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NYC Releases Sobering Report on Young Gay Men and HIV

A new report out of New York City reveals a disturbing trend among men under 30 fueled by several factors - an optimism that AIDS is readily treatable, high rates of drug use, and a stigmatization young men feel about disclosing their HIV status.

CondomThe NYT reports:

"The number of new H.I.V. infections in men under 30 who have sex with men has increased sharply in New York City in the last five years, particularly among blacks and Hispanics, even as AIDS deaths and overall H.I.V. infection rates in the city have steadily declined. New figures from the city’s Department of Health and Mental Hygiene show that the annual number of new infections among black and Hispanic men who have sex with men rose 34 percent between 2001 and 2006, and rose for all men under 30 who have sex with men by 32 percent. At a time when the number of new cases among older gay men is dropping — by 22 percent in New York City during the same period — AIDS experts are bearing down on what they say is a worrisome and perplexing growth of H.I.V. infection among young men..."

There's at least one very clear reason for the disparity between age groups and infection. Said NYC health commissioner, Thomas R. Frieden: "People who grew up watching their friends die of AIDS are a lot more careful than those who didn’t."

There's also a sense of inevitability, according to outreach worker Lynonell Edmonds, particularly among blacks and Hispanics, because that community has been so hard hit. Said Edmonds: "A lot of guys say, 'I’m going to get it anyway. I call it, ‘Don’t ask, don’t tell.' People are not asking — it’s like it’s an offensive question."

New H.I.V. Cases Drop but Rise in Young Gay Men [nyt]

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  1. Anyone fucking without a condom is an idiot and a fool.


    Posted by: Webster | Jan 2, 2008 12:05:37 PM

  2. "...a stigmatization young men feel about disclosing their HIV status"

    This is really labored locution - HIV-negative people are not stigmatized by their status. What they mean is that HIV positive men are not disclosing their status to their sex partners. Not being asked is not an excuse for failing to mention you are HIV-positive to someone you are engaging in unprotected with.

    Posted by: kipp | Jan 2, 2008 12:27:57 PM

  3. Any guy engaging in unprotected sex should assume they are getting HIV. Negative men who think they can have sex without condoms without consequence are fooling themselves. Let's not starting pointing fingers at one party (the poz guy not disclosing) without remembering that there is another partner involved (the neg guy barebacking).

    Posted by: wetcnt | Jan 2, 2008 12:37:27 PM

  4. Just kind of picking all of your brains...where are we with the risk of transmission through oral sex, with or without swallowing. Any news on that?

    Posted by: Jake | Jan 2, 2008 12:47:20 PM


    PERSONAL RESPONSIBILITY of an HIV-positive person to disclose their HIV-status to their sexual partners.

    PERSONAL RESPONSIBILITY of an HIV-negative person to ask their partner's HIV status before engaging in sex.

    PERSONAL RESPONSIBILITY to practice safe sex.

    PERSONAL RESPONSIBILITY not to get so high on drugs that one looses their ability to reason and protect ourselves.

    Anyone who has casual sex without a condom is acting irresponsibly. Period.

    Posted by: noteasilyoffended | Jan 2, 2008 12:54:59 PM

  6. Come on guys, wrap it before you tap's not that difficult.

    Posted by: Homosxl | Jan 2, 2008 1:13:49 PM

  7. I totally agree with using condoms for anal - that's a no-brainer. But does anyone here actually use condoms for oral sex? I'm guessing no, but I'm curious to hear the responses.

    Posted by: Jake | Jan 2, 2008 1:19:05 PM

  8. To call anyone that has sex without a condom an idiot and a fool is ridiculously arrogant. No wonder there is such a stigma associated with infection. I don't think anyone that caught HIV from unprotected sex is going to claim they acted responsibly. So instead of acting like preachy assholes and calling people who never asked for infection names, perhaps it's time to grow up, offer positive support, and start getting a positive message out there about safer practices so that it isn't an offensive question anymore.

    Posted by: David | Jan 2, 2008 1:22:04 PM

  9. KIPP--talk about labored locution! That last sentence of yours has been working on the chain gang for the past fifty years. I would rephrase it to read: 'The fact that you may not have been asked is no excuse for failing to mention to a sex partner that you are HIV positive.' As an HIV positive man I would also add the following: The burden of disclosure of HIV status should not fall squarely upon the shoulders of the HIV positive. It is pretty damn simple for an HIV negative person to disclose status and get the conversation started about safe sex, while it is much, much more difficult for an HIV positive person to be the one who brings up the topic due to the risk that person faces of rejection. Having said that, both partners should be equally responsible for the discussion of HIV status and, if sero-discordant, both partners are equally responsible for safer-sex decisions.

