"We are very concerned about the increase in HIV among young men who have sex with men," said Dr. Thomas R. Frieden, Health Commissioner for New York City. "We're headed in the wrong direction. Unless young men reduce the number of partners they have, and protect themselves and their partners by using condoms more consistently, we will face another wave of suffering and death from HIV and AIDS."
Other local leaders in the fight against AIDS voiced similar concern.
* Debra Frasier-Howe, president of the National Black Leadership Commission on AIDS: "These numbers are devastating. After 26 years of AIDS, we cannot drift backward. We must ask all New Yorkers to accept some responsibility for helping our young people protect themselves. Their lives are not dispensable."
* Tokes Osubu, executive director of Gay Men of African Descent (GMAD): "Reversing this trend will require a new commitment to protecting this most underserved population. GMAD will continue to work with other stakeholders to save the lives of our young men. We need an integrated approach across city agencies, social justice organizations and AIDS organizations, and a less judgmental approach by faith institutions."
* Wendy Stark, interim executive director of the Callen-Lorde Community Health Center: "Health care in a supportive and affirming setting can foster healthy choices. We encourage all New Yorkers to identify a primary care provider with whom they feel comfortable discussing sexual behavior and substance use."
Blacks and Hispanics still bear a disproportionate share of New York City's HIV burden. Among all MSM, blacks received twice as many HIV diagnoses as whites in 2006 (232 versus 101), and Hispanics received 55% more than whites (157 versus 101). The disparity is even more striking among adolescents; more than 90% of the MSM under age 20 diagnosed with HIV in 2006 were black or Hispanic (81 out of 87).
Every borough except Staten Island has seen HIV increase among MSM under 30 since 2001. The largest increases occurred in Queens (49%) and Manhattan (57%). The increase in Manhattan was concentrated in East and Central Harlem (up 115%, from 26 to 56), and in the Chelsea and Clinton areas (up 56%, from 25 to 39).
To focus on more recent trends in HIV infection, this analysis excluded MSM who were diagnosed with HIV and AIDS at the same time, generally indicating that the infection has progressed for many years. In 2006, 20% of MSM diagnosed with HIV received a concurrent diagnosis of AIDS (285 men), meaning that they had missed opportunities for care to stay healthy and may have unknowingly spread HIV to others.
The new HIV data parallel a recent Health Department report (http://www.nyc.gov/html/doh/html/pr2007/pr054-07.shtmll) showing a sharp increase in the number of syphilis cases among MSM in New York City during the first quarter of 2007. The syphilis increase has affected both younger and older MSM, and half of those newly diagnosed with syphilis in New York City also report being infected with HIV. Syphilis and HIV are a dangerous combination, because syphilis causes genital sores (making HIV easier to spread) and HIV lowers immunity (which can make syphilis harder to treat).
What Are the Health Department and Community Organizations Doing to Combat HIV in New York City?
The Health Department funds an array of programs to educate New Yorkers about how to protect themselves from HIV and other STDs. Efforts to prevent infection, and support those who become infected, are under way in all five boroughs.
* The Department is working with community groups, medical providers, and others to promote risk reduction through reducing the number of partners and increasing the use of condoms. The Department distributes more than 3 million free condoms each month. The distinctive NYC Condom is available not only through Health Department clinics and community organizations but through retail establishments and entertainment venues, including bars, clubs and restaurants. For information on where to find them, visit http://www.nyccondom.org/.
* Anyone age 12 or older can get can get free, confidential, anonymous HIV testing and STD treatment at the Health Department's 10 STD clinics. Services are available without parental notification and without regard to insurance or immigration status. The clinics provide rapid HIV testing on a walk-in basis; results are typically available within 30 minutes. They also offer free testing for syphilis, gonorrhea and chlamydia, as well as hepatitis immunization. For clinic locations and hours, visit http://home2.nyc.gov/html/doh/html/std/std2.shtml.
* HIV tests are also available through New York City's public hospitals and through community organizations such as Gay Men of African Descent, the African Services Committee, the Latino Commission on AIDS, the Harlem United Community AIDS Center, the Hispanic AIDS Forum, the Callen-Lorde Community Health Center, and Gay Men's Health Crisis.
* The Health Department offers confidential partner notification to people who think they may have exposed others to HIV or another STD. Anyone can reach the Contact Notification Assistance Program (CNAP) by dialing 311 in the US.
Protect Yourself from HIV
Not having sex is the only failsafe way to avoid an STD. If you are sexually active, you can reduce your risk of STDs, including HIV, by having sex only with one person you are sure is not infected, and by using condoms. If you are having sex outside of such a relationship, other measures can reduce your risk:
* Reduce the number of people you have sex with. More partners means more risk.
* Use a latex condom whenever you have sex, whether vaginal, anal or oral.
* Avoid alcohol and drugs when you have sex. Drinking or getting high makes it much harder to avoid risky sex and to remember to use condoms.
* Know your sex partners. Get yourself tested, and get your partner tested for HIV and other STDs before you have sex.
* Know your HIV status. Free, confidential testing is available at Health Department clinics in all five boroughs, regardless of age, immigration status or ability to pay. For a list of clinics and hours, visit http://www.nyc.gov/health.
The HIV data reflect preliminary information from provider and laboratory reports of new HIV diagnoses, which are reportable under New York State law. The 2006 data presented here based on the first six months of 2006, extrapolated to the full year. Final counts will be released at the end of 2007.
Source: Sara Markt
New York City Health Department