Friday is for Faeries

Program helps men explore reasons for cruising

[Salt Lake City]

Cruising. It's nothing new — a subculture of men who seek out sexual encounters with other men in public places. Many don't identify themselves as gay. Some are married, often with children.

It's a behavior that Jerrie Buie, director of Pride Counseling, describes as complex. Men who struggle with their sexual identities sometimes stumble upon cruising. They're attracted to the anonymity, he says, but also to the social connections, the "common sense of we're all sitting here for the same reason."

Through the Healthy Self-Expressions program, Buie counsels men arrested for cruising. It's a therapeutic response to cruising that grew out of a collaboration among the gay community, law enforcement, therapists and others who got together in 2000 to address the issue.

"There are so many layers to this issue," Buie says. "It really goes beyond a bunch of men looking for sex. People in this kind of culture really struggle with a sense of orientation."

Read the rest.

The politics of disclosure

To tell the truth

by Shawn Syms
Oringinally published in Xtra.ca


Back in 1978, queer activists in Toronto, Canada formed the Right to Privacy Committee to protect the rights of people arrested for having gay sex — whose names were often published in the media, leading to ruined lives and suicides.

In the intervening years, our movement's focus has shifted away from protection of privacy and back toward the empowering nature of proclaiming our identities to the world. But there are a lot of different people, circumstances and experiences under the queer umbrella. And on the question of coming out, one size does not fit all.

Adam is a transman — but most people don't know it. He lives "stealth," in other words, not defining himself by his body and history each time he introduces himself to someone.

Some would argue that this is dishonest — or that Adam is "in the closet" about being trans. Such people "tend to understand gender and identity based on their own personal anxieties," he says.

Adam is very careful who he tells about his prior experience as female — not surprising given the threat of violence and the ongoing history of people who have been murdered once they were exposed as trans. (The Transgender Day of Remembrance is November 20; see rememberingourdead.org for more information.)

Guarding information about his past is not the same as a gay person concealing their present sexual identity, he says. And being outed by other people takes away his ability to engage others on equal terms. Once his personal history is revealed, relationships with others are usually compromised. "People treat you like a victim, and no longer consider you a peer," he points out.

"People stop talking to you, but they stare at you right through your clothes. People don't want to hire you, pray with you, eat with you or have sex with you — or enter the bathroom at the same time as you. People think it's now open for discussion to strike up conversations about your genitals, what they look like, and how they work."

"Disclosure is a gift," he says. But sometimes that gift is unwanted — or misused. "People expect you to be a visual aid, the face of all their gender questions and anxieties." They either gossip — or desire to appear "in the know" about trans people.

Having the choice of whether or not to disclose can itself be painful. Because he's stealth, gay men don't think twice about insulting women in front of him — and he's exposed to other bigoted ideas when people assume he's just one of the guys. "I've heard what people can sound like when they think no one is listening," he says.

Still, presenting himself as any other man would has integrity and offers safety. "I can stick up for women and gays in social environments where this is not expected, and actually influence someone's thinking."

Rick's a gay man with HIV. He says being gay is a basis for an identity — but, to him, having HIV isn't. "I'd like to be known as a person first, not a virus."

"People don't come out about having diabetes," he says. "And herpes is one of the most common STDs on the planet, but most people who have it don't feel the need to tell everyone."

Rick says other gay men have told him he has an obligation to tell others he's positive — or that doing so would make him a better, more honest person. "The risk is not the same for everyone. How open you can be often depends on how much you can afford to lose," he says

"I've told a few people who are close to me — but I'm not willing to do it to fulfil someone else's agenda." He's particularly annoyed when he hears this from negative guys. "It's not just an unsophisticated viewpoint — it's cavalier. This is my life we're talking about. We may have come a long way in terms of treatments, but a couple decades worth of social stigma sure hasn't gone away."

"People's opinions of you as a human being can immediately change," he explains. "They project their own fear about getting the virus — or their own guilt about unprotected sex — onto you. They judge you an irresponsible person, regardless of how you got infected."

The impact of the virus in his life is far smaller than the importance that other people give it, he says. "You become the poet with HIV, or the architect with HIV — instead of just a poet or architect."

Rick says disclosing his status involves giving up control. "Once people have that info about you, there is no telling who else will find out, or how."

He admits he is legally protected from discrimination, but says he'd just rather not have to deal people knowing. "I'm just trying to live my life," he says. "I protect my health and that of my partners. I don't need to deal with everyone else's crap on top of that."

The accounts Rick and Adam gave me are not completely analogous — being trans is not a disease. Some trans people do consider their status a medical matter — but for many, it's a basic question of self-determination and control over their own bodies and lives.

But what these stories have in common is examples of how some people's bodies are regulated because of other people's shame. There are also parallels with other issues of personal autonomy, such as women's right to reproductive choice. Most important, these stories show how the standard-issue gay directive to come out doesn't apply to all people in all situations.

You don't have to be trans — or living with HIV — to care about or learn about those issues. Demanding disclosure puts other individuals at risk — and places the onus of social change squarely on their backs. But we're far more likely to succeed in our quest for shared freedom if we all work together instead.

i’m fighting AIDS

When a close friend told Ramon Reyes that he had AIDS, it made Ramon aware of something he hadn't really thought about before. Now, the IUPUI student makes sure other people have the information they need, through his work with the National AIDS Foundation.

Visit AIDSVote.org and endorse the AIDSVote platform today!

The AIDS Foundation of Chicago--working in coalition with Housing Works, Gay Men's Health Crisis, AIDS Action Council and several dozen other groups--is proud to unveil a new source for information on U.S. presidential candidates' positions on HIV/AIDS.

www.AIDSVote.org is a candidate education and voter education project working to make sure candidates for public office know what it takes to end AIDS, and voters who care about ending AIDS know where the candidates stand on our issues.

