CDC study reveals gaping holes, unanswered questions

Mexico City, Mexico -- The U.S. Centers for Disease Control and Prevention has just released a much-awaited study confirming our worst fears: The American epidemic has been at least 40 percent larger than we have known for more than a decade. This sad news serves only to dramatically undermine the point AIDS advocates have been making throughout that time: America has utterly failed to invest meaningfully in ending a domestic epidemic that is spiraling out of control.

At the same time, the CDC study raises as many questions for Black Americans as it answers. While the data offers a closer look at the big picture than we have previously had, it does little to illuminate the dynamics of the Black epidemic, beyond reconfirming that we are far disproportionately affected.

The study concludes that Black Americans made up at least 45 percent of new infections in 2006. Given that finding, it must now be the CDC's most urgent research priority to provide useful details to our community on how the virus is spreading, who is most at risk, and what we can do about it. We cannot afford a long delay in getting this information out, and the CDC must clearly communicate directly with the Black community about when the information will be available.

The new study does tell us a few important things.

Previously, the CDC had estimated that America logs 40,000 new HIV infections a year, roughly half of them African American. But that number was based on testing technology that detected only when someone is infected with HIV; they were unable to say when the infection occurred, and thus unable to clearly know how fast or slow the epidemic was growing.

Today's study is the result of new technology that allows researchers to determine if an infection is, say, six months or six years old. Using that new tool, CDC discovered that, in 2006, an estimated 56, 300 people were newly infected.

Further, the agency previously estimated America had logged 40,000 new infections a year for the last several years. The new study finds that, actually, America's rate of new infections has never dropped below 50,000 a year. It finds that the epidemic's annual growth leveled off at 50,000 people in the early 1990s, then increased again in the late 1990s, to between 55,000 and 58,500 infections a year. The annual growth has remained in that range ever since.

That finding also implies that the current estimate for numbers of people living with HIV/AIDS--as many as 1.2 million--is inaccurate and that the real number is likely 40 percent higher. The CDC has said it will release a new estimate by year's end.

Given all of this new information, the study raises many questions about our existing understanding of who is most affected and how. It broadly confirms what we already knew: African Americans in general and gay and bisexual men of all races are most hard hit. Gay and bisexual men accounted for 53 percent of the new infections logged in 2006, the study found. African Americans, meanwhile, accounted for 45 percent of all infections that year.

Unfortunately, that's where the useful information in the study ends. We don't know how many of those gay men are Black. We don't know who among the infected Blacks are women, men, gay, straight--or anything else. Until the CDC can clarify these questions, the data released this weekend is all but useless to Black people in specific.

A mountain of previous research has found that Black women and Black gay and bisexual men are at the eye of the domestic AIDS storm. Black women are believed to account for two-thirds of all infections among women, and AIDS remains a leading cause of death for young Black women. Another CDC study found that 46 percent of black gay and bisexual men tested in several major cities were already HIV positive.

Startling numbers like these ought to make explaining the details of the Black epidemic an obvious top priority for the CDC. We are happy to see the agency's researchers have a new tool for understanding the overall American epidemic. But they must immediately use that tool to better explain the Black epidemic, which all previous research has found to be most at-risk.