NYC gay HIV rates on the rise since 2001

By Duncan Osbourne

The city health department data is reporting that new HIV diagnoses among gay and bisexual men under 30 increased from 2001 to 2006 while such diagnoses among men who have sex with men (MSM) over 30 declined during that time.

“We are very concerned about the increase in HIV among young men who have sex with men,” said Dr. Thomas R. Frieden, the city’s health commissioner, in a press statement that was released on Sept. 11 and received scant coverage. “We’re headed in the wrong direction.”

New diagnoses among MSM aged 13 to 29 went from 374 in 2001 to 499 in 2006, a 33 percent increase. Diagnoses among MSM over 30 went from 829 in 2001 to 645 in 2006, a 22 percent decline. The 2006 data for both populations was estimated.

The increase was seen among black, Latino, and white gay and bisexual men under 30 and the decline among men over 30 was consistent across racial and ethnic lines. The largest increases were among black MSM.

New diagnoses among black MSM under 30 went from 168 in 2001 to 232 in 2006. Latino MSM under 30 went from 122 new HIV diagnoses in 2001 to 157 in 2006 and the numbers went from 75 in 2001 to 101 in 2006 among whites.

HIV diagnoses among gay and bisexual men under 30 increased in every borough except Staten Island since 2001. Queens and Manhattan saw the largest increases. The growth in Manhattan was concentrated in East and Central Harlem and in Chelsea and Clinton.

The increases among young men could result from more unsafe sex among those men, more HIV testing, or a combination of the two. The health department does not know the HIV incidence rate, or the percentage who are newly infected in each year, for these demographic groups, even though testing technology exists to identify recent infections.

The declines among men over 30 are not necessarily a sign of success. It could mean that most of the susceptible men in that population are already infected and the rate of new diagnoses is slowing as fewer men in that population are available to be infected. In epidemiology, this is called saturation.

Dr. Lucia V. Torian, the department’s associate director for science, discussed this data in June of 2006 and called it “preliminary.” The trend among young men was disturbing because so many in that pool are still uninfected.

“There is a very big susceptible population,” Torian said last year referring to men under 30.

The September 11 health department statement, which called the data “preliminary,” did not say if the city would commit any new resources to respond to this trend.

“We are absolutely asking that question,” said Wendy Stark, interim executive director at the Callen-Lorde Community Health Center, a gay clinic in Chelsea. “Additional funding is needed for prevention for young men. The prevention efforts that are happening now are clearly not working.”

Stark, Debra Frasier-Howe, president of the National Black Leadership Commission on AIDS, and Tokes M. Osubu, executive director at Gay Men of African Descent, an AIDS group, were quoted in the health department statement. Stark and Osubu said they were contacted for quotes roughly a week to 10 days before the statement was released.

“There was no mention of resources,” Osubu said. “They didn’t put it forth.”

In a later statement, a department spokesperson wrote, “We are in the process of developing a targeted awareness campaign to address young MSM.”

Stark and Osubu were already aware of the trend.

“It’s distressing, but for me it’s not new,” Osubu said. “On a weekly basis we’re seeing it, we’re seeing younger people getting infected.”

For Daniel Carlson who, along with Bruce Kellerhouse, organized a series of eight town meetings from 2003 into 2005 that collectively drew thousands to talk about gay men, drugs, and HIV, the data was just one more indicator of a crisis.

“What else do our leaders need to get that we are in a crisis?” Carlson wrote in a press statement. “Our leaders need to become better advocates for HIV prevention initiatives that support more creative and innovative ways of reaching gay men fast. We need their swift action and attention because we are losing.”

In a statement, the Gay Men’s Health Crisis (GMHC) noted that federal Minority AIDS Initiative funds for New York City were recently cut by 22 percent.

“Funding for HIV prevention and care continue to go down while infection rates increase,” Dr. Marjorie J. Hill, GMHC’s chief executive officer, said in a statement. “This is a formula for disaster.”