CDC: rates of new HIV cases in MSM of color 'alarming'

The Centers for Disease Control and Prevention (CDC) released a report Sept. 11 that for the first time shows the number of new national HIV cases in specific sub-populations, and the numbers show that within the gay and bisexual male community the epidemic has taken the greatest toll among young African American men and white men in their 30s and 40s. The report found that in 2006 young African American gay and bi men between the ages of 13 and 29 were the hardest hit in terms of new infections.

"There were more new HIV infections in black MSM [men who have sex with men] between the ages of 13 and 29 than any other group of MSM, regardless of race or age," said Richard Wolitski, acting director of the CDC's Division of HIV/AIDS Prevention, during a press conference call.

The report found that in 2006 there were 5220 new HIV infections among young gay and bi black men, about twice as high as the number of infections among both young white and Hispanic gay and bi men. Wolitski called the infection rates "alarming."

Wolitski said the new report does not explain why there is such a disparity in new infections by age and race, but he said other research suggests that the high rates of infection among young black gay and bi men may be caused by a combination of stigma, lack of access to HIV prevention services, and an underestimate by young black gay and bi men of their risk for infection. He also said a factor may be that they are too young to remember the worst days of the epidemic.

The report also found that white men account for nearly half of all new infections among gay and bi men. The new infections among white gay and bi men skew much older than among black men, with the highest number of new infections among men in their 30s and the next highest number among men in their 40s. Wolitski said that other research suggests that the higher rates of infection may be a sign that men in that age group are having difficulty maintaining safer sex practices decades into the epidemic. Substance abuse, homophobia, and an already high prevalence of HIV among white gay and bi men in those age groups may also be contributing factors.

Among Hispanic gay and bi men the greatest number of new infections fell into the 13-29 age group, at 2300 new infections in 2006, but there were also more than 1800 new infections in Hispanic men ages 30-39.

Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, TB and STD Prevention, said the new numbers show the importance of reaching gay and bi men with HIV prevention messages from an early age and continuing to engage them as they age.

"On the one hand we must ensure that HIV infection does not become a rite of passage for young gay and bisexual men. That means we need to reach each new generation of MSM early in their lives to provide the knowledge and the skills they need to prevent infection. And at the same time we must develop strategies for keeping MSM in older age groups HIV-free for life," said Fenton.

Wolitski said the CDC needs to invest in research to develop new and more effective ways to reach gay and bi men with prevention messages, particularly subgroups such as African American and Hispanic men. A 15-city study by the CDC found that 80 percent of gay and bi men had not been reached by scientifically proven HIV prevention messages in the past year.

"There is a need for us to continue to invest in the research that's needed to address the specific needs of some subgroups of the MSM community for which we do not currently have clinically proven HIV prevention interventions. So we have some gaps in our armamentarium of prevention tools. Specifically for men who have sex with men who are black and Hispanic we have a relative lack of interventions, as well as for those men who are Asian Pacific Islander, American Indian or Alaskan native. So we need additional tools. We need to make sure hat the research happens to develop those tools," said Wolitski. "And it's also important to keep in mind that once we develop an intervention it's not necessarily the case that that intervention would remain effective or appealing to the population for decades to come. We need to be continuing research and efforts to update our intervention so that they speak to the issues that persons at risk are currently experiencing in their lives and that they speak to the evolving nature of the epidemic."