.7% Wyoming 217,176 3,290 1.5% Total 114,173,652 4,452,772 3.9% Supplement Table 2. Estimated population size of men who have sex with men in 104 metropolitan statistical areas with HIV surveillance data, using housing and population estimates from the American Community Survey, 2008‐2012. Adult males MSM Metropolitan statistical area n n % of males Akron, OH 260,901 5,810 2.2% Albany‐‐Schenectady‐‐Troy, NY 330,126 9,294 2.8% Albuquerque, NM 325,150 8,608 2.6% Allentown‐‐Bethlehem‐‐Easton, PA‐‐NJ 304,919 6,637 2.2% Atlanta‐‐Sandy Springs‐‐Roswell, GA 1,871,931 99,826 5.3% Augusta‐‐Richmond County, GA‐‐SC 204,039 3,464 1.7% Austin‐‐Round Rock, TX 645,051 39,949 6.2% Bakersfield, CA 303,162 5,923 2.0% Baltimore‐‐Columbia‐‐Towson, MD 990,429 44,827 4.5% Baton Rouge, LA 292,975 6,200 2.1% Birmingham‐‐Hoover, AL 405,899 16,451 4.1% Boise City, ID 221,426 3,829 1.7% Boston‐‐Cambridge‐‐Newton, MA‐‐NH 1,707,425 93,254 5.5% Bridgeport‐‐Stamford‐‐Norwalk, CT 330,908 8,315 2.5% Buffalo‐‐Cheektowaga‐‐Niagara Falls, NY 423,522 21,926 5.2% Cape Coral‐‐Fort Myers, FL 243,975 7,157 2.9% Charleston‐‐North Charleston, SC 248,282 5,539 2.2% Charlotte‐‐Concord‐‐Gastonia, NC‐‐SC 793,084 34,822 4.4% Chattanooga, TN‐‐GA 195,386 4,364 2.2% Chicago‐‐Naperville‐‐Elgin, IL‐‐IN‐‐WI 3,417,204 177,280 5.2% Cincinnati, OH‐‐KY‐‐IN 764,794 30,977 4.1% Cleveland‐‐Elyria, OH 753,541 33,700 4.5% Colorado Springs, CO 237,290 4,556 1.9% Columbia, SC 282,061 6,384 2.3% Columbus, OH 695,762 37,445 5.4% Dallas‐‐Fort Worth‐‐Arlington, TX 2,272,239 131,843 5.8% Dayton, OH 293,801 6,582 2.2% Deltona‐‐Daytona Beach‐‐Ormond Beach, FL 230,773 5,612 2.4% Denver‐‐Aurora‐‐Lakewood, CO 946,541 53,532 5.7% Des Moines‐‐West Des Moines, IA 204,551 4,820 2.4% Detroit‐‐Warren‐‐Dearborn, MI 1,554,107 62,835 4.0% Durham‐‐Chapel Hill, NC 185,349 5,490 3.0% El Paso, TX 268,100 4,353 1.6% Fresno, CA 323,309 7,496 2.3% Grand Rapids‐‐Wyoming, MI 357,276 16,825 4.7% Greensboro‐‐High Point, NC 261,145 5,800 2.2% Greenville‐‐Anderson‐‐Mauldin, SC 303,073 5,620 1.9% Harrisburg‐‐Carlisle, PA 206,297 5,698 2.8% Hartford‐‐West Hartford‐‐East Hartford, CT 452,424 22,723 5.0% Honolulu (Urban), HI 371,128 10,392 2.8% Houston‐‐The Woodlands‐‐Sugar Land, TX 2,107,885 102,173 4.8% Indianapolis‐‐Carmel‐‐Anderson, IN 673,477 32,882 4.9% Jackson, MS 197,416 4,067 2.1% Jacksonville, FL 493,776 22,767 4.6% Kansas City, MO‐‐KS 721,757 33,127 4.6% Knoxville, TN 316,231 6,127 1.9% Lakeland‐‐Winter Haven, FL 223,966 5,511 2.5% Lancaster, PA 188,228 4,637 2.5% Las Vegas‐‐Henderson‐‐Paradise, NV 734,840 45,828 6.2% Little Rock‐‐North Little Rock‐‐Conway, AR 253,254 5,178 2.0% Los Angeles‐‐Long Beach‐‐Anaheim, CA 4,741,785 308,066 6.5% Louisville‐‐Jefferson County, KY‐‐IN 452,825 22,743 5.0% Madison, WI 233,189 6,417 2.8% McAllen‐‐Edinburg‐‐Mission, TX 241,482 4,286 1.8% Memphis, TN‐‐MS‐‐AR 457,558 21,028 4.6% Miami‐‐Fort Lauderdale‐‐West Palm Beach, FL 2,096,754 133,591 6.4% Milwaukee‐‐Waukesha‐‐West Allis, WI 561,587 25,933 4.6% Minneapolis‐‐St. Paul‐‐Bloomington, MN‐‐WI 1,232,429 67,872 5.5% Modesto, CA 179,312 3,217 1.8% Nashville‐‐Davidson‐‐Murfreesboro‐‐Franklin, TN 610,381 30,347 5.0% New Haven‐‐Milford, CT 316,784 7,389 2.3% New Orleans‐‐Metairie, LA 435,817 20,395 4.7% New York‐‐Newark‐‐Jersey City, NY‐‐NJ‐‐PA 7,165,159 395,928 5.5% North Port‐‐Sarasota‐‐Bradenton, FL 274,444 8,108 3.0% Ogden‐‐Clearfield, UT 199,809 3,625 1.8% Oklahoma City, OK 458,782 21,265 4.6% Omaha‐‐Council Bluffs, NE‐‐IA 311,192 7,574 2.4% Orlando‐‐Kissimmee‐‐Sanford, FL 795,885 45,547 5.7% Oxnard‐‐Thousand Oaks‐‐Ventura, CA 301,053 7,522 2.5% Palm Bay‐‐Melbourne‐‐Titusville, FL 211,429 5,032 2.4% Philadelphia‐‐Camden‐‐Wilmington, PA‐‐NJ‐‐DE‐‐MD 2,171,443 100,373 4.6% Phoenix‐‐Mesa‐‐Scottsdale, AZ 1,530,468 89,126 5.8% Pittsburgh, PA 896,941 37,891 4.2% Portland‐‐South Portland, ME 194,947 7,562 3.9% Portland‐‐Vancouver‐‐Hillsboro, OR‐‐WA 833,286 52,287 6.3% Providence‐‐Warwick, RI‐‐MA 597,633 31,001 5.2% Provo‐‐Orem, UT 169,367 2,368 1.4% Raleigh, NC 403,724 20,135 5.0% Richmond, VA 441,102 17,772 4.0% Riverside‐‐San Bernardino‐‐Ontario, CA 1,487,933 93,321 6.3% Rochester, NY 400,877 20,825 5.2% Sacramento‐‐Roseville‐‐Arden‐Arcade, CA 783,062 44,804 5.7% Salt Lake City, UT 384,280 22,669 5.9% San Antonio‐‐New Braunfels, TX 763,142 35,488 4.7% San Diego‐‐Carlsbad‐‐San Marcos, CA 1,185,465 79,742 6.7% San Francisco‐‐Oakland‐‐Hayward, CA 1,675,079 149,806 8.9% San Jose‐‐Sunnyvale‐‐Santa Clara, CA 