The other day I mentioned that HIV infection rates in NYC were down overall, but up for young gay men. Now the City has released the analysis of the causes of death for 2006 (PDF) and actual deaths from HIV are the lowest since 1984. In fact they went down a whopping 14.8% between 2005 and 2006. Given that we didn’t know HIV/AIDS existed until 1981 or 1982 – we’re basically at an all time low for HIV-related deaths.

For those of you who wonder why guys would “risk their lives” barebacking… The reason is simple – ’cause they don’t see people dying anymore. The generation before me was decimated, my generation saw some people die and a lot of others have serious problems (prior to 1996 when protease inhibitors came out). The generation after mine just never saw the sick or dying and they are the ones where HIV infections are on the rise.

Still, 1209 people died of HIV/AIDS in New York last year. I really wish the report told more about them. We know 34% of the deaths were black men; 21% black women; 11% white men; and 3% were white women. We know they were more likely to live in the Bronx (357 with a rate of 26.8 per 100,000) than in Manhattan (277, 18/100,000) or Brooklyn (363, 14.7/100,000). We know (luckily) that kids are no longer dying of it – just one death under the age of 15. We know the average age of people dying of AIDS is climbing (now up to 48.7 years for men). We know that in terms of “years of potential life lost” that both cancer and heart disease are each two and a half times the problem of HIV/AIDS. HIV/AIDS is on par with overdoses and murder in that regard.

But how long had they been poz? Did they have good insurance? Did they adhere to their cocktails? Did they take recreational drugs? Did they have other health complications? Were they gay, bisexual, IV drug users?

There are trends in the statistics that make me think actual deaths from HIV/AIDS are primarily hitting low-income communities of color. If the deaths aren’t predominantly in the gay community, it means AIDS-related deaths in the gay community really are at an all-time low and explains why the only group with an increasing rate of HIV infection is young gay men – they just aren’t seeing the problem, so they don’t see the need for a solution. It’s classic risk vs. reward behavior.