The U.S. Centers for Disease Control and Prevention ( CDC ) announced Aug. 3 a troubling rise in new HIV infections among young gay men and men who have sex with men ( MSM ) . New HIV cases rose by nearly 50% among young African-American gay men and MSM, the sharpest increase of any group.
The CDC's first multi-year estimates from its national HIV incidence surveillance find that overall, the annual number of new HIV infections in the U.S. was relatively stable at approximately 50,000 new infections each year between 2006 and 2009.
According to the CDC, young gay men and MSM ages 13-29 accounted for 44% of new HIV cases among gay men and MSM in 2009. An estimated 2,100 young African-American gay men and MSM contracted HIV between 2006 and 2009, a 48% increase. Data from the Chicago Department of Public Health indicates that reported HIV cases among young gay African-American men 13-29 rose 62% from 2005-2008, mirroring the national trend.
"We face a snowballing health crisis among young, gay African-American men," said David Ernesto Munar, president/CEO of the AIDS Foundation of Chicago ( AFC ) . "Immediate measures are needed to prevent an even greater health emergency."
AFC is heightening its response to HIV among young gay men and MSM to address the high rates of new infections. The agency kicked off 2011 with broad community education on the intersection of anti-gay bullying, homophobia, and HIV. Renowned advocate for gay youth Dan Savage headlined the Spring Luncheon, and through an array of new programs, AFC is working to expand testing and linkage to care for gay men of color, including young gay men.
"As AFC develops our 2012-2014 Strategic Plan," Munar continued, "we will work with area youth, providers and community and government leaders to identify strategies to reduce new HIV cases among youth and link young Chicagoans living with HIV to life-saving medical care."
AFC's Director of Federal Affairs Keith Green said, "There are likely many reasons HIV cases are increasing among young African-American gay men and MSM. Primary, the forces of homophobia, stigma, and racism are creating a perfect storm for a marginalized group of youth of color. In addition, lack of access to healthcare, HIV testing and treatment is a significant driver of high HIV rates, among other factors."
"Today's CDC announcement shows how much more work is needed to reverse the course of the epidemic among African Americans and Latinos, and gay men of all races, including gay youth and young African-American gay men," said Green. "We are deeply concerned that the debt ceiling agreement reached by Congress and President Obama could undermine the fight against HIV by forcing major cuts in HIV prevention and care funding. Today's alarming news could be even worse next year."
"While incidence rates among gay men and other MSM are absolutely unacceptable, new infections were stable overall, indicating some level of success in our nation's efforts. Our prevention and care systems are working, but need to be much, stronger and much smarter," said Jim Pickett, AFC's director of prevention advocacy and gay men's health.
"The National HIV/AIDS Strategy, announced a year ago by President Obama, outlines how the United States can turn the tide against the HIV epidemic," Pickett said. "With that blueprint, continued investment and laser focus on the hardest hit populations and regions remains critical if we are to come close to achieving the Strategy's goals. The Strategy rightly pays special attention to gay men, and so should the rest of us, as these latest numbers from CDC once again reflect a terrible burden on this group."
The Strategy aims to reduce new HIV cases by 25% by 2015, increase the number of people with HIV who are in medical care, and reduce health disparities.
The new U.S. estimates were published today in the online scientific journal PLoS ONE. The incidence estimates are based on direct measurement of new HIV infections with a laboratory test that can distinguish recent from long-standing HIV infections.
"More than 30 years into the HIV epidemic, about 50,000 people in this country still become infected each year. Not only do men who have sex with men continue to account for most new infections, young gay and bisexual men are the only group in which infections are increasing, and this increase is particularly concerning among young African American MSM," said CDC Director Thomas Frieden, M.D. "HIV infections can be prevented. By getting tested, reducing risky behaviors, and getting treatment, people can protect themselves and their loved ones."
According to the new estimates, there were 48,600 new HIV infections in the United States in 2006, 56,000 in 2007, 47,800 in 2008 and 48,100 in 2009. The multi-year incidence estimates allow for a reliable examination of trends over time. They reveal no statistically significant change in HIV incidence overall from 2006 to 2009, with an average of 50,000 for the four-year period. In 2009, the largest number of new infections was among white MSM ( 11,400 ) , followed closely by Black MSM ( 10,800 ) . Hispanic MSM ( 6,000 ) and Black women ( 5,400 ) were also heavily affected.
Men who have sex with men remain the group most heavily affected by new HIV infections. While the CDC estimates that MSM represent only 2 percent of the U.S. population ( a number that is heavily debate inside and outside the gay movement ) , they accounted for the majority ( 61 percent; 29,300 ) of all new HIV infections in 2009. Young MSM ( ages 13 to 29 ) were most severely affected, representing more than one quarter of all new HIV infections nationally ( 27 percent; 12,900 in 2009 ) .
Young MSM of all races are heavily affected. By race/risk young, Black MSM were the only group to experience a statistically significant increase in new infections over the four-year time period studied. CDC estimates that new HIV infections among young, black MSM increased 48 percent during that period ( from 4,400 HIV infections in 2006 to 6,500 infections in 2009 ) .
The HIV/AIDS epidemic continues to exact a heavy toll on communities of color. While Blacks represent 14 percent of the total U.S. population, the new estimates find that they accounted for 44 percent of new HIV infections in 2009. The HIV infection rate among Blacks in 2009 was almost eight times as high as that of whites. The HIV infection rate among Black men was the highest of any group by race and sex—more than six times that of white men—and the rate among Black women was 15 times that of white women. There was no statistically significant change in HIV incidence from 2006 to 2009 overall, among Black men or Black women.
Hispanics represent approximately 16 percent of the total U.S. population, but accounted for 20 percent of new HIV infections in 2009. The HIV infection rate among Hispanics in 2009 was nearly three times as high as that of whites. The HIV infection rate among Hispanic men in 2009 was two and a half times that of white men, and the rate among Hispanic women was more than four times that of white women. There was no statistically significant change in HIV incidence from 2006 to 2009 among Hispanic men or Hispanic women.
For more information visit www.cdc.gov/hiv. To access the new CDC analysis in the journal PLoS One, visit http://dx.plos.org/10.1371/journal.pone.0017502.
-- From press releases
