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Older African-American
Men with HIV Often Have Sex Without Condoms
By Annette Whibey, Journal of Advanced Nursing
October 16, 2007
As many as four out of ten HIV positive African-American men could be
putting their partners at risk by not using condoms, according to
research in the Journal of Advanced Nursing 60.4.
A study of 130 middle-aged and older men in the USA found that many of
the 40 to 65 year-olds were engaging in high-risk sexual practices.
38 per cent didn’t use condoms during oral sex, with 25 per cent having
unprotected vaginal sex and 22 per cent having unsafe anal sex. The
research also showed that men who were single and displayed fewer HIV
symptoms were least likely to use condoms during sex.
“Despite the worrying number of men not using condoms, 78 per cent of
those who took part in the study were able to answer questions about HIV
and AIDS correctly and 25 per cent claimed to be knowledgeable about the
subject but still engaged in risky sex” says Dr Christopher Lance
Coleman from the University of Pennsylvania School of Nursing in
Philadelphia.
“These findings are of particular concern as HIV and AIDS rates among
black (non-Hispanic men) in the USA and in people over 50 have risen
considerably in recent years. In fact, AIDS prevalence statistics for
minority men in the USA are staggering.”
For example:
• In 2005, 127.6 per 100,000 cases of HIV/AIDS were African-American men
compared to 18.5 for White men, according to data for 33 US states using
confidential name-based reporting. The US Center for Disease Control
suggests that this ethnic group is eight times as likely to develop AIDS
as white males.
• Figures for 2005 also show that 44 per cent of all new cases of HIV
were black (non-Hispanic) males, based on the latest data from 50 US
states.
• AIDS rates are also rising in people over 50. In 2006, 27 per cent of
adults living with AIDS in the USA were over 50.
77 per cent of the 130 African-American men who completed the
questionnaire for this study, after responding to advertisements posted
in two infectious disease clinics, were single. The average age of the
participants was 46.
60 per cent were homosexual and 40 per cent were heterosexual. 32 per
cent had received mental health treatment during the last year and the
majority earned less than $10,000.
“While we think that our findings are compelling, it would be unwise to
conclude that - as with any study - they are representative of all older
African-American men who are HIV positive” stresses Dr Coleman.
“However, the findings of this study are worrying, particularly in view
of rising HIV and AIDS rates in both ethnic communities and the over
50s. They definitely point to the need for further research into why
older African-American men with HIV don’t use condoms.”
In 2006 UNAIDS - the joint United Nations programme on HIV and AIDS –
estimated that there are now 39.5 million cases of HIV and AIDS
worldwide. And they called for an international response to curb the
stigma experienced by homosexual men who are HIV positive.
“We welcome this move as we believe it is essential to break down
barriers to condom use among all people with AIDS and HIV” says Dr
Coleman. “Some studies have even suggested that homosexual men have sex
with women to hide their sexuality and HIV status.”
The authors hope that their findings will add to the ongoing debate
about safe sex and condom use and highlight the need for more tailored
initiatives to be developed for older African-American men.
“Health promotion messages have traditionally been targeted at young
people” says Dr Coleman. “But the increased prevalence of older ethnic
males with HIV and AIDS makes it essential for health professionals to
promote safe sex and increase condom use to this target audience.”
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