By David Brown
Washington Post Staff Writer
Friday, June 27, 2008
The number of young homosexual men being newly diagnosed with HIV infection is rising by 12 percent a year, with the steepest upward trend in young black men, according to a new report.
The double-digit increase in young gay men is about 10 times higher than in the homosexual community overall, where the number of new infections is going up about 1.5 percent a year.
The report, released yesterday by the federal Centers for Disease Control and Prevention, appears to confirm impressions that a "second-wave" AIDS epidemic is underway in gay America.
"These men represent a new generation that has not been personally affected by AIDS in the same way that their older peers were," said Richard Wolitski, acting director of HIV-AIDS prevention at CDC.
The new data cover 33 states. Whether they reflect the entire country is unknown, although the states include New York, Florida, New Jersey and Texas, all of which have large numbers of HIV-infected people.
The study found that homosexual men were the only risk group in which the number of new infections rose annually from 2001 through 2006. (Epidemiologists prefer the term "men who have sex with men," or MSM, because many of them do not identify themselves as homosexual or gay.) In contrast, injecting-drug users, homosexual men who injected drugs, and heterosexuals each showed declines in new infections over that period.
In the 13-to-24-year-old group, the average annual increase was 12 percent, compared with a 1 percent decline in 25-to-44-year-olds, and a 3 percent rise in gay men 45 and older.
In the youngest age bracket, the yearly rise averaged 8 percent among Hispanics, 9 percent among whites and 15 percent among blacks.
Previous studies have found that gay black men on average have fewer sex partners, are less likely to use drugs and are no more likely to have unprotected intercourse than gay white men. Consequently, their higher rate of infection does not appear to arise from riskier behavior.
Instead, it reflects the higher prevalence of HIV -- as well as syphilis and gonorrhea, which increase a person's susceptibility to HIV -- in the black population.
"When you see a 15 percent yearly increase, that is an epidemic that is out of control," said Phill Wilson, head of the Black AIDS Institute in Los Angeles. "And yet we don't see a response that recognizes it is an epidemic out of control."
Ron Simmons, president of Us Helping Us, an AIDS service organization for gay black men, said the revolution in antiretroviral therapy in the last decade appears to have lessened the fear of HIV infection.
"I can remember going to a funeral every four or five days. Now, if you talk to some of these young men, they say, 'If I do get infected, I will simply take the blue pill or the pink pill, like my friend,' " he said.
A study published online last month in the American Journal of Public Health showed that prevention messages tailored for gay black men can work.
Researchers recruited "opinion leaders" in the gay communities of three cities in North Carolina. The people were trained to talk to their peers not only about ways to protect themselves from HIV but also about other issues, such as homophobia in some black churches and racism.
A year later, the frequency of unprotected high-risk intercourse was down 30 percent in the three gay communities, and the number or people who said they always used condoms was up a similar amount.
The CDC is providing the strategy, called "d-UP!" -- slang for defend yourself -- to 200 organizations around the country later this year.