A sudden, surprising increase in HIV infections has been discovered among male black college students in North Carolina, and officials fear the same is probably happening across the South.
The upsurge is driven by young men having risky sexual encounters with other men. Typically they do not consider themselves to be gay or bisexual and may even have girlfriends, as well.
“It’s a public health emergency. I don’t know any other way to put it,” said Dr. Peter Leone, HIV medical director at the state Health Department.
The increase was first noticed in late 2002, and officials now believe it began in mid-2001 and is still continuing.
The high rate of HIV infection among U.S. blacks has been one of the most striking difficulties of AIDS prevention.
Unexpected high-risk group
Blacks are 11 times more likely than white Americans to get AIDS. Even though they make up 12 percent of the population, they account for 39 percent of AIDS cases and 54 percent of new HIV infections.
Among black men, like whites, the leading cause of infection is sex with other men. Experts have long lamented the high rate of risky sex among gay black men. Poverty is often listed as a strong contributor, so the new findings among relatively well-off college students were unexpected.
Indeed, a CDC study on 10 campuses in the 1990s found a very low infection rate.
The North Carolina data were presented Tuesday in San Francisco at the 11th Annual Retrovirus Conference.
Also at the conference, officials presented newly gathered data on HIV infections in New York City. Overall, 1 percent of the city’s population carries the virus, including 4 percent of men in their 40s.
Nationwide, an estimated 900,000 people have HIV. The CDC says that in recent years infections have risen somewhat among gay men of all races and fallen slightly among women.
Across the South?
The North Carolina researchers found 84 newly infected male college students over the past three years, 73 of them black. Only one black student admitted using injected drugs, and just two said they had sex only with women. The rest apparently were infected through sex with men.
“The concern is this is our best and brightest within the minority population who are coming down with a lifelong and potentially lethal infection,” Leone said.
“We have no reason to think this is limited to North Carolina,” said the CDC’s Dr. Lisa Fitzpatrick.
Leone said HIV appears to have been recently introduced among black college students. People are much more likely than usual to pass on the virus through sex during their first weeks of infection, and this might explain why so many students have caught it.
When the students were questioned, three-quarters said they thought they were not at high risk of HIV, despite frequent anal intercourse without condoms with different male partners.
“Part of it is message fatigue,” Leone said. “They’ve grown up hearing this thing. It’s old stuff to them. They just ignore it.”
Another possible factor may be an especially intense stigma against HIV and homosexuality in the South, making the students less likely to discuss their sexual identity or consider themselves gay.
“We have a very marginalized group,” he said. “They don’t identify with the messages targeted to gay white men.”