African American and Latino men who have sex with men (MSM) are becoming infected with HIV at disproportionately high rates, and the U.S. government needs to step up its prevention efforts to stem the spread of the disease, an official from the U.S. Centers for Disease Control and Prevention (CDC) announced May 31.

  "We must address the urgent prevention needs of African American and Latino gay and bisexual men, especially young men," said Helene D. Gayle, M.D., M.P.H., director of the CDC’s National Center for HIV, STD and TB Prevention (NCHSTP).

Dr. Gayle pointed to two recent CDC-funded studies that underscore the need for action. The first, a seven-city study MSM age 15 to 22, conducted between 1994 and 1998, found that 14.1 percent of African American participants tested positive for HIV, compared to 6.9 percent of Latinos and 3.3 percent of Caucasians. The second, a six-city study of MSM age 23 to 29, conducted between 1998 and 2000, found that 30 percent of African American participants had HIV, compared to 15 percent of Latinos and 7 percent of Caucasians. Recent data from this study, though based on a small sample size, indicate that annual infection rates are also sharply higher among African Americans: 17 percent, compared to 4 percent among Latinos and MSM of mixed race and 3 percent among Caucasians.

"Americans who are most threatened [by HIV/AIDS] today are those who are often most invisible to society," such as young African American gay men, said Dr. Gayle. "Efforts must continue to be tailored to the specific needs of these men" and should take into account cultural differences -- such as stigma associated with homosexuality and AIDS -- that can become roadblocks to prevention.

"There is more of a stigma in African American and Latino communities about men who have sex with men," explained Marty Algaze, communications director for GMHC in New York, NY, the nation’s longest running AIDS service organization.
 

"It's like an underground world where men have sex with men, then go home to their wives and girlfriends."

 
 
This stigma prevents many of these men from self-identifying as gay or bisexual, "so they don’t identify themselves with the prevention programs targeted to gay men."

 
 
"It’s sort of like an underground world where these men have sex with men, then go home to their wives and girlfriends" who may subsequently become infected, he said. Rates of HIV among heterosexual women of color are also skyrocketing: 64 out of every 100 women in the U.S. who become newly infected are African American, according to CDC data.

Inadequate funding also makes reaching MSM of color a challenge. "We need to find ways to reach these men, but it's so difficult, considering there’s been so little funding for prevention programs," said Algaze. In response to the CDC data, LGBT activists called on Congress and President Bush to increase funding for HIV prevention programs that target at-risk populations. "It is extremely disturbing that the 20th anniversary of the first AIDS report is marked by increasing evidence of the resurgence of the disease in young gay and bisexual men," said Winnie Stachelberg, political director of the Human Rights Campaign in Washington, DC.

Algaze urged all MSM to take steps to protect themselves against HIV. "Take it for granted that everyone you have sex with could be HIV-positive, then make decisions to protect yourself from getting infected," he said. "This is a life and death decision. AIDS is still a fatal disease -- there’s still no cure, there’s still no vaccine."

Updated: Thursday, 31 May 2001