African-American gay men are more than twice as likely to be infected with the AIDS virus than their white counterparts, but the reasons aren't abundantly clear, federal researchers said yesterday.
"Men who have sex with men account for almost half of all people estimated to be living with HIV in the United States, and African-Americans are the most heavily impacted," said Kevin Fenton, director of HIV prevention at the Centers for Disease Control and Prevention in Atlanta.
Researchers at a national prevention conference yesterday said they were somewhat perplexed by the disparity. A recent study found little difference in the rates of unprotected sex among black and white homosexuals, though the practice was common among both groups.
But new studies point to possible reasons. Black gay men in one study were more likely to be currently infected with a sexually transmitted disease, which can make them more likely to catch or transmit HIV.
Blacks were also less likely to be taking anti-retroviral medications, which can lower the concentration of virus in the bloodstream, and with it the chance of transmitting it to others.
Two years ago, a CDC study of 1,700 gay men in five cities found that 25 percent overall were infected with HIV, compared with well under 1 percent in the general population. Almost half who tested positive were previously unaware of their infection.
Overall, 46 percent of black gays and bisexuals were infected with HIV, twice the rate among whites.
In Baltimore, 8 percent of the men interviewed had become infected in the previous year - the highest rate in any of the cities surveyed.
When the epidemic first surfaced in the early 1980s, the virus devastated gay communities. Homosexual men remained the leading risk group for several years, until safe-sex education lowered the infection rate and the virus made more inroads among needle-sharing drug addicts.
But in Maryland, a shift has taken hold. In 2005, gay men accounted for a larger percentage of new infections than intravenous drug users - the first time that has happened in over a decade.
Heather Hauck, director of the state AIDS Administration, blamed the trend partly on a decline in federal prevention dollars. She said the decline has forced the state to make difficult choices about where it spends its money.
"I believe we have not been able to direct adequate resources to all of our population in Maryland," Hauck said. "We do not have the resources to do adequate prevention for everyone."
But the agency did create a program to curb risky sexual practices among black gay men. Two-day courses have been given to almost 100 men at The Portal, a center for black homosexuals, bisexuals and transgender people on Greenmount Avenue.
Rickie Green, the group's director, said the program is aimed at creating a more positive self-image among men who suffer the stigmas of being both black and gay. Men who are beaten down by prejudice may think that there's no point practicing safe sex, he said.
The program's goal is to "unlearn some of those negative messages and replace them with courage, mental health therapy, critical thinking and a plan of action," Green said.