HIV Rising Among Young Gay Men in New York

NEW YORK, Sept. 13 -- Young gay men are having a sharp increase in new HIV infections here, city health officials said.

Over the past six years, the total number of new HIV diagnoses among gay men under 30 has risen 33%, from 374 in 2001 to 499 in 2006, according to Thomas Frieden, M.D., the city's health commissioner.

On the other hand, new infections among men who have sex with men but are 30 or over fell by 22.2% over the same time period - from 829 in 2001 to 645 in 2006.

All the 2006 numbers are based on a projection from the first three quarters of that year, the city said.

"We're headed in the wrong direction," Dr. Frieden said. "Unless young men reduce the number of partners they have, and protect themselves and their partners by using condoms more consistently, we will face another wave of suffering and death from HIV and AIDS."

The increase parallels a similar spike in new syphilis cases among gay men in the first quarter of 2007, but that increase affected both young and old men. (New York Reports Spike in Syphilis Cases)

The HIV increase among young men should not come as a surprise, according to Donna Futterman, M.D., director of the adolescent AIDS program at the Children's Hospital at Montefiore in the Bronx.

"There's lots of evidence of higher rates (of HIV) in this group," she said, although she added that one possible interpretation of the data is that the city health department is getting better at offering testing to young gay men.

But on the basis of her experience, she said, "there's no question more kids are getting infected."

New York is a "harbinger" of increased rates of HIV among young men nationwide, she said, adding that elsewhere "people are definitely seeing a resurgence."

Part of that increase is driven by the fading of the worst horrors of the HIV/AIDS epidemic combined with better treatment, Dr. Futterman said, and part is driven by a comparative lack of resources aimed at educating young people about safe sex.

Dr. Futterman added that in order to offer appropriate counseling clinicians treating adolescents should be asking directly whether they have sex with men, women, or both.

In New York, the city reported, the greatest burden of the new infections is borne by blacks and Hispanics.

In 2006, 101 young whites were diagnosed with HIV, compared 232 blacks and 157 Hispanics, city officials found.

The disparity was even larger among adolescents - 81 of 87 (93%) of the gay men under 20 who were diagnosed with HIV in 2006 were black or Hispanic.

In order to tease out recent trends in HIV infection, the analysis excluded gay men who were diagnosed with HIV and AIDS at the same time - usually an indication that the HIV infection is of relatively long duration.

But the city found that in 2006, 20% of gay men newly diagnosed with HIV were diagnosed with AIDS at the same time.

A CDC spokesman said the agency has "seen signs of possible increases in HIV among young (men who have sex with men) in the U.S." and especially among young black gay men.

In the 2005 -- the latest year for which national figures are available - men who have sex with men accounted for 49% of all new HIV diagnoses, and 67% of those among men.

Also, the agency said, in a 2005 survey of gay men in five major cities -- Baltimore, Los Angeles, Miami, New York, and San Francisco - about 25% were HIV-positive.

But as in New York, blacks in the five-city study were particularly hard-hit, with 46% testing positive.

Also, about half of HIV-infected men in the study didn't know they were infected, a figure that rose to 67% among blacks and 48% among Hispanics.

Young gay men - ages 18 to 24 -- were least likely to know their status: almost 80% did not know they were HIV-positive, the agency said.