Though 77% of gay and bisexual men newly diagnosed with HIV in 2010 were initially linked to care, only 51% were retained in care after the first three months of getting diagnosed. About 49% were prescribed drug treatment and only 42% had achieved viral suppression to a level that minimized the chance of transmission.
“The science tells us that there is a dramatically positive impact when we talk about care and treatment for people living with HIV,” said Donna McCree, associate director for Health Equity in the CDC’s Division of HIV/AIDS Prevention. “There are tremendous needs there when it comes to gay and bisexual men.”
Rates of access to care were found to be lower in younger men, where only 30% of those between ages 18 and 25 were prescribed antiretroviral medications, compared with 68% among men ages 55 and older. Also, the study found large racial disparities to care, with black men having the lowest rates of initial linkage to care at 72%, retaining care at 46%, and achieving viral suppression at 37%.
Gay and bisexual men accounted for 63% of all newly infected HIV cases in 2010, and made up 52% of the estimated 1.1 million Americans living with the disease.
Despite a 33% drop in the number of new HIV cases that were diagnosed between 2002 and 2011 within the general population, the rate among gay and bisexual men between ages 13 and 24 rose by 132% during that same time, according to a CDC study published in July in the Journal of the American Medical Association.
Some attribute the rise to a change in perception of HIV, with the current young generation seeing it as a potential chronic disease instead of the virus that was a leading cause of death among adults ages 25 to 44 in 1995.
“I think over time, attitudes have changed around HIV,” said Anthony Galloway, prevention program manager with AIDS Foundation Chicago. “When looking at young people, we're seeing that a lot of the attitudes on getting infected with HIV are that it can be treated because we're seeing a lot of the older men, who have lived with HIV, living longer.”
A separate survey released Thursday by the Kaiser Family Foundation that interviewed more than 430 gay and bisexual men between July 17 and Aug. 3 found that only three in 10 reported getting tested for HIV within the past year, with only 19% saying they got tested within the last six months of the survey.
Roughly 44% of adults under age 35 reported never getting tested, compared with 21% of older adults. When asked about prevention, only 26% of respondents said they knew of pre-exposure prophylaxis, or PrEP, which can be taken by those who are HIV-negative to reduce their risk of getting infected. And less than half knew of current federal government guidelines concerning treatment that calls for those who are newly diagnosed with HIV to immediately begin antiretroviral therapy.
“We see a bit of a disconnect between what gay and bisexual men perceive as the problems with HIV in their communities and the personal actions that they report taking,” said Liz Hamel, director of Public Opinion and Survey Research for the Kaiser Family Foundation.
But attitudes may only partly explain why so many young HIV-infected gay men are not receiving care. Stigmas about the disease and sexual behavior still exists among many, including health providers, which may serve to discourage younger patients from seeking continued treatment. Also, many young HIV patients may lack access to health coverage or live in areas where resources to available treatment are limited.
“Many providers still do a relatively poor job of assessing people's sexual risks,” said Dr. Stephen Boswell, CEO of Boston-based Fenway Health, a community health center that serves the city's lesbian, gay, bisexual and transgender population. “In my view, HIV care should be regularized as much as possible in order to de-stimgatize it.”
Follow Steven Ross Johnson on Twitter: @MHsjohnson