HIV infections in U.S. stable but disparities exist

The number of Americans newly infected with HIV remained stable between 2006 and 2009, but infections rose nearly 50 percent among young black gay and bisexual men, U.S. experts said on Wednesday.

New data from the U.S. Centers for Disease Control and Prevention reveal progress since the peak of the HIV epidemic in the 1980s. But the sharp increases in infection rates among young black men who have sex with men show there is much more work to do, they said.

"We're very concerned about these increases among young gay men," Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, said in a telephone interview.

"We can't allow the health to a new generation to be lost to what is essentially a completely preventable disease."

According to the estimates, published in the journal PLoS ONE, there were 48,600 new HIV infections in the United States in 2006, 56,000 in 2007, 47,800 in 2008 and 48,100 in 2009. Over the four-year period, that amounts to an average of 50,000 cases per year.

But communities of color, and especially blacks, were disproportionately affected.

While blacks represent 14 percent of the U.S. population, they accounted for 44 percent of new HIV infections in 2009. HIV infection rates among blacks were nearly eight times higher than rates in whites, according to the study.

Hispanics, who represent about 16 percent of the population, accounted for 20 percent of new HIV infections in 2009 - a rate that was nearly three times as high as that of whites.

HARDEST HIT

Men who have sex with men - which includes openly gay and bisexual men and those who do not identify themselves as gay or bisexual - remain most heavily affected.

While this group represents 2 percent of the overall U.S. population, they accounted for 61 percent of all new HIV infections in 2009.

And young men who have sex with men - those aged 13 to 29 - are the hardest hit, accounting for more than one quarter of all new HIV infections nationally.

New HIV infections affected young men who have sex with men of all races, but the CDC saw very sharp increases among young black men who have sex with men.

"We saw increases of up to 48 percent - nearly a 50 percent increase between 2006 and 2009," Fenton said.

The reasons for this are not yet clear, he said, but the CDC said several factors are influencing this trend.

They said young black men who have sex with men are less aware of their infection status. They may encounter more homophobia than other groups, which could keep them from getting tested. They may have less access to treatment, and they have higher rates of other sexually transmitted diseases, which increases the risk of HIV transmission.

"HIV remains one of the most glaring health disparities in this country," Fenton said in a statement.

"While we all have individual responsibility to protect ourselves from HIV infection, the research clearly shows that individual risk behavior alone doesn't account for the significant racial disparities in HIV," he said.

"It is essential to understand the underlying factors that contribute to these disparities, such as poverty, discrimination and lack of access to health care."

To fight these increases, Fenton said the CDC will focus on areas where HIV infection is most heavily concentrated - among gay and bisexual men of all races, blacks and Hispanics, as outlined in the National HIV/AIDS Strategy introduced by the White House last summer.

The plan calls for better methods to gather data among affected populations and increased use of prevention tools, including earlier testing and treatment with drug cocktails that have been shown to reduce HIV transmission.

SOURCE: bit.ly/oOSezp PLoS ONE, August 2, 2011.