Researchers Raise Concerns on HIV Rate
A new study of six U.S. cities, including Los Angeles, shows alarming levels of HIV infection among young gay and bisexual men, particularly among African Americans, the Centers for Disease Control and Prevention said Monday.
One in every 10 such men is HIV-positive and the proportion climbs to 30% among African Americans, epidemiologist Linda Valleroy and her colleagues told the eighth annual Retrovirus Conference.
The numbers reflect the changing nature of the AIDS epidemic. When the problem first arose two decades ago, HIV infection was a problem almost entirely among young white males. Today, according to the CDC, more than half of the 40,000 new cases of HIV infection in the United States each year occur among blacks.
This is the first time that such a study has been conducted, so there are no comparison data, but officials were surprised at the high rate of infection, particularly among blacks.
“That 30% is an amazing statistic,” Dr. Helene Gayle, AIDS chief at the CDC, said at a news conference. “When people think ‘gay,’ they think ‘white.’ But the people still at greatest risk are sexually active gay men, and that cuts across all races and ethnicities.”
Moreover, only 29% of those who were HIV-positive knew their status, the study found. That is frightening, experts said, because of the growing rate of risky sexual behavior among young gay men, which has been documented in earlier studies.
The success of treatments using cocktails of anti-AIDS drugs apparently has seduced many young men into believing that the risks are not as severe as they used to be, said Dr. Harold Jaffe of the CDC.
Many also believe that the drug regimens sharply reduce the risk of transmitting the disease, even though there is no such evidence, said the agency’s Dr. Robert Janssen.
The numbers confirmed the warnings that AIDS activists in minority communities have been issuing.
“It has been very difficult to get the attention that is needed in our community to really begin to turn this thing around,” said the Rev. Alfreda Lanoix, of the Minority AIDS Project in Los Angeles.
There is a need for the African American community to “step up to the plate” to confront notions about homosexuality and deal openly with the AIDS epidemic, she said, adding that “business as usual is killing our community.”
In a community that has a high rate of incarceration, many men may be exposed to the virus in prison; others may engage in bisexual behavior but do not identify with a white gay or bisexual community--and thus do not receive information that may be readily available.
The CDC researchers interviewed more than 2,400 gay and bisexual men ages 23 to 29 in Baltimore, Dallas, Miami, New York City, Seattle and Los Angeles. The men were questioned and counseled about their behavior, and blood samples were drawn for HIV testing.
Overall, 12.3% of the men were found to be HIV-positive, with the rate ranging from 4.7% in Seattle to 18% in Dallas. Los Angeles was in the middle at 9.7%.
Nationally, 30% of blacks, 15% of Latinos and 7% of whites tested positive for HIV. In Los Angeles, 25% of blacks tested positive, and the percentages for Latinos and whites were the same as the national numbers.
About 7% of Pacific Islanders and 5% of Asian Americans tested positive, according to epidemiologist Trista Bingham of the Los Angeles County Health Department.
Although women were not covered in the study, the racial gap there is even more striking: Three-quarters of all newly diagnosed women are black, researchers say.
Cynthia Davis, assistant professor in the department of family medicine at Charles R. Drew University in Los Angeles, said, “For me, someone who has worked in the field for 18 years, it’s very depressing. Many of these men are bisexual, which means it’s going to increase the rates for African American women as well.”
About 46% of the men in the six-city survey reported that they had had unprotected anal sex in the previous six months, Valleroy said. The study did not specifically address the incidence of risky behavior, but other studies to be presented at the conference this week are expected to show that such behavior is rising throughout the country.
“Risky behaviors are increasing, not decreasing,” Jaffe of the CDC said.
The proportion of young gay men who are HIV-positive increases with age. A similar study by the same group reported last summer that 7.2% of gay and bisexual males ages 15 to 22 were HIV-positive, with the rate among black men soaring to 19%.
When the data in the new study were broken down by age, Valleroy said, 10.2% of the 22- and 23-year-olds were found to be HIV-positive, compared with 14.2% of the 26- to 29-year-olds.
Researchers are not completely sure why young blacks are so disproportionately represented. But Dr. Carlos del Rio of the Emory University School of Medicine noted that diseases such as AIDS are most common among groups that have been marginalized by society, such as gays. Black gays are perhaps the most marginalized of all, he added.
“In African Americans, there is a much greater stigma about being homosexual than there is among whites,” he said, and much less support from their peers. As one expert said, there is no black equivalent of West Hollywood.
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Times staff writer Jocelyn Stewart contributed to this story.
