Karen Ocamb

CDC Finds HIV Infection Rate in Young Gay Blacks Alarming

Filed By Karen Ocamb | August 04, 2011 2:30 PM | comments

Filed in: Living
Tags: black gay men, black men HIV, CDC, Centers for Disease Control and Prevention, HIV/AIDS, new infections, Phil Wilson

HIVGraph.jpeg

The Centers for Disease Control and Prevention published their new report Wednesday, Aug. 3, on the rate of new HIV infections in America. Overall, the rate remained relatively stable with about 50,000 new cases a year. But the rate among young Black gay and bisexual men rose about 48% between 2006 and 2009.

Please stop and think about this: Young Black gay and bisexual men are becoming infected with HIV at "alarming" rates every year in America - EVERY YEAR - and for some reason there does not appear to be the collective will to intervene and DO SOMETHING! The CDC sounds the alarm, AIDS activists sound the alarm, various responsible news outlets sound the alarm - but the alarm seems to be falling on deaf ears. It feels very much like the beginning of the AIDS epidemic, as documented by Rand Shilts in And the Band Played On when gays were sounding the alarm, screaming from the rooftops - but society and the Reagan administration did nothing - though they sprang into action over the Legionnaires outbreak. Black gay AIDS activist Phill Wilson, who's been HIV positive since the early/mid-80s, got it right when he said about AIDS in Black America in 2006: “If these were white college students with 50% infection rates, this would be on the news every night. But it’s poor black men and women, so nobody cares.”

Today, there is more information about HIV/AIDS than ever before and there are new treatments available - but the CDC still says it doesn't know why these infection rates are so high. Or, really, what to do about it - something they've said repeatedly, using the same language each year in their press releases. Given the economy, they announced they're now going to target specific communities with the money they've been allocated.

The new CDC numbers were based on a new calculation using a new method of testing that can distinguish new infections from existing infections. According to the new estimates, there were 48,600 new HIV infections in 2006, 56,000 in 2007, 47,800 in 2008 and 48,100 in 2009. Some of the key findings, published in the science journal PLoS ONE: Men who have sex with men (MSM) represent 2% of the total U.S. population, but accounted for 61% of all new HIV infections in 2009. Among MSM in 2009, white MSM represented the greatest number of new HIV infections (11,400), followed closely by black MSM (10,800) and Hispanic MSM (6,000).

New infections among young MSM increased 34% between 2006 and 2009 - with young, black MSM (aged 13-29) "the only subpopulation in the U.S. to experience a statistically significant increase from 2006 through 2009," according to the CDC press release, accounting for more than one quarter of all new HIV infections.

“We’re very concerned about these increases among young gay men,” Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said during a conference call with reporters. “We can’t allow the health to a new generation to be lost to what is essentially a completely preventable disease.”

Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention, said in a press release:

"We are deeply concerned by the alarming rise in new HIV infections in young, black gay and bisexual men and the continued impact of HIV among young gay and bisexual men of all races. We cannot allow the health of a new generation of gay men to be lost to a preventable disease. It's time to renew the focus on HIV among gay men and confront the homophobia and stigma that all too often accompany this disease."

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“They’re calling this ‘alarming’ but it’s clearly past that point,” Phill Wilson, President and CEO of the Black AIDS Institute, said in a press release emailed out Aug. 3. “Our house is on fire.”

I was on that CDC conference call and grew increasingly angry over the “alarming” new statistics. I checked and here are some examples of alarming rates among young Black gays and bisexual men over the years:

ABC News report, May 31, 2001:

Gay men too young to remember the earliest reports of AIDS are now spreading the disease at alarming rates that remind health officials of the explosive first years of the epidemic.

A government survey released today shows 4.4 percent of gay and bisexual men ages 23 to 29 are newly infected each year with HIV, the virus that causes AIDS. The survey, timed to mark the 20th anniversary of the discovery of AIDS, is the government’s most sweeping evidence yet of a resurgence in the disease among young gay men. It suggests even more staggering infection rates for blacks in that group: 14.7 percent -- one in seven -- become HIV-positive each year. ...