    In my opinion, the primary reason for a surge in new HIV infection rates among young men can be found in the second sentence of the New York Times article: crystal meth. This drug is destroying the gay community (notice I did not say 'GLBT community'--our lesbian sisters seem to have enough sense to avoid meth) not only because it often turns users into addicts, but also because it often turns users into people who are HIV positive. If we, as a community, made it as socially unacceptable to use crystal meth as many of us have made it sexually unacceptable to be HIV positive, we'd see a huge reduction in people using meth which would translate into a reduction of new HIV infections.

    Another phenomenon contributing to the increased rates of new HIV infections is something that the New York Times fails to address directly: the attitude of UB2. Scores of men have online sex profiles reading 'HIV-, UB2'. The only reason I can imagine for such an ad is that the person has abandoned safer sex practices as too bothersome or perhaps ineffective and has instead adopted sero-sorting as their primary means of avoiding infection with HIV. While I have no problem with sero-sorting in the dating world and completely understand why an HIV negative guy would not want to be in a long-term relationship with an HIV positive man, the concept of relying on full disclosure from a stranger you've met online on a sex hookup site is ludicrous for a host of reasons. Reason number one is the fact that such a hookup is only one shade removed from anonymous sex. Reason number two is that health authorities believe only 25% of HIV people know their status. That man advertising himself as 'HIV negative' may in fact be a man who unknowingly has an untreated HIV infection which has rendered him highly contagious due to a high viral load. Meanwhile, the HIV positive person who has disclosed his status is probably receiving treatment for his HIV disease and is thus likely to be far less contagious than the 'HIV-, UB2 guy'. I'm not saying that HIV negative guys should run out and do their best to have sex with HIV positive guys (though frankly I wouldn't mind the attention) because they are safer with an HIV positive sexual partner. What I am saying is that HIV negative men are safer only if they ignore what the trick says about his HIV status and instead treat every short term sex partner as HIV positive and act accordingly.

    Posted by: peterparker | Jan 2, 2008 1:35:54 PM

  10. The people I still see advertising bareback parties on dating sites are certainly worthy of being called idiots and fools.

    Posted by: John C | Jan 2, 2008 1:40:02 PM

  11. Peterparker,

    I think the whole UB2 is not about guys abandoning safer sex practices. I think for the vast majority of HIV negative men they do practice safe sex with others. The reason they want to practice safe sex with another negative person (ub2) is that if a condom fails they aren't freaking out so much as if someone had a condom failure with a known positive person.

    I'm sorry but I'm not really understanding your logic about being safer with a positive person. I understand about treatment and lower viral loads but isn't it true that people who seroconvert are not generally on medicine at first? This is true with several of my HIV+ friends who are positive and not yet prescribed medicines by their infectious disease specialist.

    Posted by: Matt | Jan 2, 2008 1:48:36 PM

  12. JAKE--I was infected with HIV through oral sex. I sent an email to your email address saying a little more about that. I will be happy to follow up with more info later if anyone wants.

    JOHN C--I would say the vast majority of the guys at those bareback parties are HIV positive. I see nothing wrong with two HIV positive people having unprotected sex with each other. And before you, or anyone else, starts shouting 're-infection', I'll remind you that in the 25 year history of HIV there have been 16 cases of HIV superinfection. Considering all the positive guys who bareback with each other that is a damn low rate of superinfection.

    Posted by: peterparker | Jan 2, 2008 1:50:39 PM

  13. Scientists should try to develop a reliable, quick HIV test that consumers can use to test each other before sex. It doesn't exist now but if it did, it would sort out a lot of these ethical problems. Sero-sorting is the goal here. You have the right to decide who you have sex with, HIV- or HIV+.

    Until we have a cure, we should try to remove as much uncertainty as possible. I have no sympathy for HIV+ guys who want to fuck HIV- partners and wail with outrage if anyone tries to tell them otherwise. There is a reason there still is a stigma. Who the hell wants HIV?

    And BTW isn't it a crime to conceal if you have HIV and then have sex with an unprotected partner?

    Posted by: Mike | Jan 2, 2008 2:06:59 PM


    Lately, I've been staying away from serious topics here on Towleroad, but I just want to thank you for your valuable personal knowledge and insight on this subject. So many of us, especially young folks, need to get intelligent and accurate information. And yes, we need to hear/read more information on the transmission of HIV through oral sex. Thanks again.

    Posted by: Derrick from Philly | Jan 2, 2008 2:07:51 PM

  15. MATT...I disagree with you. I think many of those guys looking for UB2 sex are doing it so they can have unsafe sex without worrying about HIV infection.

