A new study of 21 major U.S. cities by the Centers for Disease Control and Prevention found that around one in five or 19 percent of gay men  is infected with HIV and nearly half or 44 percent of them do not know they are infected.
The study found that young gays and gays of color were least likely to know their HIV status.

The findings were published in a recent CDC Morbidity and Mortality Weekly Report.

“This study’s message is clear:  HIV exacts a devastating toll on men who have sex with men in America’s major cities and yet far too many of those who are infected don’t know it,”  said Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

“We need to increase access to HIV testing so that more [gay men] know their status and we all must bring new energy, new approaches and new champions to the fight against HIV among men who have sex with men,” Fenton said.

The study’s results bolster key themes in the President’s National HIV/AIDS Strategy for the United States which says “the United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men” and lists homosexuals among a few priority populations to focus HIV prevention efforts.

The President’s strategy also sets targets for reducing the number of individuals living with HIV who are unaware of their HIV status.

The CDC study found that gays of all races and ethnicities were severely affected, especially blacks:  28 percent were infected by HIV, compared to 18 percent of Hispanics and 16 percent of whites.

The study also found a strong link between socioeconomic status and HIV among gays:

Prevalence increased as education and income decreased and awareness of HIV status was higher among those with greater education and income.

The study provided additional insight into gays most in need of HIV testing and prevention:

• Among racial/ethnic groups, blacks with HIV were least likely to be aware of their infection (59 percent unaware vs. 46 percent for Hispanics and 26 percent for whites).

• While young gays (under age 30) had lower HIV prevalence than older men, they were far more likely to be unaware of their HIV infection.  Among those aged 18-29 who had HIV, nearly two-thirds (63 percent) were unaware, versus 37 percent for men age 30 and older.

• Young gays and those of color were less likely than whites to know they were HIV-infected.

Among blacks under age 30, 71 percent were unaware of their infection; among Hispanics MSM under age 30, 63 percent were unaware; among whites under 30, 40 percent were unaware.

CDC officials said the low awareness likely reflected several factors:  They may have been infected more recently, may underestimate their personal risk, may have had fewer opportunities to get tested or may believe that advances in HIV treatment minimize the threat of HIV.

For young blacks, discrimination and socioeconomic factors, such as poverty, homophobia, stigma and limited health-care access, may be especially acute and pose particular challenges, the study found.

“For young men who have sex with men, including young men of color who are least likely to know they may be infected, the future is truly on the line,” said Dr. Jonathan Mermin, director of the CDC’s Division of HIV/AIDS Prevention.  “It is critical that we reach these young men early in their lives with HIV prevention and testing services and continue to make these vital services available as they become older.”

The CDC estimates that the majority of new sexually transmitted infections are transmitted by individuals who are unaware of their infection. Once people learn they are HIV-infected, most take steps to protect their partners, studies have shown.

The CDC recommended that homosexuals of all ages get tested for HIV at least annually, preferably every three to six months if they are at increased risk, such as having multiple or anonymous sex partners or use drugs during sex.

For more information, log on to www.cdc.gov/hiv or www.actagainstaids.org.