H. Alexander Robinson

Ending AIDS Will Require All of Us

Filed By H. Alexander Robinson | December 20, 2007 12:44 PM | comments

Filed in: Living
Tags: African-American, CDC, HIV/AIDS, LGBT, Unprotected Sex

The news has been filled with rumors that the Centers for Disease Control and Prevention will release new estimates of the number of Americans becoming infected with HIV. According to recent news reports the CDC may raise the annual estimate by 50%.

Even more disturbing is that data shows steady increases in new cases among African Americans including women and Black gay men.

African-American gay men are more than twice as likely to be infected with the AIDS virus as their white counterparts. Federal researchers said they were somewhat perplexed by the disparity. A recent study found little difference in the rates of unprotected sex among black and white homosexuals, though the practice was common among both groups.

However, a quick look at comments on the blogs and responses to a World AIDS Day commentary published on the Bilerico Project might lead one to conclude that it is Black men on the down low or DL that are to "blame" for this rise in HIV/AIDS in Black communities.

Much of the commentary on the rise in new infections has a startling resemblance to the rhetoric we heard at the beginning of the epidemic. Remember when there was very little sympathy for irresponsible, self-indulgent gay men and IV drug users. We have the innocent victims--the babies and users of blood products.

Somehow many of us seem to have forgotten or in some cases never knew just how painful and unresponsive those debates were.

Now two new U.S. studies of gay and bisexual men who know they are infected with HIV show that more than one-third have recently had unprotected intercourse.

According to the study in many cases, these men are engaging in unprotected sex with other HIV-infected men -- a practice called "serosorting," where partners with a similar, HIV-positive blood test status decide to forego condoms.

However, Dr. Kenneth Mayer, medical research director at Fenway Community Health, also found that almost a third of the men -- 31.4 percent -- said that they had had unprotected anal intercourse with at least one partner of unknown serostatus, and almost a quarter had unprotected intercourse with a partner who they knew was HIV uninfected.

Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention has said that there are now more than one million people estimated to be living with HIV in the United States, more than ever before. He also noted that half of all U.S. cases of HIV infection still occur among "men who have sex with men" (MSM), the CDC's umbrella term for gay and bisexual men, as well as men who may not identify as such but engage in male-male sexual activity.

And, Mayer added, unsafe sex was strongly linked to the use of recreational drugs, particularly methamphetamine, and was 60 percent more likely among younger men than older men. Though Black gay and bisexual men have been hit hard by HIV/AIDS, studies show that they are more likely to engage in safe-sex practices than their white counterparts.

In a CDC study, researchers examined data from 53 studies conducted from 1980 to 2006. The studies compared the safe-sex behaviors of black and white gay and bisexual men. Across all studies, there were no overall differences [by race] in reported unprotected receptive sex or any unprotected anal intercourse. In fact, among young MSM -- those ages 15 to 29 -- African-Americans were one third less likely than whites to report in engaging in unprotected anal intercourse.

Black gay or bisexual men were also "36 percent less likely than whites to report having as many sex partners as white MSM. Blacks in the study were also less likely to use recreational drugs, such as methamphetamine or cocaine, compared to whites.

The HIV epidemic in the United States may, in fact, be on the rise but the CDC has yet to release any new estimates.

New statistics on rates of unprotected sex among gay and bisexual men are more certain, however. In Mayer's analysis, researchers had more than 500 Boston-area HIV-infected gay or bisexual men complete "behavioral risk assessments." Three-quarters of the men were white, with ages ranging from 21 to 70.

The research team found that 37.3 percent of the men said they had engaged in unprotected anal intercourse over the past three months. In 41.3 percent of these cases, unsafe sex took place with another HIV-infected partner, but in 31.4 percent of cases the unprotected behavior took place with a partner whose HIV status was unknown. In 23 percent of cases, the infected man engaged in unprotected sex with a partner he knew to be HIV-negative, the study found.

Another study, this one led by CDC researcher Nicole Crepaz, found similar results. Her team reviewed data from 27 studies published between 2000 and 2006. The studies included more than 10,000 gay or bisexual men who knew they were HIV-positive.

Everyone, regardless of race, sexual orientation or HIV status is responsible for his or her actions. We should all be doing everything we can to protect ourselves and others from sexually transmitted diseases including HIV infection and AIDS.

However, there is no one person or community who is to blame. I urge us all to make and keep a resolution for the New Year and the years to come--we must resolve to do our part in preventing anyone else from becoming another AIDS statistic. In some cases this may mean reaching out with a hand of compassion, understanding and acceptance to someone who is still on their journey to self-acceptance and communal responsibility.

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