Most study subjects with HIV were not aware of infection

Of 573 men determined to have virus, 77 percent didn't know it, CDC says


BARCELONA, Spain - The vast majority of young gay and bisexual men in the United States who were found to have the AIDS virus in a recent study were unaware of their infection, according to results reported as the 14th International AIDS Conference opened here yesterday.

The rates of awareness among minority gay men ages 15 to 29 in the study were staggeringly low. Among those studied, 90 percent of blacks, 70 percent of Hispanics and 60 percent of whites said they did not know they were infected with HIV, the virus that causes acquired immune deficiency syndrome.

Most of the infected men perceived themselves as being in a low risk category, despite having engaged in frequent high-risk sex such as unprotected anal intercourse, said Duncan MacKellar, an epidemiologist from the federal Centers for Disease Control and Prevention in Atlanta, which conducted the study.

The study involved 5,719 men who were interviewed at dance clubs, bars and other places frequented by gays in six cities: Baltimore, Dallas, Los Angeles, Miami, New York and Seattle. The study tested the men for exposure to the AIDS virus, finding that 573 had HIV. Of those, 440, or 77 percent, had said they were unaware they were infected. The results of the HIV tests were available to the men, but it is not known how many sought them or learned that they were infected.

"It is alarming that in the third decade of the epidemic we don't know why so few black gay men know their status," said Phill Wilson, executive director of the African-American AIDS Policy and Training Institute in Los Angeles. Wilson said more research was needed to send "the best prevention messages to ensure that these men know their risk and understand how to prevent infection."

The study's findings got the conference off to an unnerving start as health officials reported that the spread of HIV in the United States continued to be disproportionately high among blacks.

CDC officials, who are responsible for tracking the AIDS epidemic in the United States, reported that 55 percent of new HIV infections in 25 states from 1994 through 2000 were among blacks, who make up only 12 percent of the population in the United States.

In 2000, the latest year for which data is available, blacks accounted for 43 percent of AIDS cases, compared with 34 percent for whites and 21 percent for Hispanics, who are 13 percent of the population. Other ethnic groups accounted for the remaining 3 percent.

"The study shows that the very men who are at greatest risk of HIV infection are those who are least likely to think they are at risk," Wilson said. That's a direct call to develop not only new prevention messages but also new messengers."

Interviews by CDC epidemiologists with people who were recently diagnosed with HIV or AIDS showed that 70 percent reported having been sexually active within the previous year, with their use of condoms varying. Women with steady male partners were least likely to report condom use; 57 percent said they used condoms. Heterosexual men with more than one partner were most likely to report condom use - 75 percent. About two-thirds of gay men said they used condoms whether they had sex with a steady partner or more than one partner.

At the opening session of the International AIDS Conference, Dr. Peter Piot, an assistant secretary-general of the United Nations, said lack of knowledge was not the barrier to effective prevention and treatment of AIDS. "It's political will," said Piot, who directs the U.N. program on AIDS.

Piot said he was encouraged by the growing interest of government leaders in AIDS, which he said is now "a global political issue."

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