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]

Comments

  1. kipp says

    “…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.

  2. wetcnt says

    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).

  3. Jake says

    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?

  4. noteasilyoffended says

    Two words: PERSONAL RESPONSIBILITY!

    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.

  5. Jake says

    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.

  6. David says

    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.

  7. peterparker says

    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.

  8. says

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

  9. Matt says

    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.

  10. peterparker says

    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.

  11. Mike says

    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?

  12. Derrick from Philly says

    PETERPARKER,

    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.

  13. peterparker says

    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.

  14. 1♥ says

    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.

  15. Sebastian says

    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.

  16. Josh says

    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.

  17. peterparker says

    JOSH…you 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.)

  18. Matt says

    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.

  19. DJ_N_VA says

    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.

  20. ReasonBased says

    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.

  21. Oral says

    ORAL SEX?

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

  22. Oral says

    ORAL SEX?

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

  23. Sebastian says

    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.

  24. Kipp says

    “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.”

    PeterParker: I agree that people should bring up the issue of HIV status regardless of their own status or the presumed status of their sexual partner(s). But disclosing poz status is something that is the burden solely of those who are poz – whether that disclosure occurs in the context of a mutually initiated discussion of HIV status or not.

    I think it’s too easy for people to interpret your words as a 50/50 bargain: “If he doesn’t ask then I’m not wrong for not telling.” And I’ve know people who give that exact rationalization. The burden of telling every sexual partner you are HIV-positive must be both enormous and daunting – so much so that I fear giving any rhetorical wiggle-room for people to shirk that responsibility.

  25. Kipp says

    I should add that I was originally merely taking issue with phrasing of the article synopsis – not criticising the article because it didn’t just blame dishonest poz men.

    If people think seroconversion is inevitable, or that their status isn’t important because of low self-esteem or “ease” of treatment, then no amount of honest disclosure is going to help.

    I just have a problem with preventation literature that seems to suggest that the disclosure of one’s poz-status is somehow a shared responsiblity.

  26. jose says

    The New York Times is doing its best to associate AIDS with gays. What about straights? Straights are just as prone to it. The New York Times needs to stop demonizing gay men.

  27. Webster says

    “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…”

    Jake, you misunderstood. In this day and age with what we know now, fucking without a condom isn’t an option. I’m not condemning people who have been infected, I’m saying that anyone who fucks without a condom is an idiot and a fool, knowing what we know. Certainly you can understand that?

  28. GMB says

    Jose, a recent study showed that the New York Times devoted *MORE* articles to gay subjects, gay rights issues, etc, than any other newspaper worldwide. Its Opinion pages routinely favor the advance of gay rights and gay marriage; they are not at all demonizing gay men.

    They’ve also published other stories on the HIV infection rates among straight Americans, sex workers in Africa, and countless others.

    The New York Times should be highly COMMENDED for running this story. It could save people’s lives, and that is very much in the interests of gay people.

    – GMB

  29. Dayton says

    “Jake, you misunderstood. In this day and age with what we know now, fucking without a condom isn’t an option. I’m not condemning people who have been infected, I’m saying that anyone who fucks without a condom is an idiot and a fool, knowing what we know. Certainly you can understand that?”

    I just can’t agree with you Webster. I agree, people should take the necessary steps to protect themselves from this virus but when it comes to sex, people are going to do what we naturally do, and that’s get the full experience sex can provide. Condoms put a cap on both physical and psychological sensations, that we know. Anyone who says differently can’t and shouldn’t speak for the rest of us.

    So is a person who discards condoms an idiot? No. Their just fucking like humans fuck. But at the same time, there’s a horrible virus out there that could consume their lives.

    Its all more complicated than it seems. My advice is for gay men to try and build a community more inviting and fulfilling than what it is now.

  30. Mitch says

    Here is something I love. Read “1♥” comments above :

    “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.”

