HIV epidemic among young men unabated because many are unaware they are infected

U.S. health officials say many young gay and bisexual men who are HIV-positive are unaware they have the virus.

A study by the Centers for Disease Control and Prevention (CDC) in Atlanta, of more than 5,600 men between the ages of 15 and 29 found that more than three-quarters of those who tested positive for HIV were unaware they were infected and, of more concern, the majority of these men had considered themselves at low risk of having the AIDS virus, half had had unprotected sex with another man during the previous 6 months.

The implication of these results is that the HIV epidemic among young gay and bisexual men which "continues unabated," could be partly explained because many are ignorant of their infection.

Duncan A. MacKellar and his colleagues in their report found that the high rate of unrecognized HIV infection can in part be blamed on the low rate of regular testing for the virus, and even though many men in the study had undergone HIV testing in the past, few had regular tests done.

Even though experts recommend people at high risk of HIV be tested for the virus and other sexually transmitted diseases at least once a year. Only a minority of those who were unaware they were HIV-positive had been tested in the past year.

MacKellar says limited access to healthcare and the fear of testing positive, may be contributing factors.

Gay and bisexual men were recruited for the study from various venues, including bars, parks, cafes and stores, in 6 U.S. cities. The men were surveyed about their sexual behaviour, their perceptions of their own HIV risk and how many times they had been tested for the virus. They also gave blood samples for testing. Ten percent of the group were found to be HIV-positive, and 77 percent of those had been unaware they were infected.

The researchers do say however that their figures are not necessarily a reflection of gay and bisexual men across the U.S., in fact, previous household-based studies have found lower rates of unrecognized HIV infection.

MacKellar however still maintains that the fact that so many men in this study were unaware of their infection "underscores the urgency" of increasing HIV testing among young men who have sex with men.

The researchers suggest that HIV testing at venues such as clubs and bars may help reach more men with unrecognized infection and Health departments and community groups are presently working to expand such outreach programs to ensure that people actually get their test results by using newer, rapid HIV tests that provide results in 20 minutes.

According to MacKellar it is also important for individual doctors to routinely recommend HIV testing to patients who might be at increased risk, and says the CDC is working with providers to make HIV testing a more routine part of healthcare.

The full report is published in JAIDS Journal of Acquired Immune Deficiency Syndromes, April 15, 2005.