    My point about sex with a person who knows they are HIV positive is this: Most people in the U.S. who know they are HIV positive receive treatment for HIV. Most people who are being treated for HIV have an undetectable viral load. A person with an undetectable viral load is *much* less likely to infect someone than a person with a higher viral load. Meanwhile, people who don't know they are infected with HIV don't get treated for HIV. This results in their having a detectable (and often high) viral load which means they are more likely to infect a sex partner.

    As for the timing of medications, it is variable. Usually, a person with a higher viral load will be treated with anti-retrovirals regardless of how long they have known their HIV positive status. I know only one person with HIV who is not treating his disease. His doc took him off meds because he was having a great deal of gastrointestinal issues and his doctor wanted him to work with a gastro doc to resolve those issues before they begin to treat his HIV again.

    Posted by: peterparker | Jan 2, 2008 2:13:36 PM

  16. I think the Gay community needs to reach out to more men and tell them that as a community we care about them. A day doesn’t go by that the Gay community isn’t insulted and assaulted by the hatemongering religious right. I believe this constant hate against us is taking its toll on us and we stop caring about ourselves which leads to drug abuse and unsafe sex. We should push for relationships that are based on love and commitment and letting everyone in the Gay community know that they count and are important to the future of the community.

    Posted by: 1♥ | Jan 2, 2008 2:34:12 PM

  17. This is just sad, and, there is no reason for this rise, anyone with a clue should know about using a condom, good grief, years ago when I took a "safer sex" class, yes, some of us did, the guy said, assume everyone you sleep with is positive, and, that way you'll always use a condom.

    I think that this issue has many facets to it, and, the main one being a lack of self worth and not caring about what you allow someone do to you and your body.

    Posted by: Sebastian | Jan 2, 2008 2:45:52 PM

  18. Bottom line here is this:

    Poz Guys shouldn't have to be asked if they are HIV+ or not. It's cowardly if they don't tell their partner their status. I'm Poz and I tell everyone regardless if i'm rejected or not. I wouldn't wish this on anyone.

    Sorry PeterParker but the disclosure does fall soley on the HIV Positive partner. Do you tell everyone regardless if they ask or not? If not, then you sir are cowardly and if you do you are to be commended.

    Posted by: Josh | Jan 2, 2008 2:58:04 PM

  19. misunderstood my post. Perhaps I did not express my point of view as clearly as I would have liked, so I will try again.

    Of course those who are HIV positive should disclose their status. We pozzies should disclose our status if asked by a partner...and we should disclose our status if our partner fails to inquire about our status.

    But the burden of the responsibility to have the discussion of HIV status should not fall solely on the shoulders of a person simply because they happen to have, or not have HIV. If two (or more) people are planning to have sex, then all parties share the responsibility to discuss things like HIV, regardless of the health status of any participant in said sexual activities. (Jesus Christ, I should've gone to law school as my father encouraged me to do.)

    Posted by: peterparker | Jan 2, 2008 3:31:51 PM

  20. Don't do what your father encouraged you too. If I had done what my dad encouraged, I would have slit my wrist and been in a body bag by now lol.

    Posted by: Matt | Jan 2, 2008 3:49:21 PM

  21. When i read profiles that say UB2 i just laugh. I mean just cause someone says they are not poz doesn't mean anything. If you have unprotected sex you know what you are getting yourself into. I had a friend that became hiv positive from his partner and his partner knew about it. I don't know how my friend forgave him but as he put it, it takes two to tango.

    Posted by: DJ_N_VA | Jan 2, 2008 3:57:56 PM

  22. The reason is clear. It is called BAREBACKING. I walking with friends along 8th avenue the other day and we walked into one of the video stores. What struck me is the sheer number of BB videos on the shelves. I remember only 4-5 years ago it was nearly impossible to see new BB videos. And I can't imagine this does not reflect a broader trend in real life.

    Posted by: ReasonBased | Jan 2, 2008 4:05:48 PM

  23. ORAL SEX?

    So who will post some recent reliable information on the chances of getting infected from oral sex?

    Posted by: Oral | Jan 2, 2008 4:15:40 PM

  24. ORAL SEX?

    So who will post some recent reliable information on the chances of getting infected from oral sex?

    Posted by: Oral | Jan 2, 2008 4:16:37 PM

  25. Josh, you seem like a stand up guy, honesty is always the best policy, but, in these cases, it seems that ones status is secondary if at all of any importance, its more about getting off, which goes back to the lack of self esteem.

    Oral sex and, infections? From what I've heard, there's a possiblity, perhaps someone here can help you out on it.

    Posted by: Sebastian | Jan 2, 2008 4:31:42 PM

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