Lost in Theory

BY Benjamin Ryan

May 11 2006 11:00 PM ET

Researchers at the CDC found several touted theories about why HIV spreads so rapidly among black men, but no single theory'nor any combination of theories'can be pointed out as the likely culprit.

''High rates of STDs, including syphilis, gonorrhea, and chlamydia, facilitate the spread of HIV both through increased infectiousness and increased receptivity to infection.

' A lack of knowledge about their seropositive status might lead men to unknowingly pass along the virus. Black men who have sex with men are usually tested less frequently, and later after infection, than men who
are white, Hispanic, or of other races.

The report found insufficient data to support other hypotheses, but its authors believe more research is necessary on several topics.

''Blacks may be more genetically susceptible to HIV, since they are less likely to have a genetic variant known as a 'CCR5 32 base pair deletion' than whites, which is believed to create resistance to HIV infection.

''Blacks are less likely to be circumcised than whites, and recent studies have shown that circumcision can lower a man's risk of sexually transmitted HIV infection.
' HIV-positive blacks may be more infectious since they'and African-Americans in general'have less access to health care services, and as such are less likely to have suppressed HIV levels in the body though stable antiretroviral therapy.

''Blacks are more likely to have sex with other blacks, making them more likely to be exposed to the virus through this 'sexual network.' The CDC believes the data to support this hypothesis is strong.

''Black men are more likely to be incarcerated, putting them at risk for HIV through unprotected sex or needle sharing while in prison. Studies have shown prisons to have high HIV prevalence rates.

In addition to those theories addressed by the CDC, there are many other common theories about why black men'whether or not they have sex with other men'have high rates of HIV infection.

''Belief in conspiracy theories about HIV, which lessens condom use.

''Mistrust of the medical community in part because of the Tuskegee syphilis experiments on blacks from the 1930s to the 1970s.

''Silence on HIV issues from black churches.

''High dropout rates, unemployment, poverty, disenfranchisement, and feelings of hopelessness or depression that may lead to risky behaviors.

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