By Dann Denny
The Herald-Times
BLOOMINGTON, Ind. — A new government study found that the rate of HIV infections diagnosed in the United States each year has dropped by one-third over the past decade, but an IU researcher says the data is hardly cause for celebration — mainly because the infection rate has increased in young men who have sex with other men.
The study, released online last week by the Journal of the American Medical Association, found that 16 out of every 100,000 people ages 13 and older were newly diagnosed with HIV in 2011, a 33 percent decline from 2002, when the diagnosis rate was 24 per 100,000 people. The actual number of new HIV cases declined as well, from more than 56,000 in 2002 to just over 43,000 in 2011.
The data show declines in HIV infection diagnoses rates among men, women, whites, blacks, Hispanics, heterosexuals, injection-drug users and most age groups. But diagnoses rates increased among young gay and bisexual men ages 13 to 24, where the number of HIV diagnoses each year rose 132 percent — from nearly 3,000 in 2002 to almost 7,000 in 2011.
“We have made some strides, but we still have a long way to go,” said Brian Dodge, associate professor in Indiana University’s School of Public Health. “I would say the next AIDS generation will be young men having sex with men, which includes men who have sex with both men and women.”
Dodge said young males having sex with other males often feel emboldened and invincible because they did not live through the early years of the AIDS epidemic, when an AIDS diagnosis was tantamount to a death sentence.
“They are living in an era when they assume you can take a pill for HIV and everything will be fine,” he said. “They also are living in a time when the social networking sites are encouraging the practice of unprotected sex, creating a lot of peer pressure to become involved in very risky behaviors.”
Dodge said among the group of men having sex with other men, there are certain demographic, behavioral, economic and biological factors that can push their rates of HIV infection even higher.
He said low-income, nonwhite men who engage in unprotected sexual activity — particularly those who are biologically more predisposed to become infected with sexually transmitted infections — make up a subset of men that is highly susceptible to HIV infection.
“Young, black, poor men who have sex with men make up the subgroup most at-risk for HIV infection,” he said.
Dodge said we, as a society, need to do more to help the high-risk group of men than simply promoting condom use.
“We have to help them find jobs and a purpose in life,” he said. “They need to not only know how to protect themselves from HIV infection, but a reason to protect themselves .... and their partner.”
Dodge said there is a powerful correlation between HIV infection and socio-economic status, adding that unemployment is one of the strongest predictors of undiagnosed HIV infection.
“The link between HIV and low socio-economic status probably comes down to a lack of access to medical treatment and other contextual factors,” he said.
The World Health Organization estimates that 35 million people in the world have the HIV virus, which destroys the immune system and can cause AIDS. In the U.S., 1.1 million people are thought to be infected, though far fewer than that number have actually been diagnosed.
‘We must be doing something right’
The study is based on HIV diagnoses from all 50 states’ health departments, which get test results from doctors’ office, clinics, hospitals and laboratories. The data span a decade, making this a longer look at these trends than any previous study, according to the CDC.
It found that among the overall U.S. population, the HIV diagnosis rates dropped over the past decade even though the percentage of adults being tested rose during that time, from 37 percent in 2000 to 45 percent in 2010, according to CDC data.
“This is an encouraging trend, and it shows we must be doing something right,” Dodge said. “There are other areas of the world, such as sub-Sahara Africa, where the rate of HIV infection is continuing to rise.”
Dodge said people today have more access to information about the importance of protective sexual behavior and are benefiting from recent pharmaceutical innovations that can help prevent HIV infections through prophylactics.
“And once someone becomes infected with the HIV virus, there is less of a stigma associated with medications and anti-viral treatments,” he said. “People are not hiding their medicine bottles like they once did.”
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(c)2014 the Herald-Times (Bloomington, Ind.)
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