Our HIV crisis: Young and at risk

Our HIV crisis:
Young and at risk

Published on February 4, 2015


In most students’ minds, the HIV/AIDS crisis was an event of the past: a bleak time of public condemnation of men who have sex with men, a searing recognition of the absence of legal and human rights afforded to affected communities and, for many, a period of intense sadness and fear. Yet the belief that HIV in America is no longer a public concern couldn’t be further from the truth.

Federal research shows that the nation’s HIV rate fell by a third from 2001 to 2011. But, in the same 10-year time frame, new diagnoses of HIV among gay and bisexual men between the ages of 13 and 24 increased by nearly 133 percent. Why is this happening, and why aren’t people paying attention?

Kyle Tramonte — Green on the Vine

We can attribute this lack of awareness at least partially to a diminished sense of urgency surrounding the virus. With the advent of prescription drugs that depress HIV-positive individuals’ viral loads, it slowly fell out of the news cycle. Soon after, the same-sex marriage movement all but replaced other LGBT community issues on the national airwaves. A cohort of young men now face an increased risk of contracting a virus relegated to the past, all while the public looks elsewhere.

Yes, the virus is spread more easily through anal intercourse, making gay men more susceptible. Still, we must recognize that two behavioral trends play an outsized role in the spike in incidence: Gay and bisexual men tend to have more partners and to use condoms less often than our heterosexual counterparts. But, as Michael Specter noted in the New Yorker over a year ago, “HIV is tied up with sex, a basic human need, but also with desire, shame, discrimination and fear. What twenty-year-old man, enjoying his first moments of sexual adventure, is going to be scared because, ten years before he was born, people like me saw gay men writhe and vomit and die on the streets where he now stands?”

According to an article in the News (“Sex isn’t always safe at Yale,” Jan. 23), Yale students cite decreased sensation as a primary motivation for not using a condom. Condom usage among men who have sex with men increased in the 1980s and 1990s as a direct result of the mass death of members of the gay community. But because we as a society no longer see people dying in the street, the split-second decision to forego safety at the expense of pleasure is calculated using a misguided risk assessment.

The nature of HIV testing also provides some answers. Tests that measure the antibodies resulting from HIV infection are subject to a “window period” of six to 12 weeks. If you get tested in the first three months post-infection, you may return negative results. Even further, an individual’s viral load is highest in this time window, making the period immediately post-infection also the most dangerous. Antigen (RNA) tests can return results within one to three weeks of infection, but these tests are more expensive and offered less often.

These numbers are, of course, only relevant to those who choose to get tested; the Centers for Disease Control and Prevention report that one in five infected people do not know they are HIV-positive. The takeaway? Self-reported, medically unsubstantiated assessments of sexual health should be viewed with at least some caution for the benefit of community health.

On this campus, ignorance regarding the state of HIV in America is also a product of the predominantly white and wealthy composition of the student body. A sizeable portion of our peers identify as gay and bisexual, but as long as the HIV crisis disproportionately affects people of color and the economically disadvantaged, HIV prevention will likely remain an issue to be tackled at a later date. We must recognize that HIV is a problem that affects all of society if we are to make a dent in public consciousness.


The first step in combatting the HIV/AIDS crisis is getting tested. If you or someone you know would like to receive free, confidential HIV testing, please call 203-936-8669.

Nearly six years ago, public health researcher Ron Stall predicted that 50 percent of gay and bisexual men in our generation would contract HIV by age 50. Quality of life for HIV-positive members of our society has improved drastically in the last 20 years, but failure to recognize this degree of incidence in any community is a crime.

In conversations with professors and students, an interesting metaphor arose: If you are standing on the bank of a swift-moving river and see someone floating by, you might try to save them. If you see 10 people float by, it’s probably best you look upstream to see what the hell is going on. In the coming weeks, I will be talking to University administrators, students and public health experts to examine what role Yale and its students can play in addressing the crisis. We have to; people are drowning and few are on the riverbank to even notice.



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About the series

Our HIV Crisis is a series examining the HIV/AIDS epidemic. Focusing primarily on high-incidence communities in America, as well as on the landscape here at Yale, these columns seek to inform students about the most recent trends and challenges in combatting the crisis.