San Francisco Officials Discuss Higher Prevalence of HIV Among Black MSM

Black men who have sex with men (MSM) have the largest prevalence of HIV of any other group in San Francisco, according to a report presented at a meeting of the city's HIV Prevention Planning Council, the Bay Area Reporter reports.

Willi McFarland, director of HIV/AIDS Statistics and Epidemiology at the San Francisco Department of Public Health, estimated that 32% of black MSM in San Francisco have HIV, compared with 26% of white MSM, 23% of Hispanic MSM and 10% of Asian/Pacific Islander MSM.

Blacks represented 14% of new HIV cases in the city last year and 14% of those living with HIV/AIDS in San Francisco. About 51,000 blacks live in San Francisco, making up 7% of the city's population, according to the Reporter. White MSM still make up the majority of the city's HIV cases, and last year 57% of new HIV diagnoses were among whites, according to the Reporter.

McFarland said, "Nearly one-third of African-American MSM have HIV. That rate of transmission is significantly high. The question starts to arise, 'Why do we see such a discrepancy?'" He added, "Much to our shame, we took this by surprise. We should have seen it coming. For more than a decade, African-American men have been disproportionately affected by HIV."

According to the Reporter, previous research has shown that black MSM do not engage in risky behaviors more often than their peers, nor do they seem to have higher rates of sexually transmitted infections that raise the risk of HIV transmission.

McFarland said that a closed sexual network among black MSM might explain their higher HIV prevalence. According to his report, black MSM are 3.2 times more likely to have a black sexual partner than would be expected if there were no preference.

In addition, research has shown that black MSM are two times more likely than white MSM to have partners who are 10 years older, according to the Reporter. The Reporter says that a recent national study indicated that older black MSM generally are less likely to use condoms.

McFarland said, "It is highly likely that HIV infection gets into that network at a very high rate and is sustained at a high rate. It is similar to Africa, where older men infect younger women. It is a vicious cycle, and we may be seeing this in the African-American MSM population in San Francisco."

According to the Reporter, many black MSM in San Francisco are unaware of their HIV status, which could be contributing to higher HIV prevalence among the population.

Jonathan Batiste, a member of the HIV Prevention Planning Council and coordinator of the Black Coalition on AIDS' Black Spectrum Program, said, "With the black men I am talking to, it isn't my personal experience that most black men date other black men." He also warned against applying the national study's findings on condom use among older black MSM to black MSM in San Francisco.

Batiste added, "Not having a strong gay identity makes you more likely to contract HIV. You don't have the information you need or a support network."

Grant Colfax, the city's HIV prevention director, said that he intends to hold meetings across the city with various communities to gather their thoughts on what the city should do in terms of HIV prevention.

Source-Kaiser Family Foundation
LIN/S