This article by Liz Hamel, Jamie Firth, Tina Hoff, Jennifer Kates, Sarah Levine and Lindsey Dawson first apopeared in The Kaiser Report, a pubblication of The Henry J. Kaiser Family Foundation, here.
From the earliest days of the HIV epidemic, gay and bisexual men have been among the hardest-hit groups in the United States. While gay men make up just 2 percent of the U.S. population, they account for two thirds (66 percent) of new HIV infections, a majority (56 percent) of people living with HIV, and more than half (55 percent) of all AIDS deaths since the epidemic’s beginning.
It is estimated that 12-13 percent of gay and bisexual men in the U.S. are HIV-positive, including one in five in many major U.S. cities.
Gay men are the only group in the country among whom new infections are on the rise; between 2008-2010, new infections rose 12 percent overall among gay men, and 22 percent among younger gay men ages 13-24.
Recent research shows that antiretroviral therapy, which already has helped to dramatically increase the quality and length of life for people with HIV, has the potential to play a powerful role in the prevention of HIV. People living with HIV can reduce the risk of transmitting the infection to others by up to 96 percent if they are taking consistent ARV treatment5, and for those who are HIV negative, new pre-exposure prophylaxis (PrEP) offers a daily pill that can help them to stay negative.
What do gay and bisexual men know and think about HIV, and about these new treatments? What are the obstacles to this population taking greater advantage of them? To help answer these questions, the Kaiser Family Foundation conducted a survey of gay and bisexual men in the U.S. focusing on attitudes, knowledge, and experiences with HIV/AIDS and new HIV therapies.
The survey was conducted July 17-August 3, 2014 with a sample of 431 men who self-identified as either gay or bisexual using a nationally representative, probability-based Internet panel (more details available in the Survey Methodology section of this report). Some highlights of the survey are presented here, and a more comprehensive examination of the survey findings follows.
Highlights of Survey Findings
• The survey allows us to provide some basic demographic information about gay and bisexual men, and finds that just over half (53 percent) report being in a committed relationship, including one in five (20 percent) who say they are married. Twelve percent live in a household with at least one child under the age of 18.
• About half of gay and bisexual men say HIV/AIDS is a “very” or “somewhat” significant issue for them personally (49 percent), while the other half say it is “not too significant” or “not a significant issue” in their lives (51 percent). However, just about a third (35 percent) say they are personally concerned about becoming infected, while more than half (56 percent) say they are not personally concerned.
• Just a third of gay and bisexual men realize that new infections are on the rise among gay men. About one in five (22 percent) think rates are decreasing and the rest either think the situation is staying the same or acknowledge that they don’t know.
• Most gay and bisexual men are not aware of current treatment recommendations for those who are HIV-positive, or of the latest developments in reducing new infections. Only about a quarter (26 percent) know about PrEP, a recently approved medication that people who are HIV-negative can take to lower their risk of becoming infected. Just one in ten know someone, including themselves, who has taken PrEP, and eight in ten say they have heard only a little or nothing at all about the new medication.
• Fewer than half (46 percent) of gay and bisexual men are aware that people with HIV should start antiretroviral (ARV) treatment as soon as they are diagnosed, and only a quarter (25 percent) know about treatment as prevention, or TasP; that is, that taking consistent ARV treatment significantly reduces the risk of passing HIV on to one’s sexual partners.
• Majorities say that too many gay men not knowing their status (75 percent), complacency about HIV in the gay community (62 percent), and HIV-related stigma (56 percent) are major reasons it’s been hard to control the spread of HIV among gay men.
• Few gay and bisexual men report talking much at all about HIV with friends or even with sexual partners. Three-quarters (68 percent) say they “rarely” or “never” discuss HIV with their friends, and large shares report not talking much about it with casual sexual partners (50 percent) or with long-term partners (60 percent).
• Relatively few gay and bisexual men report getting tested for HIV as regularly as is often advised. While seven in ten say they have been tested at some point in their lives, just three in ten (30 percent) say they were tested in the last year, including 19 percent who say their most recent test was within the past 6 months. Fully three in ten (30 percent) say they have never been tested for HIV.
• More than half (56 percent) of gay and bisexual men say that a doctor has never recommended they get tested for HIV, and six in ten (61 percent) say they rarely or never discuss HIV when they visit their doctor. Lack of communication with doctors may be a barrier to more men getting tested: almost half say they’ve never discussed their sexual orientation with a doctor, and three in ten say they don’t feel comfortable discussing sexual behaviors with health professionals. Three in ten gay and bisexual men report that they don’t have a regular physician, and these men (who tend to be younger, lower-income, and more racially diverse) are even less likely to report discussing HIV with doctors and to say they have been tested for HIV.
To read the rest of the report go here.
Commentary from GMHC (Gay Mens Health Crisis)
"HIV/AIDS might not be a death sentence anymore, but there are still 50,000 new infections in the United States every year-and gay and bisexual men are still among those most at risk," said GMHC CEO Kelsey Louie. " The Kaiser Family Foundation study is a needed wake-up call that communicating the correct information about HIV and AIDS to the public has never been more critical. We must do more to educate our gay and bisexual men about how HIV and AIDS can affect them, and how life-saving medications like PrEP and PEP can help them prevent HIV infections and stay healthy. . .
The Foundation's survey comes on the heels of a new CDC report showing that 58% of gay and bisexual men diagnosed with HIV are not virally suppressed."