697,953 37,748 5.4% Scranton‐‐Wilkes‐Barre‐‐Hazelton, PA 215,374 3,739 1.7% Seattle‐‐Tacoma‐‐Bellevue, WA 1,319,369 81,998 6.2% Spokane‐‐Spokane Valley, WA 198,082 5,264 2.7% Springfield, MA 228,149 5,176 2.3% St. Louis, MO‐‐IL 1,008,456 39,036 3.9% Stockton‐‐Lodi, CA 239,028 5,130 2.1% Syracuse, NY 244,499 6,150 2.5% Tampa‐‐St. Petersburg‐‐Clearwater, FL 1,051,763 62,239 5.9% Toledo, OH 222,959 4,570 2.0% Tucson, AZ 367,451 10,401 2.8% Tulsa, OK 337,751 7,307 2.2% Virginia Beach‐‐Norfolk‐‐Newport News, VA‐‐NC 622,546 24,493 3.9% Washington‐‐Arlington‐‐Alexandria, DC‐‐VA‐‐MD‐‐WV 2,068,780 118,961 5.8% Wichita, KS 225,215 4,019 1.8% Winston‐Salem, NC 230,211 4,913 2.1% Worcester, MA‐‐CT 342,863 8,709 2.5% Youngstown‐‐Warren‐‐Boardman, OH‐‐PA 211,666 3,549 1.7% Part 2. Sensitivity Analyses Methods The denominators for our analyses were derived using a method of estimating the county‐level population sizes of men who have sex with men (MSM) [1]. In order to examine the influence of this estimation method on our findings, we conducted analyses using two additional sets of denominators from methods based on previous studies [2, 3]. For the following tables, we have labeled these methods Method 1, Method 2, and Method 3, in order of increasing complexity. The first, Method 1, multiplies a standard percentage of adult men who have had sex with another man in the past five years by the number of adult men in each county to determine the number of MSM. For this value, we used 3.9%, as reported in Purcell et al. The second method (Method 2) uses the stratified percentages of adult men who have had sex with another man in the past year at four levels of urbanicity: large central metropolitan counties (4.4%); large fringe metropolitan counties (2.5%); small or medium metropolitan counties (1.4%); and non‐metropolitan counties (1.1%). These percentages are multiplied by the number of adult males in counties of the corresponding urbanicity levels to obtain the number of men who had sex with another man in the past year. These population sizes are then scaled up to achieve the national 5‐year male‐male sex estimate from Method 1, or 3.9% of the US adult male population. Finally, Method 3 applies the method reported in Grey et al. [1], which uses the assumed national percentage of US men who have had sex with another man in the past five years [3], the urbanicity‐specific percentage of US men who have had sex with another man in the past year [2], and the relative representation of same‐ sex male households in an area, as used by Lieb et al [4]. A summary of the major components of the three models is provided in Supplement Table 3. Supplement Table 3. Major components of three methods to estimate the county‐level population sizes of men who have sex with men in the US, using data from the American Community Survey Method Component 1 2 3 3.9% of adult men in the US have had sex with another man in the past five years X X X Variation of the percentage of adult men who have had sex with another man by X X urbanicity strata Within urbanicity strata, the percentage of adult men who have sex with men varies X according to the relative representation of same‐sex male households Results Each method was used to generate the outcomes reported in Tables 2 through 4 of the manuscript. The following tables present findings according to the three methods, with each rate as its own table. Thus, Table 2 is presented as Supplement Tables 4a (state‐level prevalences of HIV diagnosis among MSM), 4b (state‐level rates of new HIV diagnosis among all MSM), and 4c (state‐level rates of new HIV diagnosis among MSM without an HIV diagnosis); Table 3 is presented as Supplement Tables 5a (state‐level prevalence of HIV among MSM) and 5b (state‐level prevalence of undiagnosed HIV among MSM); and Table 4 is presented as Supplement Tables 6a (CBSA‐level prevalence of HIV diagnosis among MSM), 6b (CBSA‐level rates of new diagnosis among all MSM), and 6c (CBSA‐level rates of new diagnosis among MSM without an HIV diagnosis). Supplement Table 4a. Prevalence of HIV diagnoses among men who have sex with men, US states and District of Columbia, 2012 Rate per 100 MSM State n Method 1 Method 2 Method 3 9.49 13.05 15.78 Alabama 6,442 3.14 6.10 6.49 Alaska 335 9.52 7.47 8.14 Arizona 8,748 6.83 13.30 15.04 Arkansas 2,843 California 85,307 15.84 11.60 10.85 Colorado 8,028 10.81 12.76 11.42 Connecticut 3,178 6.16 6.97 7.30 Delaware 1,115 8.63 10.59 8.45 