GAY HIV RATES BUCK CITY DECLINE

New testing data suggests that New York City gay and bisexual men are
becoming infected with HIV at a far higher rate than other groups and
those men are not seeing a decline in their new infection rate.

"This is the only group where we are seeing it stabilize and not go
down," said Dr. Lucia V. Torian, associate director for science in
the city health department. "This looks like it might be a problem."

The city used the detuned assay, a procedure that identifies new
infections, to test 3,464 HIV-positive blood samples collected at
city clinics between June 1, 2000 and December 31, 2004. A new
infection was defined as occurring less than 170 days before the
blood sample was taken.

Among men who have sex with men (MSM), the incidence rate, or the
percentage who are newly infected in a year, was 3.79 percent in the
second half of 2000 and 2.84 percent in second half of 2004. That
decline was not statistically significant. The overall rate among
those men for the entire study period was 3.02 percent.

While 3.02 percent may seem low, incidence is cumulative. If that
rate were sustained for five years, or just six months more than the
study period, then 15 percent of the population being tested would be
infected at the end of that time.

The data for gay and bisexual men is in stark contrast to that
reported for other populations. Among all men, the incidence rate
went from 0.72 percent in the second half of 2000 to 0.44 percent in
second half of 2004. During those two periods, the rate among
heterosexuals went from 0.29 to 0.08, the rate among women went from
0.32 percent to 0.06, and the rate among injecting drug users (IDU)
went from 2.54 percent to 1.04 percent. Those declines were
statistically significant.

The rate among gay men is stable while other groups are seeing declines.

"The bad news is that it's not going down and it ought to be going
down," Torian said. "The community of MSM has poured its heart and
soul into prevention for a couple of decades. Although incidence
[among MSM] is no longer in the double digits the way it was in the
first few years of the epidemic... it remains eight to 10 times
higher than in the rest of the city."

The data has limits. The blood samples were taken from visitors to
the city's sexually transmitted disease clinics and two thirds of
those people have an STD, which indicates they are having unsafe sex.
Having an STD makes it easier to acquire or transmit HIV to a sex
partner. A higher incidence rate in this population is not unusual.

"They are going to present a higher risk profile overall," Torian said.

However, the non-gay sample registering declines was also drawn from
STD Clinics.

The health department presented some of the data, which did not
include incidence rates, at last year's 16th International AIDS
Conference in Toronto. Gay City News made a Freedom of Information
request for data on the "HIV incidence rates for the demographic
groups in the study" last December.

The health department, which presented the data at another conference
on February 28, released the incidence data to Gay City News after
the newspaper agreed to honor the second conference's March 1 embargo
on releasing data to the media. To get comment, Gay City News read
the study to interviewees, but agreed to not share copies.

One group, the Gay Men's Health Crisis (GMHC), would not comment
without first seeing a copy of the study. Other groups did comment
and said the decline among IDUs was due to syringe exchange, or the
practice of giving unused needles to injectors, while the MSM data
was "demoralizing," as one activist put it.

"It seems to me that with the IDU population we are really going to
the heart of the problem," said Tokes M. Osubu, executive director of
Gay Men of African Descent. "For MSM, we really haven't been able to do that."

Osubu said, "The fact that we're having this conversation 25 years on
is very scary. Those who hold the purse strings are not looking at
the factors that are driving the epidemic in this community."

Jay Laudato, executive director of the Callen-Lorde Community Health
Center, a gay clinic, agreed.

"I think we're all looking for answers and how to help gay men stay
HIV-negative," he said. "I don't think that anyone has come up with a
good answer so far... What we're seeing in New York City is a gay
epidemic and I hope the city acts on this and redoubles its efforts
to address the epidemic among gay men. I hope they advocate with the
federal government which has refused to do anything about the spread
of HIV among gay men."

Terri Smith-Caronia, director of New York City public policy at
Housing Works, an AIDS service organization, said, "It's really
disappointing that those numbers have not declined. I think we need
more focused programs and funding geared towards men who have sex
with men and for the city to throw its weight behind this population
the same way it threw its weight behind targeting IDUs."