Many of you may be aware of HIV Vaccine Awareness Day on May 18, National HIV Testing Day on June 27 and World AIDS Day on December 1, but did you know that National Gay Men’s HIV/AIDS Awareness Day is on September 27? We have our very own day to highlight awareness of HIV/AIDS and while some of us may not like to think about HIV or AIDS, it’s a fact that men who have sex with men are the most at risk in the community of contracting the virus without a current cure.

The National Association of People with AIDS (NAPWA) is the lead organizer for National Gay Men’s HIV/AIDS Awareness Day, which was launched in 2008. This awareness day was founded to raise awareness of the HIV epidemic and it’s important for barebackers and men who have unprotected sex with men to be aware of HIV and other sexually transmitted infections, although this particular day focuses on HIV/AIDS. You may have noticed that I referred to unprotected sex twice, one using the words “bareback sex” and the other reference being men who have “unprotected sex” with men. Even though this might be considered the same thing, some guys who have unprotected sex with other guys do not consider themselves barebackers, for whatever reason, so I will use the words “unprotected sex” to include everyone.

I have retrieved the following information from the NAPWA website to help capture the picture of HIV in our world today:

  • At least 1.1 million Americans are living today with HIV.
  • Half of them are men who have sex with men.
  • One in five doesn’t know he is infected.
  • There is no cure yet for HIV.
  • At least half, possibly as many as three-quarters of new infections come from people who don’t know they are infected themselves.

What is really scary about these statistics is that one in five people do not know that they are infected and that at least half and possibly as many as three-quarters of new infections come from people who don’t know they are infected themselves. There are a number of possible causes for this which I will consider here. Some guys may be afraid to get tested, so they avoid being tested or their testing frequency may be inconsistent. This makes it difficult to be able to honestly provide an HIV status to potential sexual partners. Some people also lie about their HIV status just so they don’t miss out on having sex with someone.

A really big problem with HIV testing using the ELISA test; the most common HIV test, is that there is a window period of up to thirteen weeks before the HIV antibodies can be detected. The problem with this is that if someone is tested within the window period due to a recent HIV infection, they may get a false negative test result and think that they’re HIV-negative, when they may actually be HIV-positive and transmitting the virus to other people during this time. HIV is a very sneaky virus, because it can take a while to show up in test results, but is still transmittable during this time, plus it mutates as well which is why it’s not a simple task to find a cure.

There is a different test which can be completed which is called a PCR DNA test, where this particular test can detect HIV antibodies after about four days of a person being infected and this is a far more useful test, but it’s more expensive and as a result is not as common as the regular ELISA tests. Being aware of HIV is important because it helps you understand more about the virus, the window period and how to prevent its spread, which is why awareness days are so important.

Here are a few considerations which may help reduce the spread of HIV:

  1. Test yourself every three months and ensure that you keep up this cycle. If you can test yourself using the PCR test and get yourself tested for other STI’s at the same time, this would be even better. Regular HIV tests every three months are extremely important.
  2. If you find that you may have been diagnosed with a false-negative test result during the window period, try to notify anyone you my have had unprotected sex with that they may have been infected and to get tested as soon as possible. There are a number of online notification services designed to help you do this.
  3. Try to be as honest as possible with guys you are about to have unprotected sex with. While discussing sexually transmitted infections is no fun, it’s an important step to help keep yourself and others healthy. If you have an infection, let the other guy know prior to having unprotected sex with him. Don’t wait for him to ask or avoid the discussion altogether.

A recent article from Aidsmap HIV tests every 3 to 6 months suggested for all sexually active gay men in US reports that sexually active gay and other men who have sex with men should have an HIV test every three to six months, which is a recommendation made after investigators in 2008 examined HIV prevalence and risk behavior in 7,271 gay men from 21 cities who believed themselves to be HIV-negative, where overall 9% of men tested HIV-positive. All of the men who took part in the National HIV Behavioral Surveillance System study reported sex with another man and completed questionnaires about HIV testing and sexual risk and only men who believed themselves to be HIV-negative were eligible for inclusion in the study.

The same article also refers to June 1981 being the first time that clusters of what was to become known as AIDS were reported in young gay men in New York and San Francisco and thirty years later there is still no cure for HIV/AIDS. The article provides deeper reporting, so please take a look at the article to learn more about this study. What was found is that relying on another person to know their HIV status is not an accurate or reliable method of avoiding HIV transmission, as it was found that 9% of the 7,271 study participants believed they were HIV-negative, but were in fact HIV-positive, which is approximately 650 men. If you multiply this by the number of guys these men may have had unprotected sex and then multiplied the number of unprotected sexual encounters those guys may have had, you can see just how quickly these numbers add up.

I have also found another interesting article published last month which relates to HIV infection rates, which you can read about in the article Steady HIV infection rate in the US conceals large increases in young gay and black men at Aidsmap. According to this article, almost 50,000 adults a year are being infected with HIV in the United States according to an estimate by the Centers for Disease Control (CDC). While the findings indicate that the infection rate has remained steady over the past four years with approximately 1 infection for every 2,000 US citizens over 13 years of age, the infection rate in young people, gay men and black men has increased by 20.5% in young people aged 13 to 29, 34% in young gay men, by 43% in young black men and by 48% in young, black gay men. To find out the survey methods, click on the article title above.

These percentages are displayed in terms of numbers below to give you a better understanding of the infection rate. Please note that some of these numbers overlap because of reporting categories:

  • 48,100 new HIV infections in the whole United States in people over 13 in 2009
  • 18,800 HIV infections in young people aged 13 to 29 in 2009
  • 7,600 HIV infections in young African-American men aged 13 to 29 in 2009
  • 29,300 HIV infections in men who have sex with men in 2009
  • 10,800 HIV infections in black men who have sex with men in 2009
  • 12,900 HIV infections in young men who have sex with men in 2009
  • 6,500 HIV infections in young black men aged 13 to 29 who have sex with men in 2009

References:

  1. HIV tests every 3 to 6 months suggested for all sexually active gay men in US – Aidsmap
    http://www.aidsmap.com/page/1826026/
  2. Steady HIV infection rate in the US conceals large increases in young gay and black men – Aidsmap
    http://www.aidsmap.com/Steady-HIV-infection-rate-in-the-US-conceals-large-increases-in-young-gay-and-black-men/page/2032212/
  3. Oster AM et al. HIV testing among men who have sex with men – 21 cities, United States, 2008. Morbidity and Mortality Weekly Report, 60: 694-99, 2011.
  4. Prejean J et al. Estimated HIV incidence in the United States, 2006-2009. PLoS One 6(8) e17502. doi:10.1371/journal.pone.0017502, early online edition, August 2011.
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