July 3, 2012
Theresa Mack, M.D., M.P.H.
Every month, HIV specialist Theresa Mack, M.D., M.P.H.--an associate medical director at St. Luke's Medical Group in Harlem, N.Y.--will answer your most pressing HIV/AIDS questions.
HIV remains an epidemic in our community, and Black males account for the greatest number of new infections in the United States. Men who have sex with men (MSM) are particularly affected, with young Black MSM between the ages of 13 and 29 experiencing a 48 percent increase (pdf) in new HIV infections between 2006 and 2009.
Regardless of how you self-identify--heterosexual, gay, same-gender-loving, bisexual, MSM or MSMW (men who have sex with men and women)--unprotected sexual activity places you at risk for acquiring HIV.
A number of factors are believed to account for the increase in new infections among Black men:
Men typically get diagnosed with HIV at an earlier stage in the disease than women do. Another difference between men and women is that women typically experience symptoms at a higher T-cell (CD4) count than men. For example, a man with a T-cell count of 300 is more likely to experience no symptoms than a woman with the same count.
Even if a man experiences no symptoms, it is important for him to begin antiretrovirals as soon as possible after an HIV diagnosis. Treating the disease not only enables him to maintain a longer and healthier life but also makes him less likely to transmit HIV to his sexual partners. This is also true for women.
Studies have shown that male circumcision has decreased the transmission of HIV from positive men to their female partners in African countries. Researchers are currently examining whether this is a prevention option for serodiscordant couples in the United States.
If an HIV-negative male or female has possible HIV exposure (sexual intercourse without a condom or the condom breaks), taking a PEP (postexposure prophylaxis) protocol may prevent HIV infection.
Annual checkups with your primary care provider are mandatory even if you are feeling well, regardless of your HIV status. If your physician doesn't talk to you about preventing HIV or, if you're already positive, not transmitting it to others, initiate the discussion and/or consider changing doctors.
Men should be screened not just for HIV and other sexually transmitted diseases but also for such conditions as diabetes, high blood pressure, high cholesterol and kidney disease. Men should also adopt certain healthy lifestyle habits, regardless of their HIV status:
The bottom line is this: Having unprotected sex increases your risk of HIV infection every single time.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about health and wellness.