If We Knew What We Know Now...

via HuffPost Gay Voices, by Ace Robinson

Would we have stopped AIDS? It is a valid question to ask, as the world has been aware of this epidemic for over 30 years.

GMHC was passionately and courageously created 30 years ago by a group of gay men who did not know how far-reaching and devastating this disease would be to all corners of the Earth.

We know through retrospective epidemiological data that the first confirmed American AIDS death occurred in 1969: a 15-year-old, sexually active young man in Saint Louis, Mo. who had never traveled abroad.

And by the time HIV was isolated and identified in 1981, it had already found its target communities: people who have engaged in anal sex, injection-drug users, breastfed infants, and individuals who received medically sanctioned human tissue (i.e., donated blood or organ transplants).

During the early '80s in the States, a strong cultural shift had just occurred, from "free love" and "live and let live" to the conservative Christian movement led by Jerry Falwell.

The Moral Majority had become a major player in the political field, which led to the election of President Ronald Reagan. The policies that would shape America for the next eight years would also mold America's response to the introduction of AIDS into the lives of countless individuals and the American lexicon.

Due to advances in diagnosis and treatment of the virus, in addition to the political activism of the direct and indirect victims of HIV/AIDS, the virus is no longer a death sentence for the estimated 1.2 to 1.5 million Americans who are affected, according to the Centers for Disease Control and Prevention (CDC).

But lest we forget, these data, which seem so large, are a measure of the prevalence of HIV/AIDS in 2011. Thirty years ago, that number was exponentially smaller.

Imagine an America that only had around 10,000 to 20,000 persons with HIV/AIDS, and a world that may have had about 70,000 to 100,000 total cases.

Couple that information with the knowledge that a muted health care response would eventually lead to 2 million deaths annually. Would it have been morally acceptable to demonize particular populations?

We have all heard countless justifications for why some people "got it," without any level of sympathy. These sentiments are based on racism, sexism, homophobia, classism, and/or prejudice against addicts.

Typically, bleeding hearts only pour out to individuals who are considered without fault in their HIV status, such as newborns or hemophiliacs.

After 30 years of AIDS, we know what works and, more importantly, what does not work. We know that first and foremost, education is the greatest deterrent to infection (if one is HIV-negative) or infecting another person (if one is HIV-positive).

Furthermore, we have seen the effect of readily available medication (anti-retroviral drugs) on the level of impact that HIV/AIDS has on an individual and on a community. And we have seen effective public health initiatives that have saved countless lives, domestically and internationally (e.g., syringe needle exchanges).

Moreover, after 30 years of AIDS, we know that our leaders have a choice of when, how, and to whom any and all interventions are available. To the ultimate detriment of 20 million people each year, those interventions are often not available, sometimes due to funding, and sometimes due to normative culture values that punish those most in need: the world's outcasts.

It is not being cynical to suggest that if we knew then what we know now, all possible barriers to the spread of HIV/AIDS would have been enacted.

Even in 2011, Congress has taken actions that will diminish headway in the fight against HIV/AIDS. Reinstating the federal ban on syringe-exchange funding, coupled with funding for abstinence-only education, unfortunately shows a trade of proven-effective health policy for proven-ineffective actions.

As HIV public health advocates, our hope is that the correct actions are taken so that in a few decades, we do not look back and wonder why the tools that we have today were not utilized. There is no viable excuse for knowing now what we already know and still not doing the right thing.


Read the rest

Empowering Young, Black, Gay Men for HIV Prevention

via HuffPost Gay Voices, by Charles Stevens

The most recent statistics indicate that an entire generation is being impacted by HIV on an epic scale.

HIV cases among young, black, gay and bisexual men increased to an estimated 48 percent between 2006 and 2009, according to new data from the U.S. Centers for Disease Control and Prevention (CDC).

Ultimately, it is impossible to discuss HIV/AIDS in the black community without addressing the importance of tolerance.

It is up to us -- relatives, co-workers and friends -- to engage our black, gay brothers in a conversation that is constructive and rooted in concern, one that turns to them for insight instead of turning them away.

