Nineteen percent of men who have sex with men in a study of 21 U.S. cities was found to be infected with HIV and nearly half did not know they were infected, according to a report released Thursday by the U.S. Centers for Disease Control and Prevention.
The report shows that among the men who have sex with men, or MSM, participating in the 21-city study, young MSM and MSM of color were least likely to know their HIV status.
“This study’s message is clear: HIV exacts a devastating toll on men who have sex with men in America’s major cities, and yet far too many of those who are infected don’t know it,” said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
“We need to increase access to HIV testing so that more MSM know their status, and we all must bring new energy, new approaches and new champions to the fight against HIV among men who have sex with men,” Fenton said.
A CDC statement says the study consisted of testing 8,153 MSM in 21 cities that participated in the CDC’s 2008 National HIV Behavioral Surveillance System program. The program looks at HIV prevalence and awareness of HIV status among at-risk populations, the statement says.
“While MSM of all races and ethnicities were severely affected, black MSM were particularly impacted: 28 percent of black MSM were HIV-infected, compared to 18 percent of Hispanic and 16 percent of white MSM,” the CDC statement says.
“The study also found a strong link between socioeconomic status and HIV among MSM: prevalence increased as education and income decreased, and awareness of HIV status was higher among MSM with greater education and income,” it says. “These findings echo similar disparities found in recent NHBS research among heterosexuals.”
The CDC study follows the release earlier this year of President Barack Obama’s National HIV/AIDS Strategy document, which, among other things, calls for allocating greater resources for HIV prevention programs targeting MSM.
“The United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men,” the Obama strategy document says. “Given the starkness and the enduring nature of the disparate impact on gay and bisexual men, it is important to significantly reprioritize resources and attention to this community.”
Carl Schmid, deputy executive director of the AIDS Institute, a national advocacy group on HIV issues, praised the Obama strategy document as an important step in pushing for more aggressive HIV prevention programs. But he said there’s little evidence so far that the strategy’s recommendations on MSM have been carried out.
“This alarming new data provides further evidence that prevention efforts for gay men have not been adequate to meet the growing epidemic and should be dramatically scaled up if we are going to prevent HIV infections in our country,” he said.
“The severity of the impact of HIV in the gay community is nothing new,” Schmid said. “What has been missing is an appropriate response by our government at the federal, state and local levels and the gay community itself.”
Schmid said that despite the long history of HIV having a greater impact on gay men, “there are only a handful of approved behavioral interventions for men who have sex with men and even fewer targeted for a specific race or ethnicity.”
He was referring to CDC- approved intervention programs for HIV that must be adopted in order for community based organizations, such as D.C.’s Whitman-Walker Clinic, to obtain certain federal grants.
The data for the CDC study was collected in 2008, before the Obama strategy document was developed, and Schmid said he was hopeful that the strategy document’s recommendations would be quickly put into place.
“This study showed many of these same trends among MSM in DC,” said Ray Martins, Whitman-Walker’s chief medical officer.
“In D.C., the study found that one in every seven MSM is infected with HIV and 42 percent of participants were unaware they had HIV, even though 70 percent of participants had seen a doctor in the previous 12 months,” Martins said.
“One in every three African-American MSM in D.C. over the age of 30 tested positive for HIV,” he said. “Rates were also much higher for younger African American MSM and other MSM of color.”
The CDC study, which was published in its journal Morbidity and Mortality Weekly Report, included these additional findings:
* “Among racial/ethnic groups, black MSM with HIV were least likely to be aware of their infection (59 percent unaware, vs. 46 percent for Hispanic MSM and 26 percent for white MSM).”
* “While young MSM (under age 30) had lower HIV prevalence than older men, they were far more likely to be unaware of their HIV infection. Among MSM aged 18-29 who had HIV, nearly two-thirds (63 percent) were unaware, versus 37 percent for men age 30 and older.”
* “Among young MSM, young MSM of color were less likely than whites to know they were HIV-infected. Among HIV-infected black MSM under age 30, 71 percent were unaware of their infection; among HIV-infected Hispanic MSM under age 30, 63 percent were unaware. This compares to 40 percent of HIV-infected white MSM under age 30.
IMAGE: An illustration showing HIV on the cellular level.