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HIV numbers still highlight racial disparity
Extended for the Online Edition
by David Ernesto Munar
2008-08-06


MEXICO CITY ( Aug. 2 ) —Forty percent more people in the United States were infected with HIV than previously estimated in 2006, federal researchers announced ahead of the 17th International AIDS Conference.

The analysis, published in the Aug. 6 issue of the Journal of the American Medical Association ( JAMA ) , determined that 53 percent of 2006 infections resulted from male-to-male sexual contact. By race and ethnicity, 45 percent were believed to occur among Black individuals and 17 percent among Hispanics.

Rumors about the new figures led federal officials to lift an embargo on the data ahead of the official briefing to reporters about the research findings. AIDS activists had called for the release of the new data for nearly a year and speculated openly at the December 2007 National HIV Prevention Conference whether the release had been intentionally suppressed to shield the federal government from criticism for rising HIV infection rates.

'This improved estimate means little if it does not serve as the spark to inflame our collective anger about the deadly neglect of an acute emergency,' said Mark McLaurin, board member for the Community HIV/AIDS Mobilization Project ( CHAMP ) . 'This week, President Bush signed a new global AIDS bill, but persistent underfunding and restrictions here at home tie our hands in combating the epidemic in our own backyard.'

The new figures suggest escalating rates of infection among African American and Latino gay men, populations McLaurin and others said have been virtually ignored by government HIV prevention programs.

'The time to argue whether this is a Black epidemic or a gay disease is over. It's absolutely and distinctly both, as we will see in this new data,' said McLaurin. 'And if you are a young, gay Black man, the likelihood that you will encounter HIV is staggeringly high, even if your personal behavior is no more 'risky' than people in other communities.'

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AIDS advocates noted that only four of 49 HIV prevention interventions endorsed as 'effective or highly effective' by CDC researchers target gay men. And none of the 49 were designed for gay men of color.

'Where infection rates for other populations are holding steady or showing slight declines, HIV infections among gay men tragically continue to climb, said Jim Pickett, AIDS Foundation of Chicago advocacy director. 'This is a direct result of years of policy and programs that demonize and ignore the sexual health needs of gay men, especially African-American and Latino gay men who bear the brunt of the epidemic in the U.S.'

Others called the new findings a wake-up call for the U.S. to develop and implement a more rigorous approach to achieve progress on anti-HIV efforts in the United States.

'Our country has no national AIDS strategy; flat, and then actually declining, funding for HIV prevention; persistent, Jesse Helms-era restrictions on proven means of effective prevention; and the pernicious intersection of HIV and major social injustices, such as mass imprisonment, said Walt Senterfitt, CHAMP board chair of Los Angeles in a statement.

'Shortly after this announcement, Sens. [ John ] McCain and [ Barack ] Obama will speak at Rick Warren's Saddleback Church, where they will face questions on HIV/AIDS,' he added. 'Will they take this opportunity to call out for bold measures in the domestic epidemic, including a national AIDS strategy, full funding for honest HIV prevention and groundbreaking research, and an end to homophobic abstinence-only-until-marriage programs? Or will they continue to relegate the domestic epidemic to the back-burner of this campaign?'

Researchers used back-calculation methods to estimate annual HIV infection trends as far back as 1977. The analysis shows that U.S. HIV infections peaked at 130,000 infections annually in the early 1980s, dropped to 85,000 from 1985 to 1990, and then fluctuated between 50,000 to 60,000 from 1990 to 2006.

Annual HIV infections among Black individuals peaked at 45,000 cases as early as 1985, surpassing infections among white individuals estimated at 31,000 that year. HIV infections among Latinos also peaked in 1985 at 18,000 annual infections.

By mode of transmission, infections among men who have sex with men ( MSM ) led all other risk groups in the 1980s, declined in the early 1990s, below the number of infections estimated for injection drug users ( IDUs ) , and then increased again as the leading mode of transmission in 1994. Annual HIV infections for MSM have steadily increased since 1994. IDU cases declined slightly since 1994 and heterosexually acquired HIV infections also began to decline in 2000.

David Ernesto Munar is on assignment covering the International AIDS Conference in Mexico City for Windy City Times. He is a vice president at the AIDS Foundation of Chicago and chairs the board of the National Association of People with AIDS.

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