There have been significant political and medical advances made in HIV/AIDS prevention.

The National AIDS Strategy, a key achievement of Barack Obama's presidency, is a prime example. By focusing with laser precision on at-risk groups and prioritizing addressing disparities in HIV, there will be historic gains.

On the scientific front, advances in biomedical HIV-prevention tools, such as pre-exposure prophylaxis, or PrEP, have given us signs of hope even as we take a collective gasp at the work ahead of us.

However, HIV has never been merely a public health issue but a social one, as well. It is an issue that impacts us not only abstractly but also in a very real and tangible way.

The black community as a whole has made substantial progress, more than is credited, in terms of embracing our diversity. Many unsung heroes and heroines have taken great strides in challenging anti-gay attitudes.

Straight allies have also spoken out unapologetically in support of their gay brethren. However, there is still work to do, and HIV/AIDS makes building bridges across orientations even more critical.

The black community has just as much of an incentive to be a part of the solution: the "win" is the lives of our people, the lives of young, black, gay men. These men are valued; their lives are priceless. They are assets to our communities.

Read the rest

Progress through Resiliency

via Positively Aware, by Amy Herrick, Mary Hawk, Mackey Friedman, Chingche Chiu, James Egan, Mark Friedman, and Ron Stall

While improvements in approaches to HIV prevention have been made over the 30 years since the start of the AIDS epidemic, HIV among MSM is far from eradicated.

Despite more than two decades of prevention efforts focused toward MSM, the rates of HIV infection in this population continue to rise.

What is the state of the HIV/AIDS epidemic among men who have sex with men (MSM) in the U.S.?

A 2008 report released by the Centers for Disease Control and Prevention (CDC) showed that MSM accounted for 46% of all new HIV infections and HIV infection rates among young MSM increased at a rate of about 12% each year between 2001 and 2006.

This report further noted that MSM were the only risk group who experienced an increase i n infection rates during this time.

In fact, according to a recent study by researchers at the University of Pittsburgh, even if the rate of HIV infection among MSM remains at the current level, by the time a group of young MSM (18 years old) reach the age of 40, 41% of them will be HIV-positive.

We cannot make any progress in fighting the HIV/AIDS epidemic in the U.S. unless we find ways to lower rates of HIV transmission among MSM.

How do other health disparities among MSM relate to risk for HIV/AIDS?

A growing set of recent scientific papers had shown that health problems among MSM are interconnected and function as a group to increase HIV risk in this population.

Because they are sexual minorities, gay, bisexual, and other MSM experience massive minority stress and social marginalization (for example, widespread bullying, gay-bashing, and other forms of violent harassment).

Studies suggest that these negative experiences increase a person’s risk for multiple health issues, including depression, anxiety, drug use, and sexual risk behaviors.

This process happens over time as people are exposed to discrimination and social marginalization.

These experiences cause stress to the individual, resulting in lowered self-esteem, increased emotional distress, and a sense of social isolation, all of which cause a person to be more vulnerable to serious emotional and physical health problems.

According to the CDC, a syndemic is, “Two or more afflictions, interacting synergistically, contributing to excess burden of disease in a population.”

In other words, negative health conditions are thought to interact to form a syndemic: synergistic epidemics that, together, can lower a person’s overall health and make him or her more susceptible to disease.

For example, health problems such as drug use, depression, and domestic violence have been found to interact so that their impact on the overall health of the person is greater than what we might expect from looking at each affliction separately.

While many studies involving MSM have shown interconnections between health problems, such as drug use and high-risk sex, two recent studies have focused on syndemic conditions in samples of adult MSM and young MSM.

These two studies showed that as the number of psychosocial conditions (such as depression, anxiety, and experience of abuse) a person has increases, so will his likelihood of having unprotected anal sex, as well as his likelihood of becoming infected with HIV.

It has been suggested that this set of co-occurring psychosocial health problems operating together as a syndemic may actually be driving the HIV epidemic among MSM, while also working to raise the levels of other health problems among MSM.