District of Columbia 7,360 80.67 46.29 20.96 16.96 15.70 14.35 Florida 47,520 17.77 21.15 18.51 Georgia 24,101 8.54 16.03 11.16 Hawaii 1,758 2.16 4.21 4.92 Idaho 477 11.18 9.69 10.17 Illinois 20,495 6.35 7.73 8.37 Indiana 5,876 2.56 5.08 5.45 Iowa 1,133 4.23 6.63 7.59 Kansas 1,723 5.89 7.68 8.08 Kentucky 3,697 Louisiana 8,954 13.95 19.71 21.72 Maine 771 3.88 7.69 5.13 Maryland 11,052 13.43 13.24 13.38 Massachusetts 8,181 8.56 9.00 7.24 Michigan 9,377 6.57 7.03 8.34 5.71 5.58 5.54 Minnesota 4,416 10.85 20.70 23.34 Mississippi 4,469 9.30 10.59 11.04 Missouri 7,994 1.60 3.35 3.66 Montana 239 3.87 7.59 8.01 Nebraska 1,015 12.68 9.09 9.86 Nevada 5,070 3.16 4.89 4.44 New Hampshire 621 10.63 9.61 10.23 New Jersey 13,402 5.89 11.44 10.18 New Mexico 1,729 19.49 15.44 14.61 New York 54,606 9.71 12.09 13.06 North Carolina 13,202 1.28 2.59 3.33 North Dakota 132 7.41 7.83 8.81 Ohio 12,259 6.12 7.67 8.74 Oklahoma 3,293 6.47 7.31 6.07 Oregon 3,673 6.71 7.33 7.81 Pennsylvania 12,477 Rhode Island 949 6.17 4.30 4.09 South Carolina 7,332 11.04 19.51 21.63 South Dakota 196 1.65 3.36 3.62 Tennessee 9,198 10.11 11.42 12.29 12.23 10.45 11.77 Texas 42,973 4.16 4.12 4.71 Utah 1,532 2.91 6.12 3.96 Vermont 275 10.20 10.66 10.63 Virginia 11,888 7.72 7.59 6.82 Washington 7,681 3.34 6.43 7.41 West Virginia 930 4.06 5.23 5.82 Wisconsin 3,388 1.57 3.34 4.04 Wyoming 133 50 US States & Washington, DC 493,453 11.08 11.08 11.08 Supplement Table 4b. Rates of new diagnoses among men who have sex with men, US states and District of Columbia, 2013 Rate per 100 MSM State nMethod 1Method 2Method 3 Alabama 442 0.65 0.89 1.09 Alaska 12 0.11 0.22 0.24 Arizona 513 0.55 0.43 0.46 Arkansas 192 0.46 0.89 1.00 California 3,860 0.71 0.52 0.49 Colorado 241 0.32 0.38 0.33 Connecticut 188 0.36 0.41 0.43 Delaware 60 0.46 0.56 0.46 District of Columbia 313 3.35 1.92 0.85 Florida 2,711 0.95 0.88 0.80 Georgia 1,708 1.24 1.48 1.30 Hawaii 78 0.37 0.70 0.51 Idaho 15 0.07 0.13 0.15 Illinois 1,273 0.69 0.60 0.64 Indiana 332 0.36 0.43 0.47 Iowa 77 0.17 0.34 0.37 Kansas 109 0.27 0.42 0.48 Kentucky 260 0.41 0.54 0.55 Louisiana 730 1.12 1.58 1.76 Maine 21 0.11 0.21 0.14 Maryland 762 0.91 0.90 0.90 Massachusetts 443 0.46 0.48 0.40 Michigan 547 0.38 0.41 0.48 Minnesota 202 0.26 0.25 0.24 Mississippi 316 0.76 1.45 1.66 Missouri 341 0.39 0.45 0.48 Montana 19 0.13 0.26 0.30 Nebraska 51 0.19 0.38 0.39 Nevada 329 0.81 0.58 0.64 New Hampshire 21 0.11 0.16 0.15 New Jersey 790 0.62 0.56 0.60 New Mexico 102 0.34 0.67 0.57 New York 2,264 0.80 0.63 0.61 North Carolina 859 0.62 0.77 0.83 North Dakota 13 0.12 0.25 0.29 Ohio 767 0.46 0.49 0.53 Oklahoma 236 0.43 0.54 0.63 Oregon 159 0.28 0.31 0.26 Pennsylvania 739 0.39 0.43 0.45 Rhode Island 54 0.35 0.24 0.23 South Carolina 452 0.67 1.19 1.24 South Dakota 9 0.07 0.15 0.17 Tennessee 563 0.61 0.69 0.76 Texas 3,129 0.87 0.75 0.84 Utah 72 0.19 0.19 0.22 Vermont 12 0.13 0.27 0.17 Virginia 683 0.58 0.60 0.61 Washington 325 0.32 0.32 0.29 West Virginia 46 0.16 0.32 0.35 Wisconsin 190 0.23 0.29 0.32 Wyoming 11 0.13 0.27 0.34 50 US States & Washington, DC 27,641 0.61 0.61 0.61 Supplement Table 4c. Rates of new diagnoses among men who have sex with men and who do not have an HIV diagnosis, US states and District of Columbia, 2013 Rate per 100 MSM without an HIV diagnosis Method 1 Method 2Method 3 State n Alabama 442 0.71 1.02 1.29 Alaska 12 0.11 0.23 0.25 0.61 0.47 0.50 Arizona 513 0.49 1.03 1.17 Arkansas 192 0.84 0.59 0.55 California 3,860 0.36 0.43 0.37 Colorado 241 0.38 0.44 0.47 Connecticut 188 0.50 0.63 0.50 Delaware 60 15.68 3.51 1.06 District of Columbia 313 1.15 1.05 0.93 Florida 2,711 1.51 1.87 1.59 Georgia 1,708 0.41 0.83 0.57 Hawaii 78 0.07 0.14 0.16 Idaho 15 0.78 0.66 0.71 Illinois 1,273 0.38 0.47 0.52 Indiana 332 0.18 0.36 0.39 Iowa 77 0.28 0.45 0.51 Kansas 109 0.44 0.58 0.60 Kentucky 260 1.30 1.96 2.24 Louisiana 730 0.11 0.23 0.15 Maine 21 762 1.05 1.04 1.04 Maryland 0.50 0.53 0.43 Massachusetts 443 0.41 0.44 0.52 Michigan 547 0.27 0.27 0.26 Minnesota 202 0.85 1.83 2.18 Mississippi 316 0.43 0.50 0.54 Missouri 341 0.13 0.27 0.31 Montana 19 0.20 0.41 0.42 Nebraska 51 0.93 0.64 0.71 Nevada 329 0.11 0.17 0.16 New Hampshire 21 0.70 0.62 0.66 New Jersey 790 0.36 0.75 0.63 New Mexico 102 0.99 0.75 0.72 New York 2,264 0.69 0.88 0.96 North Carolina 859 0.12 0.26 0.30 North Dakota 13 0.50 0.53 0.58 Ohio 767 0.46 0.59 0.69 Oklahoma 236 0.30 0.34 0.27 Oregon 159 0.42 0.47 0.49 Pennsylvania 739 0.37 0.26 0.24 Rhode Island 54 0.75 1.47 