http://www.cnn.com/2008/HEALTH/conditions/09/12/hiv.blacks.gays/
ATLANTA, Georgia (CNN) -- Young black gay men, black women and
white gay men in their 30s and 40s are much more likely to be
newly infected with HIV than other groups in the United States,
according to a new analysis from the Centers for Disease Control
and Prevention.
The analysis -- based on figures showing that the HIV infection
rate for 2006 is much worse than previously thought -- looks at
the number of new HIV infections and who gets them. The study
appears in this week's Morbidity and Mortality Weekly Report.
It shows 53 percent of the estimated 56,000 cases of new HIV
infection in 2006 were among gay and bi.ual men, and 46
percent of the infections occurred among blacks. Within the gay
and bi.ual group, young black men (13 to 29 years old ) were
roughly twice as likely to get infected as young white and young
Hispanic men. And among women, black women were almost 15 times
more likely to get HIV than white women and almost four times
more likely than Hispanic women.
These new figures -- highlighting which age, gender and racial
groups are at higher risk -- are based on data released by the
CDC in August. Those numbers showed that new HIV infections for
2006 were 40 percent higher than the CDC had previously
estimated. See the new analysis of HIV data
"The new analysis include a wealth of information, but there are
three big take-aways," according to Dr. Kevin Fenton, director
of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB
Prevention at the CDC.
"First, the number of new HIV infections among young black [gay
and bi.ual men] is alarming and shows the need to reach each
new generation with prevention early in their lives. Second, the
heavy impact of HIV infection in white [gay and bi.ual men] in
older age groups demonstrates the need for ongoing efforts to
keep gay and bi.ual men HIV-free over the course of their
lifetime. A third finding: compared to women of all races, black
women bear the heaviest burden of HIV," Fenton said.
The higher rate of new HIV infections among young gay black men
and black women comes as no surprise to Phill Wilson, the CEO
and founder of Black AIDS Institute, a think-tank based in Los
Angeles, California. "Basically, it affirms what we have known
for a long time and what we have been telling the CDC for a very
long time," Wilson said.
"AIDS in America continues to be a black disease as manifested
by the numbers," Wilson said. "We have an epidemic that is 40
percent worse than we thought, and African-Americans are grossly
disproportionately impacted. Particularly black women and young
black gay men."
The CDC study didn't examine the specific factors that account
for the heavy burden of HIV among young black gay men, but the
CDC has theories.
"Other data suggest a range of possible factors," said Richard
Wolitski, acting director, Division of HIV/AIDS Prevention at
CDC.
"They include stigma, lack of access to effective HIV prevention
services and underestimation of personal risk. In addition, many
younger men have not personally experienced the severity of the
early AIDS epidemic."
Wolitski said differences in the frequency of high-risk .ual
behavior and substance use do not account for this disparity.
White gay and bi.ual men account for close to half, or 46
percent, of HIV incidence among gay and bi.ual men, but the
majority of new infections occurred in men in their 30s,
followed by men in the 40s, the CDC found.
"A range of factors likely contribute to continued transmission
in these age groups," said Wolitski, noting the marked
difference in age at the time of infection in the different
racial groups. "They include the difficulty of consistently
maintaining safer behaviors for many years or even decades, as
well as homophobia, substance abuse and higher HIV prevalence
within this group."
Among Hispanic gay and bi.ual men, most new infections
occurred in the young age group, like blacks, but at much lower
rates.
Black women are also disproportionately at risk of HIV infection.
"Based on the incidence estimates released last month, we
already know that African Americans overall accounted for 45
percent of new HIV infection in 2006, while representing only 12
percent of the U.S. population," Wolitski said. "[The Morbidity
and Mortality Weekly Report's] data show that while there were
fewer new HIV infections among black women than there were among
black men, black women were far more affected by HIV than women
of other races."
"A range of issues may contribute to the disproportionate HIV
risk for African-Americans in the United States, including
poverty, stigma, limited access to health care, [an already
existing] higher HIV prevalence among African-Americans, higher
rates of other STDs and drug abuse. Many black women face
additional challenges such as power imbalances with men in
.ual relationships, which can limit their ability to protect
themselves, like using condoms," Wolitski said.
The CDC hopes that these new figures can help it target
education and prevention efforts to specific populations.
"Today's analysis serves as a powerful reminder that the United
States epidemic of HIV is far from over and that we all need to
do more," Fenton said. "The U.S. epidemic will end only when all
of us -- federal, state and local government; politicians,
communities, businesses, social and civic organizations;
schools, families and individuals across the nation -- realize
that ending AIDS is possible and then collectively commit to
make that happen."
Wilson, while hopeful that the new figures will bring new
attention to an old problem, is less sanguine. He notes that the
U.S. doesn't spend enough resources to end the HIV epidemic,
that the money doesn't target the groups at highest risk, and
that it doesn't use organizations with proven track record of
reaching and mobilizing the black community.
"When it comes to black America, we continue to be an
afterthought when it comes to HIV prevention," Wilson said.
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