Thursday, June 2, 2011

Gay, bi men remain key to HIV epidemic

via Washington Blade, by Lou Chibarro Jr.

On June 5, 1985, the U.S. Centers for Disease Control and Prevention published an article in its authoritative journal Morbidity and Mortality Weekly report that experts now consider the first signal that an unprecedented worldwide epidemic had begun.

“In the period of October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carini pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died,” the MMWR article stated.

“Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients,” said the article. “The occurrence of pneumocytosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual.”

It would take another few years before scientists named the condition detected in the men discussed in that MMWR article as Acquired Immune Deficiency Syndrome or AIDS. The name AIDS followed an earlier term used by some researchers and the media – Gay Related Immune Disorder or GRID.

In reflecting on the tumultuous developments surrounding AIDS over the past 30 years, leaders of AIDS advocacy organizations and LGBT activists in the U.S. who lived through the early years of the epidemic say that, to some extent, the MMWR article of June 1981 still has considerable resonance for gay men.

They acknowledge that so much has changed for the better over the past 30 years, including breakthroughs in biomedical research resulting in highly effective drugs that transformed AIDS from a death sentence into a manageable, chronic illness like diabetes.

But AIDS activists also point out that HIV and AIDS continue to disproportionately impact gay men or men who have sex with men (MSM) in the United States and other countries.

And although the perception of AIDS as a “gay disease” has largely receded from the minds of most Americans, AIDS activists say they find themselves in the ironic position of having to remind Congress and state and local governments that more resources and funding are needed for HIV prevention programs targeting gay and bisexual men.

“MSM is the only group for whom, according to the CDC, new infections are still increasing,” said Ronald Johnson, vice president for policy and advocacy for AIDS United, a national group formerly known as AIDS Action.

“So there continues to be a concern that there is not enough targeted prevention resources to MSM, particularly MSM of color and young MSM of all races and ethnicities,” Johnson said.

According to the CDC, while MSM account for about 2 percent of the U.S. population, more than half of all new HIV infections in the U.S. each year (53 percent) occur among MSM. CDC data also show that MSM make up nearly half of all people living with HIV in the U.S. – 48 percent.

CDC figures show that white MSM “account for the largest number of annual new HIV infections of any group in the U.S., followed closely by black MSM,” according to a CDC fact sheet released last month.

“There are more new HIV infections among young black MSM (aged 13-29) than among any other age and racial group of MSM,” the fact sheet says.

The Obama administration, with input from AIDS advocacy organizations, released a National HIV/AIDS Strategy document in July 2010 that, among other things, calls for an aggressive effort to develop better HIV prevention programs targeting MSM.

Johnson and Carl Schmid, deputy executive director of the AIDS Institute, a national advocacy group, praised the administration for developing the strategy document, which they say covers most of the bases needed for addressing HIV prevention programs for MSM.

But the two said the proposals in the strategy document have yet to be fully implemented. They note that delays in its implementation are due, in part, to the U.S. economic situation that has prevented needed increases in federal AIDS funds and severe cutbacks in state and local funding for AIDS-related programs.

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