HIV infections soar among gays
By Joyce Howard Price
THE WASHINGTON TIMES
New cases of HIV, which causes AIDS, jumped sharply among homosexual men in the United States from 1999 to 2002, the federal Centers for Disease Control and Prevention reported yesterday.
The number of new infections climbed 17 percent for homosexual men in this period, compared with 7.3 percent for all men, the study revealed. It was published in the CDC's Morbidity and Mortality Weekly Report.
"Reports of syphilis outbreaks and increased unprotected sex raise concerns regarding increases in HIV transmission among men who have sex with men," the authors of the report said. HIV is the acronym for human immunodeficiency virus.
In a telephone interview yesterday, Dr. Rob Janssen, director of the CDC's AIDS division, said black men continue to account for more than half (55 percent) of new HIV diagnoses in the country, making them the hardest-hit population.
HIV cases increased 26 percent and 8 percent, respectively, among Hispanic men and non-Hispanic white men during the survey period.
In all racial categories, the greatest number of men being diagnosed with HIV were homosexual or bisexual, Dr. Janssen said. Researchers say their data were based on 102,590 new HIV diagnoses in 29 states in the survey period. Of those, 43,144 were among homosexual and bisexual men. The other infections, including heterosexual men, were mostly transmitted through intravenous drug use. The rates of infection for both the groups remained steady during the period.
Growing numbers of homosexual men appear to be ignoring "safe sex" warnings and putting themselves at risk for HIV and sexually transmitted diseases. One reason, Dr. Janssen said, is the erroneous belief that AIDS is "curable." The other is that HIV/AIDS is viewed as a chronic, not terminal, disorder, which can be managed with a variety of drug cocktails.
However, he said, not everyone will respond to HIV/AIDS treatments, and prevention is the best course. Exacerbating the problem, he said, is the failure of many people to know their HIV status. "We estimate that some 250,000 of the 900,000 Americans believed to be positive for HIV do not know they are infected."
CDC researchers say their analysis did not include some states having the highest prevalence of exposure to HIV or infection with other sexually transmitted diseases through homosexual or bisexual contact. Such jurisdictions include New York, California, Illinois and the District. The omissions — owing to the recent switch from counting only full-blown AIDS cases to including HIV cases — make the findings even more worrisome, investigators say.
The HIV findings follow the release of other data in recent days from the CDC and the National Center for Health Statistics, which showed that the rate of primary and secondary syphilis increased 9.1 percent last year.
The rise in syphilis cases last year is the second consecutive annual increase. The CDC attributed the rise to more syphilis cases among men, especially homosexual and bisexual men.
The HIV surveillance data from the 29 states support 25-state results released in July at the National HIV/STD Conference in Atlanta.
In July, the CDC reported that AIDS-related deaths fell 5.9 percent last year, but overall AIDS diagnoses rose 2.2 percent. The earlier results showed that HIV cases among men having sexual relations with men rose 7.1 percent from 2001 to 2002.
"These findings add to the growing concern that we are facing a potential resurgence of HIV among gay and bisexual men," Dr. Harold Jaffe, director of the CDC's National Center for HIV, STD and TB Prevention, said at the conference in Atlanta.
Dr. Janssen said the study "reinforces the concerns" raised by Dr. Jaffe, who has researched AIDS at the CDC since the center began tracking the disease.
Initially, AIDS primarily was a disease affecting homosexual men. Their share of the epidemic began to wane by the early to mid-1990s, as many homosexual men turned away from unsafe sexual practices.
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News from 15th International AIDS Conference
PROMOTION
by Christopher Curtis
PlanetOut Network
Before the 15th International AIDS Conference in Bangkok, Thailand, ended on Friday, the U.S. Centers for Disease Control and Prevention (CDC) released studies that look at several contributing factors in the rise of HIV infections among gay and bisexual men.
"The advent of powerful antiretroviral drugs has had unintended consequences," said Dr. Waimar Tun, a CDC researcher, in a quote published in the Miami Herald.
According to the CDC, the number of new HIV cases diagnosed jumped 17 percent among gay and bisexual men from 1999 through 2002, just a few years after effective anti-AIDS drugs became widely available.
CDC research claims effective antiretroviral treatments have led to "treatment optimism" -- the reduced concern over HIV infection leading to a lack of safer sex practices.
On Wednesday CDC researcher Dr. Patrick S. Sullivan reported those who expressed "treatment optimism" were nearly twice as likely not to have used condoms during their last sexual encounter. Dr. Sullivan said it did not matter whether sex partners were HIV-positive or did not know or reveal their status.
The research interviews were conducted with nearly 1,500 HIV-negative or untested men at gay bars in 13 U.S. cities between July 2000 and February 2002.
Another CDC study looked into the psychology of the AIDS epidemic and found that social anxiety among men who were HIV-positive played a role in high-risk behavior.
In the study, an HIV-positive man was more likely to engage in unprotected anal sex with someone who was either negative or had an unknown status if he had difficulty with social interactions, feared being observed in public by others or suffered from performance anxiety.
Those who feared being observed by others were the most risky, according to the study. They were 15.4 times more likely to engage in unprotected anal sex.
CDC researchers noted that men who have sex with both men and women are more likely to engage in high-risk behavior than men who are exclusively homosexual. Those behaviors included injection drug use, and having sex under the influence of alcohol and drugs.
Researchers followed two groups of men who have sex with both men and women and discovered the younger group, between the ages of 15 and 22, was less likely to have unsafe sex than the older group, 23-29.
While researchers agree more education efforts need to be made, the manner in which safe-sex messages are presented needs to be refined. In one CDC study, 94 percent of HIV-positive respondents admitted to seeing HIV messages in the media.
To fight the spread of HIV/AIDS, the CDC has shifted its prevention focus. Instead of targeting uninfected people considered most at risk (minorities, men who have sex with men, and drugs users), the CDC plans to target its message to people who already have the virus and might transmit it to others.
Some AIDS activists say the change in strategy could work, but others disagree.
"There are 299 million of you who don't have HIV, and one million of us who do," Kevin Conare, executive director of Action AIDS Philadelphia told the Philadelphia Inquirer. "So it makes sense to work with us."
However, Terje Anderson, executive director of the National Association of People with AIDS, told the Atlanta Journal-Constitution that "focusing on people with HIV can be counterproductive," adding, "When you start shaking your finger and saying, 'bad boy' and 'bad girl,' it's creating an environment that is stigmatizing."
2007-03-21 07:45:35
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