HIV Infections Rise, Young Males Hit Hardest

Article excerpt

Like many American teenagers, Max Siegel didn't learn much about sex in school. In junior high school, Siegel says a gym teacher told boys in his class that sex is dangerous and it's better to wait until they "grow up and marry."

"Unfortunately, this abstinence-only lecture was the only education I received on the subject," Siegel says.

At 17, he began seeing a 23-year-old man. "The first time we had sex, I took out a condom, but he ignored it," Siegel says.

As a result, Siegel says he "contracted HIV from the first person with whom I consented to having unprotected sex."

In June, the Centers for Disease Control and Prevention (CDC) released data showing that young gay men like Siegel are being infected at startingly high rates. Among males age 13-24, HIV diagnoses increased 12 percent annually between 20012006.

"We're worried," says David Ernesto Munar, vice president of the AIDS Foundation of Chicago. "The trend data has confirmed our worst fears."

Other distressing news soon followed. In August, the CDC announced that it was wrong about the number of new infections in the U.S. There were actually about 56,000 people infected with HIV in 2006 - not 40,000 as previously estimated.

Who's getting hit the hardest? The CDC notes that the most affected groups were young black men who have sex with men (MSMs), white MSMs in their 30s and 40s and Hispanic MSMs. (Overall, MSMs account for 53 percent of new infections, heterosexuals account for 31 percent of new infections and injection drug users represent 12 percent of new infections.)

According to a September CDC Fact Sheet analysis of data reported in Morbidity and Mortality Weekly Report:

* "There were more new HIV infections in young black MSM (aged 13-29) than any other age/racial group of MSM. The number of new infections among young black gay and bisexual men was roughly twice that of whites and Hispanics.

* White MSM accounted for close to half (46%) of HIV incidence in 2006. Most new infections among white MSM occurred in those aged 30-39 ... followed by those aged 40-49.

* Among Hispanic MSM, most new infections occurred in the youngest (13-29) age group ... though a substantial number of new HIV infections were among those aged 30-39."

Understanding why infection rates are rising

The spate of bad news hasn't gone unnoticed in Atlanta, where Richard Wolitski, PhD, works as acting director of the Division of HIV/AIDS Prevention at the CDC.

"This is a wake-up call for the nation," Wolitski says. "We need to do more as individuals, as a community and a nation."

Asked why more gay men were contracting the disease, Wolitski cited several factors, including the failure of HIV prevention programs to educate MSMs. A recent CDC study found that 80 percent of gay and bisexual men in 15 cities hadn't received an "intensive HIV prevention intervention" in the past year.

"We're not reaching all the men that are at risk," Wolitski says.

On the subject of younger gay men, "Some data suggest teens view HIV as being a problem for older men and not so much of a problem for them," Wolitski says. "Also, as people begin their first sexual relationship, sex is often not anticipated and planned. Sometimes, youth are just not prepared to protect themselves in the heat of the moment."

And even when they are prepared, they need to have the skills to negotiate safe sex with their partners. Siegel, the HIV-positive man who contracted the disease as a teenager, had a condom and asked his partner that he use it.

"I knew enough to suggest a condom, but I did not have an adequate understanding of the importance of using one and even if I had more reasons to use a condom, I had no idea how to discuss condoms with my partner," he says. "The abstinenceonly message did not prepare me for life."

Siegel made his comments to the U.S. House Committee on Oversight and Government Reform in April. …