In Light of World AIDS Day, CDC Reports HIV Rate Remains Severe Among Gay, Bisexual Men

In light of the December 1 observance of World AIDS Day, a newly released report from the U.S. Centers for Disease Control and Prevention (CDC) notes that the HIV infection rate remains severe among gay and bisexual men, particularly men of color. "About two-thirds of all new HIV infections in the U.S. occur in gay and bisexual men, which represents one of the largest disparities in existent public health," Demetre Daskalakis, director of the CDC's Division of HIV Prevention, said in a Tuesday CDC medical briefing about the report. Gay and bi men accounted for 66 percent of all new HIV infections in 2019. Despite that, the number of new HIV infections among gay and bi men actually decreased by 8 percent over the last decade, according to a newly released CDC Vital Signs report, which dives deeply into issues surrounding a single disease. While new HIV infections decreased most among white gay and bi men over the last decade, the number of infections remained mostly the same among Black and Hispanic/Latino gay and bi men.

Additionally, the report found that while 74 percent of HIV-positive white gay and bi men had achieved viral suppression through medications in 2019, only 62 percent of Black gay and bi men and 67 percent of Hispanic/Latino gay and bi men had achieved the same outcome through medications. Viral suppression makes it virtually impossible for HIV-positive people to transmit the virus to other sexual partners. But racial disparities also exist among gay and bi HIV-negative men taking medications to avoid contracting the disease in the first place. Among HIV-negative men in 2017—the year for which the most recent data was available—42 percent of white gay and bisexual men had taken pre-exposure prophylactics (PrEP). PrEP is a daily medication that can reduce a person's chances of contracting HIV up to 99 percent. Comparatively, only 27 percent of Black gay and bi men and 31 percent of Hispanic/Latino gay and bi men had used PrEP in 2017.

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Daskalakis blamed numerous social factors and cultural stigmas against homosexuality for the health disparities between gay and bi men of different races. "It's clear that persistent factors, like discrimination, healthcare access and use, education, income, housing and transportation are contributing to continuing HIV disparities and standing in the way of our goals," Daskalakis said. "To end the HIV epidemic, we will need to address the systemic factors that turn health differences into public health injustice," he added. During the briefing, CDC Director Rochelle Walensky mentioned the 2019 federal plan to end HIV in the U.S. by 2030. The plan is called Ending the HIV Epidemic in the U.S. (EHE). "Right now, EHE is focused on the 57 jurisdictions that account for more than half of all new HIV infections and about two of every three new HIV infections amongst Black and Latino/Hispanic people," Walensky said. The CDC is using an initialism called ROOT to help reach the EHE's goals and to reduce racial disparities in HIV, Daskalakis said. ROOT prioritizes (R)esources to the communities most in need for HIV testing and care; reaching people (O)utside of traditional healthcare settings with HIV self-testing and mobile services; (O)vercoming systemic racism, homophobia, transphobia and other HIV-related stigmas that raise barriers to health information and services; and embracing a (T)otal-person approach to healthcare. A total-person approach addresses HIV as well as other sexually transmitted illnesses and also incorporates HIV prevention and care into healthcare services that people are already accessing, Daskalakis said.