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According to new estimates from the Centers for Disease Control around half of gay and bisexual black men in the United States will be diagnosed with HIV in their lifetime.

While the lifetime risk of a positive HIV diagnosis has fallen from 1 in 78 Americans overall in 2005 to 1 in 99 today, the decline has not been distributed equally among the U.S. population. For the foreseeable future, the CDC estimates that gay, bisexual, black and Hispanic people will continue to bear the brunt of the HIV epidemic. The new study is the first time that the CDC has estimated lifetime HIV risk based on race.

The CDC states that a number of factors may contribute to the higher HIV risk associated with gay and bisexual black men.

Those factors include socioeconomic circumstances – such as limited access to quality health care and higher levels of unemployment – smaller sexual networks and lack of awareness of HIV status.

“These estimates are a sobering reminder that gay and bisexual men face an unacceptably high risk for HIV—and of the urgent need for action,” said Dr. Eugene McCray, director of the CDC’s Division of HIV/AIDS Prevention. “If we work to ensure that every American has access to the prevention tools we know work, we can avoid the outcomes projected in this study.”

The chances of being diagnosed with HIV is highest in the District of Columbia, as well as in Southern states, such as Georgia, Florida, Louisiana and Maryland.

Part of the CDC’s prevention efforts aimed at slowing the spread of HIV include increased testing, getting those with HIV diagnoses into ongoing care and on antiretrovirals to suppress the virus, and promoting the use of pre-exposure prophylaxis (PrEP) and condoms, particularly for those populations at higher risk of infection.

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