Statement of the National Black Gay Men’s Advocacy Coalition:

CDC Revised Incidence Data Shows Continuing Impact of HIV on Young Black Gay Men

August 3, 2011

Our nation has made considerable progress in addressing the HIV epidemic in the 30 years since the first cases were reported by the Centers for Disease Control and Prevention in June 1981.  Community leadership, sound public health and our investment in science has resulted in a decrease of HIV infections from an estimated incidence of 130,000 in the early 1980s to a current CDC estimate of 50,000 annually.   The revised incidence report released today on PLOS, however, shows that the burden of HIV among young black gay men (13 – 29 years of age) is unacceptably high.  There is an urgent need for a greater investment in both existing prevention strategies and new approaches to stem the epidemic in the United States. 

The CDC report highlights that 44% of new infections occur among African-Americans, who experience and incidence rate 8 times that of whites, further evidence of a growing concentration of the epidemic among America’s racial minorities and the poor.  Additionally, 77% of infections occur among males, with black males comprising over 30% of all estimated cases.  61% of new infections are reported to be occurring among gay men and other men who have sex with men (MSM).  Overall, individuals classified by CDC as MSM (of all races and ethnicities, including transgender women), are the only population that continues to show increases in new HIV infections.  In addition, 3% of estimated infections also occurred among MSM who inject drugs, adding to the impact of HIV in the lives of gay men.

Most disturbing to the National Black Gay Men’s Advocacy Coalition is the 48% increase of estimated annual infections among young black gay men between 2006 and 2009 (from 4,200 incident cases in 2006, to 6,500 in 2009).   The startling disproportionate burden of HIV that this population shoulders stands alone and demands immediate attention at all levels. 

Dishearteningly, the incidence data comes despite evidence that shows young black gay men engage in less risk behavior than their peers of other races, yet experience greater infection rates due to higher levels of sexually transmitted diseases, lower levels of HIV testing, and inadequate access to healthcare and treatment that can both improve individual health and reduce transmission of HIV .

The HIV incidence data also comes on the heels of two other reports released this week that cause concern to our community.  The CDC reported on Monday in the Annals of Internal Medicine that rates of primary and secondary syphilis increased disproportionately in recent years among black, Hispanic, and young men who have sex with men.  Syphilis has been on the rise since 2000, and studies suggested MSM accounted for a majority of the new cases.   In this new study of 27 states, the largest increases between 2005 and 2008 were found among MSM in their teens and 20s.  In 2008, MSM ages 20-29 had the biggest increase in syphilis, to about 12 cases per 100,000.  That same year, the absolute increases in syphilis rates among black MSM were 8 times the rate for white MSM.  Black MSM had 19 cases of syphilis per 100,000, Hispanic MSM had over 7 cases per 100,000, and white MSM had 4 per 100,000.  (“Primary and Secondary Syphilis among Black and Hispanic Men Who Have Sex with Men:  Case Report Data from 27 States,” and the editorial, “Resurgent Syphilis in the United States: Urgent Need to Address an Evolving Epidemic,” Annals of Internal Medicine (2011; 155:145-151 and 192-193, respectively).

NBGMAC is further concerned by a new study commissioned by Janssen Therapeutics and the National Medical Association (NMA) that reported social stigmas are still the highest barriers to African-American frontline physicians testing their patients for HIV.  Numerous studies have shown that Black gay men are often unaware of their HIV status, even when in care.   Physicians interviewed for the Janssen-NMA study reported that only one-third of their patients had been tested for HIV in the past year, and not because the patients themselves were opposed to testing.  The study states that “physicians were unwilling to recommend HIV testing because of social stigmas associated with the procedure.”   This misguided attitude among our health care providers is deadly and has no place in the practice of medicine.

The HIV epidemic in black communities across the United States demands urgency, especially in addressing the lives of young black gay men.  In response to the new estimated HIV incidence report and these other studies, NBGMAC calls for:

-          The CDC to immediately increase the funding that it anticipates awarding in the next month to organizations providing services to young MSM and transgender of color from $9 million to $14 million.

-          The CDC and the Health Resources and Services Administration to jointly create an investment fund to strengthen the capacity of indigenous black gay organizations to provide HIV testing, prevention and treatment education and linkage to care services.

-          The HRSA and the Center for Medicaid and Medicare Services to require all physicians at publicly funded institutions or receiving public reimbursement for the delivery of health care services in high prevalence areas  to undergo continuing medical education and certification in HIV testing and treatment. 

-          The White House Office of National AIDS Policy to convene a high-level consultation on young black gay men and HIV with the full participation of the National HIV/AIDS Strategy coordinating agencies.

-          The White House to reconvene it’s meeting on HIV and Black Men, to include Black Women, and to develop a specific strategy on ending the health disparity of HIV among African Americans.

-          The NIH Office of AIDS Research to develop and issue a high priority research plan to address HIV among gay men, especially African American and Latino gay men in the United States, including using novel technologies and strategies to lower the viral load and prevalence in these communities.

Availability for comment: 

Ernest Hopkins, Chair, NBGMAC & Director of Legislative Affairs, San Francisco AIDS Foundation, 415-987-8855

Cornelius Baker, Senior Policy Advisor, NBGMAC, 202.489.7490