Why High HIV Rates in Black, Latino Gay Men?

Experts suggest that there are various cultural and economic reasons for increased infection numbers.

Posted:
 
(Continued from Page 1)

"Sex without a condom is the natural way to have sex. The condom is the extra thing," Bynes added. "Our job is to convince people to do the extra thing."

Though sex without a condom can lead to HIV infection, some gay men still take their chances. "A lot of guys have turned me down because I wouldn't have raw sex with them," Khalil Hodge, a 26-year-old Brooklyn, N.Y., resident, told The Root.

Then there's the example of the Bareback Brotherhood, an online community in which men gather to hook up and tell tales of their raw-sex experiences. As McCree explained, the rising infection rates can't be separated from "the environment and the context in which these behaviors occur."

Reaching for Solutions

But there is hope. According to studies by Truvada's manufacturer, Gilead, the pill -- part of a prevention regimen called pre-exposure prophylaxis, or PrEP -- when taken daily and combined with condom use and consistent physician care, is highly effective in preventing transmission of the virus. Many in the health care and advocacy communities are celebrating the existence of a new tool in the HIV-prevention toolbox in addition to other PrEP methods, such as microbicides, which are currently in trials.

"As a provider who sees patients, there's a diversity of those who like this or that delivery device, so I'm glad that I will have multiple contraceptives," Dr. Damon Francis of the East Bay AIDS Center and Oakland's Downtown Youth Clinic, told The Root. "It would be great with PrEP to have options that fit different lifestyles."

One of the drawbacks, however, may be the cost. At about $40 per pill, Truvada is $13,900 for one year's supply. "Two big challenges will be determining who will pay that $13,900 per year and who will be the providers to a population who generally aren't engaged with the health care system, aren't typically insured and don't have a regular doctor relative to other groups like seniors and women," Francis added.

And those aren't the only questions. AIDS Healthcare Foundation Director Michael Weinstein said that Truvada studies done in the United States demonstrated a 42 percent effective rate among men who have sex with men. He denied accusations that AHF has a financial reason for not supporting the drug but claimed that the drug is not quite a magic solution. "Adherence is a huge issue that will result in people thinking they're protected when they're not," Weinstein said. "And if they do become infected ... they will spread a resistant virus."

There is obviously still work that needs to be done on many fronts -- from education about prevention to searching for cures. With its Let's Stop HIV Together campaign, the CDC is doing its part to combat the apathy, discrimination and stigma still associated with HIV. Francis has observed firsthand how those infected and their families aren't always up-front about their positive status. "I've been to three funerals in the last year of my HIV-positive patients, none of whom died of AIDS," Francis said. "It was not mentioned that they were HIV-positive."

Then there's the case of Timothy Ray Brown of San Francisco, who has claimed to be the first patient cured of AIDS. Six years ago Brown was living with the disease in Berlin when he developed leukemia. In a subsequent stem cell transplant done to treat the cancer, his doctor used a donor who was among the 1 percent of whites who are resistant to the AIDS virus. The procedure worked, and Brown has shown no signs of HIV infection for five years. His case has become part of a new cure road map from international AIDS specialists.