by Steve Martindale
Young gay and bisexual men are becoming infected with HIV at twice the expected rate, according to the latest findings from the Vanguard Project.
The study has found higher rates of HIV infection in the Vancouver area than have been reported in similar studies in American cities.
Almost 3% of participants seroconverted in the first year of the study, not including the men who tested positive at the beginning of the project. While this percentage may seem low, the cumulative effect is alarming. If this trend were to continue, one-quarter of young gay and bisexual men who are currently HIV-negative would in theory become infected in the next decade, and it would take under 25 years for half of the HIV-negative population to become infected.
Psychological and emotional well-being may be key issues in explaining why young people continue to put themselves at risk: 22% of study participants reported having been diagnosed with a mood disorder or mental illness (most commonly depression); over half had seriously considered suicide at some point in their lives and 18% had made at least one suicide attempt.
Violence is also common in our community: 11% of participants reported having been gay bashed; 18% had experienced domestic violence; and one-quarter had been sexually abused or assaulted. Preliminary results from the study suggest that men who have been victims of violence are subsequently more likely to put themselves at risk for HIV infection.
The study has also found that HIV infection rates and risk behaviours were considerably higher among sex trade workers and street-involved youth than among young gay and bisexual men in general. Poverty, substance use, mental health, low literacy and unstable housing pose additional risks for this particularly vulnerable population. Male sex trade workers are more likely to have been sexually abused, assaulted and institutionalized, and report higher rates of substance use, particularly injection drugs.
Although infection rates are much higher among injection drug users (IDUs) than among gay and bisexual men, the rate of infection found in the Vanguard Project was mainly not attributable to injection drug use.
"This indicates that there are at least two overlapping epidemics of HIV in the Vancouver area," says Dr. Steffanie Strathdee, who oversees both the Vanguard Project and the Vancouver Injection Drug Users Study (VIDUS), which is examining the recent outbreak of HIV among the local IDU population.
Vanguard nurse Mary Lou Miller, Dr. Strathdee and I presented these findings in Ottawa last week at the annual conference of the Canadian Association for HIV/AIDS Research. The full text of these presentations can be found on the newly revised Vanguard website.
It's clear from our findings that young men who have sex with men (MSM) must continue to be the focus of intensive prevention efforts. Such efforts should take into account the fact that not all MSM self-identify as gay or bisexual and therefore may not be reached through conventional education efforts; and that young MSM are often victims of physical and sexual violence, which may affect attitudes and behaviours surrounding safer sex.
In the wake of the recent decision by the Surrey School Board to ban gay and lesbian resource materials, our findings illustrate the urgent need to foster more supportive environments for sexual minority youth.
*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.
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