A startling increase in the number of reported HIV infections among young black men in Milwaukee County who have sex with men may be linked to several risk factors, including internalized homophobia and living on the streets, according to a joint investigation by local, state and federal health officials released Thursday.
The investigation began after the Wisconsin Division of Public Health noted a 144% increase in reported HIV diagnoses in Milwaukee County from 2000 to 2008 among black men ages 15 to 29 who have sex with men.
The resulting investigation – which involved the state, Milwaukee Health Department and U.S. Centers for Disease Control and Prevention – found the increase likely wasn’t due to intensified testing efforts, but to increased transmission of HIV through high risk behavior and nondisclosure of HIV status.
If the spike in HIV diagnoses among young black men isn’t reversed, the entire metro area could see increased rates, Milwaukee Health Commissioner Bevan Baker warned Thursday.
A higher percentage of young black males than nonblack males have male sex partners at least five years older, according to the investigation, which involved a sampling of Milwaukee County men with HIV or syphilis diagnoses. Older men are more likely to be infected with HIV.
The Milwaukee Health Department last summer announced a multifaceted strategy to boost HIV testing, reduce stigma in the community and teach men to protect themselves.
The city partnered with Diverse & Resilient, an organization that works to improve the public health of lesbian, gay, transgender and bisexual individuals. That group networked with multiple other community groups and the medical community. It has trained 60 men to help provide information to the targeted population.
Root causes
Young black men are less likely to see a doctor, are at greater risk of being homeless, are more likely to have a lower economic status, and lack access to health care and health information, said Gary Hollander, executive director of Diverse & Resilient.
Internalized homophobia makes them more likely to occasionally have unprotected sex, and being shunned by family and church teachings because of their sexuality increases their chances of being homeless, Hollander said.
“If they are couch hopping to find housing, they’re at greater risk for not adhering to the best health practices, and are more vulnerable to predators exchanging sex for housing, and sex for food,” he said.
The broader questions that need to be addressed, according to Hollander, include services and housing available to this group, whether they have safe venues to remain drug-free and how churches can support them.
“It’s one thing to be 17 and poor,” he said. “Add to that housing that’s vulnerable, being preached against at church and being bullied at school.”
About $4 million in funding from national sources recently has been granted for prevention efforts. On Thursday, Mayor Tom Barrett called on the CDC to reconsider its funding formula so Milwaukee can be eligible to receive “critical resources that will enable us to more efficiently address our city’s high HIV rates.”
Larger cities, whose overall HIV and AIDS infection rates are higher, are getting the lion’s share of federal money for prevention, Baker said.
“The CDC needs to be more agile and nimble to change their formula,” he said.
In 2009, CDC funding to Wisconsin for HIV prevention totaled $3.4 million, according to a CDC spokeswoman.
Black men ages 15 to 29 who have sex with men form the group most affected by HIV, according to Thursday’s report. That age group in 2008 accounted for 71% of new diagnoses among Milwaukee County black men who have sex with men. Nationwide in 2006, black men ages 13 to 29 who have sex with men accounted for an estimated 52% of all new HIV infections among black men who have sex with men – nearly as many infections as Hispanic and white men in this age group combined.
Free testing
The Milwaukee Health Department will provide free, confidential HIV and STD testing from 3 to 7 p.m. Monday at Heartlove Place, 3229 N. King Drive. Call (414) 286-3521.
Tags: HIV