Gay-HIV Epidemic Continues; Black Men at Highest Risk
"We were so disheartened to find out that so few HIV-positive men knew they were infected," Valleroy says. "That means newly infected people are transmitting the virus without knowing it."
HIV is a human virus, not a gay virus. The New York City data reveals this in a sobering statistic: More than two-thirds of the men in the study -- including 60% of self-identified gay men and 96% of self-identified bisexuals -- reported having sex with a woman.
Whether these numbers represent a resurgence of HIV among gay men depends upon whom one asks. Torian says the new numbers are "at best" as bad as it has ever been. Valleroy objects to the word "resurgence" because it implies that HIV among young gay men had gone away for a while -- and it never has.
CDC AIDS director Helene Gayle, MD, takes a longer view.
"It's a resurgence in the sense that our society has let up to a certain extent," she tells WebMD. "It's a societal resurgence, even if it's seen mainly in groups that have had consistent risk behavior over time. We have not put a focus on maintaining prevention efforts at the levels where they need to be. We need to be concerned about it."
Valleroy says it's time to act.
"There have been gaps in what we have been doing in prevention," she says. "Prevention efforts have been fairly good at reaching white men, older men in their late 20s and 30s -- less good at reaching adolescents or people in college. I would like to see more efforts in different cities to reach young men. It is a problem in schools, because they have a problem with sex education -- certainly with gay sex education. A lot can be done to reach younger men before they start going out and having sex."
To Valleroy and Torian, this means individualizing prevention efforts.
"Especially with African-American gay men, there could be a greater effort in trying to figure out where they are and trying to reach them," Valleroy says. "We should be spending time figuring out where this person is having problems -- is it drinking, self-esteem, drugs, depression? Prevention should be more centered on individual people and their risks. We are all different, and we slip up for different reasons."