HIV Spikes For Young Gay Black Men In U.S.

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The Centers for Disease Control recently released a study showing a sharp increase in HIV infection rates among young black men who have sex with men. Many of these men aren't aware they're infected. Guest host Tony Cox discusses the study with the director of the CDC's National Center for HIV and AIDS Prevention, and the Harlem United Community AIDS Center's Senior Director of Federal Policy.

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TONY COX, Host:

This is TELL ME MORE from NPR News. I'm Tony Cox, sitting in for Michel Martin.

Coming up, even though a plural marriage is illegal in the United States, there are families that continue to practice polygamy as part of their religion. We'll talk with two open polygamists about their marriages and their faith. That's just in a few moments.

But first, some alarming news about HIV in America. The Centers for Disease Control and Prevention recently released a study showing that, overall, the number of infections in the U.S. is relatively stable. However, there is a sharp increase in the number of young black, gay and bisexual men, many of whom don't even know that they are infected. The CDC is calling for urgent action.

Joining us today, Dr. Kevin Fenton. He is the director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Also with us, Kali Lindsey. He is the senior director of federal policy at the Harlem United Community AIDS Center and joins us here in our studios in Washington. Welcome to the both of you.

KEVIN FENTON: Thank you.

KALI LINDSEY: Thank you.

COX: Dr. Fenton, let's begin with this. What did you find and why are the results so alarming?

FENTON: Well, the data really shows that HIV remains a severe and pervasive problem in the United States. There are more than 1.2 million Americans living with HIV. And the new data shows that new HIV infections are stable. But that stability is not acceptable. About 50,000 people still become infected with HIV each year. And, again, bisexual men bear a severe and disproportionate burden, nearly 64 percent of those new HIV infections.

COX: Why are so many of these men unaware, given years of efforts to educate folks on the importance of getting testing and seeking treatment?

FENTON: Actually, there are many factors which are resulting in this continued burden of epidemic among gay men. In the overall trends that we saw for gay and bisexual men, we saw that young men who have sex with men remain heavily affected. And they represent nearly a quarter of all new infections in the United States.

We're particularly concerned about young men who have sex with men because this is a new generation of men who are becoming infected, who may not have benefitted from some of the earlier messages and earlier exposure to the HIV/AIDS epidemic who are now growing up in a time when there are effective treatments for HIV and there may be less concern within the general population about HIV. And that may be contributing to some of the complacency around the epidemic within the gay community.

COX: If you're just joining us, this is TELL ME MORE from NPR News. I'm Tony Cox.

And we are talking about the recent numbers that the CDC released, which note an alarming increase in HIV infections among young black gay and bisexual men. We are talking with Dr. Kevin Fenton of the CDC. Also, with Kali Lindsey of the Harlem United Community AIDS Center.

Kali, you are now a health care professional in this area, but you have also struggled to deal with this on a personal level. Were you one of the people that would have been in this study, someone who didn't know what was happening and, as a result, was not seeking treatment when you should have been?

LINDSEY: That's absolutely right. In fact, when I found about my own HIV diagnosis, I actually found out in the emergency room, like many of my younger brothers are finding out about their HIV status today. In fact, I had 217 T cells by the time I found out. And I was actually diagnosed with AIDS. And part of that was because there is a kind of a social construct that prevented me from accepting my HIV risk that didn't necessarily motivate me to actually go in and get tested. But once my health deteriorated and I was in the emergency room and they asked me if I wanted the test, I accepted it and I found out that I...

COX: One of the things that I read about your background was that you struggled particularly with the pressures of accepting and then treating your HIV/AIDS. And you went into, for lack of a better term, a black hole for six months.

LINDSEY: Yes. That's right. That's right. I mean, for all of us that find out that we're HIV positive, the day that we get that diagnosis is a very, very, very bad day. And it takes all of us a different level of experience to overcome the information that we've received and to accept our positive diagnosis.

For me, that was about six months. But I had kind of an intrinsic fight that forced me to go out and seek care and get engaged in the community to have access to other people that were having a similar experience and also contribute to kind of the social reformation that will hopefully prevent that perpetuation in the future.

COX: In your case, this was about a decade ago, almost.

LINDSEY: Almost. Yeah.

COX: So are things different now? Even though Dr. Fenton and the CDC have shown that the numbers don't suggest that things are better, that they in fact may be getting worse for African American males. But do you see progress at all?

LINDSEY: Well, I do see progress a lot in the science and in the biomedical technologies that we have available to people in community today. But if we were to broaden our conversation and really think about HIV as a social construct, not just as a health construct, we would probably be reminded of Martin Luther King, who said the arc of the universe bends towards progress.

And if we are to talk about HIV in the black community, particularly amongst black gay men, we first have to recognize that this conversation isn't simply about sex. It actually has very little to do with sex. This conversation is about power in circumstances, where extreme circumstances lead to extraordinary decision making about behavior and risk when it comes to coping and survival.

COX: A final question for you, Dr. Fenton. What is the CDC doing to help reverse this trend?

FENTON: Well, the good news is that's the first time in the United States we have a national HIV/AIDS strategy, which really gives us a vision for bringing AIDS to an end here in the United States.

And CDC's committed to building upon that national strategy and implementing what we call high-impact prevention and showing that the best combination of interventions are available and targeted to the right populations at a scale big enough to make a difference.

So whether that is looking at rare infections that are occurring, focusing our best interventions, especially for young black gay and bisexual men, and bringing those interventions to scale. Those are important ways in which we're making a difference in this epidemic.

COX: Really quickly, Kali, are there people that you just are not going to be able to convince that this is the thing they need to do?

LINDSEY: That's absolutely right. I mean, for some of us, unfortunately, we see this ongoing risk of infection as poor decision making and poor social acceptance. And, unfortunately, instead of it being about creating a better social environment and a better health care environment, we think people just need to change their lives and their behavior and that's just not the case.

COX: Not going to happen, despite the best efforts of the CDC and of your organization. It keeps you busy 24/7, I'm certain.

FENTON: That's right.

COX: We'll just have to see if the results change, and in a positive way, in the coming days and months. Kali Lindsey is senior director of federal policy at the Harlem United Community AIDS Center. He joined us here in our studios in Washington. Also with us, Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Gentlemen, thank you both.

FENTON: Thank you.

LINDSEY: Thank you.

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