An analysis by the US Centers for Disease Control and Prevention (CDC) of HIV diagnoses among men who have sex with men shows a disturbing 12 per cent annual increase in new cases among 13 to 24 year olds, especially young blacks males.
The study, reported in this week’s issue of the CDC’s Morbidity and Mortality Weekly Report (MMWR), reports an analysis by CDC researchers of new HIV diagnoses from 2001 to 2006 in 33 states that have confidential, long-standing, name-based HIV reporting.
All racial and ethnic sub groups of men who have sex with men (MSM) have seen a rise in HIV diagnoses except for American Indians/Alaskan Natives. The highest increase was among young black MSM, where a 15 per cent rise in HIV diagnoses was observed, considerably higher than that observed among their white (9 per cent) and Hispanic (8 per cent) counterparts.
In the 25-to-44 year old MSM there was an average annual decrease of 1 per cent, while among the over 45s there was a 3 per cent annual rise in HIV diagnoses between 2001 and 2006.
Diagnoses rates among injecting-drug users, homosexual men who injected drugs, and heterosexuals went down over the same period.
However, the federal agency was careful to point out that the data used in the analysis only shows when the men were diagnosed with HIV, not when they became infected. This is important because a person can be infected for years before diagnosis. However, in the case of young MSM, it is likely that overall, diagnoses will reflect quite recent infection.
Acting director of HIV-AIDS prevention at CDC, was reported by the Washington Post as saying that:
“These men represent a new generation that has not been personally affected by AIDS in the same way that their older peers were.”
Whether the trends in the report are representative of the whole of the US is not known, since it only covers 33 states, including New York, Florida, New Jersey and Texas, states with very large numbers of people with HIV.
The report does not include any analysis on HIV risks, for instance whether riskier behaviour is linked to these trends.
However, the report has raised concerns that the trends reveal a rising epidemic that is not being recognized. Phill Wilson, head of the Black AIDS Institute in Los Angeles, told the Washington Post:
“When you see a 15 percent yearly increase, that is an epidemic that is out of control.”
“And yet we don’t see a response that recognizes it is an epidemic out of control,” he added.
Some suggest that the improvements in treatments for HIV/AIDS may have led to a reduction in fear in a new generation.
Ron Simmons, president of Us Helping Us, an AIDS organization that supports young gay black men, told the Post he could remember going to funerals, sometimes every four or five days. But now, the attitude among young men is that if they get infected they just need to “take the blue pill, or the pink pill”, like their friend does.
The CDC report concludes that the trends revealed in the report underscores the need for:
“Expanded access to HIV prevention among young MSM, especially young black MSM.”
“Trends in HIV/AIDS Diagnoses Among Men Who Have Sex with Men — 33 States, 2001–2006.”
A Mitsch, MPH, X Hu, MS, K McDavid Harrison, PhD, T Durant, PhD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Weekly, June 27, 2008 / 57(25);681-686.
Sources: CDC, Washington Post.
Written by: Catharine Paddock, PhD