Newsday - January 24, 2001
Laurie Garret, Staff Writer

The HIV epidemic appears to be on a dangerous upswing in New York City among young, gay, African-American men, according to new city Health Department data obtained by Newsday.

A department survey of gay men aged 23 to 29 years finds that the city apparently is witnessing the strongest upturn in HIV infections in the nation.

Most striking are the racial differences the survey of 542 gay New Yorkers identifies: 2 percent of the gay white men were HIV-positive versus 14 percent of the Latinos and 33 percent of the African- Americans in that age group.

Further, the survey used sophisticated new HIV tests, called detuned ELISAs, to sort out those men who became infected within six months before being tested-new HIV cases. Health department analysts declined to interpret the figures, pending further analysis. However, "lgny," a publication of the lesbian and gay community of New York, submitted the city's raw data to epidemiological analysis and found that 4.5 percent to 6.3 percent of young gay men in the city were becoming newly infected each year, compared with less than 1 percent of gay men nationally and 3.7 percent annually in San Francisco-the city with the largest population of gay men in the United States.

"I think it is a disaster," said Ronald Johnson, associate director of the city's Gay Men's Health Crisis. "I suspect that New York may have a bigger problem than in other cities." But he said that if other cities would do similar detailed analysis by race and ethnicity, "we might not see New York stand out quite so clearly."

The New York City study is scheduled to be released at the Conference on Human Retroviruses, convening in Chicago in two weeks. Study director Lucia Torian described the survey in detail yesterday for Newsday.

Health department scientists visited gay bars, video clubs, dance clubs and other well-known social centers of the homosexual community between March, 1999, and July, 2000. Study participants agreed to answer lengthy questionnaires and submit to an HIV test. All of those who tested positive for HIV were immediately offered guidance for treatment and social services.

No HIV-positive Asian men were found. Among the white men, 2 percent proved to be infected, Torian said. "This is lower than we expected," she said. "We don't have a solid explanation for that because we don't see the kinds of differentials in behavior between black and white men to explain this."

"We really tried to mine the data set" to figure out why the African-American infection rate was so high, Torian said. But nearly every behavioral factor usually associated with the risk of contracting HIV was either lower among the blacks compared with the whites or about equal. Intravenous drug use, male prostitution, histories of having syphilis or gonorrhea, lack of knowledge about HIV, having large numbers of sex partners-all of these risks tended to be lower among the African-Americans. African-American men also showed a better understanding of the relationship between being treated for AIDS with available drugs and the risk of passing HIV; white males in the survey were more likely to believe, mistakenly, that treatment eliminated the risk of passing the virus and could cure the disease.

All racial groups displayed an alarming tendency to risk having sex without using a condom. Ninety-six percent admitted to having done so with a gay partner at some time, Torian said, and 58 percent acknowledged having done so within the previous six months.

One clear difference that did emerge in the survey was jail time. While 18 percent of the surveyed white males said that they had spent at least one night in jail, 39 percent of the Latinos and 47 percent of the African-Americans had served time in jails or prisons.

"We're calling this issue, 'Our House Is on Fire,'" said Tony Spencer of the National Black Leadership Council on AIDS. "HIV/AIDS is so prevalent among prison populations. And in most of the prisons in New York State they aren't even treating HIV. Condoms are not distributed."

A 1999 report from the federal Centers for Disease Control and Prevention found that 29 percent of all deaths in U.S. prisons were due to AIDS, 17 percent of all men released from prison in 1996 were HIV-positive, and 57,000 inmates were HIV-infected in 1997. There were no figures on numbers of inmates who contracted HIV during incarceration.

Dr. Pauline Thomas, assistant New York City health commissioner, cautioned against assuming that the higher HIV rates in African- Americans and Latinos could be explained by their histories of incarceration.

New York's black leadership expressed shock at the numbers. The Rev. Al Sharpton said that "to have such a disproportionate situation, with 33 percent of the black men infected versus just 2 percent of white men, is an absolute crisis. I think it would be a challenge for us to respond, and the appropriate response would be a crisis one, including calling for government disaster relief."

Hazel Dukes, chair of New York State's division of the National Association for the Advancement of Colored People, has served for two years on the Black Leadership Council on AIDS. She said she found the numbers "absolutely astounding. It's shocking to me because we're not burying our heads in the sand on this anymore. No!"

Five years ago much of the black political and religious leadership in New York and the rest of the nation shunned the entire HIV/AIDS issue, Dukes noted. But two years ago the Congressional Black Caucus garnered funds for all-out campaigns in the African- American community, and New York City has been a major recipient of federal dollars for AIDS education. To see HIV rates climbing, after all those education efforts, "is disheartening and astounding," Dukes said.

But Pernessa Seele, chief executive officer of Balm in Gilead, which was founded a decade ago to promote the active involvement of black church leaders in New York in the battle against AIDS, dismissed the AIDS education efforts as "wholly inadequate."

For Johnson, a gay African-American, talk of AIDS education in the black community has rarely seemed genuine. He argues that "prevention efforts have never been targeted adequately to gay men of color. We're reaping what we sow with these horrific numbers. I think this is the legacy of not providing adequate support for efforts aimed at gay men of color."

Dr. Thomas Weisfuse, associate commissioner for disease intervention for New York City, said the take-home message of the study is that much more attention must be given to funding groups that reach out to young, gay, black and Latino men. It is an effort, he said, that must rapidly escalate, "regardless of who the next mayor is, of who is in Washington, D.C."

Two other reports released by the Department of Health in December cited a 2.1 percent increase in deaths due to AIDS and an increase in syphilis cases, with the highest rates seen in gay, white men living in Manhattan. The latter statistic was viewed by officials as an indication that unsafe sexual practices in the gay white community, particularly among men aged 35 to 50, were on the upswing. National figures in 2000 saw several clusters of syphilis emerge in that group of gay men, as well as an upsurge in gonorrhea rates in the white, middle-aged gay group.

The death-rate increase came after five years of steadily declining AIDS death rates in the city, and was viewed as indication of either eventual failures in HIV drug cocktails used to treat the disease or of an increase in the number of people diagnosed too late to benefit from therapy.

A Surge in HIV

A recent survey of gay men in New York City shows that at least 4.5 percent test HIV-positive. Following are results by race and by risk.

010124
ND010103

Copyright © 2001 - Newsday. All rights reserved. All pages of newsday.com are copyright © Newsday, Inc. Other parties may also own rights to portions of newsday.com content. No portion of newsday.com content may be published, broadcast or distributed, directly or indirectly, in any medium without Newsday's prior written consent. Newsday, Inc. will not be held liable for any delays, inaccuracies, errors or omissions in any content on newsday.com. http://www.newsday.com.

ÆGiS is made possible through unrestricted grants from Roxane Laboratories, Inc., iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1990, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.