HIV “Exploding” Among Very Young Gay Men

HIV “Exploding” Among Very Young Gay Men

In confronting the AIDS epidemic, we’ve often been confounded when it comes to effective prevention techniques and activities, especially as the disease worked its way into populations outside the mainstream.

This has included the homeless, IV drug users and sex workers, among others, as well as poor, single black women who are particularly at risk for HIV infection.

While men who have sex with men have been at the core of the epidemic since the beginning, community case workers at VillageCare, one of New York City’s oldest AIDS care providers, say we’re facing an explosion in HIV infection among younger gay males.

These very young gay men are told by their families, friends, religious leaders and others that their sexuality is a mistake or an abomination.  They feel isolated and rejected, and are often depressed.

Among them, men of color are doubly traumatized as sexual and ethnic minorities – often economically shortchanged and rejected by “black society,” where churches vehemently condemn homosexuality.

Howard Haughton, a VillageCare case management program supervisor who is closely involved in reaching out to these young men, describes them this way:  “Many of our guys get the message that they are not worth saving.  In that context, wearing a condom may not factor in at all.”

What VillageCare community HIV case workers are seeing in New York was confirmed nationally by the Centers of Disease Control’s latest HIV incidence report, which showed a 21 percent increase in infections among those aged 13 to 29.  This was driven by a 34 percent increase among young men, including a 48 percent increase among young black/African American men who have sex with men (MSM).

The most telling finding in the latest report, though, was this one:  “CDC estimates [that] MSM represent approximately 2 percent of the U.S. population, but accounted for more than 50 percent of all new HIV infections annually from 2006 to 2009.”

Many of these young men were shaped by negative, often traumatic, experiences as they grew up. Among VillageCare’s caseload, 30 percent report childhood sexual trauma, and 50 percent report a history of sexual and/or physical abuse.  They also tell of being bullied or attacked in school, living in a family steeped in culture that disapproves of homosexuality, and being in constant fear of being disowned for being gay.

All of this results in a marginalized community of young men who have sex with men, operating on the fringes, invisible to the rest of society — particularly the mass media.

These are young men searching for love in the dark without a map. They lack role models and are unable to discern appropriate sexual boundaries. At worst, they can be promiscuous, even careless; at best, they have trouble negotiating safer sex.

Reaching out to them effectively is difficult, because secrecy and silence abound.

It means meeting them on their own turf – “where they’re at,” Haughton says, getting out on the street, finding them and connecting without scaring them off. “When these men are engaged with caring people, their ability to change their circumstances and behavior is extraordinary,” he says.