Read the rest

Reversing the Alarming HIV Increase Among Black Gay Men, Part 2

via BlackVoiceNews, by Rod McCullom

The second of a two-part series examining the high rates of new HIV infection among Black gay and bisexual men.

 Part 1 described the new data detailing the dramatic increases in new infections, examined some of the reasons driving the numbers and described the CDC's new social-marketing initiative, designed to encourage testing among Black MSM.

In light of the persistent increase in new infections among MSM (men who have sex with men)--and despite the Centers for Disease Control and Prevention's new testing initiative--a consensus has emerged among prominent Black gay men who have leadership positions in HIV/AIDS policy, prevention and public health: A larger investment is needed from public and private sources, as well as a more "holistic" approach to Black gay men's sexual health.

"It's a question of dollars," says A. Cornelius Baker, senior policy adviser of the Washington, D.C.-based National Black Gay Men's Advocacy Coalition (NBGMAC), which delivered a forceful set of recommendations in response to the CDC's incidence report.

 Across the federal bureaucracy, "there is not a sufficient investment in line with the scope of the epidemic in Black and Latino gay populations," he says.

"The CDC must increase funding to organizations providing services to young MSM and transgender [people] of color from $9 million to $14 million," says Baker, who is also board chair of the Black AIDS Institute.

 "Five years after its initial commitment, the numbers are worse, and their investment remains at $9 million. That makes no sense."

Among NBGMAC's additional recommendations: increased funding, capacity building in Black gay organizations, continuing HIV education for medical professionals, high-level consultations with Black gay men and research on how to lower the viral load in MSM communities of color.

Read the rest

Not Shocking: Med Schools Score Poorly in Teaching Gay/Lesbian Health

via U.S. News and World Report

Medical schools set aside an average of only seven hours for topics related to the health care needs of lesbian, gay, bisexual and transgender (LGBT) patients, a new study says.

The survey of deans of 150 American and Canadian medical schools also found wide variation in the amount, content and quality of instruction on LGBT health.

For example, a third of the schools had no LGBT content during their clinical years, about 7 percent had no content during preclinical years, and about 4 percent had no content in any of their years.

And while most (97 percent) taught that physicians should ask patients if they have sex with men, women, or both when obtaining a sexual history, less than two-thirds of schools taught about the difference between sexual behavior and identity (for example, that a man might have sex with men and yet self-identify as straight).

The findings appear Sept. 7 in a medical education theme issue of the Journal of the American Medical Association.

"Lesbian, gay, bisexual and transgender (LGBT) individuals have specific health and health care needs," wrote Dr. Juno Obedin-Maliver, Stanford University School of Medicine, and colleagues. Some of these pertain to HIV and other sexually transmitted infections, adult and adolescent health issues and issues around gender identity, among others, he said.

Compared to their peers who are not LGBT, this group is "more likely to face barriers accessing appropriate medical care, which may create or increase existing disparities," Obedin-Maliver added.

While experts have called for medical schools to cover LGBT issues, the actual content and amount of such training hasn't been known, the study authors noted.

More information via U.S. Centers for Disease Control and Prevention has more about LGBT health.

New Campaign: Testing Makes us Stronger

lboards. “Your HIV test result expires every time you have risky sex. Stay strong and informed

Source: The Bay Citizen (http://s.tt/132Ig)

Your HIV test result expires every time you have risky sex. Stay strong and informed.

lboards. “Your HIV test result expires every time you have risky sex. Stay strong and informed

Source: The Bay Citizen (http://s.tt/132Ig)

Read about the CDC's new HIV testing campaign focused on gay black men which takes an assets-based approach to the effort - looks very nice. Some images from the campaign below. Waddya think?

HIV Epidemic Growing Fastest Among Black Gay and Bisexual Men

via Colorlines, By Kai Wright

Young black gay and bisexual men are the only population in the U.S. in which the pace of HIV’s spread is increasing, according to a startling study released by the Centers for Disease Control and Prevention yesterday.