Left unchecked, the infection rates for gay and bisexual men threaten years of progress the country has made to control the spread of HIV/AIDS, analysts for the Centers for Disease Control and Prevention said. “The numbers we’re publishing right now are more like the findings you see in the ’80s than the findings you see in the ’90s,” said CDC’s Linda Valleroy, who led the survey.....

Health officials expressed extreme concern about the high new-infection rates among young black gays and bisexuals, saying the stigma in the black community of having HIV or AIDS may be keeping testing rates low. There are no comparable historical data on infection rates for young black gays and bisexuals. The one-in-seven infection rate in that group is roughly the same as current infection rates in South Africa, Valleroy said.

Rod McCullom at Rod 2.0, August 25, 2006

reviewing an ABC News documentary “Out of Control: AIDS in Black America:"

Phill Wilson delivered the money quote of the hour: “If these were white college students with 50% infection rates, this would be on the news every night. But it’s poor black men and women so nobody cares.”

Unlike the woefully inadequate BET “special” allegedly devoted to HIV and the down-low, the ABC producers presented plenty of statistical evidence to demonstrate that the majority of heterosexual HIV transmissions had little or nothing to do with gay/DL/bisexual men.

Steven Reinberg, HealthDay Reporter, after a CDC teleconference call, Sept. 11, 2008:

The rate of new HIV infections among young gay or bisexual black men is significantly higher than new infections among whites and Hispanics of the same age, the U.S. Centers for Disease Control and Prevention announced Thursday.

“The number of new HIV infections among young black men who have sex with men is alarming,” Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention said during a teleconference.

Among black males aged 13 to 29, the incidence of HIV infection was 1.6 times higher than that of whites and 2.3 times higher than for Hispanics, according to findings published in the Sept. 12 issue of the CDC’s Morbidity and Mortality Weekly Report.

Forty-eight percent of new infections among black men were among those aged 13 to 29, compared with 31 percent for whites and 21 percent for Hispanics. This finding highlights the need to reach men at an early age and teach them about HIV prevention, Fenton said.

“There were more new HIV infections in black men who have sex with men between the ages of 13 and 29 than any other group of men who have sex with men, regardless of race or age,” Dr. Richard Wolitski, acting director of the CDC’s division of HIV/AIDS Prevention, added during the teleconference.

The reasons why young black men are being infected with HIV at a relatively early age aren’t clear. Some factors may include the stigma of homosexuality, lack of access to HIV prevention services, and an underestimation of personal risk, Wolitski said...

“What is going on with young black gay men is a clear indication of our failure to develop messages which are targeted to the communities that are most at risk,” said Kevin Frost, CEO of the Foundation for AIDS Research....

In August, the CDC released new estimates of the number of HIV new cases in 2006, in the United States, which now total 56,300 and are significantly higher than the previous estimate of 40,000. “We learned that the HIV epidemic was worse than previously known,” Fenton said.

These findings should renew a sense of urgency about HIV prevention, Fenton said. “To be able to end the HIV epidemic in the United States, it is absolutely essential that we reverse the years of increases of HIV incidence among gay and bisexual men,” he said.

A study by the CDC found that 80 percent of gay and bisexual men have not been reached with intensive HIV-prevention methods that are most effective, Fenton said.

“Today’s analysis serves as a powerful reminder that the U.S. epidemic of HIV is far from over,” Fenton said. “The US epidemic will end only when all of us realize that ending AIDS is possible. We need to reduce the stigmatism, racism and homophobia that impede our ability to fight HIV.”

