San Francisco Chronicle - September 12, 2008
Elizabeth Fernandez, efernandez@sfchronicle.com.

A new, detailed picture released Thursday of the swath of HIV infections nationally illustrates the severe impact the virus is taking on young black gay and bisexual men, black women, and white gay and bisexual men in their 30s and 40s.

The report by the Centers for Disease Control and Prevention, for the first time breaking down new infections in terms of race, gender and age, shows an alarming prevalence of the disease in young black men. The report found that the number of new infections in black gay and bisexual men 13 to 29 years old is roughly twice that of white or Hispanic gay men in the same age group.

"The house has been on fire for African American gay men for many years," says Mark Cloutier, chief executive of the San Francisco AIDS Foundation. "It keeps spreading, and we aren't bringing the fire corps to it."

The new analysis - based on 2006 figures, the latest available - also shows that among Hispanic men who have sex with other men, most new infections are occurring in the 13-29 age group. Overall, white gay men account for almost half the number of new HIV cases with most of them among white men 30 to 39 years old, followed by those 40 to 49 years old.

Additionally, the report found that while there were fewer new HIV infections among black women than black men, black women are disproportionately affected by HIV compared with women of other races, with an incidence rate nearly 15 times as high as white women and nearly four times as high as Hispanic women.

The study augments a CDC report last month that documented a significantly higher-than-expected rate of new HIV infections in the United States in 2006 - 56,300 actual infections compared with the estimate of 40,000.

"In short, we learned that the HIV epidemic is worse than was previously known," said Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention during a telephone news conference Thursday.

He said the report will help public health experts more directly target prevention efforts to "ensure that HIV infection doesn't become a rite of passage for young gay and bisexual men."

"That means we need to reach each new generation ... early in their lives to provide the knowledge and skills they'll need to prevent infection," Fenton said. "At the same time, we must develop strategies for keeping (older gay men) HIV-free for life."

Dr. Richard Wolitski, acting director of the CDC's Division of HIV/AIDS Prevention, said new infections can be attributed to such factors as "lack of access to effective HIV prevention services and underestimation of personal risk."

"Many younger men have not personally experienced the severity of the early AIDS epidemic," he said.

Bay Area experts said the report underscores the critical need to educate the young.

"For some time, we've tried to come up with strategies to get young people to take fewer risks and to make smart decisions with their partners," said Jimmy Loyce, executive director of the San Francisco-based Black Coalition on AIDS. "Young people still believe they are bulletproof - it happens to other people, not to them."

That's how Phillip Garcia felt when he was a teenager. Now 22, Garcia, who is African American and Hispanic, learned in December that he is HIV-positive.

He said he probably contracted the virus when he was 15 or 16, and living in Texas, his home state.

"As I got further into my teens, I became more cautious and more educated, but by then, it was too late," said Garcia, a freshman at UCSF who is studying fashion design. "In the black and Latino communities, there is a sense of machismo - a lot of men don't disclose that they are having sex with other men. We need to better inform young people. Sexual experimentation is beginning so early for a lot of kids. I don't think the message is being delivered as strongly as it should be in school or at home."

Ryan Fails said he never got the message when he was growing up in Ohio. Nor did he pay much heed when he was in his early 20s and living in Washington, D.C.

Fails, 27, who is white and African American, learned he had HIV two years ago.

"In school, there was more focus on teen pregnancy and things like syphilis and crabs," said Fails, a San Francisco resident who worked as a political consultant. "We really didn't go into AIDS. I never thought that AIDS applied to me."

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