1.56 South Carolina 452 0.08 0.16 0.18 South Dakota 9 0.68 0.78 0.87 Tennessee 563 0.99 0.83 0.95 Texas 3,129 0.20 0.20 0.23 Utah 72 0.13 0.28 0.18 Vermont 12 0.64 0.67 0.68 Virginia 683 0.35 0.34 0.31 Washington 325 0.17 0.34 0.38 West Virginia 46 0.24 0.31 0.34 Wisconsin 190 0.13 0.28 0.36 Wyoming 11 50 US States & Washington, DC 27,641 0.69 0.69 0.69 Supplement Table 5a. Prevalence of HIV infection among men who have sex with men, by US state, 2012 Rate per 100 MSM Method 2 Method 3 State n Method 1 11.64 16.00 19.36 Alabama 7,900 3.84 7.47 7.94 Alaska * 410 11.42 8.97 9.77 Arizona 10,500 8.40 16.37 18.51 Arkansas 3,500 24.95 18.27 17.10 California 134,400 11.98 14.15 12.66 Colorado 8,900 8.91 10.08 10.57 Connecticut 4,600 12.38 15.20 12.13 Delaware 1,600 123.85 71.06 32.18 District of Columbia 11,300 21.59 19.99 18.27 Florida 60,500 24.40 29.04 25.42 Georgia 33,100 12.14 22.80 15.87 Hawaii 2,500 2.85 5.56 6.50 Idaho * 630 15.16 13.14 13.79 Illinois 27,800 7.46 9.08 9.83 Indiana 6,900 3.61 7.17 7.70 Iowa 1,600 5.40 8.47 9.70 Kansas 2,200 8.44 11.02 11.59 Kentucky 5,300 16.67 23.56 25.96 Louisiana 10,700 6.04 11.96 7.99 Maine * 1,200 19.69 19.41 19.61 Maryland 16,200 12.77 13.42 10.80 Massachusetts 12,200 7.64 8.17 9.69 Michigan 10,900 6.72 6.57 6.53 Minnesota 5,200 13.11 25.02 28.20 Mississippi 5,400 10.59 12.05 12.57 Missouri 9,100 2.81 5.90 6.43 Montana * 420 4.96 9.72 10.25 Nebraska * 1,300 16.25 11.66 12.64 Nevada 6,500 4.84 7.48 6.79 New Hampshire * 950 13.33 12.04 12.83 New Jersey 16,800 8.17 15.88 14.13 New Mexico 2,400 27.09 21.46 20.30 New York 75,900 11.84 14.74 15.93 North Carolina 16,100 1.84 3.72 4.79 North Dakota * 190 8.95 9.45 10.63 Ohio 14,800 7.61 9.54 10.88 Oklahoma 4,100 10.21 11.54 9.58 Oregon 5,800 8.66 9.46 10.08 Pennsylvania 16,100 7.15 4.99 4.75 Rhode Island 1,100 14.30 25.28 28.03 South Carolina 9,500 1.68 3.43 3.70 South Dakota 200 12.09 13.66 14.70 Tennessee 11,000 17.76 15.17 17.09 Texas 62,400 4.62 4.57 5.23 Utah 1,700 5.50 11.57 7.49 Vermont * 520 11.58 12.11 12.07 Virginia 13,500 10.45 10.28 9.23 Washington 10,400 4.32 8.29 9.56 West Virginia * 1,200 4.79 6.17 6.87 Wisconsin 4,000 2.13 4.52 5.47 Wyoming * 180 50 US States & Washington, DC 666,900 15.08 15.08 15.08 * Counts indicated as numerically unstable, per the source US Centers for Disease Control and Prevention report [5] Total counts calculated by different methodology than used for jurisdictions and thus do not sum to column totals, per the source US Centers for Disease Control and Prevention report [5] Supplement Table 5b. Prevalence of undiagnosed HIV infection among men who have sex with men, by US state, 2012 Rate per 100 MSM n Method 1 Method 2 Method 3 State Alabama 1,600 2.36 3.24 3.92 Alaska * 20 0.19 0.36 0.39 Arizona 1,200 1.31 1.02 1.12 Arkansas 800 1.92 3.74 4.23 California 16,400 3.04 2.23 2.09 Colorado 950 1.28 1.51 1.35 Connecticut 710 1.38 1.56 1.63 Delaware 240 1.86 2.28 1.82 District of Columbia 1,400 15.34 8.80 3.99 Florida 8,100 2.89 2.68 2.45 Georgia 6,900 5.09 6.05 5.30 Hawaii 220 1.07 2.01 1.40 Idaho * 80 0.36 0.71 0.83 Illinois 5,300 2.89 2.51 2.63 Indiana 1,000 1.08 1.32 1.42 Iowa 330 0.74 1.48 1.59 Kansas 380 0.93 1.46 1.67 Kentucky 890 1.42 1.85 1.95 Louisiana 2,700 4.21 5.94 6.55 Maine * 90 0.45 0.90 0.60 Maryland 3,900 4.74 4.67 4.72 Massachusetts 2,000 2.09 2.20 1.77 Michigan 1,900 1.33 1.42 1.69 Minnesota 770 1.00 0.97 0.97 Mississippi 1,200 2.91 5.56 6.27 Missouri 1,500 1.74 1.99 2.07 Montana * 30 0.20 0.42 0.46 Nebraska * 190 0.72 1.42 1.50 Nevada 1,000 2.50 1.79 1.94 New Hampshire * 120 0.61 0.95 0.86 New Jersey 3,700 2.94 2.65 2.83 New Mexico 280 0.95 1.85 1.65 New York 7,700 2.75 2.18 2.06 North Carolina 2,600 1.91 2.38 2.57 North Dakota * 20 0.19 0.39 0.50 Ohio 3,100 1.87 1.98 2.23 Oklahoma 740 1.37 1.72 1.96 Oregon 850 1.50 1.69 1.40 Pennsylvania 2,700 1.45 1.59 1.69 Rhode Island 200 1.30 0.91 0.86 South Carolina 2,000 3.01 5.32 5.90 South Dakota 30 0.25 0.51 0.55 Tennessee 1,800 1.98 2.24 2.40 Texas 12,100 3.44 2.94 3.31 Utah 250 0.68 0.67 0.77 Vermont * 0 0.00 0.00 0.00 Virginia 2,000 1.72 1.79 1.79 Washington 1,300 1.31 1.28 1.15 West Virginia * 200 0.72 1.38 1.59 Wisconsin 650 0.78 1.00 1.12 Wyoming * 40 0.47 1.00 1.22 50 US States & Washington, DC 98,700 2.34 2.34 2.34 * Counts indicated as numerically unstable, per the source US Centers for Disease Control and Prevention report [5] Total counts calculated by different methodology than used for jurisdictions