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.