More than 70 gay black leaders met with senior CDC officials at an agency-sponsored meeting August 29-31 in Atlanta to discuss CDC's role in reducing HIV among black men who have sex with men (MSM).

A CDC survey, released in June, of black MSM in five major US cities found that 46 percent were HIV-positive. A 1994 CDC study found that 21 percent of black MSM were infected, and the figure had climbed to 30 percent six years later.

"We recognize that this is not business as usual," said Ron Valdiserri, CDC's acting director for HIV, STD and TB prevention. "As a nation we need to take a serious look at the state, local and community level. That's why we called this meeting."

Earlier, in an open letter to black MSM, "Nearly Half of Us May Already Be Infected. Who Gives a Damn?" posted on the Black AIDS Institute (BAI) Web site, 50 black gay leaders vowed to make that high infection rate resonate.

"I was shocked that there wasn't any reaction from anyone," following the study's release, said Phill Wilson, BAI's CEO. "Not from the black community, gay community or straight community. This data demanded front page coverage."

"The prevention program was designed for gay white men, and we were told to make it work for gay black men. It didn't," said Wilson, a signatory to the letter and a conference participant. "Many people are taking from this data that gay blacks are engaging in riskier behavior, but that's not the case. HIV prevention in the black community was delayed, which is why there's higher incidence."

"We've modified our research to understand the high rate of infections in the black community," said Valdiserri. While he empathized with the frustrated leaders, Valdiserri said CDC also needs community help fighting new infections among African Americans. The vast majority of CDC's prevention budget goes to state and local health departments, he said.

To reduce new infections, the leaders recommended that:

• CDC should establish an office for gay black health issues.

• CDC should set a goal of a 50 percent reduction in new HIV infections among black MSM over five years.

• President George W. Bush should speak about HIV among black MSM on World AIDS Day, Dec. 1.

• The Presidential Advisory Council on HIV/AIDS should immediately address black MSM HIV rates.

Valdiserri said CDC is reviewing the recommendations and will give the group an update in September.

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