Kaiser Survey Offers Comprehensive Look at Gay Men's Attitudes and Behaviors Regarding HIV
September 30, 2014
HIV/AIDS education and advocacy seem to still have a long way to go in reaching gay and bisexual men in the U.S., according to a comprehensive report released by the Kaiser Family Foundation. The report presents the findings of a recent Kaiser survey among a nationally representative sample of 431 adult men who self-identified as gay or bisexual. In particular, while gay and bisexual men say complacency around HIV/AIDS is a problem, these same men admit to almost never talking about HIV with their friends or even their casual sexual partners. Many of them say they've never been asked by physicians to take an HIV test.
This lack of knowledge "is a major concern," writes Kaiser Family Foundation President Drew Altman in The Wall Street Journal. "There is no question that the problem of HIV among gay and bisexual men remains urgent -- and under the radar."
Just over half (51%) of the men surveyed did not feel HIV/AIDS was a significant issue in their lives. Only a third of the respondents knew that HIV infections are rising among gay men, and fewer than half (46%) knew that doctors recommend that HIV-positive individuals start antiretroviral therapy immediately following diagnosis.
Adding to the lack of personal knowledge or awareness of HIV/AIDS, the Kaiser report noted that the U.S. Centers for Disease Control and Prevention (CDC) estimates that 18% of gay and bisexual men don't know their status. The first step to knowing one's HIV status is getting an HIV test. Most health organizations recommend routine HIV testing at least once a year, or even once every three to six months, for sexually active adults. But one of the key findings of the Kaiser survey was that 56% of the gay and bisexual men surveyed said "that a doctor has never recommended they get tested for HIV," while 61% said "they rarely or never discuss HIV when they visit their doctor" and 47% said "they've never discussed their sexual orientation with a doctor or other health care professional."
This may be partly why testing rates are extremely low, with 70% of the respondents admitting they had not tested for HIV in the past year. Only 19% of the respondents said they had an HIV test in the past six months.
Furthermore, gay and bisexual men under 35 were "twice as likely as older men to say they have never been tested for HIV." Among younger gay and bisexual men, 44% said they've never been tested for the virus compared to only 21% of men older than 35.
Another generational difference: "Nearly half (47 percent) of gay and bisexual men ages 35 and older say they have lost someone close to them to the disease." However, "a mere 8 percent of those 18-34 say the same." Further, "older men are more likely than younger men to say they know someone currently living with HIV."
This may be because fewer people are dying from AIDS-related complications due to advances in treatment and more tolerable regimens. Still, the CDC says that only 28% of HIV-positive Americans are on regular antiretroviral therapy, which means that nearly three-quarters of Americans with HIV/AIDS do not receive lifesaving treatment. The report points to stigma as a persistent barrier between American gay and bisexual men and HIV/AIDS knowledge.
"Discrimination and stigma are still barriers to spreading the word about testing and new treatments," laments Altman. In the survey, the respondents said that major factors contributing to HIV's persistence include "too many gay men not knowing their status (75 percent), complacency about HIV in the gay community (62 percent), and HIV-related stigma (56 percent)."
Ironically, though, three-quarters of the respondents also indicated they "'rarely' or 'never' discuss HIV with their friends, and large shares report not talking much about it with casual sexual partners (50 percent) or with long-term partners (60 percent)."
The report also examined racial differences: The survey found that "gay and bisexual men of color are more likely than those who identify as white to say HIV/AIDS is a significant issue for them personally." According to the CDC, people of color overall are the most "heavily affected" by new HIV/AIDS diagnoses and men who have sex with other men are the number one demographic affected by new HIV/AIDS diagnoses, which may be in part why gay and bisexual men of color in the survey also were more likely than those who identified as white to say "they are personally concerned about becoming infected (53 percent versus 28 percent)."
The report further noted that men of color are "more likely than white men to report consistent condom use (61 percent versus 39 percent)." Overall, "nearly half (46 percent) of gay and bisexual men ... say they use condoms all or most of the time." A quarter of the survey respondents, however, said they never used condoms at all.
Josh Kruger is an award-winning writer and commentator in Philadelphia. His work often focuses on HIV/AIDS, cultural stigmas and social problems. You can follow him on Twitter @jawshkruger.
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