Miami Herald - Friday, June 1, 2001
Tony Pugh, herald Washington Bureau

The study of young men who have sex with other men found that 4.4 percent -- about 1 in 25 -- became infected with HIV each year in the late 1990s. That is about the same as infection rates in the mid-1980s, before AIDS prevention methods and awareness began to dramatically cut back new infections.

Among blacks in the study, the infection rate was almost 15 percent, nearly 1 in 7 gay and bisexual men. That's more than four times the rate for Hispanics (3.5 percent) and nearly six times the rate among white non-Hispanics (2.5 percent).

Linda Valleroy, the epidemiologist with the Centers for Disease Control and Prevention in Atlanta who led the study, said that while the 4.4 percent overall rate is worrisome, the 14.7 level among blacks is "explosive."

The findings, she said, indicate that the HIV "epidemic among men who have sex with men, and among African-American men in particular, is growing worse."

The report focused on men ages 23 to 29 in Miami, Baltimore, Dallas, Los Angeles, New York and Seattle.

Social worker Anthony McWilliams says he sees it every day -- a new generation of gays and bisexuals numb from years of endless AIDS statistics and warnings about the epidemic.

"It becomes blah, blah, blah -- noise to them," said McWilliams, a counselor for AID Atlanta. "It's just not getting through to them.

They need to hear it a new way."

The 4.4 percent infection rate is a marked increase from the 2 to 3 percent rates of the early 1990s, Valleroy said, and is similar to rates found in eastern and southern Africa in the early 1990s. HIV infection rates now exceed 20 percent in Africa, she said.

The study found that more than half the estimated 40,000 new U.S. HIV infections each year now occur among blacks, who make up only about 12 percent of the population. Hispanics, who also constitute about 12 percent of the population, account for 19 percent of new infections. White non-Hispanics, who make up more than 70 percent of the population, account for just 26 percent of new HIV cases.

GROWING

"In our community HIV/AIDS has been growing significantly in the African-American population," said Dr. Michael Kolber, director of adult HIV services in the University of Miami Department of Medicine.

A lack of education about preventing AIDS in lower socioeconomic groups is largely to blame, Kolber said. "If you look at the dollars that are going into educating and preventing infection in these populations, they are dramatically less than the money going into treating those with the disease," Kolber said.

Funding and attention are focused on developing techniques for managing AIDS, for helping patients improve their adherence to the complicated drug regimens -- also important issues in poorer communities.

"The studies have demonstrated that adherence is diminished in people who are depressed, who are homeless, who are poorly educated," Kolber said. "That's a huge population."

Because of the stigma about homosexuality and AIDS in the black community, black gay men learn early not to talk about sexual problems, said Phill Wilson, executive director of the African American AIDS Policy and Training Institute at the University of Southern California in Los Angeles. Black gay men also are less likely to seek counseling, get tested for HIV or share knowledge of their positive HIV status with partners, Wilson said.

Campaigns to increase HIV testing have had only limited success, Kolber agreed, because of the stigma of infection. "Cultural differences are incredibly important," he said. "We need to know how to get into these communities, to make it OK to get tested, to give them places to go.

"I think we're trying, but it's almost as if we're at the beginning of the curve," Kolber said. "The disease is going wild in these lower socioeconomic groups, and it's going to get worse."

Since researchers first isolated the HIV virus that causes acquired immune deficiency syndrome in 1983, more than 22 million people have died from AIDS worldwide, said U.S. Surgeon General Dr. David Satcher. Today, AIDS is the leading cause of death in Africa and the fourth-leading cause of death in the world.

HISTORIC

"This could be the worst infectious disease outbreak in recorded history," Satcher said Thursday at a news conference to release the report.

Nationally, 774,467 AIDS cases have been reported in the United States and 450,000 people have died from it. Between 800,000 and 900,000 Americans are currently infected with the HIV virus.

About one-third are receiving treatment, another one-third know they are infected but don't receive treatment and the remaining one-third don't know they are infected, Satcher said.

AIDS prevention groups called the figures extremely disturbing, saying the country needs to devise new ways to reach young adults at risk.

Some South Floridians agree that many young people ignore the risk.

"The perception is how the book looks on the outside," said Juan Carlos Castillo, 27, of Northwest Miami-Dade. "When you are young, you think you are invincible and you think you can't be harmed.

People our age don't give it a second thought. If you look good, then it's OK, they say."

Eugene Carral, 21, a law student from Miami Springs who says he practices safe sex, says AIDS is absent from conversations among his friends.

"People stopped thinking about it. It's not even on the back burner in people's mind," said Carral.

Herald medical writer Christine Morris, staff writer Johnny Diaz and the associated Press contributed to this report.

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