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The spread of HIV and the 'down low'

There is a lot of controversy as to whether the rapid spread of HIV among black women is due to black men that are on the ‘down low’. The term loosely describes men sleeping with men, having unprotected sex but do not consider themselves to be gay, often simultaneously engaged in long-term relationships with unsuspecting women. The San Francisco Chronicle has a series on the various aspects of a problem that no one can agree how to identify, let alone stop. “Secret encounters of bisexual black men could be creating wave of infected women“, by Jason B. Johnson, is the first piece out.

At a time when black women are being diagnosed with HIV at a rate 20 times that of white women, five CDC studies will be among the first to try to learn how many white, black, Asian and Latino men fit the down-low profile; identify how, if at all, being on the down low differs from being “in the closet,” and determine whether down-low men have a role in infecting women with HIV.

Most black women with HIV say they were infected through heterosexual contact, but it isn’t known how their male partners were infected — by sex with other men, or by using contaminated needles to inject drugs.

“We need to take a step back when we look at the down-low phenomenon,” said Gregg Millett, a behavioral scientist with the CDC division on HIV/AIDS. “There’s very little that is known.”

…In 2001, the CDC issued a report citing rising rates of HIV and AIDS among gay black and Latino men. The agency then found signs the disease was spreading more broadly among male and female blacks:

— In 2002, African Americans accounted for more than half of new HIV cases reported in the United States, though they are only 13 percent of the population.

— In 2003, African American men accounted for 44 percent of new AIDS cases among all men.

— In 2003, African American women accounted for two-thirds of new AIDS cases among all women. White women accounted for 15 percent and Latinas 16 percent.

— The rate of HIV and AIDS was 58.2 cases per 100,000 black women, and only 2.9 per 100,000 white women. The rate for Latinas was 8.1 per 100,000.

— The leading cause of HIV infection among African American women in 2002 was heterosexual contact, followed by injection drug use, according to the Centers for Disease Control and Prevention.

Read the eye-opening article on this complicated subject.

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Pam Spaulding

Pam Spaulding