His death sentence was later overturned (mostly because Burdine's public defender had slept through much of his trial), but the homophobic thinking – that prison is some kind of paradise for gay men – lingers on. After 17 minutes of deliberation, the jury obliged and sentenced Burdine to die. Other factors may include different degrees of knowledge of partners’ HIV status, and presenter Hyman Scott commented that there was some evidence that black men might not so often be doing other things that reduce HIV risk, such as withdrawal before ejaculation.I n 1984, when Calvin Burdine was awaiting sentencing for allegedly stabbing his gay lover to death, the prosecuting attorney encouraged the jury in his closing remarks to award Burdine the death penalty, rather than life in prison, on the grounds that sending a gay man to prison was akin to sending a kid to a candy store. Other factors include network effects, meaning that black men tend to have sex partners from a smaller pool of mainly black partners, and more age-mixing, meaning that black men in some studies have been found to be more likely to have partners who are significantly older than them – and therefore more likely to have HIV. Health inequalities also mean that partners are less likely to have undetectable viral loads. It may be simply because HIV prevalence is higher in US black men so they are generally in a higher-risk environment. Black men were in a minority in the studies used, and made fewer study visits, so the figures for them have more uncertainty. Why the higher risk for black men? This is the unanswered question, and isn’t explained by this study – the findings of which have been observed in other studies too.
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However, because of relatively few trial visits and HIV infections in black men, this difference was not actually statistically significant.Īdjusting it by age reduced the increased risk to a 22% higher risk for black men (because they tended to be younger), but an added risk remained. It varied just as much if not more for ethnicity: it was 1 in 141 for white men (and almost the same for Latino), and 1 in 96 for black men and ‘others’ (which were mainly men of mixed race). The average per-contact risk varied with age: for unprotected receptive sex (with an HIV positive partner) it was 1 in 102 for under-25s, 1 in 115 for 25 to 30 year olds, and 1 in 156 for the over-30s. On the contrary, they had considerably fewer – just three for receptive sex and five for insertive sex on average in six months, compared with eleven and twelve respectively for white men. This was not because black men had more unprotected sexual contacts. Unadjusted for other factors, men under 25 had a 31% higher per-contact risk of being infected, and black men had a 78% higher risk.
Risk varied between studies, with the HIV risk in VAX004 72% higher and in EXPLORE 13% lower than in the VPS study. Researchers from the University of California, San Francisco, and the San Francisco Department of Public Health, used data from surveys of gay men that were conducted from 1992 to 2003 to find out if young men and black men had a higher per-contact risk of HIV infection that was not explained by other behavioural or demographic factors.Īveraged across studies, the risk for unprotected receptive sex with partners of unknown HIV status was one per 204 contacts – not much less risky than with known HIV-positive partners. This is not explained by individual risk behaviour: young gay black men actually have fewer partners and lower rates of recreational drug use than other gay men.
Black people form 12% of the US population but have 45% of new HIV diagnoses and, while new HIV diagnoses stayed steady amongst most population groups in the last three years, they increased by 48% in young black gay men. Young men who have sex with men (MSM) and MSM of colour have the highest HIV incidence rates in the US. An analysis of four studies of sexual risk and HIV infection in US gay men, presented at the 20th Conference on Retroviruses and Opportunistic Infections (CROI 2013), has found a 22% higher risk of HIV infection per sexual contact in black gay men that is not explained by other factors such as number of sexual partners, injecting drug use or age.