Rise in AIDS cases seen in younger homosexuals

NEW YORK — NEW YORK -- Signs that the AIDS virus is continuing to spread among younger homosexuals are prompting fears that another generation of gay men will be racked by tragedy.

The high toll of AIDS among gay men so far has largely resulted from the rampant spread of the virus during the late 1970s and early 1980s, a time when few people were even aware of a disease that was only recognized by doctors in 1981. In some cities like New York and San Francisco, close to half the gay men became infected in that period.


Since then, encouraged by a barrage of information and the example of deathly ill friends, gay men have largely changed their behavior. Huge numbers adopted "safer sex" practices, such as using condoms or avoiding anal intercourse, and the rate of new AIDS infections slowed drastically, studies have found.

The hope was that in the new climate of AIDS awareness, succeeding generations of gay men could avoid disaster. Gay men accounted for more than 60 percent of the 152,000 cases of AIDS reported through September.


But sketchy evidence suggests that many homosexual teen-agers and young adults are still engaging in unprotected intercourse and that many are becoming infected with the human immunodeficiency virus, leading to calls for much more aggressive prevention campaigns.

"Safe sex is not something that gay teen-agers have embraced," said Dr. Donna Futterman, who sees the consequences in her work as medical director of the adolescent AIDS program at Montefiore Medical Center in the Bronx.

Gay men and those who counsel them say it can be difficult for

teen-agers who are experimenting with their homosexuality -- often in turmoil about their sexual identity, struggling with society-induced shame and desperate for affection -- to scrupulously avoid risks.

Even young men who are better adjusted and well-informed about acquired immune deficiency syndrome may not fully understand that almost any unprotected sex may be suicidal, or they may have a dangerous sense of youthful invulnerability.

Many similar issues also bedevil efforts to protect heterosexual teen-agers from AIDS, a growing problem in inner cities. But with the virus so prevalent among homosexuals, the risks for gay men are especially high.

Although the extent of AIDS infection in younger gay men is not known, the available indicators have touched off alarm.

In a 1989 survey of homosexual men aged 18 to 25 in three West Coast cities, 43 percent said they had engaged in unprotected anal intercourse in the previous six months. That is more than twice the rate found in surveys of older gay men, said Robert B. Hays of the University of California at San Francisco, an author of the study.


A 1989 study of homosexual and bisexual men visiting clinics for sexually transmitted diseases in the San Francisco Bay area found 41 percent of men aged 20 to 24 in San Francisco, and 24 percent in neighboring counties, infected with the AIDS virus.

The researchers, from the San Francisco and California health agencies, said the findings were alarming because most of the younger men probably acquired the virus "since 1983, when the annual incidence of new infections began to decline in San Francisco."

Likewise, a small sample of homosexual men visiting New York City clinics for sexually transmitted diseases in 1988 found 13 of 38 of those aged 15 to 24, or 34 percent, to be carrying the virus. While those visiting venereal disease clinics cannot be considered a representative sample, researchers consider the figures ominous.

"What comes out over and over is that younger gay men express the view that AIDS is a problem of the older generation," Mr. Hays said. "They say if I have sex with someone my age, then that's safe sex."

Gary Reynolds, a 26-year-old in Santa Cruz, Calif., once held that attitude. "I was aware of AIDS early on," he said. "But I thought that AIDS was a problem for men in their 30s who go to bathhouses and live in San Francisco," said Mr. Reynolds, whose AIDS was diagnosed several years ago.