HIV Infections Down in France--Except for Gay Men

by Kilian Melloy
Monday Sep 13, 2010

Although HIV infections are declining among the general population in France, one demographic stands out as an exception to the trend: HIV infections are increasing among gay men in that country, according to a new report. reported on Sept. 9 that a new study issued by the French National Institute for Public Health Surveillance determined that instances of new infection among gay men continue to rise, even as the numbers are falling in France for the general population, with HIV rates among gays 200 times greater than that of heterosexuals. The study looked at infection rates for 2008, and found that half of new cases were gay men.

The story noted that more than 33 million people worldwide are living with HIV. In some places, such as sub-Saharan Africa, the disease is prevalent among heterosexuals. The trend in Western countries, however, has been for gays to be more affected by HIV rates.

That has been more and more true of young men in recent years. For some time, researchers have noted that despite efforts to promote safer sex, HIV rates are climbing among young gay men in Europe and in the United States. So are rates for other sexually transmitted diseases, such as syphilis; unfortunately, individuals already infected with one STI may be at an elevated risk for contracting others, including HIV.

While some of the blame may rest with younger gays not having access to safer sex messages, a perception among young MSMs (men who have sex with men) that AIDS is no longer a serious health concern may also be driving the increased incidence in HIV. Most serious of all, however, is a tendency toward unsafe sex and other risky behaviors, such as drug use, which affect judgment and may lead to more unsafe sex-and a higher rate of HIV infection.

MSMs in America are 44 times more likely than men in the general population to become infected with HIV, and 40 times more likely than women in general, the U. S. Department of Health and Human Services announced earlier this year. Syphilis rates for MSMs were 46 times greater than for other men, and 71 times greater than the rate of infection among women in general.

Among the factors for the disparities, the CDC noted, were a lack of safer sex precautions, such as condom use, and the ongoing stigmatization of HIV and AIDS that make gays, bisexuals, and other men who have sex with men (MSMs) less likely to learn about and use safer sex precautions, or to get tested. As a result, MSMs were also less likely to get treated. Moreover, younger MSMs are less likely to engage in safer sex practices; in addition, there is a lack of education around syphilis, in terms of recognizing symptoms of the disease.

The survey results were presented during the CDC's 2010 National STD Prevention Conference. A press release on the new results explained, "While CDC data have shown for several years that gay and bisexual men make up the majority of new HIV and new syphilis infections, CDC has estimated the rates of these diseases for the first time based on new estimates of the size of the U.S. population of MSM." The newly formulated estimates show that abut 2% of men in the United States have sex with other men, though the margin for error could mean that the figure is as low as about 1.5% or as high as nearly 3%.

"Because disease rates account for differences in the size of populations being compared, rates provide a reliable method for assessing health disparities between populations," the release said.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said the director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Kevin Fenton, M.D. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

Added Fenton, "There is no single or simple solution for reducing HIV and syphilis rates among gay and bisexual men. We need intensified prevention efforts that are as diverse as the gay community itself. Solutions for young gay and bisexual men are especially critical, so that HIV does not inadvertently become a rite of passage for each new generation of gay men."

And the trend is not confined to the United States: researchers in the U.K. and Europe have also noted the increase, reported British newspaper The Guardian on Sept. 7. "By investigating the genetic profile of the virus in more than 500 newly screened patients over nine years, scientists in Belgium have identified clusters of people with type B virus--not the one that is most prevalent in Africa," The Guardian reported. "Those infected are almost all white, male, gay and young," the article continued.

The researchers noted that, "Members of this cluster are significantly younger than the rest of the population and have more Chlamydia and syphilis infections," the article said.

That is not to say that heterosexuals do not also face the risk of contracting HIV; overall, just under half of the new cases of HIV in Britain were gay men, but straights were also getting infected. One main difference was that while gays seemed to be getting infected without traveling to other countries, heterosexuals--who were picking up a different strain of the virus--seemed to be contracting the virus while abroad, the article said.

"Gay men are still the most at risk of HIV infection in the UK," said Nick Partridge, the head of British AIDS charity the Terrence Higgins Trust. "We also know that more than a quarter of people with HIV in the UK are currently undiagnosed, and they're far more likely to pass the virus on than those who know they have it."

The Belgian study, which looked at HIV trends in Britain and Europe, was carried out by researchers at Ghent University. But health experts in the United States also cautioned that HIV remains a serious health threat here.

Next: "New Wave" of HIV Cases About to Hit America?


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