Rod McCullom, Feb. 9, 2009: CDC: “Alarming” HIV Rates Among Young Black Gay Men in Mississippi:

Continuing a disturbing trend reported on Rod 2.0 on the rate of HIV infections among young black gay men, who are the demographic hardest hit by the epidemic: The Centers for Disease Controls reports young black gay and bisexual men are becoming infected with HIV at even higher rates in the South--the phrase used is “alarming”--particularly in Mississippi which has the nation’s highest concentration of black residents.

The New York Times reports on the small survey of young black gay and bisexual HIV positive men. The Mississippi residents were all in their teens and early 20s and most had engaged in risky sexual behaviors but “thought it unlikely they would be infected.” ....

Key quote: “We need to make sure that H.I.V. infection does not become a rite of passage for young black men who have sex with men," says Dr. Alexandra Oster, one of the authors of the survey published last week in the agency's Morbidity and Mortality Weekly Report.

The report on young black gay/bi men in Mississippi reflects similar data seen in New York City. In the nation’s largest city, that demographic represents half of all new infections.

HIV/AIDS continues to devastate Americans. Blacks comprise 12% of the U.S. population but account for almost 50% of all HIV infections and persons living with HIV. The CDC reports more HIV infections occur among young black men who have sex with men than any other group.

Young Black Men Unaware of HIV Risks [NYT]

Phill Wilson, Aug 3, 2011:

Wilson, who sits on the President's AIDS Advisory Council, notes that Blacks are about 12 percent of the population but 44% of all HIV infections. Black men are 70% of all infections in the African American community and Black gay/bi men are 73% of all infections in Black America.

Here's more of Wilson’s press release:

“That is an outrage,” Wilson said. “That number is completely unacceptable. Especially now when the prevention toolbox is literally exploding with new options.”

The last year has seen a dramatic flurry of advancements in HIV prevention. The new data comes on the heels of promising trial findings around vaginal microbicides for women and new research that showed that when an HIV-positive person started drug therapy almost immediately after diagnosis, their chances of infecting others was dramatically reduced. ??The sobering statistics come weeks after breakthroughs were reported on the efficacy of pre-exposure prophylaxis, or PrEP-providing daily antiretroviral pills to uninfected individuals prior to HIV exposure. PrEP has shown to be safe and effective for gay and heterosexual partners.

“These are powerful new biomedical prevention technologies that we didn’t have a year ago. Thirty years into the epidemic and we may be turning the corner. But we still need to know why Black men are at a higher risk,” he adds.

Researchers are not sure why. Individual risk behaviors “do not account” for the substantial increase. Researchers says black gay/bisexual men do not choose more partners, are less likely to use intravenous drugs and are no more likely to have unsafe anal intercourse than other gay/bisexual. The data suggests one possibility: Young black MSM often do not know their HIV status.

The results also come during an economic downturn that has seen many people losing jobs and many others slipping through the proverbial “safety net”-losing health insurance, unemployment, and other benefits. It also comes at the same time many states are cutting HIV/AIDS prevention funding and the ongoing funding crisis in the AIDS Drug Assistance Program (ADAP).

“People need to know their HIV status,” says Wilson. “Those who are HIV positive need to be linked to appropriate care immediately. Federal and state governments must address the ADAP crisis. HIV/AIDS is not “somebody else’s” problem. It’s OUR problem that we have to solve because we’re all paying for it-and we’re all losing loved ones. And we’re losing our youth-what type of legacy is that?” ??The new data was released almost one year to the week that the Obama Administration announced its National HIV AIDS Strategy, the nation’s first roadmap to combating the epidemic.

“We now have the tools that could dramatically drive down new infections,” says Phill Wilson. “We have a roadmap to victory. We understand that people must be tested and know their status. We understand that linking ‘poz’ people to care right away saves lives. And we know that providing anti-retrovirals to healthy people can also save lives. We understand this-but we need smart solutions, we need targeted resources and we need all hands on deck. The house is on fire.”

Unfortunately, stigma, discrimination and homophobia are potent factors that keep many people in closet and afraid to learn their HIV status.

