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CDC: Unsafe Sex Common for HIV+ Men

After HIV Infection, 35% of Men Who Have Sex with Men Continue Unsafe Sex

35% of HIV+ MSM Have Unsafe Sex continued...

On the other hand, men seem to behave badly with men they meet on the Internet than they do when they meet at bars or gay-oriented events. Nearly two-thirds of MSM recruited online reported recent unsafe sex in the Crepaz study.

And the Mayer team found that men who reported substance use -- particularly methamphetamines -- were three times more likely to have a sexually transmitted disease (syphilis in nearly 80% of cases).

"This study really underscores the continued need for positive protection methods for men," Fenton said.

Fenton also called attention to a troubling study by CDC researcher Kate Buchacz, PhD, MPH, and colleagues.

The Buchacz study showed that half of MSM diagnosed with syphilis at STD clinics in three major cities -- Atlanta, San Francisco, and Los Angeles -- were also infected with HIV.

Each year, studies suggest, 3% to 4% of U.S. MSM get HIV. But Buchacz and colleagues found that more than 10% of men with syphilis infections had recent HIV infections, too.

"Syphilis in the U.S. is overwhelmingly concentrated in MSM," Fenton said. "This demonstrates the need for routine HIV testing and investigation of HIV-positive men for syphilis infection."

African-American MSM: Surprising New Data

The U.S. HIV epidemic first appeared among MSM -- and almost half of U.S. HIV infections are among MSM.

But America's HIV epidemic is vastly worse for African Americans than for any other racial or ethnic group. Half of U.S. HIV infections are among African Americans. And African-American men are seven times more likely to have HIV than white men are.

Nearly half of African-American MSM -- 46% -- are HIV positive, CDC researcher Gregorio Millett noted at the news conference. Millett's team conducted a painstaking analysis of data on African-American MSM collected in 53 studies conducted from 1980 through 2006.

The study showed that:

  • African-American MSM are no more likely than white MSM to report unsafe sexual activity. During the 1980s -- but not from 1990-2006 -- African-American MSM were 60% more likely than white MSM to report unprotected anal intercourse. Millett suggests that HIV "seeding" during the 1980s may have shaped the current epidemic.
  • African-American MSM tend to have fewer sex partners than white MSM.
  • African-American MSM were 36% less likely than white MSM to report use of drugs linked to HIV infection -- that is, injection drugs, crack or cocaine, opiates, and amphetamines.
  • African-American MSM are no more likely than white MSM to report commercial sex work or sex with known HIV-positive partners.
  • HIV-positive African-American MSM are only half as likely as white MSM to be taking anti-HIV drugs. Lack of treatment could play a role in increased HIV transmission.
  • African-American MSM are 71% less likely than white MSM to think of themselves as gay and 58% less likely to disclose their same-sex behavior to others. Both of these factors are linked to higher risk of HIV infection.

Millett's team is now investigating social network factors that may affect HIV transmission among African-American MSM.

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