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AIDS Increases Among Young and Old Men

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HIV/AIDS is up among the young and the old, according to newly released data from the CDC. The news prompts us to re-examine two stories ran lately.

Diagnoses of AIDS or HIV are up among men who have sex with men, the federal Centers for Disease Control announced this week, citing data from 33 states. "During 2001-2006," the CDC noted, "male-to-male sex remained the largest HIV transmission category in the United States and the only one associated with an increasing number of HIV/AIDS diagnoses."

The numbers are worse for young gay men, those between 13 and 24, who are seeing a 12.4 percent annual increase in diagnoses, and even worse for young black gay men, who saw a 15 percent annual increase. That compares to an overall increase in HIV/AIDS among the gay population (the CDC uses the more precise term "men having sex with men," or MSM, and not gay) of 1.5 percent a year.

The good news, as it were, is that the young MSM population only makes up 14 percent of HIV/AIDS diagnoses, while MSM between 25 and 44 make up 64 percent of cases and their infection rate is acyually down 1.1 percent a year.

And for those who recall our ground-breaking look at AIDS among older Americans — click here and here for Barbara Hesselgrave's two articles — AIDS has also increased among MSM 45 and older. The rate there is up 2.7 percent a year. And that population makes up a larger percentage of the total cases among MSM, at 22 percent.

While the CDC report comes with a handful of caveats about interpreting its data, the double-digit increases imply there is a second wave of AIDS in the U.S. as some health experts have warned for a while.

Experts suggest several reasons for the increase, including declining education efforts targeting at-risk communities and an increasingly cavalier attitude toward the disease
in an age of retroviral treatments. In an effort to reverse the trend, the CDC is calling for improved and wider HIV testing — it estimates a quarter of those with HIV don't know it. The feds call for "at least" annual testing from sexually active MSM and an opt-out approach for screening all patients age 13 to 64 in clinical settings.

They also call for greater screening for sexually transmitted diseases like syphilis and gonorrhea, which help spread the virus between partners. "STD and HIV prevention efforts should be as fully integrated as possible," the CDC recommended.

That should provide some grim satisfaction to Jeff Klausner, who heads the San Francisco Department of Public Health's efforts against sexually transmitted disease. Our Matt Smith profiled his somewhat lonely battle to compel gay hookup sites on the Web to carry safe-sex warnings. He sees the sites as party to the upsurge in syphilis among gay men.

No one has produced data publicly so far linking any facet of the spike in AIDS among young men to the sex sites (and the latest CDC data doesn't even include info from California). Still, it's probably a matter of time before people besides us start making informal connections.