March 26, 2010 | by Lou Chibbaro Jr.
14 percent of D.C. gay, bi men are HIV positive: report

Dr. Shannon Hader, head of the D.C. Department of Health’s HIV/AIDS Administration, said a study of men who have sex with men found that 40 percent did not know they were HIV positive until they were tested. (DC Agenda photo by Michael Key)

A first-of-its-kind study of men who have sex with men in the District of Columbia found that 14 percent were HIV positive, a figure five times higher than the 3 percent HIV infection rate among all adults in the city.

The study also found that black men who have sex with men had an HIV infection rate of 25 percent, compared to an 8 percent infection rate among white MSM who participated in the study.

“The numbers in this study are staggering, but they are changeable,” says a report accompanying the study, which was conducted for the city by George Washington University’s School of Public Health Services.

“We are convinced that there are no foregone conclusions to getting HIV for men who have sex with men,” says the report.

D.C. Mayor Adrian Fenty and officials with the Department of Health and its HIV/AIDS Administration released the study at a news conference Thursday outside the Wanda Alston House for LGBT youth in Northeast D.C.

D.C. Council member David Catania (I-At Large), who chairs the D.C. City Council’s Committee on Health, also participated in the news conference.

Fenty joined Department of Health Director Dr. Pierre Vigilance and HIV/AIDS Administration head Dr. Shannon Hader in noting that the study’s troubling findings of high HIV infection rates among MSM were offset by what they said were highly useful new data generated by the study.

“Knowing the facts about our HIV/AIDS epidemic improves how we fight this disease,” Fenty said.

Pointing to a separate study released last week, he noted that “we’ve already shown that we can make progress against HIV by reducing AIDS cases and deaths and increasing people getting into medical care.”

“This study shows that we have more work to do to fight HIV/AIDS among men who have sex with men,” he said.

In a finding that surprised city health officials who commissioned the study, MSM over age 30 years reported using condoms less frequently than MSM under 30, and black MSM of all ages used condoms more frequently than whites.

Yet the infection rate for black MSM remains extraordinarily high, the report says, most likely because the number of infected black MSM is significantly higher than white MSM, increasing the chance of infection even if safer sex is practiced most of the time.

“Though white men were more likely to engage in higher risk sexual behavior, more men of color were impacted with HIV,” says the report.

“Contrary to some perceptions, younger men generally had safer sex behaviors, while older men got tested less and used condoms less and had more sex partners,” it says.

The study found that 65.7 percent of black MSM reported using a condom during their most recent instance of anal sex, compared to 46.6 percent of white MSM who reported using a condom during their last occasion of anal sex.

Hader said the study was conducted using protocols established by the U.S. Centers for Disease Control & Prevention for similar studies of MSM in other cities.

The D.C. MSM study consisted of 500 participants who were recruited “at open air venues, gyms, bars, restaurants, and clubs where men who have sex with men tend to frequent,” says the study report. “Participants were interviewed at these venues, which were located in Wards 1, 2, 5, 6 and 8.”

The study, which was conducted in 2008, doesn’t identify the specific venues, and representatives of the GWU team that conducted the survey declined at the news conference to disclose the names of the venues.

The report acknowledges that the study did not reach all MSM and most likely under-represents some groups, including MSM who don’t identify as gay or bisexual, and younger white MSM.

It notes that of the nearly 100 white men under age 30 who participated in the study, none were found to be HIV positive.

Vigilance and Hader said that while most of the MSM participants in the study reported having been tested for HIV, 40 percent did not know they were HIV positive until they were tested at the time of the study. Among those who tested positive during the study, nearly three-quarters had seen a doctor or other health care provider at least once in the previous 12 months, but were not tested.

Vigilance and Hader noted that a D.C. public health policy established four years ago calls for all adults in the city to be tested routinely for HIV during regular doctor visits, just as they are tested for high blood pressure and diabetes.

As a result of the study’s findings, Vigilance said the health department is calling on MSM to be tested for HIV twice a year instead of the once-a-year recommendation made four years ago.

Hader also announced at the press conference that the Department of Health is launching a new MSM HIV screening project in partnership with the Whitman-Walker Clinic and the Crew Club, a gay male gym and social venue.

According to Hader, the yearlong project will screen about 500 men at the Crew Club considered to be at high risk for HIV. She said pharmaceutical company Gilead Sciences, Inc., is contributing $40,000 to the project and the Crew Club is contributing more than $5,000 along with special accommodations on its premises to conduct the screening.

She said that while the 14 percent HIV infection rate among MSM in D.C. is too high, previous MSM studies in Baltimore, Los Angeles, Miami, New York and San Francisco found a combined infection rate of 25 percent in 2005. She noted that in Baltimore, the MSM infection rate was found to be 40 percent.

The D.C. Center for the LGBT Community also announced that its HIV Prevention Working Group would hold a town hall meeting Monday, March 29, to discuss the MSM study findings. The event will take place 7-9 p.m. at 1810 14th St., N.W.

