San Francisco: Discussing Higher HIV Prevalence Among Black MSM
Black menwho have sex with men have the highest prevalence of HIV of any other group inSan Francisco, according to a report presented at a Jan. 10 meeting of thecity's HIV Prevention Planning Council, the Bay Area Reporter reports. Willi McFarland, directorof HIV/AIDS Statistics and Epidemiology at the San Francisco Department of Public Health, estimated that 32% of black MSM inSan Franciscohave HIV, compared with 26% of white MSM, 23% of Hispanic MSM and 10% ofAsian/Pacific Islander MSM.
Blacks represented 14% of new HIV cases in the city last year and 14% of thoseliving with HIV/AIDS in San Francisco.About 51,000 blacks live in San Francisco, making up 7% of the city's population,according to the Reporter. White MSM still make up the majority ofthe city's HIV cases, and last year 57% of new HIV diagnoses were among whites,according to the Reporter.
McFarland said, "Nearly one-third of African-American MSM have HIV. Thatrate of transmission is significantly high. The question starts to arise, 'Whydo we see such a discrepancy?'" He added, "Much to our shame, we tookthis by surprise. We should have seen it coming. For more than a decade,African-American men have been disproportionately affected by HIV."
According to the Reporter, previous research has shown that blackMSM do not engage in risky behaviors more often than their peers, nor do theyseem to have higher rates of sexually transmitted infections that raise therisk of HIV transmission.
McFarland said that a closed sexual network among black MSM might explain theirhigher HIV prevalence. According to his report, black MSM are 3.2 times morelikely to have a black sexual partner than would be expected if there were nopreference. In addition, research has shown that black MSM are two times morelikely than white MSM to have partners who are 10 years older, according to theReporter. The Reporter says that a recent nationalstudy indicated that older black MSM generally are less likely to use condoms.
McFarland said, "It is highly likely that HIV infection gets into thatnetwork at a very high rate and is sustained at a high rate. It is similar to Africa, where older men infect younger women. It is avicious cycle, and we may be seeing this in the African-American MSM populationin San Francisco."
According to the Reporter, many black MSM in San Francisco are unaware of their HIVstatus, which could be contributing to higher HIV prevalence among thepopulation.
Jonathan Batiste, a member of the HIV Prevention Planning Council andcoordinator of the Black Coalition on AIDS' Black Spectrum Program, said,"With the black men I am talking to, it isn't my personal experience thatmost black men date other black men." He also warned against applying thenational study's findings on condom use among older black MSM to black MSM in San Francisco.
Batiste added, "Not having a strong gay identity makes you more likely tocontract HIV. You don't have the information you need or a supportnetwork."
Grant Colfax, the city's HIV prevention director, said that he intends to holdmeetings across the city with various communities to gather their thoughts onwhat the city should do in terms of HIV prevention (Bajko, Bay AreaReporter, 1/17).
Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Reportis published for kaisernetwork.org, a free service of The Henry J. KaiserFamily Foundation.