HIV Prevalence and Associated Risks in Young Men Who Have Sex With Men [Valleroy LA, et al. JAMA 2000; 284: 198]: This study was intended to determine the current state of the HIV epidemic in young adults in the U.S. using the Young Men's Survey, a multisite, venue-based survey that was conducted between 1994 and 1998. Gay men aged 15 - 22 years were surveyed in 194 venues in Baltimore, Dallas, Miami, New York, San Francisco and Seattle. The prevalence of HIV among 3,492 participants was 7.2%, 0% in 15 year-olds, and 9.7% in 22 year-olds. The rate was significantly higher in African Americans. Only 46 (18%) of 249 participants with HIV infection were aware of their seropositive status, and only 37 (15%) were receiving care for HIV. The authors conclude that there is a need to evaluate and intensify the efforts to prevent HIV transmission among gay men, especially African American gay men.
Comment: This is a sobering report since it has been thought that in the gay community HIV peaked in the mid-1980's and has decreased substantially since. Comparative HIV seroprevalence rates for young men in other populations were noted in the discussion section. HIV prevalence among 205,000 men aged 17 - 22 years applying for U.S. military service was 0.11% for black men, 0.01% for Hispanics and 0.01% for white men. The seroprevalence by race for this study of gay men showed 3.3% for whites, 14.1% for African Americans and 6.9% for Hispanics. There were wide differences between the seven cities ranging from 2.2% in Seattle to 12.1% in New York. The study also showed high rates of high-risk behavior including the observation that 41% of all participants reported they had unprotected anal sex during the previous six months. posted 7/19/2000