CDC researchers looked at new infections between 2006 and 2009 and discovered that, as expected, we’re still logging roughly 50,000 new infections overall each year in the U.S. We’ve been at that level for several years. The study also re-confirmed that African Americans are a wildly disproportionate number of those new infections.

Blacks accounted for 44 percent of new infections, despite being just about 12 percent of the overall U.S. population in the 2010 Census.But CDC noted with alarm that, unlike all other subpopulations in the U.S., black gay and bisexual men between the age of 18 and 29 saw a dramatic increase in infections: up by 48 percent in the three-year span of the study.

“We are deeply concerned by the alarming rise in new HIV infections in young, black gay and bisexual men and the continued impact of HIV among young gay and bisexual men of all races,” CDC’s HIV prevention director Jonathan Mermin declared in a statement. “We cannot allow the health of a new generation of gay men to be lost to a preventable disease. It’s time to renew the focus on HIV among gay men and confront the homophobia and stigma that all too often accompany this disease.”

Read more.

New H.I.V. Cases Persist at 50,000 a Year

via New York Times, By Donald G. McNeil Jr.

Despite years of great progress in treating AIDS, the number of new infections with the virus that causes it has remained stubbornly around 50,000 a year for a decade, according to new figures released on Wednesday by federal officials.

The American epidemic is still concentrated primarily in gay men, and is growing rapidly worse among young black gay men.

That realization is causing a rift in the AIDS community. Activists say the persistent infection rate proves that government prevention policy is a flop. Federal officials are on the defensive even as they concede that the epidemic will grow if prevention doesn’t get better, which they know is unlikely while their budgets are being cut.

And some researchers believe it is impossible to completely wipe out even a fatal, incurable disease when it is transmitted through sex and carries so much stigma that people deny having it and avoid being tested for it.

Looking backward, epidemiologists at the Centers for Disease Control and Prevention believe new cases peaked at 130,000 a year in the 1980s, sank slowly during the 1990s and plateaued at 50,000 around the year 2000.

Both Dr. Kevin Fenton, chief of AIDS prevention for the C.D.C., and Dr. Anthony S. Fauci, chief of AIDS research at the National Institutes of Health, took issue with Mr. Kramer’s interpretation. While both agreed that 50,000 new annual infections was, in Dr. Fauci’s words, “a great concern,” both pointed to some areas where substantial progress had been made and said that new studies were seeking ways to get more people tested and treated early in the course of the illness, which would make them less infectious and drive transmission rates down.

“The C.D.C. is absolutely not resting,” Dr. Fenton insisted. “It was a major accomplishment to drop infections from 130,000 to 50,000, and we’re dealing with an epidemic that is dynamic.”

But, he conceded, 50,000 is an “unacceptably high level,” and without better prevention efforts, “we’re likely to face an era of rising infection rates.”

Read more.

How often do you get tested? Willing to do so 2, 3 or 4 times a year?

More Frequent HIV Testing May Protect Gay Men

via Internal Medicine News

More than half – 59% – of new cases of HIV in the United States in 2009 occurred in men who have sex with men, based on data from 7,271 of them, as published on June 2 in the Morbidity and Mortality Weekly Report.

"Given the high prevalence of new HIV infection among MSM [men who have sex with men] who had been tested during the past year, sexually active MSM might benefit from more frequent HIV testing," such as every 3-6 months, the researchers wrote (MMWR 2011;60:694-9).

Researchers from the Centers for Disease Control and Prevention reviewed data from MSM in 21 cities that were collected as part of the National HIV Behavioral Surveillance System (NHBS). The MSM were aged 18 years and older (mean, 34 years); 44% were white, 25% were Hispanic, and 23% were black.

Overall, 680 (9%) of the MSM were infected with HIV. Although 29% of these had been tested during the past 6 months, 16% had never been tested. A total of 61% had tested negative for HIV during the past year. Of the 61%, 7% were positive for HIV when they were tested by the NHBS (15% of blacks, 7% of Hispanics, and 3% of whites).

