Disturbing New Information on MSM and HIV

One of the most frustrating aspects of working in HIV is addressing the many myths (as well as conspiracy theories) surrounding it-the most persistent of which is that AIDS is a "gay disease." Clearly this myth started early in the history of HIV in the U.S., yet has persisted despite clear evidence of how HIV is transmitted and the growing diversity of those whom become infected. Moreover, it has been convenient for many to affix the label of "gay" to anyone who has had sex with the same gender. However, a startling new report from the Centers for Disease Control (CDC) may add additional fuel to that myth. A CDC study conducted in 21 cities tested over 8,000 gay and bisexual men participating in the 2008 National HIV Behavioral Surveillance System.

The study found that almost one in five men having sex with men (MSM) was infected with HIV and that almost half of them did not know it. Black MSM were infected at a rate of 28%, as compared to 18% for Latino men and 16% for Caucasian MSM. Black MSM were even less likely to know their status than other races (59% were unaware) with young black MSM, a shocking 71% of which were unaware of their status. There was also a high co-morbidity with HIV status and socioeconomic variables-with HIV + status increasing as education and income decreased.

Studies such as these point to the glaring need for new creative strategies, not to mention social marketing approaches, to attract more and younger MSM to get tested. Moreover, despite all of the hoopla about '"men on the down low" as the culprit for rising infection rates with women, we cannot overlook the fact that many of the men in this study were bisexual and therefore, may have female partners. Previous studies have shown us that when someone knows their HIV status they are more likely to practice safer sex. Hopefully a renewed focus on HIV prevention targeting MSM may lead to a sorely need national dialogue revealing the diversity and complexity of the topic. Perhaps that discussion will help dispel the myth.

HIV may have been present for 32,000 years

Despite the persistent myth that HIV was a man-made disease, unleashed upon the unsuspecting, disenfranchised of our society (read gays and blacks), now comes more evidence that it may have been present in monkeys and apes for a millennia. New research, published in Science magazine last month, report the presence of the ancestor of the simian HIV virus in Africa possibly dating back as far as 78,000 years. This fascinating research, that studied monkey species on a volcanic island off of the coast of West Africa, who developed in isolation, found that four of the six species had been infected with HIV.

Although this study may help to answer certain questions, such as why HIV infects most simian species, but doesn't kill them, it fails to answer the main one: how did a relatively benign monkey virus become one of the greatest health crises in the history of mankind. Many still believe that the human HIV epidemic was caused by, purposely or inadvertently, human meddling.

Evidence of the great age of HIV does point to the likelihood that, over centuries, the virus killed off weaker monkeys leaving behind those who became resistant to it. However, does that mean that it will take thousands of years before we are able to adapt naturally to HIV? Can we survive that long with rising rates, declining government support and the aggressive mutation of the virus?

Our obvious advantage is, of course, our technological superiority. We now have over 30 medications to treat HIV and many believe that a cure is still possible. However, by following the path of HIV and other diseases, it hopefully reminds us of our fragility and vulnerability as we continue, sometimes in the interest of capitalism and expansion, to invade more exotic and isolated lands and interact with previously unknown species.