by Janet Steffenhagen
Young homosexual men in Vancouver are twice as likely to become infected with HIV as previously expected and more likely to contract the virus than gay men in many other North American cities, a study suggest.
The study estimates the infection rate is now three per cent. In other words, if 100 gay young men tested HIV negative, by next year three of them would be HIV positive.
That's twice the rate detected in recent studies of gay men in several U.S. cities, according to the findings of the Vanguard Project, which began assessing HIV in young gay men in 1995.
The study, to be released today at a conference on AIDS in B.C., is grim news for a city struggling to deal with and HIV/AIDS epidemic among drug addicts in the Downtown Eastside.
"What this suggests is that there are really two overlapping epidemics of HIV infection in the city - injection drug users and young gay men," said Dr. Steffanie Strathdee, manager of the Vanguard Project at the B.C. Centre for Excellence in HIV/AIDS.
It is not clear why HIV/AIDS is flourishing in Vancouver. With injection drug users, some blame the popularity of cocaine because that drug is injected more often than heroin, increasing the frequency with which a needle may be used or shared.
But there is also grinding poverty, poor housing, and a sense of desperation that overwhelms any concern about the statistical possibility of contracting a disease.
There are similar struggles for young gay men, Philip Hannan of AIDS Vancouver said Monday.
The study found that young gay men who experience child sexual abuse, alcohol abuse, or any other form of domestic abuse have a higher risk of HIV infection, he said.
"If you want to address people's risk to HIV, you also have to address substance abuse and all these other issues," Hannan said. "Just as with IVU [intravenous drug user] populations, you need to put those support structures in place, whether it's detox or supportive community environments."
The Vancouver study also found that gay men aged 18 to 30 are twice as likely to engage in unprotected sex now than they were a year ago.**
That is a disturbing trend because researchers had hoped that behaviors were changing, Strathdee said.
"But in fact young gay men are, in some respects, no different than young people in general. There's a feeling of invincibility and that it won't happen to me, just like pregnancy."
And unlike older gay men, they have not yet watched their friends die, she said.
They have also been buoyed by reports about new drug cocktails that have delayed the onset of full-blown AIDS for some, and suggest a cure is within reach.
"When you're 20 years old and you're embarking on a lifetime of safe sex with latex between you and another person, that's a pretty big commitment. It's easier to fall off the safe-sex band wagon if you think you can be treated." Strathdee's message to the conference today will be that the epidemic isn't over and education hasn't been successful with every community.
Hannan said a young gay man who feels isolated and afraid may be unwilling to talk about safe sex with a partner who is showing him kindness and affection.
The federal health department estimates there were 3,000 to 5,000 new HIV infection in 1996 in Canada. That compares with 2,500 new cases annually from 1989 to 1994.
*Note from the Project Coordinator: this headline is misleading, and isn't supported by the actual text of the article. We aren't saying that the infection rate among young gay and bisexual men has increased, as we didn't know what it was before we began this study. The infection rate we found in the Vanguard Project is about twice as high as what has been reported by similar studies in the United States, so it's higher than we might have expected, but not necessarily any higher than what it used to be.
**Although this is correct in epidemiological terms, this statement can be very misleading, and has caused some confusion. There has in fact been a marginal increase in risk behaviours from one year to the next. When you compare only those whose behaviour has changed from one year to the next, however, participants are twice as likely to have increased their risks rather than decreased them.
For more information, contact:
Bonnie Devlin
Vanguard Project Coordinator
608 - 1081 Burrard Street
Vancouver, BC, Canada, V6Z 1Y6
Tel: (604)806-8306
Fax: (604)806-9044