and thus do not sum to column totals, per the source US Centers for Disease Control and Prevention report [5] Supplement Table 6a. Prevalence of HIV diagnoses among men who have sex with men, 104 US metropolitan statistical areas, 2012 Rate per 100 MSM Metropolitan Statistical Area n Method 1 Method 2 Method 3 Akron, OH 529 5.20 9.38 9.10 Albany‐‐Schenectady‐‐Troy, NY 778 6.04 10.90 8.37 Albuquerque, NM 878 6.92 12.49 10.20 Allentown‐‐Bethlehem‐‐Easton, PA‐‐NJ 405 3.41 6.14 6.10 Atlanta‐‐Sandy Springs‐‐Roswell, GA 16,404 22.47 19.93 16.43 Augusta‐‐Richmond County, GA‐‐SC 920 11.56 20.85 26.56 Austin‐‐Round Rock, TX 3,201 12.72 8.76 8.01 Bakersfield, CA 692 5.85 10.55 11.68 Baltimore‐‐Columbia‐‐Towson, MD 5,631 14.58 12.56 12.56 Baton Rouge, LA 1,575 13.78 24.86 25.40 Birmingham‐‐Hoover, AL 2,196 13.87 9.76 13.35 Boise City, ID 271 3.14 5.66 7.08 Boston‐‐Cambridge‐‐Newton, MA‐‐NH 6,216 9.33 8.37 6.67 Bridgeport‐‐Stamford‐‐Norwalk, CT 841 6.52 11.75 10.11 Buffalo‐‐Cheektowaga‐‐Niagara Falls, NY 937 5.67 3.55 4.27 Cape Coral‐‐Fort Myers, FL 618 6.49 11.71 8.63 Charleston‐‐North Charleston, SC 1,112 11.48 20.71 20.08 Charlotte‐‐Concord‐‐Gastonia, NC‐‐SC 3,567 11.53 8.85 10.24 Chattanooga, TN‐‐GA 657 8.62 15.55 15.06 Chicago‐‐Naperville‐‐Elgin, IL‐‐IN‐‐WI 18,183 13.64 9.70 10.26 Cincinnati, OH‐‐KY‐‐IN 2,198 7.37 5.78 7.10 Cleveland‐‐Elyria, OH 2,824 9.61 6.63 8.38 Colorado Springs, CO 522 5.64 10.17 11.46 Columbia, SC 1,893 17.21 31.03 29.65 Columbus, OH 3,326 12.26 8.45 8.88 Dallas‐‐Fort Worth‐‐Arlington, TX 14,654 16.54 10.54 11.11 Dayton, OH 911 7.95 14.34 13.84 Deltona‐‐Daytona Beach‐‐Ormond Beach, FL 709 7.88 14.21 12.63 Denver‐‐Aurora‐‐Lakewood, CO 6,428 17.41 14.78 12.01 Des Moines‐‐West Des Moines, IA 361 4.53 8.16 7.49 Detroit‐‐Warren‐‐Dearborn, MI 5,834 9.63 7.40 9.28 Durham‐‐Chapel Hill, NC 959 13.27 23.92 17.47 El Paso, TX 1,242 11.88 21.42 28.53 Fresno, CA 1,034 8.20 14.79 13.79 Grand Rapids‐‐Wyoming, MI 587 4.21 2.92 3.49 Greensboro‐‐High Point, NC 1,217 11.95 21.55 20.98 Greenville‐‐Anderson‐‐Mauldin, SC 903 7.64 13.78 16.07 Harrisburg‐‐Carlisle, PA 534 6.64 11.97 9.37 Hartford‐‐West Hartford‐‐East Hartford, CT 1,032 5.85 3.81 4.54 Houston‐‐The Woodlands‐‐Sugar Land, TX 12,861 15.64 10.36 12.59 Indianapolis‐‐Carmel‐‐Anderson, IN 2,951 11.24 8.33 8.97 Jackson, MS 1,606 20.86 37.62 39.49 Jacksonville, FL 2,437 12.65 8.59 10.70 Kansas City, MO‐‐KS 3,309 11.76 9.47 9.99 Knoxville, TN 757 6.14 11.07 12.36 Lakeland‐‐Winter Haven, FL 591 6.77 12.20 10.72 Lancaster, PA 270 3.68 6.63 5.82 Las Vegas‐‐Henderson‐‐Paradise, NV 4,121 14.38 8.25 8.99 Little Rock‐‐North Little Rock‐‐Conway, AR 1,208 12.23 22.06 23.33 Los Angeles‐‐Long Beach‐‐Anaheim, CA 39,798 21.52 12.35 12.92 Louisville‐‐Jefferson County, KY‐‐IN 1,874 10.61 7.38 8.24 Madison, WI 427 4.70 8.47 6.65 McAllen‐‐Edinburg‐‐Mission, TX 605 6.42 11.58 14.12 Memphis, TN‐‐MS‐‐AR 3,704 20.76 13.70 17.61 Miami‐‐Fort Lauderdale‐‐West Palm Beach, FL 23,407 28.62 21.57 17.52 Milwaukee‐‐Waukesha‐‐West Allis, WI 1,836 8.38 5.81 7.08 Minneapolis‐‐St. Paul‐‐Bloomington, MN‐‐WI 3,890 8.09 5.91 5.73 Modesto, CA 312 4.46 8.05 9.70 Nashville‐‐Davidson‐‐Murfreesboro‐‐Franklin, TN 2,974 12.49 9.76 9.80 New Haven‐‐Milford, CT 870 7.04 12.70 11.77 New Orleans‐‐Metairie, LA 4,020 23.65 19.54 19.71 New York‐‐Newark‐‐Jersey City, NY‐‐NJ‐‐PA 57,861 20.71 15.01 14.61 North Port‐‐Sarasota‐‐Bradenton, FL 795 7.43 13.39 9.80 Ogden‐‐Clearfield, UT 185 2.37 4.28 5.10 Oklahoma City, OK 1,599 8.94 6.31 7.52 Omaha‐‐Council Bluffs, NE‐‐IA 704 5.80 10.46 9.30 Orlando‐‐Kissimmee‐‐Sanford, FL 5,555 17.90 12.82 12.20 Oxnard‐‐Thousand Oaks‐‐Ventura, CA 610 5.20 9.37 8.11 Palm Bay‐‐Melbourne‐‐Titusville, FL 539 6.54 11.79 10.71 Philadelphia‐‐Camden‐‐Wilmington, PA‐‐NJ‐‐DE‐‐MD 9,127 10.78 9.14 9.09 Phoenix‐‐Mesa‐‐Scottsdale, AZ 6,511 10.91 6.53 7.31 Pittsburgh, PA 1,785 5.10 3.70 4.71 Portland‐‐South Portland, ME 416 5.47 9.87 5.50 Portland‐‐Vancouver‐‐Hillsboro, OR‐‐WA 3,043 9.36 7.49 5.82 Providence‐‐Warwick, RI‐‐MA 1,206 5.17 4.03 3.89 Provo‐‐Orem, UT 87 1.32 2.38 3.67 Raleigh, NC 1,816 11.53 7.25 9.02 Richmond, VA 2,259 13.13 11.69 12.71 Riverside‐‐San Bernardino‐‐Ontario, CA 5,406 9.32 6.74 5.79 Rochester, NY 1,139 7.29 4.84 5.47 Sacramento‐‐Roseville‐‐Arden‐Arcade, CA 2,191 7.17 4.84 4.89 St. Louis, MO‐‐IL 4,526 11.51 10.67 11.59 Salt Lake City, UT 1,128 7.53 4.41 4.98 San Antonio‐‐New Braunfels, TX 3,598 12.09 7.61 10.14 San Diego‐‐Carlsbad‐‐San Marcos, CA 9,170 19.83 