    Now lets be honest here. Where do you really think that hate is coming from? The religious right? Think about it. As gay men out there, when was the last time a religious or political figure directly hurt or assaulted or insulted you. Think who really has. Who has made you feel like shit. Thats right, it’s your fellow gay men. Who tells you you are fat. You chastizes you – DIRECTLY – for being queeny. Who serosorts you? Who rejects you at a club? Who talks smack about you to your face? Who gossips about you behind your back? Who fucks you and doesn’t call the next day? OK I’ll stop, but it’s not the religious right. It’s not Mike Huckabee (even though he is a royal asshole). Its your so called friends and acquaintances. And bloggers. And blog commentors— see above. The very minute you begin to love yourself is the minute to realize to take all the poison around you and eliminate it. I know here in New York the gays and the lesbians are more segregated than the blacks and the whites in 1960’s Alabama. Gay men are really unhealhity hinging upon each other for support, and when you start to look outside that very very angry bubble, and start to grow with everyone around you, thats when you can realize where all that aforementioned pain is coming from.

    Think about it. Who made you feel bad about yourself today? Just think for once before you make overblown claims of blame.

  31. Paul says

    Peterparker, my sympathies for you’re having been infected through oral sex. I’ve had friends get gonorrhea in their throats from it, but all the safer sex literature I’ve read either says that findings are inconclusive or it’s safe to have oral sex (assuming you haven’t brushed your teeth or have cuts in your mouth, etc.).

    I read something along the lines of only a few dozen HIV+ people who could be tied to oral sex. It’s absurd that, nearly 30 years on, we don’t have better information about the transmission of this virus.

    And Mitch, your points are part of the reason I don’t have many gay friends.

  32. kylie says

    Meth is a major factor in this. I have guy friends who are “bi” and do meth and recently four came up positive. I have also noticed many guys exploring risky new behavior after doing that drug .What is there to that? Im a girlie & just happened upon this site & use to be in the scene and wanted to post from my experience.

  33. Pozthinker says

    I have the good fortune to have an undetectable viral load, thanks to effective daily meds and dedicated doctors. I agree that my transmission risk is low, compared to untested guys who may be in varying levels of contagion. The latest stats I have found on transmission risk to the uninfected, from a tracking study that accounted for sexual contacts, number, frequency, type, and whether and when HIV was contracted, are these:
    anal, neg inserts, poz submits: 1:1538
    anal, poz inserts, neg submits: 1:200 so use a condom, either way!
    Oral, neg inserts, poz submits: 1:20,000
    oral, poz inserts, neg submits: 1:10,000 unless cuts or sores are involved.
    My doc told me enzymes in saliva and acids in gastric fluid break down the virus.
    Unprotected mucus membranes, as in the rectum, eyes, and glans of the uncircumcised penis (the circumcised glans roughens and behaves like skin) are vulnerable to transfer. I never caught the virus through many oral episodes, but one internal emissive bareback with a friend who had just caught it and was therefore highly contagious, was all it took. So, for oral, if no bleedable areas exist, risk is low. I recommend a non alcohol, enzyme mouthwash, if any. For the squeamish, polyisoprene condoms do not taste like rubber and feel smooth for anal.
    I hope that helps. And for the record, I lost some hot chances by telling my status, but I sleep guilt free, despite the blue gonads.

  34. Pozthinker says

    I need to remark on sex with poz guys. I know it is not kharma that gets me rejected, for my first time was with a trusted mentor, when I first came out. We masturbated, and he towelled away all fluids immediately. Later, I had another poz friend, on meds, who loved cuddle time, when he felt alone. If we were going for sex, he would shower and gargle before. I tasted preseminal fluid, but he never failed to pull out before ejaculating, and swiftly towelled away the fluid. He made sure I showered after sex.
    I never caught a thing from them, not even a cold.
    For the record, you cannot get HIV from French kissing, sweat, even urine (probably ureic acid has an impact). A negligible trace may be found in tears. Bloodless saliva has enzymes that kill the virus. So for most foreplay activities, fear should be absent. For anal, or if there is doubt over oral cuts or sores, a condom is cheap insurance. For a natural, frictionless, tasteless feel, polyisoprene ones are excellent, and not vulnerable to flavored oil damage, as latex ones are. Live and learn. Learn and live!