The AIDSVote.org platform is a straightforward roadmap for our next President-it leads directly to the end of AIDS as a killer pandemic in America and around the world. We've got a ten-point domestic AIDS plan (http://www.aidsvote.org/platform#domestic) and a ten-point global AIDS plan (http://www.aidsvote.org/platform#global) with clear recommendations for public and private action to save lives, prevent new infections, and address the social conditions that drive the pandemic.

The AIDSVote.org has already been endorsed by dozens of the nation's leading AIDS groups, and by leading service and advocacy organizations in key early-primary states. We're working closely with the 08 Stop AIDS campaign (www.08stopaids.org) to highlight global and domestic AIDS issues in public events with the candidates. We'll be holding national conference calls during 2008 to explain how nonprofit groups can do election-year advocacy that's safe, legal and effective. And we'll be helping voters who care about HIV/AIDS understand the positions of candidates on life-and-death domestic and global AIDS issues.

Please take the time to visit AIDSVote.org, endorse the platform, and spread this message widely. This year World AIDS Day is on a Saturday - next year World AIDS Day will really be on Election Day.

Check out the AIDSVote website here: www.aidsvote.org

Full details on the platform are at www.aidsvote.org/platform

Endorse the platform here: http://www.aidsvote.org/member/register/

Ain’t no homosexuals here!!

by Denise McWilliams, Esq
Director Public Policy and Legal Affairs
AIDS Action Committee

Well it seems the evangelicals have finally found a way to bring AIDS into their special fold of Christian charity—they skip the part about gay men. Apparently, if AIDS is contracted by drug use or unsafe sex between heterosexuals, or better still a transfusion or perhaps maternal-child transmission, God not only permits but encourages ministering to its victims. And, there’s the international waiver—if you’re outside USA, preferably in some poor benighted African country, it doesn’t matter how you contract it. There’s room for all in the fold. But there still doesn’t seem to be any room at the inn for gay men in the United States.

Sadly, that seems to be a pretty accurate description of this administration’s position as well. Restrictions on proven interventions have essentially read the gay community out of prevention efforts and have resulted in….drum roll please…an increase of infections in gay men!! Of course I’m sure that when the CDC does finally, officially, release its increased estimates of annual HIV infection we won’t hear anything about that—but I predict there will be much conversation about the refusal of gay men to abandon their “ways” and significant hand-wringing over their unwillingness to become heterosexuals. Unspoken, perhaps, will be the phrase “Serves them right” but many of us will hear it nonetheless.

Body of Life.4 - Fats Fetish

by Norris Tomlinson

Only on LifeLube

Jumping on the “fat-free” band wagon can actually do you more harm than good. Achieving your personal best body requires a balance of healthy food intake, exercise, and rest. The food definitely should include some fats---“good” fats, that is.

What makes certain fats good for you? Check out the labels on the food you buy. Polyunsaturated and monounsaturated fats and oils are beneficial, even necessary for your health. The fatty acids---omega-3, omega-6, and omega-9---that make up poly- and monounsaturated fats may reduce the risk of stroke, high blood pressure and other health issues. Great food sources are salmon, tuna, walnuts, and almonds; among the various oils - corn, sunflower, olive, and canola top the list.

Like any good thing, taking in too many “good” fats can actually put you in a “bad” situation for your weight management. Fats contain over two times the amount of calories per gram than both protein and carbohydrates. Eating more calories than your body can use will cause you to gain unnecessary and unhealthy weight that could lead to a host of problems, including high cholesterol, diabetes, stroke, cancer, and gout.

“Good” fats are like good sex. Having just the right amount can be so good for you. In general, making sure that you include the items above---as well as seeds and avocado--- in your diet, and, severely limiting the amount of fried foods and animal products---red meat and whole milk---will start you off on the right track to a more healthy diet and to less excess baggage and all of the problems associated with carrying it.

Don’t forget the importance of keeping things moving along, as we have discussed before. Keep eating the fresh fruits, green leafy vegetables and whole grains to perfect your diet design.

For more information on “good” fats check out:

http://www.healthcastle.com/

http://www.realage.com/

http://www.pamf.com/

Stay tuned to Body of Life. Next time well discuss getting longer and leaner.

Read past Body of Life posts here.

Bio Norris
Norris Tomlinson has been a professional in the fitness industry for 18 years. He is currently the Program Director and a master Pilates instructor for Cheetah Gym Chicago. He is the former Director of Fitness Services for Bally Total Fitness Corporation, responsible for fitness programming at approximately 400 clubs across North America.

Have a question for Norris? E-mail him here.

Where Do They Stand? Leading AIDS Groups Turn Up the Heat

Leading AIDS Groups
Turn Up the Heat on ’08 Presidental Candidates

Website and new report unearth surprising responses
on hot-button HIV/AIDS issues

Clinton, Edwards, Obama and Kucinich support
ending ban on federal funds for needle exchange

New York City, Nov. 28, 2007—Housing Works, Gay Men’s Health Crisis (GMHC), and the AIDS Foundation of Chicago—three of the nation’s leading AIDS organizations—polled 16 presidential hopefuls on pressing AIDS-related issues as part of an ongoing HIV/AIDS candidate and voter education campaign. Now the results are available on AIDSVote.org.

“World AIDS Day is this Saturday, but you could also say that World AIDS Day is Election Day 2008. That’s because our next President will have the opportunity and the responsibility to end AIDS,” said Charles King, President and CEO of Housing Works. “She or he will have the tools to treat 33 million people living with HIV—including over a million Americans—around the planet, as well as the tools to stop the spread of the virus. We’re here to build the political will to make that happen.”

“More than ever, the American public is calling for meaningful health care reform which includes bold leadership in the area of AIDS,” said GMHC Chief Operating Officer Robert Bank. “Voters need to know what the candidates will do to fight AIDS when determining their readiness to be President.”

The launch of AIDSVote.org, timed to coincide with World AIDS Day on December 1, features the results of the AIDSVote.org candidate questionnaire and Where Do They Stand? The Gay Men’s Health Crisis Report on the 2008 Presidential Candidates and HIV/AIDS Issues, a detailed portrait of every candidate’s history in public life on HIV/AIDS issues.