11.38 11.50 San Francisco‐‐Oakland‐‐Hayward, CA 17,152 26.26 18.69 11.45 San Jose‐‐Sunnyvale‐‐Santa Clara, CA 2,248 8.26 4.80 5.96 Scranton‐‐Wilkes‐Barre‐‐Hazelton, PA 212 2.52 4.55 5.67 Seattle‐‐Tacoma‐‐Bellevue, WA 5,938 11.54 8.12 7.24 Spokane‐‐Spokane Valley, WA 254 3.29 5.93 4.82 Springfield, MA 556 6.25 11.27 10.74 Stockton‐‐Lodi, CA 524 5.62 10.14 10.21 Syracuse, NY 487 5.11 9.21 7.92 Tampa‐‐St. Petersburg‐‐Clearwater, FL 5,504 13.42 8.55 8.84 Toledo, OH 516 5.93 10.70 11.29 Tucson, AZ 1,292 9.02 16.26 12.42 Tulsa, OK 1,029 7.81 14.09 14.08 Honolulu (Urban), HI 1,170 8.08 14.58 11.26 Virginia Beach‐‐Norfolk‐‐Newport News, VA‐‐NC 3,527 14.53 11.12 14.40 Washington‐‐Arlington‐‐Alexandria, DC‐‐VA‐‐MD‐‐WV 15,976 19.80 17.56 13.43 Wichita, KS 477 5.43 9.79 11.87 Winston‐Salem, NC 790 8.80 15.87 16.08 Worcester, MA‐‐CT 541 4.05 7.30 6.21 Youngstown‐‐Warren‐‐Boardman, OH‐‐PA 322 3.90 7.03 9.07 Supplement Table 6b. Rates of new diagnoses among men who have sex with men, 104 US metropolitan statistical areas, 2013 Rate per 100 MSM n Method 1 Method 2 Method 3 Metropolitan Statistical Area Akron, OH 36 0.35 0.63 0.58 Albany‐‐Schenectady‐‐Troy, NY 33 0.25 0.46 0.35 Albuquerque, NM 47 0.37 0.66 0.50 Allentown‐‐Bethlehem‐‐Easton, PA‐‐NJ 30 0.25 0.45 0.46 Atlanta‐‐Sandy Springs‐‐Roswell, GA 1,393 1.88 1.67 1.36 Augusta‐‐Richmond County, GA‐‐SC 89 1.10 1.99 2.79 Austin‐‐Round Rock, TX 256 0.99 0.68 0.63 Bakersfield, CA 72 0.60 1.09 1.13 Baltimore‐‐Columbia‐‐Towson, MD 515 1.32 1.14 1.14 Baton Rouge, LA 155 1.34 2.42 2.91 Birmingham‐‐Hoover, AL 130 0.82 0.58 0.79 Boise City, ID 13 0.15 0.27 0.33 Boston‐‐Cambridge‐‐Newton, MA‐‐NH 423 0.63 0.56 0.46 Bridgeport‐‐Stamford‐‐Norwalk, CT 50 0.38 0.69 0.61 Buffalo‐‐Cheektowaga‐‐Niagara Falls, NY 80 0.48 0.30 0.37 Cape Coral‐‐Fort Myers, FL 72 0.74 1.34 0.93 Charleston‐‐North Charleston, SC 84 0.85 1.53 1.46 Charlotte‐‐Concord‐‐Gastonia, NC‐‐SC 285 0.90 0.69 0.80 Chattanooga, TN‐‐GA 35 0.45 0.82 0.85 Chicago‐‐Naperville‐‐Elgin, IL‐‐IN‐‐WI 1,361 1.01 0.72 0.78 Cincinnati, OH‐‐KY‐‐IN 168 0.56 0.44 0.53 Cleveland‐‐Elyria, OH 218 0.74 0.51 0.63 Colorado Springs, CO 18 0.19 0.34 0.36 Columbia, SC 99 0.89 1.60 1.43 Columbus, OH 229 0.83 0.58 0.56 Dallas‐‐Fort Worth‐‐Arlington, TX 1,019 1.13 0.72 0.76 Dayton, OH 61 0.53 0.96 0.89 Deltona‐‐Daytona Beach‐‐Ormond Beach, FL 55 0.61 1.10 0.95 Denver‐‐Aurora‐‐Lakewood, CO 198 0.52 0.45 0.36 Des Moines‐‐West Des Moines, IA 28 0.34 0.62 0.57 Detroit‐‐Warren‐‐Dearborn, MI 390 0.64 0.49 0.61 Durham‐‐Chapel Hill, NC 70 0.94 1.70 1.13 El Paso, TX 96 0.90 1.62 2.22 Fresno, CA 88 0.69 1.24 1.16 Grand Rapids‐‐Wyoming, MI 31 0.22 0.15 0.19 Greensboro‐‐High Point, NC 75 0.73 1.32 1.26 Greenville‐‐Anderson‐‐Mauldin, SC 80 0.67 1.21 1.42 Harrisburg‐‐Carlisle, PA 30 0.37 0.67 0.52 Hartford‐‐West Hartford‐‐East Hartford, CT 73 0.41 0.27 0.33 Houston‐‐The Woodlands‐‐Sugar Land, TX 1,013 1.20 0.80 0.98 Indianapolis‐‐Carmel‐‐Anderson, IN 175 0.66 0.49 0.53 Jackson, MS 106 1.36 2.46 2.51 Jacksonville, FL 210 1.08 0.73 0.95 Kansas City, MO‐‐KS 154 0.54 0.44 0.47 Knoxville, TN 49 0.39 0.71 0.81 Lakeland‐‐Winter Haven, FL 49 0.56 1.00 0.88 Lancaster, PA 27 0.36 0.66 0.55 Las Vegas‐‐Henderson‐‐Paradise, NV 292 1.01 0.58 0.63 Little Rock‐‐North Little Rock‐‐Conway, AR 124 1.24 2.24 2.24 Los Angeles‐‐Long Beach‐‐Anaheim, CA 1,938 1.04 0.59 0.62 Louisville‐‐Jefferson County, KY‐‐IN 136 0.76 0.53 0.58 Madison, WI 27 0.29 0.53 0.41 McAllen‐‐Edinburg‐‐Mission, TX 66 0.68 1.23 1.60 Memphis, TN‐‐MS‐‐AR 257 1.43 0.94 1.18 Miami‐‐Fort Lauderdale‐‐West Palm Beach, FL 1,592 1.92 1.44 1.13 Milwaukee‐‐Waukesha‐‐West Allis, WI 98 0.44 0.31 0.37 Minneapolis‐‐St. Paul‐‐Bloomington, MN‐‐WI 177 0.36 0.27 0.25 Modesto, CA 15 0.21 0.38 0.53 Nashville‐‐Davidson‐‐Murfreesboro‐‐Franklin, TN 181 0.75 0.58 0.62 New Haven‐‐Milford, CT 56 0.45 0.81 0.73 New Orleans‐‐Metairie, LA 356 2.05 1.69 1.68 New York‐‐Newark‐‐Jersey City, NY‐‐NJ‐‐PA 3,007 1.07 0.77 0.76 North Port‐‐Sarasota‐‐Bradenton, FL 54 0.50 0.90 0.69 Ogden‐‐Clearfield, UT 6 0.08 0.14 0.17 Oklahoma City, OK 155 0.85 0.60 0.74 Omaha‐‐Council Bluffs, NE‐‐IA 35 0.28 0.51 0.44 Orlando‐‐Kissimmee‐‐Sanford, FL 368 1.16 0.83 0.80 Oxnard‐‐Thousand Oaks‐‐Ventura, CA 53 0.45 0.81 0.73 Palm Bay‐‐Melbourne‐‐Titusville, FL 45 0.54 0.98 0.88 Philadelphia‐‐Camden‐‐Wilmington, PA‐‐NJ‐‐DE‐‐MD 614 0.72 0.61 0.61 Phoenix‐‐Mesa‐‐Scottsdale, AZ 406 0.67 0.40 0.44 Pittsburgh, PA 109 0.31 0.22 0.28 Portland‐‐South Portland, ME 12 0.16 