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Gregorio A. Millett, MPH, John L. Peterson, PhD, Richard J. Wolitski, PhD and Ron Stall, PhD, MPH

At the time this article was written, Gregorio A. Millett, Richard J. Wolitski, and Ron Stall were with the Centers for Disease Control and Prevention, Atlanta, Ga. John L. Peterson is with the Department of Psychology, Georgia State University, Atlanta.

Correspondence: Requests for reprints should be sent to Gregorio A. Millett, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E-45, Atlanta, GA 30333 (e-mail: gmillett{at}cdc.gov).

HIV rates are disproportionately higher for Black men who have sex with men (MSM) than for other MSM. We reviewed the literature to examine 12 hypotheses that might explain this disparity.

We found that high rates of HIV infection for Black MSM were partly attributable to a high prevalence of sexually transmitted diseases that facilitate HIV transmission and to undetected or late diagnosis of HIV infection; they were not attributable to a higher frequency of risky sexual behavior, nongay identity, or sexual nondisclosure, or to reported use of alcohol or illicit substances. Evidence was insufficient to evaluate the remaining hypotheses.

Future studies must address these hypotheses to provide additional explanations for the greater prevalence of HIV infection among Black MSM.

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