“Too many of us in the Black community are distracted by myths and misinformation,” Wilson adds. “When we don’t understand the science of HIV/AIDS, we cannot protect ourselves. That means we are less willing to get tested, less likely to start treatment, and less likely to take ownership of the disease. But we can win this battle and we can win this war.”

CDC Press Release (AIDS.gov & CDC.gov)

New multi-year data show annual HIV infections in U.S. relatively stable Alarming increase among young, black gay and bisexual men requires urgent action

The CDC's first multi-year estimates from its national HIV incidence surveillance find that overall, the annual number of new HIV infections in the United States was relatively stable at approximately 50,000 new infections each year between 2006 and 2009. However, HIV infections increased among young men who have sex with men (MSM) between 2006 and 2009, driven by alarming increases among young, black MSM - the only subpopulation to experience a sustained increase during the time period.

The new estimates were published today in the online scientific journal PLoS ONE. The incidence estimates are based on direct measurement of new HIV infections with a laboratory test that can distinguish recent from long-standing HIV infections.

"More than 30 years into the HIV epidemic, about 50,000 people in this country still become infected each year. Not only do men who have sex with men continue to account for most new infections, young gay and bisexual men are the only group in which infections are increasing, and this increase is particularly concerning among young African American MSM ," said CDC Director Thomas Frieden, M.D. "HIV infections can be prevented. By getting tested, reducing risky behaviors, and getting treatment, people can protect themselves and their loved ones."

According to the new estimates, there were 48,600 new HIV infections in the United States in 2006, 56,000 in 2007, 47,800 in 2008 and 48,100 in 2009. The multi-year incidence estimates allow for a reliable examination of trends over time. They reveal no statistically significant change in HIV incidence overall from 2006 to 2009, with an average of 50,000 for the four-year period. In 2009, the largest number of new infections was among white MSM (11,400), followed closely by black MSM (10,800). Hispanic MSM (6,000) and black women (5,400) were also heavily affected.

"While we're encouraged that prevention efforts have helped avoid overall increases in HIV infections in the United States, and have significantly reduced new infections from the peak in the mid-1980s, we have plateaued at an unacceptably high level," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "Without intensified HIV prevention efforts, we are likely to face an era of rising infection rates and higher health care costs for a preventable condition that already affects more than one million people in this country."

In addition to providing the first estimates for 2007, 2008, and 2009, CDC has also updated its earlier estimate of HIV incidence for 2006 (previously 56,300), which reflects refined research methods and additional years of data reporting. While the estimates announced today are based on the most current data, CDC will continue to refine the estimates over time as improvements in methods or additional data are available.

Gay & bisexual men bear greatest burden; young, black gay and bisexual men experience significant increases in HIV

Men who have sex with men remain the group most heavily affected by new HIV infections. While CDC estimates that MSM represent only 2 percent of the U.S. population, they accounted for the majority (61 percent; 29,300) of all new HIV infections in 2009. Young MSM (ages 13 to 29) were most severely affected, representing more than one quarter of all new HIV infections nationally (27 percent; 12,900 in 2009).

Young MSM of all races are heavily affected. By race/risk young, black MSM were the only group to experience a statistically significant increase in new infections over the four-year time period studied. CDC estimates that new HIV infections among young, black MSM increased 48 percent during that period (from 4,400 HIV infections in 2006 to 6,500 infections in 2009).

Though the reasons are not yet clear, studies suggest that several factors may be driving this trend: higher proportions of young, black MSM are unaware of their infection than MSM of other racial/ethnic groups; stigma of HIV and homosexuality, which can hinder utilization of HIV prevention services; limited access to health care, HIV testing and treatment; increased likelihood of having older sexual partners (who are more likely to be HIV infected), compared to MSM of other racial/ethnic groups; higher rates of some sexually transmitted diseases among young black men, which can facilitate HIV transmission; and under-estimating personal risk for HIV.

