Gay, Bi Share of City HIV Epidemic Grows

As number of new gay infections increase, percentage of total new cases nears 40 percent

Reflecting national data showing that HIV continues to impact gay and bisexual men more than any other U.S. population, a city health department report shows that new HIV diagnoses among New York City men who have sex with men (MSM) have increased.

During the past four years, the percentage of new diagnoses attributable to gay and bisexual men has increased from about one quarter of the citywide total to just under 40 percent.

“Clearly, these are preliminary numbers,” Dr. Lucia V. Torian, director of the health department’s HIV epidemiology program, said of six month comparisons just released. “We need to continue watching. We thought it was important to point out that we are seeing something new.”

New HIV diagnoses among gay and bisexual men went from 479 in the first six months of 2004 to 507 in the first half of 2005. That increase may or may not be statistically significant.

But, between 2001 and the first half of 2005, the health department reported that the proportion of new HIV diagnoses attributable to gay and bisexual men went from 26 percent of all new diagnoses to 39 percent of all new diagnoses.

“It’s a 50 percent hike,” Torian said. “It’s big. It’s part of a five-year trend. I personally don’t need a significance test to tell me something is wrong with this picture.”

That increase could result from actual increases in new infections among gay and bisexual men, decreases in such infections among other populations while the new infection rate among MSM stays the same, or a combination of the two.

“It’s suggestive that it’s a combination of the two,” Torian said. “We do have an uptick among diagnoses among MSM, we do have an uptick among black men… The uptick is very small.”

Comparing the two six-month time periods, the city reported that new HIV diagnoses went from 673 to 691 among African Americans. At the same time, new diagnoses increased among black men and decreased among black women, which suggests that the increase among African Americans is among gay and bisexual men.

Equally disturbing is that the health department is reporting that new HIV diagnoses increased among all gay and bisexual men under 30 from 2001 to 2004, while new diagnoses among such men over 30 declined.

“Among young, black MSM under 30 there is an increase,” Torian said. “There is an increase among young, Hispanic MSM and among young, white MSM.”

This could mean that all the gay and bisexual men over 30 who might be infected have been infected—that the group is saturated—and the virus is now spreading in a group where there are uninfected bodies.

“There is a very big susceptible population,” Torian said, referring to gay and bisexual men under 30.

In 2005, the federal Centers for Disease Control and Prevention (CDC) estimated that one million Americans are living with HIV or AIDS and MSM accounted for half of the cases. In the U.S., men accounted for 74 percent of the cases and, among males, gay and bisexual men accounted for 67 percent of the new HIV diagnoses.

In 2003, the CDC reported that between 1999 and 2002 new HIV diagnoses among gay and bisexual men increased 17 percent. New diagnoses among those men increased eight percent between 2003 and 2004, the CDC estimated last year. New diagnoses among heterosexuals and injecting drug users declined from 2001 to 2004.