February 6, 2001

Study in 6 Cities Finds H.I.V. in 30% of Young Black Gays

By LAWRENCE K. ALTMAN

HICAGO, Feb. 5 — Thirty percent of young gay black men are infected with the AIDS virus, according to a study of six large cities in the United States, federal researchers said here today.

The study, conducted by the Centers for Disease Control and Prevention from 1998 through 2000 in Baltimore, Dallas, Los Angeles, Miami, New York and Seattle, found that gay black men in their 20's had the highest H.I.V. infection rate of any group in that age range.

The study found that among young gay men, 15 percent of Hispanics, 7 percent of non-Hispanic whites and 3 percent of Asian-Americans, are infected with the virus. Over all, the study found that 12.3 percent of gay and bisexual men from 23 to 29 were infected with H.I.V., the AIDS virus.

"The rates are strikingly high and worrisome," Dr. Robert Janssen, a co-author of the study, said in an interview. "We have not been putting adequate resources into gay men of color. And we definitely need to bolster our efforts in reaching them."

The study also found that gay and bisexual men in their 20's of all races were engaging in behavior that put them at high risk for AIDS, said federal researchers who presented the findings at the Eighth Annual Retrovirus Meeting here today.

A total of 46 percent of participants said they had had unprotected anal intercourse in the preceding six months. Officials at the centers called the figure "alarming" because the men grew up and went to school in an era when widespread publicity and prevention efforts were directed at AIDS. Many older gay men became infected before AIDS was recognized. The disease was first detected in 1981 when the men in the new study were 3 to 9 years old.

A similar study by the centers from 1994 to 1998 found that 7 percent of 15- to 22-year-old gay and bisexual men were infected by H.I.V., Dr. Janssen said. That study found that 14 percent of the blacks were infected, 7 percent of the Hispanics and 3 percent of the non-Hispanic whites. In recent years, about 40,000 Americans have become newly infected each year, with blacks accounting for slightly more than half of the new cases. At the height of the epidemic in the early 1980's, there were more than 150,000 new infections annually.

But because the newer and earlier studies focused on different age groups, there was no way to determine whether the percentage of new infections in each group was rising, Dr. Janssen said in an interview.

However, a number of other studies have shown small but significant increases in rates of gonorrhea, syphilis and other sexually transmitted infections. Epidemiologists use such infections as behavior markers for the risk of new H.I.V. infections in a community because of a strong correlation of H.I.V. and other sexually transmitted diseases among infected individuals. Also, sexually transmitted infections can make it easier for H.I.V. to enter the body.

Health officials also expressed concern that of the 293 infected men in the study, only 29 percent knew they were infected. Fewer than one-fourth were receiving medical care or anti-H.I.V. therapy.

Health officials suspect that a substantial proportion of current H.I.V. transmission is from people who do not know they are infected.

San Francisco, which used a recently developed test to detect recent H.I.V. infections, is the only city in the nation that has reported an increase in infections among gay and bisexual men in recent years. The test is available only for research purposes. But Dr. Janssen expressed hope that it could be used more broadly later this year.

Although there is no direct evidence of rising H.I.V. numbers among gay and bisexual men in other areas of the country, the new and earlier studies raise suspicions that such an increase may be occurring, Dr. Janssen said.

In the six cities study, epidemiologists surveyed more than 2,400 men at bars and other places frequented by young gay men and conducted extensive interviews.

The prevalence of infection ranged from a low of 4.7 percent in Seattle to 18 percent in Dallas, and there was a high level of risky sexual behavior in all six cities.

Gay men remain the largest group of people with AIDS, accounting for about 40 percent of AIDS cases and new infections reported in recent years. Women make up 30 percent.