No Time to Stop Thinking

Some of the most important scientific advances regarding HIV are presented at a meeting called the Conference on Retroviruses and Opportunistic Infections, which I attended in February. This annual event draws the world's leading researchers and is a forum for discussion of HIV treatment and prevention advances'and challenges. One big AIDS story this year was about black men on the 'down low,' or DL. This is a new name for an old behavior among some men of all races'guys who define themselves as heterosexual but who also have sex with other men. They don't always tell their partners'male or female'about that behavior. Unfortunately, there are only sensationalized media stories about DL men and no real data about the extent of their risk or their partners' risk for HIV. At the retrovirus meeting Centers for Disease Control and Prevention scientist Greg Millett discussed the need for more facts about this population of men who have sex with men. His main point: We don't have any real numbers about how many men are on the DL or how safe (or not) they're being'just media hype. Don't get me wrong'DL behavior is real. But we won't know how widespread it is until new research takes a better look at this type of sexual behavior. The meeting's other big story concerning African-Americans was based on a small study of men in North Carolina colleges that compared their sexual behavior with that of men of the same age who were not in college. In both groups'and regardless of whether or not they had HIV'high-risk behavior was very common. Four out of 10 HIV-positive college students reported having casual unprotected sex with a male partner, compared to one third of HIV-negative students and one quarter of HIV-negative men who were not in school. What's most troubling about this study is that despite having had casual unprotected sex, only two of the 53 men in the entire study said they thought they were likely to get infected. This data is consistent with another study released by the CDC in 2002 in which the majority of young black HIV-positive gay men neither knew they were infected nor thought they were at risk of infection. AIDS has been around for 20-plus years. How can this be? Many AIDS organizations and universities have pulled back prevention efforts on college campuses. What we consider 'basic' facts about transmission may no longer actually be taught. If young black men'and women too'are to have sex safely and responsibly, or delay the onset of sexual activity, we must go back to school with AIDS 101. And we need to create a climate that encourages people to be honest with one another about their sexual desires and behavior. Demonizing people with HIV is not an effective prevention strategy. With African-Americans accounting for more than half of all new HIV infections in this country, AIDS strikes us way out of proportion to our numbers. Sixty percent of us know someone who has died of AIDS. The rate of African-American men with AIDS is eight times the rate of white men. For African-American women, it's 20 times that of white women. A recent study of U.S. HIV infections found that three quarters of heterosexual HIV infections are among African-Americans. As the founder of the nation's first and only think tank devoted to HIV and people of African descent, I spend almost every hour of every day talking about or thinking about AIDS. It's my belief that a lot more of us need to be doing so to stop the epidemic from ravaging our people. Wilson is the director of the Los Angeles'based Black AIDS Institute.