"We are deeply concerned by the alarming rise in new HIV infections in young, black gay and bisexual men and the continued impact of HIV among young gay and bisexual men of all races," said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention. "We cannot allow the health of a new generation of gay men to be lost to a preventable disease. It's time to renew the focus on HIV among gay men and confront the homophobia and stigma that all too often accompany this disease."

Communities of color, particularly African Americans, disproportionately affected

The HIV/AIDS epidemic continues to exact a heavy toll on communities of color. While blacks represent 14 percent of the total U.S. population, the new estimates find that they accounted for 44 percent of new HIV infections in 2009. The HIV infection rate among blacks in 2009 was almost eight times as high as that of whites. The HIV infection rate among black men was the highest of any group by race and sex - more than six times that of white men - and the rate among black women was 15 times that of white women. There was no statistically significant change in HIV incidence from 2006 to 2009 overall, among black men or black women.

Hispanics represent approximately 16 percent of the total U.S. population, but accounted for 20 percent of new HIV infections in 2009. The HIV infection rate among Hispanics in 2009 was nearly three times as high as that of whites. The HIV infection rate among Hispanic men in 2009 was two and a half times that of white men, and the rate among Hispanic women was more than four times that of white women. There was no statistically significant change in HIV incidence from 2006 to 2009 among Hispanic men or Hispanic women.

"HIV remains one of the most glaring health disparities in this country," said Fenton. "While we all have individual responsibility to protect ourselves from HIV infection, the research clearly shows that individual risk behavior alone doesn't account for the significant racial disparities in HIV. It is essential to understand the underlying factors that contribute to these disparities, such as poverty, discrimination and lack of access to health care."

Dr. Fenton also noted that the greater overall prevalence of HIV in minority communities means individuals within those communities face greater risk of acquiring HIV with every sexual encounter.

Reducing new infections a key goal of the National HIV/AIDS Strategy

Announced by White House officials in July 2010, the National HIV/AIDS Strategy seeks to reduce HIV incidence in the United States and prioritizes HIV prevention efforts in the populations where HIV is most heavily concentrated - gay and bisexual men of all races, African Americans and Latinos. To implement the Strategy, CDC is pursuing "High-Impact Prevention," an approach that will prioritize prevention activities based on their effectiveness, cost, coverage, feasibility and scalability, in order to have the greatest possible impact with available resources.

With better ways to measure the epidemic, more data about affected populations, and a growing number of prevention tools, CDC has been working to target the best mix of interventions to the hardest hit areas and populations. New biomedical tools such as pre-exposure prophylaxis (PrEP) for MSM and heterosexual men and women, along with expanded testing, treatment and linkage to care, could have an important impact on infection rates, if used strategically and in combination with other proven prevention strategies.

For more information visit www.cdc.gov/hiv. To access the new CDC analysis inthe journal PLoS One, visit http://dx.plos.org/10.1371/journal.pone.0017502.

(Cross-posted at LGBT POV)

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These new finding are very troubling ... between the HIV/AIDS problem in the Black community and the enormous "wealth gap" between whites and Blacks that we just learned about via the recent Pew research report, you and I and all America have a lot of work to do to bring our Black brothers and sisters, who in general I love so much, into full participation in the promise that America makes to them.

Forgot to say: Thank you once again, Karen, for your thorough and caring reportage of this issue which is so vital to the entire LGBT community. If we want to confront the gay racism that surrounds us, this must become a foremost priority for our attention and resources, this absolutely must be where we start.

It is alarming indeed! And has been for a while. I think the main crux is getting the black/African-American community ti admit homosexuality and bisexuality exist in their community and allow there to nt be a stigma upon the LGBTQA members of their community.
While working at our local ASO it took years to finally get into one church in the Black/African-American community and talk about HIV and AIDS. And that there are gay men and bisexual men who are at risk because no one wanted to talk about it, accept them, help them.
It seems a problem in most close-knit communities, especially people of color. I pray and hope for them to let the information and acceptance in. And stop this spiraling upward of infection in all youth.