Surge in New HIV Infections Among Young Black Gay Men Troubling: CDC

And rate of new cases among all Americans is stuck at about 50,000 per year

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Aug. 3 (HealthDay News) -- The number of new HIV cases in the United States has remained stable at about 50,000 a year, but a recent jump in new cases among black gay and bisexual men is "alarming," government health officials said.

New HIV infections among black gay and bisexual men rose 48 percent between 2006-2009, according to a report from the U.S. Centers for Disease Control and Prevention (CDC). That increase was the only significant rise in cases among the populations covered by the study, the agency added.

And while it's great that the overall rate of new HIV infections among Americans isn't increasing, CDC director Dr. Thomas Frieden noted that the fact that numbers have stalled around 50,000 "isn't good enough."

He added that "the stable overall rates mask a large increase among black men who have sex with men in the 13 to 29 year age group. We are very concerned about this trend," he said.

The bottom line, according to Frieden: "HIV is preventable and we need to do more to prevent it."

He spoke to reporters during an early afternoon press conference on Wednesday.

Overall, there are now about 1.2 million people infected with HIV in the United States and about one in five don't know they are infected, Frieden said.

"It is crucial that we work with communities, with health care providers, with people who are infected and with people who are at risk to drive down the rate of new HIV infections," he said. "It is possible to do that."

The new report was published in the Aug. 3 issue of the online journal PLoS ONE.

According to the report, 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. These data are based on a laboratory test that can tell new HIV infections from long-standing ones, the researchers said.

In 2009, the overall number of new cases were highest among gay and bisexual white men at 11,400, followed by black gay and bisexual men at 10,800, with rates higher among young men (ages 13-29). However, since blacks make up a much smaller percentage of the population than whites, the number of new infections in that group is especially disconcerting.

Two other groups hit hard were Hispanic gay and bisexual men (among whom there were 6,000 new cases) and black women, with 5,400 new cases, the researchers said.

Still, only young black gay and bisexual men charted a significant rise in new infections over time. In this group, new cases jumped by 48 percent -- from 4,400 in 2006 to 6,500 in 2009. That means that even though blacks represent just 14 percent of the U.S. population, they accounted for 44 percent of new HIV cases in 2009, the CDC said.

In fact, the rate of new HIV infections among blacks was almost eight times higher than among whites. Among black men, the rate of new HIV infections was more than six times higher than among white men, and among women the HIV infection rate was 15 times greater than among white women, the researchers reported.

The researchers can only speculate as to the reasons for the trend. They theorized that more black gay and bisexual men may not be aware they are infected, or there might be a stronger stigma within the black community attached to being gay or having HIV. Stigma can prevent men from seeking out HIV-prevention services.

In addition, blacks may have more limited access to health care and HIV testing and treatment, the researchers said.

Finally, since HIV is endemic in the black community, gay and bisexual men may simply be more likely to be exposed to the virus. At the same time, the CDC team said, some blacks may underestimate the extent of their risk.

Hispanics also shouldered a disproportionate burden of HIV in America. Even though they represent 16 percent of the U.S. population, Hispanics comprised 20 percent of new HIV infections in 2009. For Hispanic men the HIV infection rate was 2.5 times greater than among white men. Among Hispanic women the HIV infection rate was four times higher than among white women, the researchers found.

Dr. Margaret A. Fischl, professor of medicine and director of the AIDS Clinical Research Unit and co-director of the University of Miami Developmental Center for AIDS Research, commented that "this trend has been slowly emerging over the past couple of years, so people should not be surprised."

The fact that the rate of new HIV infections has stabilized overall was a "great thing a couple of years ago. Today, it's terrible, because if anything, it should be going down," she said. "We have a lot of work to do, or this epidemic is not going to remain level with new infections; it's going to take off again with increasing rates."

More information

For more information on HIV/AIDS, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Margaret A. Fischl, M.D., professor of medicine, director, AIDS Clinical Research Unit, co-director, University of Miami Developmental Center for AIDS Research; Aug. 3, 2011, teleconference with: Thomas Frieden, M.D., director, U.S. Centers for Disease Control and Prevention; Aug. 3, 2011, PLoS ONE, online

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