CDC releases subpopulation estimates from data on annual new HIV infections; new infections high among blacks, MSM

Sep 15 2008

The majority of new HIV infections in the U.S. in 2006 occurred among men who have sex with men, according to a study released Thursday in CDC's Morbidity and Mortality Weekly Report, the New York Times reports.

In addition, blacks have the highest incidence rates of any racial and ethnic group in the U.S. The study was a follow-up to a CDC study released last month that found there were about 56,300 new HIV infections in 2006, the most recent year for which data are available (Harris, New York Times, 9/11).

According to the study, 72% of new HIV infections in 2006 among men were contracted through male-to-male sexual contact, including 81% of new infections among white men, 63% among black men and 72% among Hispanic men. Among MSM with new HIV infections, 46% were white, 35% were black and 19% were Hispanic, according to the study (Fox, Reuters, 9/11). Blacks accounted for 46% of all new infections in 2006, although they account for 12% of the U.S. population, the study said (New York Times, 9/11).

The study found that the number of new HIV infections among black MSM ages 13 to 29 is about twice that of white or Hispanic MSM in the same age group. Most new infections among black and Hispanic MSM occurred in men ages 13 to 29, while most new infections among white MSM occurred in men ages 30 to 39, followed by those ages 40 to 49 (Fernandez, San Francisco Chronicle, 9/12).

Girls and women accounted for 27% of all new HIV infections, and 80% of new infections among girls and women were transmitted through high-risk sexual contact with men, the study said. Among women, 61% of new infections occurred among blacks, 23% among whites and 16% among Hispanics (Reuters, 9/11). The rate of new infections among black women is almost 15 times higher than among white women; the rate among Hispanic women is nearly four times higher than white women, the study said (New York Times, 9/11).

An accompanying CDC fact sheet discusses redoubling HIV prevention efforts, especially among the black community, adding that the "alarming number of new infections among young black MSM underscores the need to ensure that each new generation has the knowledge and skills to prevent HIV infection beginning early in their lives" (Reuters, 9/11). The fact sheet also noted that HIV prevention efforts have not reached 80% of MSM in 15 cities nationwide. CDC recommended increasing HIV testing programs and strategies to target prevention efforts toward people at high risk of HIV transmission (New York Times, 9/11).

Reaction

Kevin Fenton -- director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention -- said CDC already has designed two prevention programs targeted toward black MSM, adding that other programs can be adapted for other groups. "We've already put in place a number of interventions," Fenton said, adding that the "response has already begun." According to Fenton, CDC this year will begin promoting HIV testing specifically to blacks. He added that he will testify in congressional hearings next week about the need for increased HIV/AIDS prevention funding (Lauerman, Bloomberg/Philadelphia Inquirer, 9/12).

Fenton said the study serves as a "powerful reminder that the U.S. epidemic of HIV disease is far from over" (New York Times, 9/11). Fenton said the study will help health workers more effectively target prevention messages to "ensure that HIV infection doesn't become a rite of passage" for young MSM. Public health officials "need to reach each new generation ... early in their lives to provide the knowledge and skills they'll need to prevent [HIV] infection," Fenton said, adding, "At the same time, we must develop strategies for keeping [older MSM] HIV-free for life."

Richard Wolitski, acting director of CDC's Division of HIV/AIDS Prevention, said the high number of new infections among younger MSM can be attributed to factors such as a "lack of access to effective HIV prevention services and underestimation of personal risk." He added that "many younger men have not personally experienced the severity of the early AIDS epidemic" (San Francisco Chronicle, 9/12). The Times reports that young black men are more likely to have been incarcerated, and HIV/AIDS among former inmates is high primarily because of behaviors outside of prison, according to studies. According to Wolitski, young black MSM, more so than white MSM, also tend to have partners who are older and therefore more likely to already be living with HIV (New York Times, 9/11).

Phill Wilson, CEO of the Black AIDS Institute, said CDC's response is insufficient to address HIV/AIDS among the black community. "The fundamental question is, 'Why aren't we doing a better job of responding to the epidemic in black America?'" Wilson said (Bloomberg/Philadelphia Inquirer, 9/12). Mark Cloutier, CEO of the San Francisco AIDS Foundation, said that the "house has been on fire for African-American gay men for many years," adding that HIV "keeps spreading" among black MSM but health workers "aren't bringing the fire corps to it" (San Francisco Chronicle, 9/12).

The study is available online.

A kaisernetwork.org interview with Fenton from the XVII International AIDS Conference about the updated HIV incidence numbers is available online. A kaisernetwork.org interview with Wilson from the XVII International AIDS Conference about the updated HIV incidence numbers also is available online.