In general, men with higher incomes and education were more likely to be tested. Testing rates were similar among different ethnicities. However, "the high proportion of HIV-infected persons among minority MSM, particularly black MSM, who had not previously received a diagnosis of HIV infection and were tested during the past year underscores that testing among these populations should be a priority for HIV testing programs," the researchers wrote.

The findings were limited by several factors, including the possible underreporting of HIV-positive status and high-risk behaviors, and the recruitment of study participants from bars and clubs in cities with a high prevalence of AIDS, the researchers noted.

But the results suggest that MSM could be tested every 3 months or every 6 months, instead of the annual testing currently recommended by the CDC, they added.

"MSM account for just [2%] of the U.S. population but represent more than half of all new [HIV] infections in the United States," CDC director Thomas R. Frieden said in a statement issued on June 2.

The statement and the current MMWR report appear on the 30-year anniversary of the publication of the first case of HIV in what became the MMWR, Dr. Frieden said. Although effective treatment for HIV is widely available, high-risk groups such as MSM should remain vigilant about prevention, and they should be encouraged to take advantage of new interventions such as pre-exposure prophylaxis, he emphasized.

Visit www.hivtest.org for HIV testing sites in your area.

CDC Releases Interim Guidance for the Use of HIV Drugs as Prevention for Gay Men

Only some men should use AIDS drug for prevention
via Reuters, by Maggie Fox

Only high-risk gay and bisexual men should use Gilead's HIV drug Truvada to protect themselves from the AIDS virus, federal officials said on Thursday in the first official guidance on using the drug.

A study published last November showed that the pill, which combines two AIDS drugs, reduced the HIV infection rate by nearly 44 percent in high-risk gay and bisexual men. It worked even better if the men used the drug consistently.

Some doctors have already been using the experimental approach, called pre-exposure prophylaxis, or PrEP for short. This use of the drug is not approved by the U.S. Food and Drug Administration, which has approved Truvada for treating HIV infection.

But the U.S. Centers for Disease Control and Prevention decided to issue some guidance for doctors who may want to prescribe the drug to protect people at very high risk of infection with the fatal and incurable virus.

Read the rest.


Read the CDC's Morbidity and Mortality Weekly Report's "Interim Guidance: Preexposure Prophylaxis for the Prevention of HIV Infection in Men Who Have Sex with Men."

After news that HIV pill prevents infection... now comes the tricky part

via CNN
by Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention (he's gay, btw)

Excerpt:

First, we need to learn how best to implement the pre-exposure prophylaxis approach in the real world. The study results were achieved in a controlled trial, in which men received regular prevention and adherence counseling -- including messages about condom use, HIV testing, testing and treatment for other sexually transmitted diseases and close safety monitoring.

The challenge before us is how do we make this work in diverse health care settings?

Read the rest.

Gay and Bisexual Men's Health - NEW RESOURCES

The CDC has a number of new info resources that will be very handy for all of us working in gay/bi men's health, as well as HIV/AIDS.

The following came to LifeLube's inbox this morning....Check them out.

Updated Factsheet: HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)
The HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)factsheet has recently been updated with information from the 2008 HIV Surveillance Report: Diagnoses of HIV infection and AIDS in the United States and Dependent Areass

MMWR: Prevalence and Awareness of HIV Infection Among Men Who Have Sex With Men --- 21 Cities, United States, 2008
Men who have sex with men (MSM) are at increased risk for infection with human immunodeficiency virus (HIV). In 2006, 57% of new HIV infections in the United States occurred among MSM. To estimate and monitor risk behaviors, CDC's National HIV Behavioral Surveillance system (NHBS) collects data from metropolitan statistical areas (MSAs) using an anonymous cross-sectional interview of men at venues where MSM congregate, such as bars, clubs, and social organizations. 

New CDC Site: Gay and Bisexual Men's Health
Gay and bisexual men and other men who have sex with men (MSM) represent an incredibly diverse community. Gay and bisexual men have both shared and unique experiences and circumstances that affect their physical health and mental health needs as well as their ability to receive high-quality health services. 