The AIDSVote.org website answers questions like "where does Rudy Giuliani stand on needle exchange funding?"; "will Sen. Barack Obama end federal support for ineffective and harmful abstinence-only education?"; and "will Sen. Hillary Clinton redouble efforts against global HIV/AIDS?". Voting records and public comments provide the basis for GMHC’s comprehensive report and a useful “quick chart” comparing the candidates’ AIDS-related public record and positions.

Some of the notable information available on AIDSVote.org and on GMHC.org:

• The GMHC report documents, for the first time in one place, the stark differences between Democratic and Republican presidential candidates on nearly every AIDS issue. For example, seven Democrats have committed to investing $50 billion to fight HIV/AIDS globally over the next five years. No Republican candidate has made a similar commitment. All eight Democratic candidates support comprehensive sex education, whereas seven of eight Republicans have opposed it. Most of the Democrats support lifting the ban against HIV-positive foreign nationals visiting and/or immigrating to the U.S.; most Republican candidates either support the existing ban or have not come out against it.

• The three leading Democratic candidates—Sen. Barack Obama, former Sen. John Edwards, and Sen. Hillary Clinton—have all publicly supported ending the ban on federal funding for needle exchange, a scientifically proven intervention to reduce the spread of HIV without increasing drug use. President George W. Bush and former President Bill Clinton faced stiff criticism by public health experts for failing to lift the ban during their terms in office.

• For the first time, five presidential candidates—Clinton, Edwards, Obama, Rep. Dennis Kucinich, and Gov. Bill Richardson—have committed to crafting a national AIDS strategy early in their first term if elected. The creation of a comprehensive outcomes-based national AIDS strategy with explicit benchmarks and accountability mechanisms is a key plank in the AIDSVote.org platform. The U.S. requires nations applying for billions of dollars in federal funding under the President’s Emergency Plan for AIDS Relief (PEPFAR) to develop such plans—but the U.S. has yet to develop its own national strategy to combat the domestic HIV/AIDS crisis.

AIDSVote.org is a nonpartisan voter and candidate education campaign endorsed by dozens of leading AIDS organizations including the Campaign to End AIDS, AIDS Action Council, the National Association of People with AIDS, the Global AIDS Alliance, and HealthGAP.

While not endorsing candidates for public office, AIDSVote.org is dedicated to ensuring that presidential candidates know about the best possible strategies to make progress against HIV/AIDS in the U.S. and abroad. The website includes domestic and global AIDS platforms, which detail how the next president of the U.S. can end AIDS in places as remote as South Africa and as close as South Carolina.

“We not only hope to better inform voters about how important HIV/AIDS policy issues and the need for a national AIDS strategy are in the election but also hope to better inform the candidates themselves,” said Rebecca Haag, AIDS Action Council executive director.

“AIDSVote.org wants to make sure that whoever moves into 1600 Pennsylvania Avenue in January 2009 will make ending the AIDS epidemic a top priority,” said David Ernesto Munar, vice president at the AIDS Foundation of Chicago. “It’s a matter of life and death.”

The answers to the candidate questionnaire and GMHC’s candidate report are only the first installments that will be available on AIDSVote.org, which will track the presidential candidates’ positions on HIV/AIDS up until the November 2008 election.

Reflecting on the International Transgender Day of Remembrance

[Diego Sanchez blogged this last week for AIDS Action Committee and LifeLube wanted to share it with you here...]

by Diego Sanchez of AIDS Action Committee

A week after saluting our fallen soldiers on Veterans Day, and days before food and football feasting on Thanksgiving, we honor and reflect on our murdered transgender brothers and sisters on the International Transgender Day of Remembrance (TDOR) on Nov. 20.For some, it’s a day on the calendar. For me, it’s a day of vivid, visceral feeling because I know one thing: that on any day of any year, as a transsexual Latino man, I could be among those killed. I could, like too many others—remembered or forgotten—be attacked by someone with no regard for my life, someone who may not face responsibility for his or her brutal act of violence. TDOR remembers our dead and celebrates our lives.

The penalties for killing or firing someone like me are topics of debate in the halls of Congress, in the media and at people’s dinner tables. It’s troubling to realize that the protections most of us take for granted must be justified for the transgender community—we must convince people of our humanity. Those attitudes are humbling in their cruelty and destructive potential.

When I was five, I told my parents that I was “born wrong.” I didn’t have other language for it, but I knew I felt like a boy, despite being born female. My mother embraced me and showed me a magazine cover featuring Christine Jorgensen, then the most visible transsexual woman. She held me and told me it would be okay. Like every mother, I’m sure that she wished her embrace could protect and keep me safe in the world. But it couldn’t and it can’t.

In the trans community, experiences like mine are rare. Life has treated me gently and kindly. I was dually socialized. Mom gave me lessons for girls. Dad gave me tools to be a wise gentleman. I studied hard, enjoyed people, sports and music and built a successful career. I’ve reached my 50th birthday. So many of us are murdered well before our prime. That’s humbling, too.

Read the rest.

Who knew Danish pharmaceuticals could be so cute AND sexy?

Rates of infection remain high in the gay community—in Chicagoland and across the nation

LIVING WITH HIV

For Chris Stueber, a gay 26-year-old who lives in Rogers Park, staying HIV-negative is worth the hassle. He said he uses condoms, reads up on the risks and gets an HIV test every six months. But Stueber said many of his friends and acquaintances aren't so vigilant about preventing HIV, the virus once dreaded as an inevitable precursor to AIDS.

All too often, Stueber said, young men talk of having unprotected sex without questioning HIV status, figuring that odds are they'll eventually contract HIV anyway—and if they do, they can manage it with medication.

"The thinking is, 'There's a pill for that,'" Stueber said, noting that ubiquitous ads for HIV medications send mixed messages. "It's gotten to be mainstream."

