Young Gay Men and Black Gay Men Aren’t Staying on HIV Treatment

New study reveals less than 50 percent of HIV positive gay men are receiving treatment

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Recent analysis from the Centers for Disease Control and Prevention shows that only half (49.5 percent) of gay and bisexual men diagnosed with HIV in the United States are receiving treatment for their infection. And just 42 percent have achieved viral suppression – meaning their virus is under control at a level that helps keep them healthy and also greatly reduces their risk of transmitting HIV to others.

The findings – based on 2010 data and published recently in CDC’s Morbidity and Mortality Weekly Report – underscore the need for improvements at each stage of HIV care, from diagnosis to retention in care and support for treatment adherence.  

An HIV/AIDS prevention specialist with the CDC says this shows one of the most powerful tools to protect health and prevent HIV treatment is reaching only a fraction of gay men who need it.

“The findings underscore the need for improvements at each stage of HIV care, from diagnosis to retention in care and support for treatment adherence,” Richard Wolitski, Ph.D, Lead Behavioral Scientist, Division of HIV/AIDS Prevention, CDC told SFGN. 

In a released statement, Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, said, “It’s unacceptable that treatment, one of our most powerful tools for protecting people’s health and preventing new HIV infections, is reaching only a fraction of gay men who need it.”

The report reveals disparities in care for young gay men and black gay men:

  • Overall, among MSM diagnosed with HIV, three-quarters (77.5 percent) were linked to care within three months of diagnosis, but only half (50.9 percent) were retained in care. In large part because many were not in care, fewer than half of MSM diagnosed with HIV (49.5 percent) were prescribed antiretroviral therapy and only 42 percent achieved viral suppression. 
  • While 71 percent of young (aged 13-24) MSM diagnosed with HIV were linked to care, only 45.7 percent were retained in care. Largely as a result, fewer than one-third (30.5 percent) of those aged 18-24 (the most comparable age group for which data are available) were prescribed antiretroviral therapy, and just one-quarter (25.9 percent) achieved viral suppression (vs. 42 percent of MSM overall).
  • While 72 percent of black MSM diagnosed with HIV had been linked to care, only 46 percent were retained in care. Largely as a result, fewer than half (47.1 percent) of black MSM were prescribed antiretroviral therapy and just 37 percent achieved viral suppression (vs. 44 and 42 percent of white and Hispanic MSM, respectively).

The findings suggest that age-and race-related disparities in care and treatment may play a key role in the disproportionate burden of new HIV infections among young and African-American gay and bisexual men. High prevalence of HIV within these communities, coupled with low rates of viral suppression, means people in these groups are at higher risk of infection with every sexual encounter. 

“Factors such as economic barriers, stigma, homophobia and discrimination may deter these men from accessing medical care, which means they wouldn’t be getting the care and treatment they need,” said Wolitski. “While this analysis found that levels of engagement in HIV care are higher for Latino gay and bisexual men than for African American men, many HIV-infected Latino gay and bisexual men are not receiving the care they need.  As is a challenge for the Latino community, as a whole, complex social issues such as stigma and discrimination can also affect access to and willingness to stay in care. Additionally, language barriers can influence access to high-quality information and medical care.”

But the news isn’t all grim. Studies like this highlight the work that needs to be done.

“Stopping the spread of HIV among gay and bisexual men in the United States is CDC’s highest HIV prevention priority. We know that getting tested at least once a year and using condoms help stop the spread of HIV. Powerful new HIV prevention tools like pre-exposure prophylaxis (PrEP) have the potential to alter the course of the epidemic. And recent research shows that starting HIV treatment early not only helps people with HIV stay healthy, but can nearly eliminate the risk they will pass the virus to others during sex,” Wolitski told SFGN. “Today, one of CDC’s highest prevention priorities for gay and bisexual men is to ensure that every man infected with HIV knows it and receives effective care and treatment. At the same time, all gay men must have the knowledge and tools they need to protect themselves from infection. CDC is aggressively investing in scientifically proven technologies and approaches, and pioneering new technologies and solutions that will redefine the nation’s approach to HIV prevention. We fund state and local health departments, and community-based organizations (CBOs) across the country to reach those at highest risk with the strategies that can have the greatest impact – with more prevention resources now going to reach gay and bisexual men than any other population.”

Some of those resources include an 11-city MSM Testing Initiative to identify best practices for delivering HIV testing to gay and bisexual men. The CDC provided $55 million to community-based organizations to test an additional 90,000 young gay, bisexual, and transgender youth of color.

In addition, the CDC launched the Care and Prevention in the United States project – a three-year $44.2 million pilot program that is helping eight state health departments increase the number of people with HIV who receive ongoing medical care and treatment.

The agency has also released national communications campaigns, including several designed to increase testing among gay and bisexual men of color and, most recently, Start Talking. Stop HIV, which encourages all gay and bisexual men to talk openly with their sexual partners about HIV risk and how to identify the prevention strategies that are right for them.


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