Mixner: What happened to silence = death?

[sing it sister]

Ask yourself: Have I been tested for HIV in the last year? Have I talked about HIV with my partners? Have I reached out to friends that I’m worried about, who may be at risk?

via dcagenda, by David Mixner

If you listen to gay rights discussions these days, you’d think that marriage equality and “Don’t Ask, Don’t Tell” are the only issues that matter. And they do matter — for our dignity and our fundamental civil rights. But there is a fire in our house that we are no longer talking about, that we pretend no longer exists: the unchecked spread of HIV.

Not only did HIV never leave the gay community, it’s getting worse. New HIV infections among gay men have doubled in the last 15 years. Last week, the Centers for Disease Control & Prevention reported that gay and bisexual men are more than 44 times as likely as straight men to test positive for HIV. But instead of increasing funding in response, states are slashing their prevention budgets.

Amid this crisis, the silence from our community is deafening. Where’s the outrage? Where’s the protest? Understandably, after decades of coping with AIDS, we’ve been eager to change the subject. But in our impatience to move on, we’ve overshot the mark. Our silence is fueling the spread of HIV.

Read the rest.

Let's make some sense of these HIV, syphilis numbers, shall we?

A couple of days ago, the Centers for Disease Control and Prevention (CDC) released a new data analysis looking at the rates of HIV and syphilis among gay, bisexual, and other men who have sex with men.  

And they aint pretty.

Below we share important context - thanks to friends of LifeLube - to help understand these numbers and move forward with some solutions. These points have a bit of Chicago flavor, but most apply from sea to shining sea.

REVIEW OF THE DATA

•    On Wednesday, March 10, the Centers for Disease Control and Prevention (CDC) released new data that underscore the nation’s ongoing struggle to halt the spread of HIV and sexually transmitted diseases (STDs) in the United States.

•    Rates of HIV infection among gay, bi men and other men who have sex with men (MSM) are more than 44 times higher than rates among heterosexual men and more than 40 times higher than women.

•    Rates of syphilis, an STD that can facilitate HIV infection and if left untreated, may lead to sight loss and severe damage to the nervous system, are reported to be more than 46 times higher among gay, bi and other MSM than among heterosexual men and more than 71 times higher than among women.

HISTORICAL NEGLECT FOR GAY/BI MEN HAS PERPETUATED HIV DISPARITIES AMONG THIS POPULATION

•    Rates of HIV and syphilis among gay and bisexual men in the United States are staggering and appalling.

•    Since the beginning of the domestic epidemic, gay and bisexual men have remained the most impacted by HIV – yet investments in prevention have not matched the need.

•    In 2007, gay men, bisexual men and other MSM accounted for 53% of new HIV/AIDS cases in the United States, even though this group makes up between 2.8 and 5.3% of the U.S. male population, according to the CDC.

NATIONALLY, PUBLIC HEALTH ENTITIES HAVE PROVIDED INADEQUATE HIV PREVENTION SERVICES FOR GAY/BI MEN

•    CDC spends approximately $650 million per year on HIV prevention activities. Approximately $300 million of that goes to state and city health departments that have consistently under-funded services targeting gay and bisexual men.  Between 2005-2007, only 29% of federal risk- reduction funding managed by state and local health departments supported services for gay/bi/MSM.

o    For federally funded counseling, testing and referral services (CTR), state and local health departments directed only 11% of the total funds distributed during the same period toward gay/bi/MSM.

o    Most of the CTR allocation went to the general population and the majority of that money was directed to low-risk heterosexuals, according to the CDC.

o    In 2009, only 20% of gay/bi/MSM had access to HIV prevention services, according to the CDC.