The MSM study revealed:

• more than one-third of men participating in the study did not know the HIV status of their last sex partner;

• “younger men who have receptive anal sex (bottoms) and older men who have insertive anal sex (tops) were less likely to use condoms;”

• “younger men were twice as likely to have an older partner (54 percent versus 28 percent) and older men were more likely to have more sex partners;”

• “over half (52 percent) of men reported using non-injection drugs; among those using drugs, crystal meth use [was] 15 percent, lower than reported by MSM in other cities;”

• about one-third of the men in the study reported having met a sex partner on the Internet during the previous three months;

• there was little difference between younger and older men in the use of the Internet to find sex partners;

• and 74 percent of the men who met a sex partner through the Internet reported using a condom in the sexual encounter while 56 percent of the overall participants in the study reported using a condom with a recent sex partner.

The study, titled “MSM in D.C.: A Life Long Commitment to Stay HIV Free,” is available through the Department of Health’s website, www.doh.dc.gov.

Lou Chibbaro Jr. has reported on the LGBT civil rights movement and the LGBT community for more than 30 years, beginning as a freelance writer and later as a staff reporter and currently as Senior News Reporter for the Washington Blade. He has chronicled LGBT-related developments as they have touched on a wide range of social, religious, and governmental institutions, including the White House, Congress, the U.S. Supreme Court, the military, local and national law enforcement agencies and the Catholic Church. Chibbaro has reported on LGBT issues and LGBT participation in local and national elections since 1976. He has covered the AIDS epidemic since it first surfaced in the early 1980s. Follow Lou

11 Comments
  • This report does not state exactly how many (not rates or percentages of) gay men were found to be “HIV positive.”

    It does not tell us what other illnesses or medical conditions those men currently or recently suffered from.

    It fails to tell us how many of the gay men said to be “HIV positive” were also psychoactive drug users (amyl and/or butyl nitrites) or used IV drugs.

    • The report says 500 men were surveyed. I think they assume you know how to use 4th grade math to figure out how many of those 500 were HIV+ (14% of 500 equals 70). I’m not sure I get the distinction between psychoactive and IV drugs. And whether you’re including prescription drugs. Or how it’s relevant? People who abuse drugs are going to have negative health outcomes. We don’t already know that? I think they only asked about drug use because of the PnP phenomenon and wanted to check whether it’s grown, shrunk or remained unchanged. What relevant information would we get from knowing what other illnesses the HIV+ men had? Are you saying MSM with other illnesses are more likely to have unsafe sex or more likely to seroconvert? One is an interesting question, the other is obvious, neither is relevant to the purpose of the study at hand. Namely: What is the prevalence of HIV in MSM in DC? Are there demographic differences of HIV prevalence? Do people actually know their serostatus, or that of their partners? How often should they check?

  • Several people have noted issues with the study’s level of representativeness. Still, it shows the continuing need for education.

  • This study seems a bit flawed or else it’s not being reported correctly.

    “It notes that of the nearly 100 white men under age 30 who participated in the study, none were found to be HIV positive”

    So according to the study 0% of white gay men under 30 have HIV in D.C?! Sounds like it wasn’t a very good sample.

  • There is so much wrong with this study and the media portrayal of it that a blog comment hardly seems the place for analysis. Convenience sampling. The lack of parsing high-risk behaviours according to the subject’s purported serostatus. Ageism. Conflating the epidemiological term “MSM” with “Gay and Bisexual men”–was self-identification sought in the study, and where are those breakouts. Resorting to deficit-based thinking around HIV and Queermen’s health. Failing to tease out disparities in access to basic health care.

    That 86% of the sample reported not being HIV-positive is good news. Can I get an “Amen” up in here for that?!

  • Recognizing that statistical analysis can demonstrate nearly any facet of disease prevelance, it is not a surprise that the incidence of HIV has increased for any demographic. However, very few programs exist that sanction behavioral change in adults, let alone teaching children about the consequences of their future actions. Why not? Abstinence and Be Faithful is not sufficient in a society where sexual innuendo is a premiere marketing tool. If DC wants to reduce the prevalence rate, let’s talk about appropriate social behavior before the behavior becomes a public health concern. Harm-reduction includes not only proper use of a condom, but also knowing when not to be in the situation in the first place.

  • Here’s what I got from the story about the “study.”

    First, after 27-years of AIDS awareness, very little seems to have really changed in the way of behavior by those who appear to be most likely to contract HIV. Unprotected anonymous sexual contact still seems to be commonplace in D.C.

    Second, that the Department of Health is going to set up an HIV screening center at the Crew Club instead of having the place closed down immediately indicates to me that political correctness rather than health policy holds as much sway over HIV/AIDS intervention now as it did in the mid-1980s when gay community leaders and health officials routinely engaged in shouting matches over the operation of gay bath houses, bookstores and bars with backroom sex clubs. I guess the band does indeed play on.

    Finally, the statistics…well, I think they are meaningless. Frankly, I think most people probably lied about wearing protection when they didn’t. But, I may just be cynical.

    • …and to think that the DC Center is about to honor the owner of the Crew Club. The DC Center has lost all credibility in my eyes. It is no wonder this epidemic continues in DC at such high rates.

  • Articles like this are excatly why the AIDS epidemic will continue. And, for the DC Department of Health to assume that “thinking” gays couldn’t see through this flawed study is amazing. But, when I think about it, the DC government was behind the study. So, that explains in itself why the study would be so flawed. As if DC employees have an ounce of common sense, yet alone intellectual merit.

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