AIDS crisis' 2nd wave?
Rise of HIV infections has some asking: Is the U.S. seeing ...
Young gay men are the most at risk, but many aren't being tested.
AIDS crisis' 2nd wave?
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By Devona Walker
Published: July 6, 2008
Nearly three decades after the AIDS crisis began, young gay males — and even more so young gay black males — continue to test positive for HIV at alarming rates.
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Youths don't see ravages
Diagnoses due to high-risk heterosexual contact declined by 4.4 percent nationwide in 2007. Among injection-drug users, diagnoses declined by 9.5 percent. Out of nearly 200,000 new diagnoses in the year, gay men represented roughly half, about 97,000 of the new cases.
Some experts suggest the spike might be generational.
"As the epidemic evolves, so do the obstacles. Now, there's a whole generation of youth who were not affected by the AIDS epidemic of the 1980s,” said Jennifer Ruth, a CDC spokeswoman.
Knight says this appears to be the case in Oklahoma.
He says many young people now coming of "sexual age” are more difficult for health educators to access.
He says they often feel less empowered than older men to convince their partners to take precautions.
Perhaps most importantly, he said, the severity of the epidemic has not been indelibly etched in their minds.
"Unlike the beginning of the epidemic, the younger folks are not seeing the ravages of HIV and AIDS. In the early '80s we would see the people on the TV with the lesions. People wasting away, looking all skeletal,” Knight said.
"There is a definite disconnect with what the virus means to the younger generation and what it meant to those of us who were there in the beginning.”
Another factor, according to the CDC, is an oversimplified optimism about treatment.
Though treatment has drastically delayed the onset of AIDS and has been effective against long-term illnesses associated with AIDS, the CDC cautioned that HIV infection will eventually lead to AIDS, which remains a fatal disease.
"Younger folks think that all you have to do is go and take some medication and you will be fine, without understanding the medications themselves come with a whole host of side effects,” Knight said, adding that many in the gay community are underinsured and cannot afford some of the prescribed medication.
Risky behavior, fearful populations
For young gay black men, the obstacles are even more poignant.
The access issues are more difficult to overcome.
The fear associated with testing positive, the lack of support if they do test positive and the tendency to be underinsured are even more pronounced.
And the contradictions, Knight said, are even more frustrating.
During Oklahoma City's Gay Pride weekend, a "primarily black gay” party was held at a local nightclub.
Weeks before the event, it was advertised that free and confidential HIV testing would be provided in a mobile unit during the evening.
Hundreds attended the party, but HIV educators only conducted 33 tests.
Two-thirds of those were for females, who are at a much lower risk than their male counterparts.
Out of the 11 remaining tests, Knight came up with two positives.
While treatment optimism is one factor, fear is another.
"It's like, ‘Do you people even have a clue about what you want to do? On one hand you want to act like it's not that big of a deal and on the other you are too scared to find out, so you can know what you need to do,'” Knight said. "From the CDC on down, there are things that are driving this epidemic that we just haven't figured out yet. We have the traditional culprits like poverty and lack of education but those have been the same from the beginning. There has to be something else besides just that.”
About 70 percent of the 2,000-plus men sampled in the CDC survey cited dread of finding out they were positive as being the reason they put off being tested.
"Most of these cases occurred in individuals under 25 years of age,” said Chris Rathbun, an infectious disease specialist at the University of Oklahoma Health Science Center.
"That's a difficult group to get into testing and a difficult group in terms of taking the information seriously. Many teenagers have this invincible mindset, and they don't think this is something that will happen to them.”
For this reason, Rathbun said fighting this second wave of infection could prove more difficult than the first.
Related Topics:
Health and Fitness, Medicine, Special Interest Groups, Sexual and Reproductive Health, HIV and AIDS, Sexually Transmitted Diseases, Contagious and Infectious Diseases, African-American Issues, GLBT Issues
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