Twenty-six years after HIV and AIDS were first spotted in the U.S., proceeding to decimate gay communities and kill hundreds of thousands more who contracted the disease through heterosexual sex, injection drug use or blood transfusions, better treatment options are allowing people to manage their infection as a chronic illness rather than succumb to it as a terminal disease.

Although treatment progress is undeniably a good thing (since anti-retroviral therapy came on the market in 1995, deaths from AIDS have dropped from a high of more than 50,000 per year to about 17,000 per year today), it may be one of several reasons why HIV infection rates remain staggeringly high in the gay community—in Chicago and nationwide—compared to other populations. About 45 percent of the 2,000 new HIV and AIDS cases diagnosed in Chicago each year are from men having sex with men, which has been constant over the last few years. Heterosexual sex accounts for about 14 percent of HIV/AIDS diagnoses while HIV among injection drug users has steadily declined, according to data from the Chicago Department of Public Health.

While the proportion of gay men with AIDS has declined considerably since the start of the epidemic, when they accounted for 85 percent of AIDS cases nationwide, gay men continue to be the most affected by HIV/AIDS. A five-city study conducted in 2004 and 2005 found that a quarter of gay men are HIV-positive, according to the Centers for Disease Control and Prevention.

As World AIDS Day approaches on Saturday, there is widespread awareness that the key to avoiding sexually transmitted HIV—the most common kind—is to avoid unprotected sex. So why does HIV remain such a scourge? Jim Pickett, director of advocacy at the AIDS Foundation of Chicago, believes gay men have been "terribly neglected" in the fight against HIV because most prevention programs focus on condom use and fail to address broader emotional issues.

Read the rest, and take a look at a great video interview with a young, gay black man living with HIV named Reginald Davis, in the Red Eye - the commuter newspaper of the Chicago Tribune.

Lack of HIV Prevention Efforts Among MSM Fueling Increase in New Diagnoses, JAMA Commentary Says

[courtesy of the Kaiser Daily HIV/AIDS Report]

A lack of HIV prevention efforts and an increase in risky sexual behaviors among men who have sex with men are fueling an increase in new HIV diagnoses among the group, Kevin De Cock, director of the World Health Organization's HIV/AIDS Department; Ronald Valdiserri of the U.S. Department of Veterans Affairs; and Harold Jaffe, a public health professor at the University of Oxford, write in a commentary in the Nov. 28 issue of the Journal of the American Medical Association, the Washington Times reports.

According to the commentary, the number of HIV/AIDS cases among U.S. MSM increased by 13% -- from 16,167 to 18,296 -- between 2001 and 2005. Syphilis cases also increased 10-fold among MSM (Wetzstein, Washington Times, 11/28). In addition, recent surveys have found an increase in risky sexual behavior among MSM who do not know their partners' HIV status, the authors write (Jaffe et al., JAMA, 11/28).

According to the authors, a lack of awareness about HIV and a decrease in HIV prevention efforts are fueling the increase. HIV/AIDS is "not as frightening as it was" when the epidemic first surfaced because antiretroviral drugs have allowed HIV-positive people to live longer, the authors write. In addition, younger MSM are unfamiliar with the effects of HIV among U.S. MSM in the 1980s, the commentary says.

The authors called on public health and community leaders to increase HIV prevention efforts and education about safer-sex behaviors to help curb the spread of the virus. Leaders also "must call for the end of stigma toward MSM, which may mitigate the internalization of homophobia leading to sexual risk behavior," the authors write. They add that leaders also should "advocate for legal domestic partnerships as a way to promote stable, longer-term" relationships among MSM (Washington Times, 11/28). In addition, HIV testing rates among MSM should be increased because many members of the group are not aware of their HIV status, the authors write. "Failure to address" issues such as testing, funding for public health strategies and community leadership "implies that the HIV/AIDS epidemic in MSM must be accepted as inevitable," the authors write, concluding that "this cannot be allowed to happen. The tragedy of the epidemic for an earlier generation of MSM must not be repeated" (JAMA, 11/28).

A summary of the commentary is available online.

The Ole Snip Snip Not Effective HIV Prevention for Black, Latino MSM

The following article abstract adds to other data published this year from Australia, for example, that circumcision is not a useful prevention method in most MSM populations

Circumcision Status and HIV Infection Among Black and Latino Men Who Have Sex With Men in 3 US Cities.

Epidemiology and Social Science

JAIDS Journal of Acquired Immune Deficiency Syndromes. 46(5):643-650, December 15, 2007.
Millett, Gregorio A MPH *; Ding, Helen MD, MS, MSPH *; Lauby, Jennifer PhD +; Flores, Stephen PhD *; Stueve, Ann PhD ++; Bingham, Trista MPH, MS [S]; Carballo-Dieguez, Alex PhD [//]; Murrill, Chris PhD, MPH [P]; Liu, Kai-Lih PhD, MPH [P]; Wheeler, Darrell PhD, MPH #; Liau, Adrian PhD *; Marks, Gary PhD *

Abstract:
Objective: To examine characteristics of circumcised and uncircumcised Latino and black men who have sex with men (MSM) in the United States and assess the association between circumcision and HIV infection.

Methods: Using respondent-driven sampling, 1154 black MSM and 1091 Latino MSM were recruited from New York City, Philadelphia, and Los Angeles. A 45-minute computer-assisted interview and a rapid oral fluid HIV antibody test (OraSure Technologies, Bethlehem, PA) were administered to participants.

Results: Circumcision prevalence was higher among black MSM than among Latino MSM (74% vs. 33%; P < 0.0001). Circumcised MSM in both racial/ethnic groups were more likely than uncircumcised MSM to be born in the United States or to have a US-born parent. Circumcision status was not associated with prevalent HIV infection among Latino MSM, black MSM, black bisexual men, or black or Latino men who reported being HIV-negative based on their last HIV test. Further, circumcision was not associated with a reduced likelihood of HIV infection among men who had engaged in unprotected insertive and not unprotected receptive anal sex.

