Do not know they have HIV!

June 2, 2009 Posted by Matthew Conaster in Sports, Health & Fitness

A first-of-its-kind study looking at HIV infection rates found that half of gay men in Chicago who have HIV did not know they were infected, and two-thirds of infected black men were unaware. In addition, infection rates for black men were more than twice the rates for whites and Hispanics. The results of the Chicago Department of Public Health survey are sobering, officials say, but not unexpected. "It's a terrible thing, but it is not surprising," says Jim Pickett, director of advocacy for the AIDS Foundation of Chicago. The statistics prove what some organizations, including the city, have been seeing for several years: That gay black men are among the fastest growing groups to test HIV-positive. The Chicago study found that more than 17 percent of gay men in Chicago have HIV; 39 percent did not get tested in the last year because they were worried about the result. Almost 600 gay men from across the city were tested for HIV/AIDS and interviewed about their lifestyles, including questions about drug use and number of partners. Ninety-one of the subjects tested positive for the virus. Thirty percent of gay black men in Chicago tested positive, the study showed, while Hispanics and white men had rates of 12 percent and 11.3 percent, respectively. A quarter of blacks aged 18-24 tested positive. More than 37 percent of blacks aged 25-34 - the highest of any age group - tested positive. The numbers are similar to national figures.

"What we think we're seeing here is the shifting sands of two epidemics," says Nik Prachand, an epidemiologist with the city of Chicago's STI/HIV/AIDS division. "What we're seeing right now is a new surge in (HIV cases) with black (gay men)."

Prachand says anecdotal data has backed up the information the city collected between August and December last year. He said it is important to understand that the prevalence of HIV in black men can be tied to the elevated rates in the black community.

"It's not that black (gay men) are exhibiting higher risk behaviors in either sex or drug use," he says, pointing to data showing them to engage in less risky behavior than whites or Hispanics. "It's sort of a network effect. When your overall community prevalence is higher, you're going to see elevated rates within subgroups."

Pickett says the study points to a need for an overhaul of how gay men approach health.

"When you focus on one specific thing, it doesn't reflect all the issues," including mental and physical health, depression and substance abuse, he says. More than 40 percent of those surveyed admitted illicit drug use, and whites were more likely to do drugs than any segment.

"We need to incorporate HIV into a broader or more holistic framework (covering) gay men's health needs from top to toe," Pickett says.

That's the city's take, too, says Prachand.

"I think it's important that our prevention points towards healing the whole community. It's an issue of being more holistic about HIV," he says.

But, with HIV's high profile in the community, Pickett and others say more testing is needed. Currently, the CDC recommends that gay men be tested once a year. Ariq Cabbler, co-chair of the Chicago Black Gay Men's Caucus, says two tests a year should be the norm; Pickett recommends three. Cabbler is worried that a new breed of promiscuous young men are not listening to the traditional HIV/AIDS messaging. The study's statistics show that men who tested negative in earlier tests are now testing positive, an indication, Cabbler says, that they are engaging in risky activity during a 90-day period of time when HIV essentially incubates in the body.

"We need to know who makes up these social networks," which include men who meet other men over the Internet or through phone networks, he says. "You're kind of playing Russian roulette."

As part of its response to the report, the health department is proposing expanded testing and condom distribution, more community-level interventions, and outreach programs, including through the Chicago Black Gay Men's Caucus. Pickett said the city has done a good job in making gay men's health a priority.

"I am happy to say that Chicago is a leader in this country in working with the community and working with gay men. I can only imagine what the numbers could be if CDPH hadn't been doing good work."

He said the AIDS Foundation and other groups are stepping up awareness efforts this month. June is Gay Pride Month.

"The moral of the story is we want to catch people early in their infection," Pickett says. "We don't want people to test positive; we want them to test negative. And we want to provide them with the right kind of counseling and the right tools to maintain that negative."

The city is formally releasing the study's results June 9 at a 1 p.m. meeting at the DePaul Center. Health officials will lead a community discussion to see how the city's response can be improved. Story From Alex Parker ChiTownDailyNews

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