Why We Should Care: Considering the Risk

Men Who Have Unprotected Sex with Men

In the U.S., HIV-related illness and death have had a tremendous impact on men who have unprotected sex with men (MSM). This group, which includes bisexuals, continues to account for the largest number of HIV/AIDS cases. However, a dramatic shift has occurred in the predominance of cases from white gay men to MSM of color, which includes non-Hispanic Black, Hispanic, American Indian/Alaska Native and Asian Pacific Islanders.

• Men who have sex with men (MSM) account for 40% of new HIV cases and 34% of all adult and adolescent AIDS cases.

• Among gay and bisexual men with AIDS, cases among men of color rose from 31% in 1989 to 52% in 1998.

Injection Drug Users

The sharing of syringes and other equipment for drug injection is a major route of HIV transmission for injection drug users (IDUs) due to blood contamination. Indirectly, infection through injection drug use contributes to the spread of AIDS to the sex partners of an IDU and to children born to mothers who contracted HIV through sharing needles or having sex with an IDU. Racial and ethnic minorities are most heavily affected by IDU-associated AIDS.

• Since the epidemic began, injection drug use has directly and indirectly accounted for more than 36% of AIDS cases in the U.S..

• Men represent 80% of IDUs worldwide. Sex with male IDUs is a major risk factor for HIV.

Heterosexual Transmission

The number of HIV infections through heterosexual contact is rising in the U.S.. Heterosexual contact accounted for 15% of all reported AIDS cases in 1999. Minorities and women have been disproportionately affected by heterosexual transmission.

• In just over a decade, AIDS cases among adult and adolescent women more than tripled, increasing from 7% of all AIDS cases in 1985 to 23% in 1998. 40% of these are attributed to heterosexual sex.

• Many women are infected because they do not know the health status or sexual and drug use practices of their partners (including husbands).

• Since the beginning of the epidemic, 7% of all men infected with HIV were infected through heterosexual contact. By contrast, in 1999, 9% of men were infected heterosexually.

• Of those infected heterosexually, the majority contracted the virus either through sex with another HIV-infected person or sex with an HIV-infected injection drug user.

Youth

Many American youth are engaging in behaviors that may put them at risk of acquiring HIV infection.

• Up to 50% of all new HIV infections are among those under age 25.

• Approximately 50% of high school students have had sexual intercourse and over 16% have had 4 or more sex partners by the end of 12th grade.

• 24.8% of high school students used alcohol or drugs during their last sexual intercourse, according to a recent CDC study.