(WASHINGTON) -- Despite decades of prevention efforts, HIV continues to increase among young gay men in urban areas, and most of these men are unaware they are infected, according to new data from the Centers for Disease Control and Prevention (CDC).
Researchers looked at survey data spanning from 1994 to 2008 on gay, bisexual and other men who have sex with men ages 18 to 29 years old living in Baltimore, Los Angeles, Miami, New York City and San Francisco, recruited from bars and nightclubs. The study focused on HIV prevalence as well as HIV testing.
They found that among those ages 23 to 29 years old, there was a trend towards increasing HIV prevalence from 1994 to 2008, with an overall prevalence of 16 percent.
“The fact that new infections increased somewhat in the 23- to 29-year-old age group indicates that this is a population that we need to be extremely concerned about and that we really need to be trying to reach them early with prevention so that we can establish healthy behaviors early on,” said Dr. Alexa Oster, lead author of the study and medical epidemiologist at the CDC.
Among gay men ages 18 to 22, the overall HIV prevalence was 11 percent, and this number remained steady over the 14-year time span of the study.
Why is there a lack of progress in stemming the epidemic among young gay men? It turns out there are many factors that lead to higher rates of HIV disease in the gay community at large.
As Dr. Chris Beyrer, director of the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health, explains, “there are structural, social and biological features that enormously favor transmission over prevention [among men who have sex with men].”
For young gay men in the United States specifically, certain external factors may put them at particularly high risk for HIV.
“There may be socioeconomic reasons that men are less likely to get into testing and care,” Oster said. “There may be issues related to stigma or homophobia. And all of those are important factors that may have a unique effect on the youngest populations.”
According to the CDC study, more than three-quarters of young gay men in urban areas were unaware they were HIV-positive, compared to 20 percent in the general population. While there were significant increases in the proportion of men who underwent HIV testing over the course of the study, “there is more work to be done,” Oster said.
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