Conclusions: In these cross-sectional data, there was no evidence that being circumcised was protective against HIV infection among black MSM or Latino MSM.

(C) 2007 Lippincott Williams & Wilkins, Inc.

Woof Wednesday

Clinton Announces Plan to Fight HIV/AIDS At Home And Abroad

Will Double Research Funding & Support Evidence-Based Prevention Programs

The Clinton campaign unveiled its plan to fight the HIV/AIDS epidemic in the U.S. and around the world. The comprehensive approach addresses the multiple challenges that HIV/AIDS has presented for over 25 years and includes investments for increased research, prevention and education, and access to treatment and other services. Hillary’s plan would especially help groups in the U.S. that have seen HIV infection rates rise over the past several years, including African Americans and gay men, and address the continued risk in Latino communities and among women. In addition, Clinton has pledged to increase funding for the global HIV/AIDS fight to at least $50 billion by 2013.

Read the rest.

Shining a Light on Gaps in HIV Prevention - March & Rally for Prevention Justice!

[Click image to enlarge. Visit the blog.]

HIV is not just a disease.
It's proof positive of injustice!
Please Unite with Us to March & Rally for Prevention Justice!

Tuesday, December 4
4:30 - 6:00 PM

Shining a Light on Gaps in HIV Prevention


March & Rally for Prevention Justice

Gather across the street from the Hyatt Hotel (corner of Baker St & Peachtree St NE) at Hardy Ivy Park for a peaceful march and spirited rally.



7:00 - 9:00 PM

Prevention Justice Dinner & Strategy Session
After the March & Rally, join us for a dinner and session at St. Luke's Church,
435 Peachtree St., NE, 2 1/2 blocks from the Hyatt Hotel

No hay bang bang without a condom in Buenos Aires

This is a cute public service advertisement LifeLube saw in the subte [metro] in Buenos Aires last week. It is part of a big campaign, complete with music video [con chicos muy guapos - see below] and a website here.

Post-exposure HIV drugs won't boost risky behavior

[via Reuters]

Giving antiretroviral drugs to people after they may have been exposed to HIV is an effective way to prevent them from contracting the virus, a new study shows.

What's more, people who know this option is available to them don't appear to be more likely to engage in risky behavior, Dr. Steve Shoptaw of the UCLA Department of Family Medicine in Los Angeles, who was involved in the research, told Reuters Health. "This is a viable way of helping people stay (HIV)-negative," he said.

So-called post-exposure prophylaxis, or PEP, has long been available to people who risk HIV infection on the job, for example a health care worker accidentally jabbed by a contaminated syringe. In 2005, the Centers for Disease Control and Prevention expanded its PEP guidelines to cover people exposed to HIV outside the workplace, for example through risky sex, condom breakage or drug use. But PEP still isn't widely used in such cases, Shoptaw and his team note, because it isn't covered by health insurance and is only very rarely offered as part of community health programs.

Read the rest.

Grants for LGBTI Social Change - ANNOUNCEMENT

Please see the following description of the Astraea Lesbian Foundation for Justice and its new round of funding, providing grants for “LGBTI social change and movement-building organizations based in Latin America, the Caribbean, Asia, the Pacific Islands, Eastern Europe, the former Soviet Republics, the Middle East, or Africa.” The deadline for this round of funding is February 1, 2008. Please see below for details.

The Astraea Lesbian Foundation for Justice began in 1977, when a small group of women created a multi-racial, multi-class, feminist foundation in order to address the lack of funding for women-specifically lesbians and women of color. They believed that even the smallest of gestures, when combined, could create, nurture and strengthen significant social change. And they were right. Grants are available internationally and in the US. The Astraea Lesbian Foundation For Justice works for social, racial and economic justice in the U.S. and internationally. Their grantmaking and philanthropic advocacy programs help lesbians and allied communities challenge oppression and claim their human rights. The new deadlines for 2007-2008 are in this article.

Today, Astraea is the largest lesbian organization in the world. They raise funds and issue grants based on the belief that all women can participate in the philanthropic process-from giving to grantmaking.

In the face of scant resources and at times, physical danger, Astraea grantees are fueling the movement for social change in villages, cities and towns around the world. A miniscule 0.3% of all foundation dollars is directed toward lesbian and gay issues. Astraea exists to fund these issues.

Application Deadline: February 1, 2008

Notification of Decision: June 30, 2008

For LGBTI social change and movement-building organizations based in Latin America, the Caribbean, Asia, the Pacific Islands, Eastern Europe, the former Soviet Republics, the Middle East, or Africa.

Download Guidelines & Application

English (pdf 264kb) Español (pdf 260kb)

Download Microsoft Word versions of the Cover Sheet & Sample Budget Form

English (word 128kb) Español (word 120kb)

http://www.astraea.org/PHP/Grants/DeadlinesAllGrants.php4

Poppers use should be target for gay men's HIV prevention

[via aidsmap]

Reducing the use of poppers in serodiscordant unprotected sexual encounters should be an objective of gay men’s HIV prevention campaigns, according to UK investigators in an article published in the online edition of Sexually Transmitted Infections.

Researchers found that gay men who inhaled poppers during unprotected anal intercourse had a significantly increased risk of being infected with HIV. The investigators think there are two reasons why poppers are implicated in HIV transmission. Firstly, they facilitate longer and 'rougher' sexual intercourse; and secondly, poppers could increase biological susceptibility to infection, either by suppressing immune function or increasing uptake of body fluids.

Read the rest.

Check out more LifeLube posts on poppers.

Bleak report on UK's sexual health; HPA urges review of gay men's prevention efforts

[via aidsmap]

The Health Protection Agency (HPA) in the UK has issued a bleak report on the state of the nation’s sexual health. Titled, Testing Times it notes an increase in HIV prevalence, a high incidence of syphilis and increases in new cases of herpes and genital warts.

