We've heard the message: HIV is spreading rapidly, so the onus is on us to protect ourselves from getting infected in the first place. Still, even though HIV has been in the news quite a bit recently—especially since National Black HIV-AIDS Awareness Day on February 7—there are still clues that not everyone is listening. A Centers for Disease Control and Prevention survey recently found that some gay and bisexual young black men admit to having risky sex. But there's also been encouraging news from basic research, including the potential that HIV might someday be eradicated via stem cell transplant.
The CDC's February 6 "Morbidity and Mortality Weekly Report" gave the results of a small survey of young gay and bisexual black men living in Jackson, Miss., who were asked questions about the level of safety of their sexual activity. Jackson was selected because a sexually transmitted disease clinic there had reported a spike in HIV diagnoses among black men who had sex with men. Twenty of 29 survey respondents said they'd had unprotected anal intercourse during the 12 months prior to testing positive for HIV—and only three had thought themselves "likely" or "very likely" to get HIV in their lifetimes.
Clearly, these young men are not getting the message that HIV can infect anyone. The question is, what more can be done to spread the message and, more important, get people to listen? That's an issue public-health officials face in addressing HIV rates, not just among gay and bisexual young black men but also among black women, white men, and people of other races as well.
The problem is not restricted to Mississippi; there was a 93 percent increase in HIV/AIDS cases among black men who have sex with men, ages 13 to 24, in 33 states between 2001 and 2006. In September, the CDC called the nationwide rate of new HIV infections in gay and bisexual black men "alarming." Gay and bisexual black men ages 13 to 29 had a rate of new HIV infections in 2006 that was 1.6 times higher than among whites and 2.3 times higher than among Hispanics, according to the September 12 issue of the CDC's MMWR. In August, the CDC estimated that about 56,300 new infections occurred nationwide in men and women of all races in 2006, up from earlier estimates of about 40,000.
Still, not all the recent HIV news has been bad. A new report from the New England Journal of Medicine describes a stem cell transplant that appears to have wiped out HIV in a 42-year-old patient. The transplant involved an HIV-positive man who had leukemia and received a transplant from a donor who possessed a gene mutation that provided a natural resistance to HIV. There is no sign of HIV in the patient's blood since the transplant. However, this is an isolated case study, so stem cell transplants—which are expensive and risky procedures—are not going to be used for other HIV patients anytime soon.
There was also news earlier this week that antiretroviral drugs were highly effective in preventing HIV infection in two experiments in monkeys and that a vaginal antiretroviral gel might offer some protection for women. If proved to work, a gel that reduces or eliminates the risk of HIV would be a great public health accomplishment. But the results of these HIV prevention studies require much more research before similar treatments would reach the masses. In the meanwhile, we need to heed today's advice to protect ourselves during sexual activity—and get tested for HIV regularly.
—January W. Payne
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