0.28 0.17 Portland‐‐Vancouver‐‐Hillsboro, OR‐‐WA 139 0.42 0.34 0.26 Providence‐‐Warwick, RI‐‐MA 94 0.40 0.31 0.30 Provo‐‐Orem, UT 3 0.04 0.08 0.13 Raleigh, NC 141 0.87 0.55 0.67 Richmond, VA 123 0.70 0.63 0.70 Riverside‐‐San Bernardino‐‐Ontario, CA 370 0.63 0.45 0.39 Rochester, NY 67 0.43 0.28 0.34 Sacramento‐‐Roseville‐‐Arden‐Arcade, CA 149 0.48 0.33 0.34 St. Louis, MO‐‐IL 233 0.59 0.55 0.61 Salt Lake City, UT 45 0.29 0.17 0.19 San Antonio‐‐New Braunfels, TX 365 1.20 0.75 0.96 San Diego‐‐Carlsbad‐‐San Marcos, CA 425 0.90 0.52 0.52 San Francisco‐‐Oakland‐‐Hayward, CA 643 0.97 0.69 0.44 San Jose‐‐Sunnyvale‐‐Santa Clara, CA 109 0.39 0.23 0.29 Scranton‐‐Wilkes‐Barre‐‐Hazelton, PA 11 0.13 0.24 0.28 Seattle‐‐Tacoma‐‐Bellevue, WA 245 0.47 0.33 0.30 Spokane‐‐Spokane Valley, WA 11 0.14 0.25 0.22 Springfield, MA 41 0.46 0.83 0.77 Stockton‐‐Lodi, CA 60 0.63 1.15 1.15 Syracuse, NY 31 0.32 0.58 0.52 Tampa‐‐St. Petersburg‐‐Clearwater, FL 402 0.97 0.62 0.64 Toledo, OH 37 0.42 0.77 0.87 Tucson, AZ 64 0.44 0.80 0.63 Tulsa, OK 111 0.83 1.51 1.47 Honolulu (Urban), HI 48 0.33 0.59 0.47 Virginia Beach‐‐Norfolk‐‐Newport News, VA‐‐NC 242 0.99 0.76 0.97 Washington‐‐Arlington‐‐Alexandria, DC‐‐VA‐‐MD‐‐WV 1,105 1.34 1.19 0.90 Wichita, KS 19 0.21 0.39 0.45 Winston‐Salem, NC 54 0.60 1.08 1.11 Worcester, MA‐‐CT 33 0.24 0.44 0.37 Youngstown‐‐Warren‐‐Boardman, OH‐‐PA 20 0.24 0.44 0.55 Supplement Table 6c. Rates of new diagnoses among men who have sex with men and who do not have an HIV diagnosis, 104 US metropolitan statistical areas, 2013 Rate per 100 MSM without an HIV diagnosis n Method 1 Method 2 Method 3 Metropolitan Statistical Area Akron, OH 36 0.37 0.70 0.63 Albany‐‐Schenectady‐‐Troy, NY 33 0.27 0.52 0.38 Albuquerque, NM 47 0.39 0.75 0.56 Allentown‐‐Bethlehem‐‐Easton, PA‐‐NJ 30 0.26 0.48 0.49 Atlanta‐‐Sandy Springs‐‐Roswell, GA 1,393 2.41 2.08 1.62 Augusta‐‐Richmond County, GA‐‐SC 89 1.25 2.51 3.91 Austin‐‐Round Rock, TX 256 1.13 0.74 0.68 Bakersfield, CA 72 0.64 1.21 1.26 Baltimore‐‐Columbia‐‐Towson, MD 515 1.54 1.30 1.30 Baton Rouge, LA 155 1.55 3.22 4.14 Birmingham‐‐Hoover, AL 130 0.95 0.64 0.92 Boise City, ID 13 0.15 0.28 0.35 Boston‐‐Cambridge‐‐Newton, MA‐‐NH 423 0.69 0.61 0.49 Bridgeport‐‐Stamford‐‐Norwalk, CT 50 0.41 0.78 0.68 Buffalo‐‐Cheektowaga‐‐Niagara Falls, NY 80 0.51 0.31 0.39 Cape Coral‐‐Fort Myers, FL 72 0.79 1.52 1.01 Charleston‐‐North Charleston, SC 84 0.95 1.92 1.81 Charlotte‐‐Concord‐‐Gastonia, NC‐‐SC 285 1.02 0.76 0.89 Chattanooga, TN‐‐GA 35 0.50 0.97 1.02 Chicago‐‐Naperville‐‐Elgin, IL‐‐IN‐‐WI 1,361 1.17 0.80 0.87 Cincinnati, OH‐‐KY‐‐IN 168 0.60 0.47 0.57 Cleveland‐‐Elyria, OH 218 0.82 0.55 0.68 Colorado Springs, CO 18 0.20 0.38 0.40 Columbia, SC 99 1.07 2.30 1.96 Columbus, OH 229 0.95 0.63 0.62 Dallas‐‐Fort Worth‐‐Arlington, TX 1,019 1.34 0.80 0.85 Dayton, OH 61 0.58 1.12 1.02 Deltona‐‐Daytona Beach‐‐Ormond Beach, FL 55 0.66 1.28 1.09 Denver‐‐Aurora‐‐Lakewood, CO 198 0.63 0.52 0.40 Des Moines‐‐West Des Moines, IA 28 0.36 0.68 0.62 Detroit‐‐Warren‐‐Dearborn, MI 390 0.71 0.53 0.68 Durham‐‐Chapel Hill, NC 70 1.08 2.21 1.34 El Paso, TX 96 1.01 2.04 3.11 Fresno, CA 88 0.75 1.46 1.35 Grand Rapids‐‐Wyoming, MI 31 0.23 0.16 0.19 Greensboro‐‐High Point, NC 75 0.83 1.67 1.58 Greenville‐‐Anderson‐‐Mauldin, SC 80 0.72 1.40 1.69 Harrisburg‐‐Carlisle, PA 30 0.40 0.76 0.57 Hartford‐‐West Hartford‐‐East Hartford, CT 73 0.44 0.28 0.35 Houston‐‐The Woodlands‐‐Sugar Land, TX 1,013 1.42 0.89 1.11 Indianapolis‐‐Carmel‐‐Anderson, IN 175 0.74 0.53 0.58 Jackson, MS 106 1.72 3.93 4.05 Jacksonville, FL 210 1.23 0.80 1.07 Kansas City, MO‐‐KS 154 0.61 0.48 0.52 Knoxville, TN 49 0.42 0.80 0.92 Lakeland‐‐Winter Haven, FL 49 0.60 1.14 0.99 Lancaster, PA 27 0.38 0.70 0.58 Las Vegas‐‐Henderson‐‐Paradise, NV 292 1.17 0.63 0.69 Little Rock‐‐North Little Rock‐‐Conway, AR 124 1.41 2.87 2.87 Los Angeles‐‐Long Beach‐‐Anaheim, CA 1,938 1.31 0.68 0.71 Louisville‐‐Jefferson County, KY‐‐IN 136 0.85 0.57 0.63 Madison, WI 27 0.31 0.58 0.44 McAllen‐‐Edinburg‐‐Mission, TX 66 0.73 1.39 1.88 Memphis, TN‐‐MS‐‐AR 257 1.80 1.09 1.43 Miami‐‐Fort Lauderdale‐‐West Palm Beach, FL 1,592 2.67 1.83 1.35 Milwaukee‐‐Waukesha‐‐West Allis, WI 98 0.48 0.33 0.40 Minneapolis‐‐St. Paul‐‐Bloomington, MN‐‐WI 177 0.40 0.28 0.26 Modesto, CA 15 0.22 0.42 0.59 Nashville‐‐Davidson‐‐Murfreesboro‐‐Franklin, TN 181 0.85 0.65 0.70 New Haven‐‐Milford, CT 56 0.48 0.93 0.83 New Orleans‐‐Metairie, LA 356 2.67 2.09 2.08 New York‐‐Newark‐‐Jersey City, NY‐‐NJ‐‐PA 3,007 1.34 