Recent data indicate that HIV and AIDS affect gay and bisexual men at rates grossly disproportional to other groups. Why did it take CDC so long to ask these questions and what will we do to answer them?

This article is part of a

special series this week focusing on HIV and AIDS in the United

States. Rewire is partnering with CHAMP, the AIDS Foundation of Chicago, the HIV Prevention

Justice Alliance, and other organizations to highlight issues on domestic HIV and AIDS policy while

several thousand people attend the National HIV Prevention Conference

in Atlanta, Georgia. See the first piece in this series by Julie Davids and David Munar, The AIDS Crisis in the United States: Wlll the Obama Administration Meet the Challenge?

CDC official Dr. Amy Lansky announced today at a plenary session of the National HIV Prevention Conference the CDC’s finding that, in the United States, gay men and other men who have sex with men (MSM) have AIDS at a rate more than 50 times (that’s right, FIFTY TIMES) greater than women and non-gay/bi men. This confirms in emphatic terms that of all the disparities and disproportionate impacts in the HIV/AIDS epidemic in the United States, the greatest one is the extraordinarily disproportionate impact on gay and bisexual men — of all races and ethnicities– though the most disproportionate impact is on African American gay, bi and other MSM.

As incidence estimates released by CDC last year revealed, MSM constitute more than half of all new cases of HIV and are the group in which the number of new cases each continues to slowly increase. What’s new today is that the CDC has calculated *rates* of HIV/AIDS prevalence among MSM, not just raw numbers. Lansky says the CDC estimates that there were 692.2 new HIV cases in 2007 per 100,000 MSM. Having a rate as well as the raw numbers allows comparisons for the first time to other population groups at risk, such as women and heterosexual men.

In turn, to calculate a rate, one must be able to know or estimate the size of the underlying population. It’s fairly easy to know how many women or African Americans or Latinas/os there are in the country or a state or a community. It’s not so easy to know how many gay men there are, especially since many gay and bi men have reasons not to disclose their sexual orientation and since the government has not been especially interested in accurately counting us. The CDC took a range of estimates from several nationally representative surveys and studies and decided to use the figure of 4.0%, representing the median estimate of the proportion of adolescent and adult men who acknowledge having had sex with another man in the past five years.

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Why has it taken so long to make this estimate, which in turn allows population comparisons and impact assessments? Maybe part of it is due to natural scientific reluctance to make guesses about things that cannot be accurately measured. But that doesn’t really make sense, because policymakers push scientists all the time to make estimates about hard-to-measure phenomena affecting public policy. Seems clear to me that this was at least an indirect effect of the pervasive homophobia still affecting much of government, public policy, media and societal norms in this country.

At the same time we applaud this newly honest statement and comparison, and what it means about the continuing devastating impact on MSM communities and populations, most especially on MSM of color, it is equally important to reaffirm the devastating and disproportionate impact that HIV has as well on other populations and communities, particularly women of color in the South and elsewhere and on transgender women in urban areas throughout the country.

We must fight for funding and adequate social investment to end HIV/AIDS wherever it continues to persist and thrive, which is almost always where concentrated social injustice also thrives. We will not decisively end AIDS anywhere unless we end it everywhere.





