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Daily HIV/AIDS Report
Public Health &
Education | AIDS RATES: Hispanic, African-American Gay Men Now
Exhibit Higher Rates of Infection than Whites
[Jan 14, 2000]
Non-Hispanic black gay men and Hispanic gay men now outnumber white gay men
in AIDS diagnoses and exhibit smaller proportionate declines in AIDS
incidence and deaths, according to this week's Morbidity and Mortality
Weekly Report. The report studied data collected from 1989 to 1998 on
AIDS diagnoses and HIV diagnoses in the 25 states that have conducted HIV
surveillance since 1994. Between 1989 and 1998, 290,582 men who have sex
with men were diagnosed with AIDS. In 1989, 31% of AIDS cases in that group
were among racial and ethnic minorities; by 1998, 52% of AIDS cases were
among minorities. Specifically, the proportion of cases among gay
non-Hispanic blacks increased from 19% to 33% during that time period, while
the percentages for Hispanics increased from 12% to 18%. Examining data from
the 25 states with HIV surveillance, researchers found that 40% of the
23,680 gay men diagnosed with HIV or AIDS from 1996-1998 were non-Hispanic
black and 7% Hispanic. Further, a larger proportion of diagnoses among
non-Hispanic blacks and Hispanics occurred in those ages 13-24, which the
researchers suggest could be a sign that "racial/ethnic [homosexual
men] may become infected at younger ages compared with white [homosexual
men]." As non-Hispanic blacks and Hispanics exhibited higher infection
rates, decreases in AIDS deaths and incidence were small. For all gay men,
AIDS incidence declined 22% from 1996-1997. The rate of decline slowed to
12% in 1998 compared to 1997. From 1996-1998, for non-Hispanic blacks that
number declined 23%, compared to decreases of 39% for non-Hispanic whites
and 26% for Hispanics. Deaths among all gay men with AIDS declined 49% from
1996-1997; the rate of decline slowed to 23% the next year. For the
1996-1998 period, AIDS deaths declined 65% for non-Hispanic whites, 60% for
Hispanics and 53% for non-Hispanic blacks (MMWR, 1/14).
What's
Going On?
Although some may be surprised by the study's
findings, Dr. Helene Gayle, director of the CDC's center for HIV prevention,
said, "From our surveillance data ... it was just a matter of time
before this crossover (of racial groups) would occur. This trend has been
going on all along, and people have ignored it. In a lot of ways, the
surprise is that people are surprised" (Brown, Washington Post,
1/14). The shift is a result of several factors, the New York Times
reports, including the fact that white gay men have "educated
themselves about the use of condoms and other prevention measures, while
minorities largely ignored the issue of infection with HIV." Part of
that problem is linked to the stigma associated with homosexuality, which
"may be even greater among blacks and Hispanics than it is among
whites." Backing that notion up is the finding in MMWR
that many non-Hispanic black and Hispanic men who became infected with HIV
from having homosexual sex did not identify themselves as either homosexual
or bisexual. Twenty-four percent of non-Hispanic blacks and 15% of Hispanics
identified themselves as heterosexual despite having had sex with men,
compared to 6% of white males. Gayle said those individuals may not consider
themselves at a high risk for AIDS and, therefore, "may not seek or
receive ... treatment services they need and many unintentionally put their
male and female sex partners and children at risk" (Altman, New
York Times, 1/14). She added, "The African-American and Latino
communities must recognize that this is not a disease that only affects
white, gay men" (Sternberg, USA Today, 1/14).
Blaming
the Silence
Leo Rennie, deputy director of the Harlem
Directors' Group, A New York City-based coalition of black AIDS-related
organizations, agreed with Gayle, saying, "One of the biggest reasons
AIDS has escalated in the African-American community is the silence there
that is so pervasive about what puts our people at risk." Ravinia
Hayes-Cozier, executive director of the Harlem Directors' Group, added,
"Since it's not discussed and since men aren't encouraged to discuss
their sexuality, they hide it, and they have no place to go to talk among
themselves about how sex is putting them at risk" (Waldholz, Wall
Street Journal, 1/14). Julio Abreu, associate director of government
affairs for AIDS Action, said, "The AIDS epidemic is once again
exposing disparities in access to care in America. Our failures to
reinvigorate prevention for the most vulnerable communities has resulted in
an explosion of AIDS cases among people of color" (AIDS Action release,
1/14). The MMWR study notes that the surveillance data
"highlight the importance of increased efforts to promote HIV
prevention and treatment services in racial/ethnic minority communities,
particularly among non-Hispanic black and Hispanic" gay men. Further,
prevention programs should focus on both HIV-infected and uninfected
populations with efforts to promote risk-reduction behavior among at-risk
youth (MMWR, 1/14). Gayle noted that funding secured by the
Congressional Black Caucus helped the CDC to grant an additional $7 million
to community-based programs reaching out to minority/ethnic gay men, but the
amount was "clearly a drop in the bucket" (Waldholz, Wall
Street Journal, 1/14).
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