Continuing high rates of HIV diagnoses in gay men and increases in diagnoses of many sexually transmitted infections in this population prompt the report’s authors to write, “current prevent efforts directed towards…MSM [men who have sex with men] are not succeeding adequately.” The report also calls for a review of HIV prevention campaigns targeted at gay men to make sure that they “are based upon proven interventions and authoritative recommendations”.

The report did find that more people attending sexual health clinics are being offered and accepting an HIV test, but an estimated third of all HIV infections in the UK are still undiagnosed.

Gay men, HIV and sexually transmitted infections

HPA figures suggest that 2,700 gay men were newly diagnosed with HIV in 2006, a total similar to the highest ever annual number of new diagnoses recorded in 2005.

Annual incidence of HIV amongst gay men attending sexual health services in 2006 was just over 2%. Almost three-quarters of new HIV diagnoses in gay men in 2006 were located in those aged 25 – 44.

Investigators estimate that there are 31,000 gay men living with HIV (diagnosed and undiagnosed) in the UK, and that almost 9% of gay men in London are HIV-positive, with the HIV prevalence amongst gay men elsewhere in the UK being 5%.

New diagnoses of gonorrhoea also increased amongst gay men, from just under 4,000 cases in 2004 to 4,524 cases in 2006, a 13% increase.

In all gay men accounted for 58% of all syphilis cases diagnosed in 2006. However, there was a small fall in the number of new syphilis cases amongst gay men in 2006 (1,417) compared to 2005 (1,438 cases).

Transmission of lymphogranuloma venereum (LGV) amongst gay men continued in 2006. But the number of cases diagnosed per quarter fell to an average of 32 compared to a peak of 45 per quarter in 2005.

Gay men living with HIV were particularly likely to be diagnosed with a sexually transmitted infection. Over a third of syphilis cases were in HIV-positive gay men, as were 75% of LGV cases and approximately 20% of all gonorrhoea diagnoses.

There has been a move to offer gay men ‘opt-out’ HIV tests as part of a sexual health screen to help cut the rate of undiagnosed HIV. But the investigators found there was no real difference in the proportion of gay men accepting HIV tests at ‘op-out’ and ‘opt-in clinics (87% vs. 83%). Anonymous blood testing showed that 47% of gay men with undiagnosed HIV who attended a sexual health clinic left the clinic without being tested for HIV, suggesting that those most likely to be HIV-positive are disproportionately likely to turn down the offer of an HIV test when they attend a sexual health clinic.

Late diagnosis of HIV continued to be a problem, with 20% of gay men diagnosed with HIV in 2006 having a CD4 cell count below 200 cells/mm3. However the median CD4 cell count at diagnosis in gay men has remained stable since 2003, at around 400 cells/mm3.

Read the rest.

What Ails Public Health?

[This is a fascinating and provocative piece

forwarded to us by a faithful reader named Chris - thanks!

LifeLube would love to know what YOU think...

So tell us - leave a comment...]

from The Chronicle of Higher Education The Chronicle Review
[images a la Google]

From the issue dated November 9, 2007
What Ails Public Health?

By PHILIP ALCABES

Public health, once the gem of American social programs, has turned to
dross. During the 20th century, the public-health sector wiped smallpox
and polio off the U.S. map; virtually eliminated rickets, rubella, and goiter; stopped epidemic typhoid and yellow fever; and brought tuberculosis — once the leading cause of death in U.S. cities — under control. It sought, with considerable success, to reform social and economic structures so the poor would have the same chance at decent health as the wealthy.

But public health seems to be a phenomenon of the past, like the Great Society or the New Deal. Not that we don't talk about it, or teach it: There are 38 accredited public-health schools and 67 other institutions offering accredited master's programs in public health in the United States, and more are being developed. If we in the academy are as serious about public health as the profusion of professional training programs signals, then we can begin restoring the field by changing how we teach it.

We have to revise our teaching radically because evidently we are failing. One testament to our failure is the activity of American health officials, the products of public-health training programs. In the past six years, Americans have seen officials redirect tax-levy funds to pay for ludicrous "biopreparedness" exercises in anticipation of wholly fabricated epidemic dangers, concocted by an administration unable to admit its mistakes after September 11. We have heard officials endorse useless "virginity pledges" for teenagers. We have seen them invoke federal quarantine law — claiming there was a hazard to the public — to arrest one man who had flown on an airplane while carrying noninfectious tuberculosis. We have listened to them tell us that our improper diet is the second leading cause of death in America. A couple of years ago, the health commissioner of New York City ignited a moral panic by issuing an official health alert over a single case of AIDS, pontificating about condom "complacency." Most recently, health officials have swept transfats out of restaurants. (If this has not happened in your town yet, it will — because no health official can afford to miss the bandwagon of banning demon foods, even, or especially, ones for which there is little sound evidence of serious harm.)

But in the past six years, no health official has argued forcefully for social changes that would genuinely improve the public's health on a significant scale. While we hear plenty about how personal "lifestyle" changes can make us healthier, health officials are not pushing for social fixes that would have even more powerful effects by limiting inequalities in wealth or their health-impairing correlates. They don't demand reforms of the sort that would make us more like those developed countries (Denmark, France, etc.) where infant-mortality rates are more than 20 percent lower than ours and where life expectancy is longer — changes like more affordable housing, a guaranteed minimum income, a higher minimum wage, restoration of workplace-safety oversights emasculated by big-business-friendly government, or better and cheaper public transportation systems.

Broad reforms in the public sphere still happen, and sometimes to the benefit of Americans' health, but health officials have not created them. Housing-policy experts link the supply of affordable housing to healthiness of neighborhoods; health officials, with a few vocal exceptions, are largely silent on the matter. Workplace safety is left to the Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health, the federal agencies explicitly dealing with occupational health; health commissioners have merely moved to ban smoking in bars. The corporate world, no longer able to afford the cost of employee health insurance, will probably push through universal health insurance in some form soon; but too many public-health officials have lost interest in reforming health-care finance.

