The CDC announced a stunning statistic this week: about half of all gay and bisexual black men in the U.S. will be diagnosed with the virus that causes AIDS during their lifetime. But LaMar Yarborough wasn’t surprised by the news.
Yarborough, 23, who is black and has AIDS, lives in Georgia, where HIV — the virus that causes his illness — is still raging. Abstinence-only sex education and poverty are contributing to its spread, said Yarborough, an HIV-prevention activist.
“We kind of saw this coming,” said Yarborough, who was diagnosed with AIDS about five years ago after having unprotected sex with men and women. “It is not shocking.”
Presented this week at a conference in Boston, the study by the U.S. Centers for Disease Control and Prevention found that one in six gay and bisexual men will be diagnosed with HIV: 1 in 2 blacks; 1 in 4 Hispanics; 1 in 11 whites. In contrast, the rate of infection for heterosexual men is 1 in 473.
Based on HIV diagnosis and death rates from 2009 to 2013, the CDC report also found that people living in Georgia and other parts of the South are more likely to be diagnosed with HIV compared to other Americans. The top three risk areas: Washington D.C., 1 in 13; Maryland, 1 in 49; Georgia, 1 in 51.
Tremayne Perry, who is black and gay, is one of the lucky ones. A financial manager living in Atlanta, Perry is HIV-negative. And he plans to stay that way.
“You have to have the conversation with your partner,” said Perry, adding that he gets tested for HIV twice a year. “Ask the question. Beyond that, even if everyone is negative, you still have to use protection when you are engaging in sexual activities. It is something that I practice. But not everything is 100 percent foolproof.”
Like Yarborough, Perry pointed to a powerful stigma surrounding HIV as one reason the incidence of the disease is so much greater among black men.
“Being homosexual is not looked well upon,” he said. “It is something actively preached against in our churches. And secondly, there is the stigma of actually having the virus.”
Deprivation and a phenomenon known as “survivor sex” are also connected to the illness, said DeWayne Ford, associate director of education and prevention services for AID Atlanta.
“People are put in situations that might put them at risk, like unemployment and homelessness,” he said. “If they are homeless, if they don’t have anything to eat, or need a place to stay, they may take up with someone who might provide those things — for condomless sex. At the end of the day, it might be about having a place to stay or something to eat.”
“I wouldn’t (attribute) it to reckless behavior,” he continued. “When people come in for an HIV screening, there is always something that leads up to it.”
Spread mainly through having sex and sharing needles with people infected with HIV, the virus infected more people in the South than in any other region every year between 2009 and 2013. New HIV cases were documented in at least 43 Georgia counties in 2013. The year before, 39,102 Georgians had HIV or AIDS; 613 of them died.
Black residents are disproportionately affected by the virus in Georgia. For example, in 2013, black Georgians accounted for 66 percent of people living with HIV in the state, though they comprised only 31 percent of Georgia’s population. In contrast, 56 percent of those infected with HIV nationwide were black in 2013.
“There are many things — not only HIV — that are much worse for African-Americans than for other populations,” said Dr. Carlos del Rio of the Emory University Center for AIDS Research. “Social determinants of health cannot be ignored.”
Nicole Roebuck, interim executive director for AID Atlanta, offered a similar view.
“It is not surprising why African-American men are impacted so disproportionately by this disease: High unemployment, lack of healthcare, race, poverty,” she said. “Those things are not said out loud enough.”
The CDC’s announcement, Roebuck said, should serve as a call to action for AIDS-prevention organizations.
“This is not surprising, but alarming,” she said. “We need to increase our efforts to make sure that those populations get a handle on the disease and transmission. We have to increase our efforts so they know that testing is available and that they can come to safe services. Once people know their status, that is the first step in changing their behavior.”
HIV by the numbers
- 1 in 2: The number of gay black men who will be diagnosed with HIV if the current rate continues. The CDC used diagnoses and death rates from 2009-2013 to project the lifetime risk of HIV diagnosis in the United States by sex, race and ethnicity, state, and HIV risk group,
- 1 in 4: The number of gay Latino men
- 1 in 6: The overall average of all gay and bisexual men who will be affected by the HIV epidemic in the U.S. at current rates.
- 1 in 11: The rates for white gay men.
- 1 in 99: The overall lifetime risk of HIV diagnosis in the United States, an improvement from 2004-2005 when it was 1 in 78.
- Overall, African Americans are by far the most affected racial or ethnic group with a lifetime HIV risk of 1 in 20 for men (compared to 1 in 132 for whites) and 1 in 48 for women (compared to 1 in 880 for whites).
- People living in the South are more likely to be diagnosed with HIV over the course of their lifetime than other Americans, with the highest risk in Washington, D.C. (1 in 13), Maryland (1 in 49), Georgia (1 in 51), Florida (1 in 54), and Louisiana (1 in 56).
Source: U.S. Centers for Disease Control and Prevention in Atlanta