0.91 0.89 North Port‐‐Sarasota‐‐Bradenton, FL 54 0.54 1.04 0.76 Ogden‐‐Clearfield, UT 6 0.08 0.14 0.18 Oklahoma City, OK 155 0.94 0.64 0.80 Omaha‐‐Council Bluffs, NE‐‐IA 35 0.30 0.57 0.48 Orlando‐‐Kissimmee‐‐Sanford, FL 368 1.41 0.95 0.92 Oxnard‐‐Thousand Oaks‐‐Ventura, CA 53 0.47 0.89 0.79 Palm Bay‐‐Melbourne‐‐Titusville, FL 45 0.58 1.11 0.99 Philadelphia‐‐Camden‐‐Wilmington, PA‐‐NJ‐‐DE‐‐MD 614 0.80 0.67 0.67 Phoenix‐‐Mesa‐‐Scottsdale, AZ 406 0.75 0.43 0.47 Pittsburgh, PA 109 0.33 0.23 0.29 Portland‐‐South Portland, ME 12 0.17 0.31 0.18 Portland‐‐Vancouver‐‐Hillsboro, OR‐‐WA 139 0.46 0.36 0.28 Providence‐‐Warwick, RI‐‐MA 94 0.42 0.33 0.32 Provo‐‐Orem, UT 3 0.04 0.08 0.14 Raleigh, NC 141 0.98 0.59 0.73 Richmond, VA 123 0.81 0.71 0.81 Riverside‐‐San Bernardino‐‐Ontario, CA 370 0.69 0.48 0.41 Rochester, NY 67 0.46 0.30 0.36 Sacramento‐‐Roseville‐‐Arden‐Arcade, CA 149 0.52 0.34 0.35 St. Louis, MO‐‐IL 233 0.66 0.61 0.69 Salt Lake City, UT 45 0.32 0.18 0.20 San Antonio‐‐New Braunfels, TX 365 1.36 0.82 1.06 San Diego‐‐Carlsbad‐‐San Marcos, CA 425 1.12 0.59 0.59 San Francisco‐‐Oakland‐‐Hayward, CA 643 1.31 0.85 0.50 San Jose‐‐Sunnyvale‐‐Santa Clara, CA 109 0.43 0.24 0.31 Scranton‐‐Wilkes‐Barre‐‐Hazelton, PA 11 0.13 0.25 0.30 Seattle‐‐Tacoma‐‐Bellevue, WA 245 0.53 0.36 0.32 Spokane‐‐Spokane Valley, WA 11 0.15 0.27 0.23 Springfield, MA 41 0.49 0.93 0.86 Stockton‐‐Lodi, CA 60 0.67 1.27 1.28 Syracuse, NY 31 0.34 0.64 0.56 Tampa‐‐St. Petersburg‐‐Clearwater, FL 402 1.12 0.67 0.70 Toledo, OH 37 0.45 0.86 0.99 Tucson, AZ 64 0.49 0.95 0.72 Tulsa, OK 111 0.90 1.75 1.70 Honolulu (Urban), HI 48 0.36 0.69 0.53 Virginia Beach‐‐Norfolk‐‐Newport News, VA‐‐NC 242 1.15 0.85 1.13 Washington‐‐Arlington‐‐Alexandria, DC‐‐VA‐‐MD‐‐WV 1,105 1.66 1.44 1.03 Wichita, KS 19 0.23 0.43 0.51 Winston‐Salem, NC 54 0.65 1.28 1.33 Worcester, MA‐‐CT 33 0.25 0.48 0.39 Youngstown‐‐Warren‐‐Boardman, OH‐‐PA 20 0.25 0.47 0.60 Interpretation In general, results were consistent between the three denominator methods, particularly at the state level. The single national MSM average Model 1 yielding the most inconsistent results, likely owing to having the most naïve assumptions. Several notable departures between the urbanicity‐based model 2 and the urbanicity and ACS‐based model 3 included San Francisco and DC. The former model yielded lower MSM denominators and implausibly high levels of HIV prevalence, likely due to a failure to detect these cities’ unusually high densities of MSM, relative to their urbanicity level. Model 3 adjusted these estimates with a city‐specific male‐male cohabitation rate, yielding more plausible results. Conversely, at the MSA and county levels, some counties with extremely high prevalence per Method 3 were places with an above‐average (for their level of urbanization) percent of the county population who were incarcerated. Persons who are diagnosed with HIV infection while incarcerated are counted as residing in the county of their incarceration, but incarcerated persons may not be included in the ACS information used in the denominators. Using the urbanicity‐based Model 2, these prevalence values were reduced to more realistic but still high levels. References 1. Grey JA, Bernstein KT, Sullivan PS, Purcell DW, Chesson HW, Gift TL, and Rosenberg ES. Estimating the population sizes of men who have sex with men (MSM) in US states and counties using data from the American Community Survey. JMIR Public Health and Surveillance, (in‐ press). 2. Oster AM, Sternberg M, Lansky A, Broz D, Wejnert C, and Paz‐Bailey G. Population Size Estimates for Men who Have Sex with Men and Persons who Inject Drugs. J Urban Health, 2015. 3. Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, Gau Z, Weinstock H, Su J, and Crepaz N. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J, 2012. 6: p. 98‐107. 4. Lieb S, Thompson DR, Misra S, Gates GJ, Duffus WA, Fallon SJ, Liberti TM, Foust EM, Malow RM, and Team SACMP. Estimating Populations of Men Who Have Sex with Men in the Southern United States. Journal of Urban Health‐Bulletin of the New York Academy of Medicine, 2009. 86(6): p. 887‐901. 5. Hall HI, An Q, Tang T, Song R, Chen M, Green T, Kang J, Centers for Disease C, and Prevention. Prevalence of Diagnosed and Undiagnosed HIV Infection‐‐United States, 2008‐2012. MMWR Morb Mortal Wkly Rep, 2015. 64(24): p. 657‐62.
JMIR Public Health and Surveillance – Unpaywall
Published: May 17, 2016
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