Why High HIV Rates in Black, Latino Gay Men?

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

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(The Root) -- Last week the Food and Drug Administration approved Truvada to help prevent the spread of HIV infections. The announcement coincides with the International AIDS Conference, taking place this week in Washington, D.C., where those working in the fields of HIV prevention, health care and public policy have converged to discuss the pandemic. This is the first year since 1990 that the United States has hosted the summit, and it couldn't come at a more appropriate time.

Alarming new statistics from the Centers for Disease Control and Prevention show that gay males make up 2 percent of the U.S. population but 50 percent of new HIV-infection cases. While men who sleep with men are routinely a large percentage of the newly infected, recent CDC research shows that for African-American gay males between the ages of 13 and 29, the HIV-infection rate rose 48 percent between 2006 and 2009. And among Latinos, gay and bisexual men account for two-thirds of new infections.

African-American and Latino men who sleep with men are the main groups to show such large statistical averages. These figures make one wonder why these populations remain the leading infected communities -- in addition to African-American women -- 30 years after the HIV/AIDS epidemic began.

It's Not Just About Behavior

Donna McCree, the CDC's associate director of health equity in the Division of HIV/AIDS Prevention, said that a sense of urgency about prevention measures has been lost. "Some of the young men weren't even around when there was no medication to treat HIV; that [fact] can have an impact," she explained to The Root. "We've learned that many in the African-American and Latino communities won't get tested because of the [negative] associations that come with it."

Socioeconomic status, drug and alcohol abuse and not having access to steady health care are other factors that may have led to the increase in infection rates among young black and Latino gay men, experts have said. And for some Latinos who might be more concerned about protecting their immigration status, getting tested for HIV is a low priority.

Meanwhile, McCree also pointed out that infection-rate increases have more to do with "background prevalence" than with a preponderance of high-risk sexual practices. "We have higher rates of HIV in African-American and Latino communities, so even with less risky behavior, because African-American and Latinos tend to have partners who are also African American and Latino, they actually face a higher risk of infection with every encounter they have because there is this background infection in their community," McCree said.

In fact, according to the Black AIDS Institute, studies have shown that high-risk behavior among blacks may be lower than in white and Latino gay male communities. In addition, the institute reports that men who are on the "down low" or less likely to identify as gay (pdf) aren't to blame for spiking incidence numbers.

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For Kevin Bynes, director of Oakland, Calif.'s AIDS Program of the East Bay, it's essential to understand the nuances of how infection is spread. "Gay sex isn't itself a higher risk -- anal sex is," Bynes told The Root. He explained that HIV, transmitted through blood and fluid exchange, is "attracted to anal sex" because the rectal mucous membrane is extremely thin and prone to tearing, allowing the virus to pass easily from one partner to another. For that reason, heterosexual couples who engage in this type of intercourse are also at increased risk.

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