SAN FRANCISCO -- A "second wave" of AIDS is spreading among young gay and bisexual men in San Francisco who were only in grade school when the AIDS virus first began to decimate America's gay communities.
And the rates of HIV infection are highest among the youngest men tested.
A new study by San Francisco's Department of Public Health was intended to check reports that increasing numbers of men in their late teens and early 20s were turning up at AIDS testing and treatment centers throughout the San Francisco Bay Area.
Researchers parked a recreational vehicle outside several San Francisco gay dance clubs and invited more than 250 patrons to have their blood tested and answer a survey. To their surprise, they found HIV-infection rates highest -- 14.3 percent -- among men age 17 to 19. The rate dropped to 14 percent among those age 20 to 22, then dipped to 10.4 percent for those age 23 to 25.
"That's the opposite of what we'd expect if there were no second wave of the epidemic," said epidemiologist George Lemp, who led the study. The overall rate of AIDS-virus infection among San Francisco gay men is roughly 50 percent.
The survey found that unsafe sex was a common practice among the young men. Bay Area health authorities and gay activists said that one reason was the notion that only the older generation -- in their 30s and 40s -- has the AIDS virus, so sex with peers is safe.
Tom Myers, spokesman for the Aris Project, a service group, said he believes homosexual and bisexual men fall into three groups divided roughly by age: Those older than 30 who were hit hardest by the virus when it circulated unchecked in the early 1980s; those in their 20s and early 30s who have always known safe sex, and those under 21 who missed most of the message.
But many young homosexual men do know about AIDS and safe sex and simply don't think they're at high risk, said Marty Fenstersheib, deputy health officer for the Santa Clara County health department. Others realize they're at risk but abandon caution when drinking or being pressured by partners.
"Giving the message over and over is not going to work anymore," Fenstersheib said.
AIDS education programs need to be recast to persuade people to change their behavior, said Dr. Sandra Hernandez, director of San Francisco's AIDS office. One-on-one counseling is more expensive, but may be more effective than billboard and television campaigns, she said.