Los Angeles, Calif. -- The number of new HIV cases in the United States has remained relatively stable at about 50,000 per year-but the soaring number of new cases among young Black gay and bisexual men is "alarming," according to government officials. New HIV cases among young Black gay and bisexual men rose an estimated 48 percent between 2006-2009, according to new data from the U.S. Centers for Disease Control and Prevention (CDC).
"They're calling this 'alarming' but it's clearly past that point," says Phill Wilson, President and CEO of the Black AIDS Institute. "Our house is on fire."
The new estimates were published today in the online scientific journal PLoS ONE. The new data surveys the period between 2006 and 2009. This is the first time HIV incidence numbers were calculated using a lab test that distinguishes recent infections from existing infections. According to the new estimates, there were 48,600 new HIV infections in the United States in 2006, 56,000 in 2007, 47,800 in 2008 and 48,100 in 2009. In 2009, the largest number of new infections were among white gay and bisexual men (11,400), followed very closely by Black gay/bi men at 10,800. Latino gay/bisexual men (6,000) and Black women (5,400) were also heavily affected.
CDC estimates gay/bi men are only about 2 percent of the population -- but accounted for 61 percent of all new HIV infections in 2008. The numbers are more severe for Black gay and bisexual men. Blacks are about 12 percent of the population but 44 percent of all new HIV infections. Black men are 70 percent of all new infections in the African American community ... and Black gay/bi men are 73 percent of all new infections in Black American men.
"That is an outrage," says Phill Wilson. "That number is completely unacceptable. Especially now when the prevention toolbox is literally exploding with new options."
The last year has seen a dramatic flurry of advancements in HIV prevention. The new data comes on the heels of promising trial findings around vaginal microbicides for women and new research that showed that when an HIV-positive person started drug therapy almost immediately after diagnosis, their chances of infecting others was dramatically reduced.
The sobering statistics come weeks after breakthroughs were reported on the efficacy of pre-exposure prophylaxis, or PrEP-providing daily antiretroviral pills to uninfected individuals prior to HIV exposure. PrEP has shown to be safe and effective for gay and heterosexual partners. "These are powerful new biomedical prevention technologies that we didn't have a year ago. Thirty years into the epidemic and we may be turning the corner. But we still need to know why Black men are at a higher risk," he adds.
Researchers are not sure why. Individual risk behaviors "do not account" for the substantial increase. Researchers says black gay/bisexual men do not choose more partners, are less likely to use intravenous drugs and are no more likely to have unsafe anal intercourse than other gay/bisexual. The data suggests one possibility: Young black MSM often do not know their HIV status.
The results also come during an economic downturn that has seen many people losing jobs and many others slipping through the proverbial "safety net"-losing health insurance, unemployment, and other benefits. It also comes at the same time many states are cutting HIV/AIDS prevention funding and the ongoing funding crisis in the AIDS Drug Assistance Program (ADAP).
"People need to know their HIV status," says Wilson. "Those who are HIV positive need to be linked to appropriate care immediately. Federal and state governments must address the ADAP crisis. HIV/AIDS is not "somebody else's" problem. It's OUR problem that we have to solve because we're all paying for it-and we're all losing loved ones. And we're losing our youth-what type of legacy is that?"
The new data was released almost one year to the week that the Obama Administration announced its National HIV AIDS Strategy, the nation's first roadmap to combating the epidemic.
"We now have the tools that could dramatically drive down new infections," says Phill Wilson. "We have a roadmap to victory. We understand that people must be tested and know their status. We understand that linking 'poz' people to care right away saves lives. And we know that providing anti-retrovirals to healthy people can also save lives. We understand this -- but we need smart solutions, we need targeted resources and we need all hands on deck. The house is on fire."
Unfortunately, stigma, discrimination and homophobia are potent factors that keep many people in closet and afraid to learn their HIV status.
"Too many of us in the Black community are distracted by myths and misinformation," Wilson adds. "When we don't understand the science of HIV/AIDS, we cannot protect ourselves. That means we are less willing to get tested, less likely to start treatment, and less likely to take ownership of the disease. But we can win this battle and we can win this war."