The AIDS epidemic in America is rapidly becoming concentrated among poor, young black and Hispanic men who have sex with men

Despite years of progress in preventing and treating H.I.V. in the middle class, the number of new infections nationwide remains stubbornly stuck at 50,000 a year — more and more of them in these men, who make up less than 1% of the population. The affected group includes men who are openly gay, secretly gay or bisexual, and those who consider themselves heterosexual but have had sex with men, willingly or unwillingly, in shelters or prison or for money. Nationally, 25% of new infections are in black and Hispanic men, and in New York City it is 45%, according to the Centers for Disease Control and Prevention and the city’s health department. Nationally, when only men under 25 infected through gay sex are counted, 80% are black or Hispanic. According to a major C.D.C.-led study, a male-male sex act for a young black American is eight times as likely to end in H.I.V. infection as it is for his white peers. The crucial factor was that more of their partners were older black men, who are much more likely to have untreated H.I.V. than older white men. According to the C.D.C., 79% of H.I.V.-infected black men who have sex with men and 74% of Hispanics are not “virally suppressed,” meaning that they can transmit the infection, either because they are not yet on antiretroviral drugs or are not taking them daily.