The decrepitude of contemporary health policy is especially lamentable because the old model of public health worked so well. Traditional public health — health improvement through social reform — dramatically altered the way Americans live and die. In the course of the 20th century, educating women and opening jobs to female workers were central, and so was offering information on family planning: Together, those factors reduced family size, which contributed more strongly to longer American life spans than any other factor. Enhancing nutrition through food inspection and by fortifying or supplementing common foodstuffs undercut the nutritional consequences of poverty. Creating public pure-water and sewage systems made cholera, the scourge of the 19th-century poor, an anachronism. Providing adequate housing, social-welfare benefits, and public baths and sanitary facilities relieved the squalor of the working class's living conditions, limiting the circulation of typhoid and other contagious diseases. And broad-based immunization programs all but eliminated the great threats to children's health, like polio, diphtheria, and measles. Public health might not have put money in the pockets of the indigent, but it restructured American society in order to ease bodily suffering.

That model has gone belly up. Public-health officials forsake the restructuring of society, and public-health professionals outside of government, including academics, often back those officials in their grandstanding and empty gestures.

When officials publicize one or another case of HIV transmitted by someone who should have known better — the New York City case in 2005, an upstate New York case in 1997 that became a media carnival, another in South Dakota in 2002 — some of my colleagues have contributed to the ensuing moral panic. "Sometimes you have to scare people to get them to do the right thing," they tell me. Many did the same last May when federal agents manufactured a health crisis where none existed by calling a news conference to alert the public about the man with tuberculosis who had flown on a commercial airliner. Even though airplane-cabin air is not conducive to the spread of TB bacteria, the man was not infectious, and officials knew that tests of the TB strain in question were incomplete, still some academics in the field ratified the official manipulation by calling the hapless man "grossly irresponsible" and turning a public-health nonevent into a security breach.

Public-health professionals also enabled the panic over West Nile virus, backing the spraying of insecticides onto parks, streets, waterways, and sometimes passers-by, when there was no cause for alarm. (West Nile does cause serious illness and death — but control of mosquito larvae in standing water is more important than killing the ones that are flying; window screens and long sleeves are effective mosquito deterrents; and the low rate of West Nile illness even in an outbreak doesn't justify the risk of putting toxic pesticides in the water supply and onto people.) And many of my colleagues support the bans on transfats, so friendly to corporate food producers like Frito-Lay and McDonald's — who can now entice people to eat their products with claims that they are "transfat free" — but of no use to the public. Others subscribe to the moral panic over crystal meth, hysterically associating it with the spread of HIV, despite the lack of evidence.

In place of the old model of social reform, today's health policy revolves around magical thinking. One part of that is a fantasy that Americans are susceptible to unprecedented disasters because of global travel and trade. There are epidemics, sure. But the U.S. Centers for Disease Control and Prevention remains very good at detecting and directing the control of outbreaks when they do occur — the severe acute respiratory syndrome (SARS) episode of 2003 offered abundant evidence of that capacity — and the structure of 21st-century American society does not enable contagion of the sort that caused catastrophic mortality in 1918 from influenza and in 1849 from cholera. (We have smaller families, are less often clustered in unavoidable close contact, and have municipal water and sewage systems.) Even HIV, the main pandemic virus of our era, spread relatively slowly in the United States, after its initial inflammations of the late 1970s and early 80s.

But facts are only scenery when the main plot is driven by an idée fixe about global threat. The international spread of SARS in 2003 was taken as evidence of that danger, despite our self-evident capacity to control it. So was the importation into the United States of a cow infected with mad-cow disease, discovered in 2003, although we're still not sure that the mad-cow agent is transmissible to humans at all. So was the spread of avian flu among bird flocks, even though the virus in question cannot be transmitted from person to person and therefore poses negligible epidemic hazard to human populations. And so was the Airplane Man, the young man with TB who became an object lesson in our supposed vulnerability. Bowing to the fantasy of global threat, the CDC leads a project called "Protecting the Nation's Health in an Era of Globalization." Accordingly, officials in diverse jurisdictions mount elaborate charades of "emergency preparedness," claiming they aim to protect us from "bioterrorism" or "emerging infections." They — and we, perforce — worry.

The other part of the magical thinking concerns personal behavior. Officials badger us to quit smoking, exercise more, eat more fruits and vegetables, avoid drugs, use condoms, reduce our stress. We are all simpletons, it seems, and need to be reminded to act in our own best interests. That we might choose to drink too much, eat fast food because we like it, skip the latex because the sex feels better without it — that, as Susan Sontag remarked, "appetites are supposed to be immoderate" — is not open for consideration. Apparently it doesn't matter that, according to available evidence, most people who eat more fruits and vegetables to avoid dying of cancer would not have died of cancer anyway, or that the most likely cause of death for people who exercise more (heart disease or stroke) is the same as that for those who don't.

That many people are too poor to afford the time or the expense of eating whole foods, exercising regularly, or reducing their stress is not part of the magical equation, either. Indeed, the matter of who can afford healthful behaviormight be exactly why the behavior-change crusade is so compelling: If you can afford to shop at a farmers' market, go to the gym, take a vacation, or live in a downtown apartment so you can walk to your office, then you are manifestly not a member of the unwholesome class. Your healthy behavior proves that you are a Worthy in the modern American moral register of health.

Not that behavior is irrelevant: Using condoms, quitting smoking, and eating healthfully do matter. The point is that while changing your behavior can make an appreciable difference to your health, it doesn't necessarily make any difference to society's health — not the difference that a guaranteed minimum income would, or child care, or health insurance. This is the magical thinking of behavior change. Our public-health authorities try to convince us that everything will be better for everyone if only each one of us would do the right thing. It's a little like believing in angels.

