Grave HIV projections from the Centers for Disease Control and Prevention ( CDC ) emerged Feb. 23 at a presentation given at the Conference on Retroviruses and Opportunistic Infections ( CROI ) in Boston. If current HIV diagnoses rates continue at the same levels, one in two Black men in the United States who have sex with men ( MSM ) will be diagnosed with HIV in their lifetime, as will one in four Latino MSM in the U.S., according to researchers.
Researchers analyzed death and diagnoses data from 2009-2013 in order to project risk of HIV diagnosis. Overall, the risk of HIV diagnosis in the United States is about one in 99, assuming current rates remain constant. The previous risk, compiled from 2004-2004 data, was one in 78.
But that risk is still considerably higher for MSM, especially MSM of color, as the new projections demonstrate. One in 11 white MSM would be diagnosed with HIV as well. For MSM overall, the risk is about one in six.
"As alarming as these lifetime risk estimates are, they are not a foregone conclusion. They are a call to action," said Jonathan Mermin, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, in a February 23 statement. "The prevention and care strategies we have at our disposal today provide a promising outlook for future reductions of HIV infections and disparities in the U.S., but hundreds of thousands of people will be diagnosed in their lifetime if we don't scale up efforts now."
The study also broke down the diagnosis projections state-by-state, with persons living in the District of Columbia at the highest risk of infection ( one in 13 ), and residents of North Dakota at the lowest ( one in 670 ). The risk in Illinois is one in 103.
When broken down by race and ethnicity, Black males had a one in 20 chance of infection, while, for Black women, that likelihood was one in 48. African Americans are not more inclined to risky sexual behavior; rather, researchers attribute the higher numbers to higher prevalence in the community, lack of access to healthcare, poverty and social stigma, according to the CDC.
The likelihood for infection for Hispanics was one in 48 for men, and one in 227 for women. For white individuals, it was one in 132 for men and one in 880 for women.
Jim Pickett, director of prevention advocacy and gay men's health at AIDS Foundation of Chicago, called the numbers "a big slap in the face and a wake-up call" to advocates.
"I don't think anyone is in denial about the seriousness of this," Pickett said. "But this was a strong reminder to those of us who do this work."
Trans women of color, who are also at a disproportionately high risk of infection, were not mentioned in the CDC's release, though another CDC panel addressed the complications researchers had previously encountered in collecting data on trans individuals, according to hivplusmag.com . Previous studies, among them the iPrex trial studying PrEP, misclassified trans participants and skewed results. Implementing a new two-step approach on questionnaires, however, which allowed participants to differentiate between the gender with which they identified and the one into which they were born, greatly increased the number of trans subjects identified in data.
Because information on transgender people is not uniformly collected in the United States, the CDC has been unable to give an accurate determination of how many trans individuals have been infected with HIV.
HIVPlusMag.com's article is at www.hivplusmag.com/stigma/2016/2/22/how-fix-misclassification-trans-women .
Related coverage at the link: www.windycitymediagroup.com/lgbt/CDC-MSM-still-at-increased-risk-for-HIV-diagnoses/54358.html .