The HIV Generation Gap

New research shows that one in four young, sexually active gay or bisexual men have never been tested for HIV. The study, conducted by the Williams Institute at the University of California, Los Angeles School of Law, also found that only 4 percent of sexually active gay and bi men in the United States use PrEP, a prevention strategy that when practiced makes it virtually impossible to contract HIV.

“Our findings suggest that health education efforts are not adequately reaching sizable groups of men at risk for HIV,” said the study’s principal investigator, Dr. Ilan H. Meyer. “It is alarming that high-risk populations of men who are sexually active with same-sex partners are not being tested or taking advantage of treatment advances to prevent the spread of HIV.”

Researchers looked at gay and bisexual men from three age groups — young (18-25 years old), middle-aged (34-41), and older (52-59) — and found that only 4 percent overall used PrEP. Those who had visited an LGBTQ health clinic and searched online for LGBTQ resources were associated with greater likelihood of PrEP use.

Only about half (52 percent) of young, sexually active gay and bi men were even familiar with PrEP as an HIV-prevention method, compared with 79 percent of men ages 34 to 41. Bisexual and non-urban men were less familiar with PrEP compared with gay-identified and urban men.

Another alarming finding was that one quarter (25 percent) of young gay and bisexual men had never been tested for HIV, compared to approximately 8 percent of middle-aged and older groups of men combined. Furthermore, black gay and bisexual men were more likely than white men to get tested, which may reflect recent community efforts targeting them.

“The extremely low rate of PrEP use, while not surprising given barriers to access in various parts of the country, is disappointing,” says lead author Dr. Phillip L. Hammack. “I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did. The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”