Magical thinking is especially odd in our time because this is purportedly the era of evidence-based policy, at least in health. Indeed, our public-health-education programs have become good at teaching how to amass and interpret evidence. But apparently we do not teach how to distinguish evidence generated by good science from evidence produced by bad science. For instance, only weak evidence exists that eliminating transfats alone from the diet will reduce heart-disease risk, and no evidence that it would have any impact for most people (transfat consumption is pretty low in America today). There is no evidence linking crystal meth to actual acquisition of HIV, beyond the known pathways for contracting the virus — although plenty of studies show an association between crystal-meth use and behaviors that people think of as bad (sex with multiple or anonymous partners). The evidence on secondhand tobacco smoke points to a substantial effect for children of smokers but a milder one for adults, and essentially onlyfor prolonged exposure in the home. (If you really wanted to reduce disease risk, you would have to ban smoking at home, not in the workplace or restaurants, and then lock up the miscreants, leaving their children to be raised by smoke free strangers while their parents were incarcerated.)

It isn't so much that health officials ignore the evidence; it just seems tangential at best — important only if it relates to how people behave and not very interesting in its details.

In this way, public health today moves closer and closer to religion. Like Western religions, it is deeply interested in behavior as a way of distinguishing the elect from the masses. And it is less interested in empirical examinations of truth. The authority of simple, received wisdom — fats are bad, cigarettes are worse (and tobacco companies are demonic), exercise makes you whole — trumps the fine print of the inevitably complicated story that science uncovers. No wonder that, when I asked how we in the public-health profession will explain our failure to say anything about AIDS prevention other than "use condoms" (advice, I pointed out, that is ignored by most adults much of the time, anyway), a senior colleague admonished me to never say that in public. It is easyto show that promoting the use of condoms has essentially no population-level impact on the AIDS epidemic in this country, given the relatively low prevalence of HIV in most U.S. populations and the very low proportion of people who use condoms consistently (other than teenagers, by the way; American adolescents are very good at being careful sexually). But that would be a calculation based on evidence, and therefore beside the point. What I was saying was blasphemy.

Can we educate the next generation of public-health professionals to dispel magical thinking like that? Can we teach them to topple feckless officialdom, forswear the sops to corporate producers on the one hand and ideological dogma on the other, and create real reform? Can we restore the twin pillars of rationalism and social justice — and somehow overcome the pernicious dictating of behavioral correctitude?

If we are to do that, we have to change what we teach, and how. Reform that gives the poor the same chance at decent health as the rich has to return to the center of American discourse. It can't be sidelined as a charming anachronism of the Great Society. But that means that we will have to eschew the old rites of the New Left: the religiosity of ideology; the hand-wringing over race; the belief in a magical vinculum joining identity to oppression, oppression to vulnerability, and vulnerability to victimhood.

Not that racism is gone, alas. The legacy of the race-saturated opportunism that helped build the American medical establishment — a history sparklingly elucidated in Harriet A. Washington's Medical Apartheid — remains to be overcome by the medical profession and continues to affect Americans' health. But a greater threat comes from what the sociologist Troy Duster calls the reinscription of the biology of race: the use of medicine — and, I will add, epidemiology — to grant biological cred-ibility to a hierarchy of social desirability.

We all agree that race doesn't exist biologically: There is no DNA signal that reproducibly encodes blackness or whiteness. But talk of risk makes it seem that it does. To identify African American "ethnicity" as a correlate of susceptibility to prostate cancer, as a recent report in Nature Genetics does, or to license a heart-failure medication (BiDil) for African-Americans only, as the Food and Drug Administration has done, is to create a biologic race where none exists. To claim, as a recent article in the American Journal of Epidemiology does, that race is associated with higher levels of "risk behavior" (in this case, smoking cigarettes and marijuana and drinking alcohol) is not only to misappropriate the idea of risk in order to condemn disapproved activities; it also reifies race by associating it with presumptively noxious, morally reproved behaviors.

In the new public health, where behavior is scrutinized and social vulnerability replaced with victimhood, other groups become races and take their place in the hierarchy of the Worthy: Hispanics (diabetes), gays (AIDS, syphilis), and now fat people (heart disease) are inked with the mark of disease risk. Social reform, that old thing, won't help; race is imprinted in the genes.


If we go on teaching our students to focus public health on so-called racial/ethnic/sexual preference disparities, we will train yet another generation of officials to claim that your health problems stem from your membership in an identity group. The racially upright can expect to be fully healthy, but the second-rate cannot. Sell them different products, aim different programs at them, but do not, for a moment, pretend that their problems can be fixed by more financial support, broader access, or fairer distribution of services. Health officials can continue to ignore the shrinking availability of health insurance, the paucity of decent housing for the poor, or the multiple insults to health that are the constant companions of dwellers in some poor, urban neighborhoods. They will go on blaming health problems on attitudes,which are beyond the reach of reform, and get away with wagging their fingers at bad behavior.

Finally, we have to develop curricula that face the vexatious positioning of health as a moral issue. We have to teach the new generation of public-health workers that, outside of Leviticus, there is no moral basis for telling people how they must spend their time. Nor is there moral probity to being healthy. The specter of ill health should not be a stick with which to compel prescribed behavior.

Yet health today also bridges the once-appealing dichotomy of Right and Good, the distinction between the just guarantee of all individuals' civil rights and the just distribution of services that might make peoples' lives better. The sum of insults to health seems to impair a fundamental freedom. So talking about health in our time pitches us into new moral ground. We have to teach the next generation of professionals to take on more-complicated moral and social questions.

We in academe can educate a new generation to replace today's advocates of magical thinking. It will take some open-mindedness, plus the will to resist the inertial tug of old dogma. But restoring sound public health to the American social dialogue is a worthy goal. To quote from Tony Kushner's Angels in America: "More life. The Great Work begins."

Philip Alcabes is an associate professor of urban public heath at the Hunter College School of Health Sciences of the City University of New York. He is writing a book on the history of thought about epidemic disease.

http://chronicle.com
Section: The Chronicle Review
Volume 54, Issue 11, Page B6