Study: Safe Sex Message Not Spreading

C H I C A G O, Feb. 6, 2001 -- A stunning one-third of young gay black men inlarge U.S. cities are infected with HIV, another sign of thegrowing racial divide in the AIDS epidemic.

The findings, based on a study released Monday, show that HIVinfections are disturbingly common among gay men of all races intheir 20s, especially considering that they grew up knowing howAIDS spreads.

However, HIV is particularly rampant among young gay blacks, andexperts worry that these men have missed the safe-sex message thathas been a drumbeat among white homosexual men since the mid-1980s.

The study found that among young gay men, 3 percent of Asians, 7percent of whites, 15 percent of Hispanics and 30 percent of blacksare infected with the virus.

"That 30 percent is an amazing statistic," said Dr. HeleneGayle, AIDS chief at the Centers for Disease Control andPrevention. "When people think 'gay,' they think 'white.' But thepeople still at greatest risk are sexually active gay men, and thatcuts across all races and ethnicities."

The study, directed by the CDC's Linda Valleroy, was presentedat the Eighth Annual Retrovirus Conference in Chicago. Since thiswas the first survey ever done among gays of this age group — 23 to29 — there are no previous numbers with which to compare thesefindings.

The Shifting Burden of HIV

Since the epidemic's start, when AIDS was primarily a disease ofgay white men, the burden of HIV has increasingly shifted toblacks. Now, just over half of the estimated 40,000 new HIVinfections annually occur among blacks. Among infected women,blacks outnumber whites almost 4 to 1.

Many worry that homosexual men have grown complacent aboutcatching HIV because effective treatments can hold the disease incheck. Some of these gay men may be more likely to have risky sex,such as anal intercourse without condoms.

The new study does not reveal whether dangerous sex practicesare growing among the young, but it does show that such habits arecommon. Almost half of the men surveyed admitted they had hadunprotected anal sex during the previous six months.

While the overall infection rate of 12 percent was alarming, theresearchers said they were most surprised by the level of AIDSinfection among the young black men. "It's really horrifying,"Valleroy said.

The survey was based on testing of 2,401 gay men ages 23 to 29between 1998 and 2000. They were tested at parks, bars, clubs andother gay meeting places in Baltimore, Dallas, Los Angeles, Miami,Seattle and New York City.

Except in Miami and Seattle, where few blacks were in the study,the infection rate for blacks was around 30 percent in all thecities.

In general, AIDS infections have become less common among gaymen since the height of the epidemic in the 1980s. For instance, inNew York, just over half of all gay men of all ages who were testedat venereal disease clinics in 1988 were infected, compared with 20percent in 1997.

Valleroy said there is no easy explanation for why the diseaseis so much more prevalent among young gay blacks. But one reasonmay be that blacks are less likely to admit their homosexuality, sothey miss the frequent exhortations for safe sex.

"Being gay is more hidden among African-Americans," she said."There is no Gay Men's Health Crisis for African-Americans. Theytend not to live in the gay neighborhoods."

Dr. Carlos del Rio of Emory University in Atlanta, who studiesAIDS in inner cities, noted that the disease largely affectspopulations on the edges of the mainstream, including gay men andpoor blacks.

"In African Americans, there is a much greater stigma aboutbeing homosexual than there is among whites," he said. "Thatmakes them even more marginalized."

Less than one-third of those who had HIV in the survey knewabout their infection.

An earlier study by the same group looked at AIDS infectionsamong gay 15- to 22-year-olds. It found that 14 percent of blackswere infected.