Local HIV/AIDS Service Providers Sound Alarm Over Infection Rates

Recent statistics indicate the rates of HIV/AIDS remain disproportionately high among gay and bisexual men in New England.

According to the Rhode Island Department of Health, there were 54 new cases among men who have sex with men in 2010. This number has been steadily increasing within the past five years. In 2009, there were 59 cases of HIV infection among gay and bisexual men. Forty-seven percent of HIV/AIDS diagnoses in that year were among MSM. That percentage was 41 percent in 2008.

Neighboring states have reported similar findings.

In Connecticut, 46 percent of HIV/AIDS diagnosed in 2009 were among gay and bisexual men. Of that total, 67 percent were white men. Thirty-four percent were black.

Within the three-year period from 2007 to 2009, 744 of the Massachusetts residents who were diagnosed with HIV contracted it through same-sex sexual activity, accounting for 41 percent of all cases and 55 percent of diagnoses among men. An additional 58 men were reported to have been exposed to the virus through same-sex sexual activity and injection drug use, accounting for 3 percent of all cases and 4 percent of HIV infections among men.

There were 6,252 men living with HIV/AIDS in Massachusetts who contracted the virus through same-sex sexual activity, according to statistics through Dec. 31, 2010. This figure represents 35 percent of all people with the virus in the commonwealth and 50 percent of men living with HIV/AIDS. An additional 575 MSM living with HIV/AIDS were reported to have also used injection drugs, accounting for 3 percent of all people living with HIV/AIDS and 5 percent of men.

The Centers for Disease Control continues to indicate gay, bisexual and other MSM of all races remain the population most impacted by HIV.

MSM account for more than half (53 percent) of all new HIV infections in the United States each year, as well as nearly half (48 percent) of people living with HIV. While the CDC estimates that MSM account for just 4 percent of the American population aged 13 and older, the rate of new HIV diagnoses among this population is more than 44 times that of other men and more than 40 times that of women. White MSM , followed closely by black MSM, account for the largest number of annual new HIV infections of any group in the United States. MSM is the only risk group in the country in which new HIV infections have been increasing since the early 1990s

These Trends Are "Very Concerning"

HIV/AIDS service providers expressed alarm at these statistics.

"I find the HIV trends very concerning and I believe now is the time for CBO's and health departments to step up our efforts to address the challenges related to HIV prevention in gay and bisexual men," said Tom Bertrand, executive director of the Providence-based AIDS Project Rhode Island. "I think CBO's have a unique role to play in ensuring that gay/bisexual men are equipped with the knowledge and skills to prevent HIV. This has to be done at an individual and community level to raise awareness and equip gay men with the ability to talk to their partners about their HIV status, negotiate save sex, and get tested for HIV regularly."

Bertrand said the rate of HIV among MSM may actually prove significantly higher. Gay and bisexual men represented roughly 73 percent of new infections in Rhode Island in 2010.

Chris Butler, a former AIDS Project Rhode Island executive director, said statistics can sometimes prove deceiving.

"HIV stats are tough to interpret because folks are not reported as HIV-positive until they test positive, so someone could have been infected five years ago and not find out until they are tested at which point it is reported," noted Butler. "So the 54 people reported in 2010 were not necessarily infected in 2010. Increases in reported infections can also be related to increased testing which has come about since the rapid test was developed a few years ago."

He said Rhode Island officials can do more to address the problem.

"I think that there has always been a shortage of quality MSM HIV prevention in Rhode Island, due mostly to the lack of funding," said Butler. "The government, which is the primary source of prevention funding, is very wary of investing in experimental or "edgy" programs which might hold some promise of effectiveness but are not scientifically proven."

Mark Forry, assistant director at the Male Center in Boston, said education must play a major role in preventing HIV infections. The MALE (Men's Action Life Empowerment) Center is a resource and wellness center for gay and bisexual men.

"I think the first piece is making sure people have information that they need to navigate the choices regarding their sexual health," said Forry. "I also think it's important to make sure that we have prevention tools and materials widely available to people, things like condoms and lube that are going to reduce the risk of an HIV transmission."

Forry said the MALE Center's goal is to target HIV prevention programs for specific populations.

"We want to make sure that the services we provide to (clients) really are going to be accessible and digestible for folks so it doesn't present another barrier as far as getting folks information," explained Forry.

There are many factors that explain why gay and bisexual men do not take greater precautions when engaging in sexual activity. Forry said trauma, a history of violence and low self-esteem may play a part. "Not everyone is able to prioritize their sexual health," he said, adding the statistics in Massachusetts reveal a high percentage of homeless youth identify as LGBT.

The MALE Center provides free rapid HIV testing and provides sexual counseling for men who wish to modify their sexual behaviors in order to cut down on risk.

"Change is not overnight," said Forry. "It's a journey and a process."