CDC study shows ‘concentrated epidemic’ of HIV in gay, bisexual men

44% of 8,000 men in 21 cities didn’t know they had virus

MIKE STOBBE  |  AP Medical Writer

ATLANTA — One in five sexually active gay and bisexual men has the AIDS virus, and nearly half of those don’t know they are infected, a federal study of 21 U.S. cities shows.

Experts said the findings are similar to earlier research, but the study released Thursday, Sept. 23 is the largest to look at gay and bisexual U.S. men at high risk for HIV. More than 8,000 men were tested and interviewed, and 44 percent of those who had the virus didn’t know they had it.

Overall, less than half of 1 percent of Americans have the AIDS virus, according to a calculation by the Kaiser Family Foundation, a research and policy organization in Washington, D.C.

But gay and bisexual men continue to be infected at much higher rates, said Jennifer Kates, Kaiser’s director of global health and HIV policy.

“We don’t have a generalized epidemic in the United States. We have a concentrated epidemic among certain populations,” she said.

That’s why a new national AIDS strategy, unveiled by the White House in July, is emphasizing more of a government focus on men who have sex with men and others at the highest risk of getting infected, Kates said.

The Centers for Disease Control and Prevention recommends HIV testing at least once a year for all men who have sex with men and are sexually active, but research indicates more than half don’t get tested.

An earlier study in just five cities in 2004-05 found similar results.

The new study, conducted in 2008, included 16 additional cities. Researchers offered free testing to the men, interviewed them and paid around $25 for their participation.

Black men were more likely to have HIV, with 28 percent reportedly infected, compared to 18 percent of Hispanic men and 16 percent of white men.

Black men were also least likely to know they were infected — about 60 percent didn’t know they had HIV — compared 46 percent of Hispanic men and 26 percent of whites.

—  John Wright

ASOs pleased with Obama’s AIDS strategy

Service providers are optimistic about holistic approach, but want to see the money to back up plan

DAVID TAFFET | Staff Writer taffet@dallasvoice.com

Raeline Nobles

The White House’s new National AIDS Strategy, released July 13, is getting good reviews from AIDS service organizations in North Texas.

The policy includes plans on how to reduce new infections, how to increase access to health care and how to improve the outcome for people living with HIV. It takes a holistic approach to AIDS, bringing resources from around the community together and recognizing the need for transportation, food and housing as well as medical treatment.

Its goals also include eliminating the stigma still attached to HIV/AIDS.

“This White House is more systemic,” said Raeline Nobles, executive director of AIDS Arms. “[They know that] when one part of the system is weak, the entire system breaks down. You have to reach out into the greater community.”

Nobles noted the focus on reducing the infection rate by 25 percent.

“I think the strategy is very aggressive,” she said. “A 25 percent drop is a huge drop.”

Still, she wondered how the plan would be funded.

“Healthcare reform will provide some answers, but not until 2014 and that’s a long time in the middle of an epidemic,” she said.

Steven Pace, executive director of AIDS Interfaith Network, said “What I hope emerges is renewed outreach and prevention because those were so destroyed under the Bush administration.”

And Don Maison, president and CEO of AIDS services of Dallas commended the plan’s “recognition of the importance of housing for overall health. … Housing has the attention of policymakers and is included for the first time.”

Maison attended a White House meeting in December with Jeffrey S. Crowley, director of the Office of National AIDS Policy. Four assistants to the president, officials from HUD and the Health Resources and Services Administration also attended.

When Maison read how their concerns were addressed in the strategy, he said he was delighted they were listening.

Nobles also was impressed with the process by which the administration put the strategy together.

She said that at least once every other week she received an e-mail asking her opinion.

Steve Dutton, executive director of Samaritan House in Fort Worth, pointed out three things he especially liked about the strategy.

“It’s important that housing is integrated into the plan,” he said. “I like the call to educating all Americans about the disease. And prevention is more than just condoms.”

He said this was the first administration that gathered information from experts and used that to formulate a strategy. He said he was impressed by the call for federal agencies to work closely with local agencies.

Like other agency directors, Dutton worried about funding.

He said the president made it clear in his executive summary of the document that this is not a budget document.

“But it clearly establishes national priorities,” Dutton said. “That’s very impressive. It’s been a long time since leadership asked people on the street, ‘What do you think?’”

Bret Camp from Nelson Tebedo Clinic was cautiously optimistic.

“It’s good that we finally have a plan,” he said. “I would like to see money behind it.”

Camp liked the idea of collaboration among faith-based groups, government agencies, the medical community and service organizations.

“That makes the continuum of prevention services seamless,” he said.

Camp pointed to the Stomp Out Syphilis program at Resource Center Dallas that works well with faith-based organizations throughout the community.
“The state holds that program up as a model,” he said.

Allan Gould, executive director of AIDS Outreach Center in Fort Worth, said the plan had the right goals for halting the spread of HIV. He said that over the last five to 10 years, most people acted as though the AIDS epidemic was over, but, “AIDS is still a huge problem.”

Gould said that the two things to watch are how the plan is implemented and where the money is coming from. The federal government funds Tarrant County and other areas with fewer than 2,000 cases of AIDS differently than cities like Dallas with more people infected with HIV.

“Small agencies will close,” Gould said.

But his reading of the strategy is that it is a fresh approach.

“It’s a health issue, not a moral issue,” he said. “The plan takes a holistic approach.”

He said the president sounded pragmatic when he announced the strategy, admitting he didn’t have all the answers.

Gould said that for the first time, ASOs wouldn’t have to wait for a change in administration to get rid of a policy or an approach that isn’t working.
But Gould laughed at one of the main goals — to reduce the stigma of AIDS.

He said you can’t tell people how to think, but he thought it was better to have that as policy than not.

Getting the prevention message out there once again, Gould said, was among the most important pieces of the new plan.

This article appeared in the Dallas Voice print edition July 23, 2010.

—  Michael Stephens