Unraveling The AIDS Mystery

By Keith Boykin, in sexuality
Tuesday, November 15 2005, 11:35AM

HIV/AIDS

For the next few days, I'm going to look at some of the mysteries of the black AIDS epidemic. Today I look at the study that supposedly showed that "46 percent of black gay men are HIV positive." Tomorrow I look further at the problem and explore solutions to the crisis. Then on Thursday I look at the relationship between black women with HIV/AIDS and black gay men.

In June 2005, the U.S. Centers for Disease Control published a report that showed that 46 percent of black men who have sex with men (MSM) in 5 American cities tested HIV positive. Since then, there's been plenty of debate and finger pointing about what to do and whom to blame. Last night, I moderated a panel on the HIV/AIDS crisis among black gay men, where the panelists and audience members discussed these issues and what to do next. To help understand the problem, I am posting the raw figures (above) from the CDC study released in June. I have also posted some observations below.

As a writer, the central dilemma for me is how to dramatize the crisis without exaggerating it. That's why it's important to understand that the statement that "46 percent of black gay men are HIV positive" is based on a total of 206 black men spread out over several cities who were recruited mostly at bars, nightclubs and street venues. In other words, that's about 41 men in each city. Here's some more information we should know about the study.

WHAT TO KNOW ABOUT THE STUDY

1. More than 2,000 men were sampled. "In the five cities, 2,261 men sampled from 258 venues participated in NHBS. The participation rate among eligible men was 83% (range by city: 69%--99%)."

2. Nearly 1,800 men were selected. "A total of 1,767 (78%) were men who had one or more male sex partners and agreed to the survey, HIV test, and STARHS test (range by city: 222--462)."

3. The median age was 32 years old. "Of these 1,767 participants, the median age was 32 years (range: 18--81 years)."

4. The plurality of those surveyed were white. "According to the study, 35% were white, 27% Hispanic, 25% black, 7% multiracial/other, and 6% Asian/Pacific Islander."

5. The study may over represent the social crowd. "Participants were recruited at bars (30%), street locations (20%), dance clubs (19%), cafés/retail stores (10%), Gay Pride events (6%), social organizations (5%), gyms (5%), sex establishments (3%), and parks (1%)."

6. The conclusions were based on 206 black men who tested positive. "Of the 1,767 MSM, 450 (25%) tested positive for HIV (range by city: 18%--40%). HIV prevalence was 46% among blacks, 21% among whites, and 17% among Hispanics."

7. The vast majority of those infected were under 30. "A total of 340 (76%) of those who were HIV positive were aged >30 years (Table 1). Of the 449 HIV-antibody--positive specimens tested by Vironostika-LS, 80 were nonreactive; of these, 31 were considered incident infections, and 49 were excluded from the incidence estimate."

8. The study looked at five cities. The five cities surveyed included Baltimore, Miami, Los Angeles, New York and San Francisco, all of which have been heavily hit by the AIDS epidemic.

9. Baltimore had the highest rate. "HIV incidence among MSM by city was as follows: Baltimore, 8.0% (95% CI = 4.2%--11.8%); Los Angeles, 1.4% (95% CI = 0.0%--2.9%); Miami, 2.6% (95% CI = 0.0%--5.6%); New York City, 2.3% (95% CI = 0.28%--4.2%); and San Francisco, 1.2% (95% CI = 0.0%--2.6%)."

10. Blacks were more likely not to be aware of their HIV status. "Of the 450 HIV-infected MSM, 217 (48%) were unaware of their HIV infections. The proportion of unrecognized HIV infection was highest among MSM who were aged <30 years, nonwhite, and surveyed in the four cities other than San Francisco (Table 1). Of the 217 MSM with unrecognized HIV infections, 64% were black, 18% Hispanic, 11% white, and 6% multiracial/other."

Additional Resources

Comments (4) reveal

Comments conceal

E-RED
November 15 2005, 11:51AM

Regrettably, it completely makes sense that Baltimore would have the highest rates of infection. That area also has the highest concentration of methodone clinics per capita, and high drug addiction rates typically correspond to high HIV infection rates. For years, Baltimore led the nation in the percentage of people with syphillis and other venereal diseases.

I consider it a function of the lack of educational and/or job opportunities in the area. Did you know that in 2004, 69% of the Baltimore 12th grade student population was NOT graduated from high school? Now if this stat includes students of all races, imagine how acute the high school dropout rate was in the Black student population?

scary ...

E-RED
(21201)

Kenneth Winfrey
November 15 2005, 2:20PM

I haven't done a statistical analysis worth mentioning in over 10 years. However, something about these numbers doesn't play well with my intuition... My common sense tells me that a sample "who were recruited mostly at bars, nightclubs and street venues" might be an indication of a serious problem, but not indicative of the entire population of gay Black men.

Coincidentally, I recently read where a white gay man stated that he no longer involves himself with Black men because of statistics like these. While many of us aren't interested in inter-racial dating issues, I am simply curious to see what impact it really has had. Will Black men be further socially isolated and ostracized by such reports?

castiron
November 15 2005, 7:14PM

That the researchers oversampled from the "social crowd" doesn't necessarily mean that the prevalence rates are an overestimate. In fact, the opposite could be true. In other words, if the researchers were to test men who have sex with other men in the "non social crowd," they might find that the rates are even higher. One hypothesis to test is whether those from the "non social" crowd are less educated about STDs, more closeted, and less empowered to protected themselves compared to those in the social crowd who are unlikely to engage in back alley sexual liasons and who are experienced in negotiating safe sexual relations.

All of this could be empirically tested if the right data were collected. How ever one cuts it, the data presented here are alarming. Each of us has to protect him- or herself. I'm responsible for my own health. I will yield or share that responsibility with no one else. Peace

alasexboi
November 19 2005, 11:05AM

Self selection is always a problem when evaluating statistics. These figures are not made from random samples of the entire community but those that choose to get tested. Income, access to health care/insurance could factor in.. as well suburban populations arent really counted here either...the numbers could be higher or lower...Regardless.. another sociological problem to add to the black man's pile...