CDC Director Julie Gerberding said the U.S. needs ‘to do so much more
than we’re doing right now’ in the domestic fight against HIV/AIDS
during a congressional hearing Sept. 16.
Obama’s win represents ‘historic milestone’ for gays. Plus: McCain won 27 percent of the gay vote.
LGBT leaders criticized for being ‘very timid and soft.’
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By Ryan Lee
Friday, October 03, 2008
ATLANTA — In 2001, the Centers for Disease Control & Prevention estimated that about 40,000 Americans become infected with HIV each year, and the agency announced its goal to reduce that number by 50 percent by 2005.
Seven years later, instead of the number of annual infections dropping to 20,000, the CDC now estimates that more than 56,000 Americans contract HIV each year, with young black gay men hardest hit by the domestic epidemic.
“We need to do so much more than we’re doing right now; we need to get AIDS back on the radar,” CDC director Julie Gerberding said at a Sept. 16 hearing hosted by the U.S. House of Representatives’ Oversight & Government Reform Committee.
“We need to make it clear it’s not a problem over there, it’s a problem at home.”
The congressional hearing came days after the CDC announced what it called its most precise measurement ever of HIV diagnoses in the U.S., which confirmed for officials what was already widely suspected by HIV/AIDS experts and activists: Gay men, specifically young black gay men, are contracting HIV at vastly higher rates than any other demographic group.
In August, the CDC announced that advanced disease surveillance technology allowed scientists to better differentiate between long-term and recent infections, and they estimated that 56,300 Americans became infected in 2006.
Of those infected, 53 percent were gay and bisexual men; of those men, 46 percent were white, 35 percent were black and 19 percent were Latino, according to a more detailed analysis published in the Sept. 12 issue of the CDC’s Morbidity & Mortality Weekly Report.
But CDC officials announced “there were more new HIV infections in young black [gay and bisexual] men aged 13-29 than any other age or racial group” of gay men.
Some 5,220 black gay men between the ages of 13-29 were infected with HIV in 2006, twice the number of Latino and white gay men in the same age group, according to the CDC analysis. While the HIV epidemic for black gay men is swelling among youth, the analysis revealed that the majority of white gay men who contracted HIV in 2006 were between the ages of 30 and 39.
“The number of new HIV infections among young black men who have sex with men is alarming, and shows the need to reach each new generation with prevention early in their lives,” said Kevin Fenton, director of the CDC’s HIV prevention division.
“The heavy impact of HIV among white [gay and bisexual men] in older age groups demonstrates the need for ongoing efforts to keep gay and bisexual men HIV-free over the course of their lifetime.”
But some black gay activists said the CDC’s new analysis simply confirms what was long known among HIV advocates — including that black women “bear the heaviest burden” of HIV among women — and shines a glaring spotlight on how CDC prevention strategies have missed the mark over the last decade.
“I don’t think there’s anything new here in these numbers,” said Phill Wilson, executive director of the Black AIDS Institute. “The question, I think for us is we waited for this breakthrough technology to be able to have a better understanding of this epidemic, now we have this breakthrough technology — where is the breakthrough sense of urgency?”
The CDC has 18 HIV-prevention interventions that it considers “scientifically based” and eligible for funding. Only two of those interventions target black gay men, and “one of those is only now being put into the field,” Wilson said.
The CDC estimates that 80 percent of black gay men have never come into contact with any of its interventions.
A 2000 study by CDC researcher Linda Villeroy has served as a guidepost for discovering HIV trends in black gay men, with each CDC announcement revealing more specific, and alarming, details about the disease’s impact on an often overlooked population.
“We’ve had a decade where, maybe we didn’t know precisely as we do now, but we’ve known for a decade,” Wilson said. “What’s taken us so long to do this? We’ve talked about it, we’ve researched it and we’ve proven it. Now what?”
‘The status quo isn’t acceptable’
CDC officials said the higher numbers the agency is reporting are the result of more sophisticated measuring techniques and do not represent an actual increase in the number of people being infected.
But critics noted the rising infection numbers coincide with seven straight years of flat funding for the CDC’s HIV prevention budget.
U.S. Rep. Henry Waxman (D-Calif.) said during the congressional hearing that when adjusted for inflation, the stagnant funding equates to a 20 percent reduction in the CDC’s prevention budget.
He also noted that the Bush administration’s allocation for the 2009 CDC prevention budget — $252.6 million — is $1 million less than was allocated in 2008.
“Instead of listening to its own experts, the administration asked Congress to fund HIV prevention programs at lower levels,” Waxman said. “The status quo simply isn’t acceptable. We aren’t doing everything we can and should.”
The $752.6 million allocated by the Bush administration is less than half of what Gerberding said would be the best-case scenario budget for HIV prevention.
Gerberding also noted, however, that throwing money into HIV prevention efforts won’t reduce infection rates if some of the socioeconomic factors that influence people’s decisions aren’t addressed.
“AIDS is a social disease as much as it is a viral disease, and part of bringing people to accept prevention is to create that expectation in an environment of hope,” she said.
“Many of the people who are getting this infection now are functioning in a society that offers them very little hope for education, economic or social attainment, and if we don’t address the underpinnings of the problem, we’re never going to be able to get where we need to be as a nation.”
But while the CDC has already developed several HIV prevention interventions for women that incorporates their sense of womanhood into staying safe, Wilson said no equivalent strategies exist for the population most affected by the disease and many other sources of stigma.
“There are no interventions now where the central message is it’s OK to be a black gay man, and because it’s OK to be a black gay man, it’s OK for you to protect yourself,” Wilson said. “There has to be leadership within the impacted communities, and in the public health arena.”
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