CHICAGO’S HIV EPIDEMIC REFLECTS NATIONAL DISPARITIES AMONG GAY/BI MEN

•    According to the Chicago Department of Public Health (CDPH), in 2006, there were 1,557 newly diagnosed infections, 62% of which were among gay/bi/MSM. Of those  gay/bi/MSM, 42% were black, 36% were white, 17% were Hispanic, and the remainder were “other.”

o    More than 22,000 people in Chicago are estimated to be living with HIV/AIDS and in 2008; CDPH reported 12,884 gay/bi/MSM living with HIV/AIDS.

CHICAGO FUNDING ALLOCATIONS ACCURATE LY REFLECT THE HIV EPIDEMIC

•    19 out of 39 CDPH HIV prevention projects targeting high-risk populations specifically focus on MSM.

•    Approximately 60% of CDPH HIV prevention funds serve MSM.

•    CDPH works closely with the HIV Prevention and Planning Group (HPPG) to ensure the prevention resources are in line with the HIV epidemic in Chicago.  HPPG recommendations are implemented in CDPH’s distribution of prevention funds.  The most recent HPPG allocation recommendations for high-risk groups (as of 2006) are as follows, based on geographical areas that divide the city into three clusters:

o    Cluster A (receives 32% of high-risk population resources) -Percent of resources to be allocated to MSM:  100%

o    Cluster B (receives 37% of high-risk population resources) -Percent of resources to be allocated to MSM:  77%

o    Cluster C (receives 31% of high-risk population resources) - Percent of resources to be allocated to MSM:  68%


INTERVENTIONS MUST EXPAND FOCUS BEYOND INDIVIDUAL-LEVEL EMPHASIS

•    Understanding the factors related to changing trends in the HIV epidemic among MSM in Chicago is complex and multifactorial, and cannot be attributed simply to individual-level behavior. Continued emphasis on prevention of individual-level risk behaviors will only have a limited impact on the disproportionate rates of HIV infection.

•    Current data show that Black MSM in Chicago have higher rates of HIV prevalence than White or Hispanic MSM despite comparable levels of sexual and drug use risk behaviors and similar frequency of HIV testing.

•    Historically inadequate, disproportionate resources directed toward gay/bi/MSM are a contributing factor to the general gay/bi/MSM disparities, and particularly impact gay/bi/MSM of color.

•    Higher prevalence of HIV among gay/bi/MSM and relatively closed sexual networks – particularly among black gay/bi/MSM, increase the chance of exposure per unprotected sexual act.

•    Unprotected anal intercourse is the most efficient means of transmitting HIV.

•    Interventions must address structural issues such as institutionalized homophobia, stigma and discrimination, as well as human and civil rights, and lack of access to health care. Additionally, the role of community viral load and sexual networks requires further study.

•    There is a pressing need for the development of new prevention methods such as topical and oral prevention as well as preventative and therapeutic vaccines.

SHORTCHANGING HIV SERVICES WILL ESCALATE DISPARITIES AND UNACCEPTABLE OUTCOMES

•    Years of neglect and the federal emphasis on ineffective abstinence-only programs that negate the existence of gay/bi/MSM have taken their toll.

•    Gay/bi/MSM must be prioritized in every community in the country, including Chicago, if the United States is to adequately address the HIV epidemic.

•    Proportionate resources must be allocated to programs serving gay/bi/MSM and must include funding for culturally competent mental health and substance use programs. This includes federal, state and local funding.

ILLINOIS BUDGET CUTS WILL PUT MORE PEOPLE AT RISK

•    In Illinois state budget cuts have resulted in a $4M cut to funding for HIV prevention programs (because of the need to maintain access to HIV medications through Illinois’ AIDS Drug Assistance Program.)

o    In Chicago, as a result of this cut, programs funded by the Chicago Department of Public Health will unable to provide evidence-based interventions and counseling and testing for over 15,000 individuals at high-risk of HIV infection, including gay men and MSM.

o    This funding cut will undoubtedly worsen the existing disparities among this population. At risk individuals, including gay men and MSM, will be impacted statewide by these cuts.

Did Americans get any healthier over past decade?

via AP, by Mike Stobbe

About 10 years ago the government set some lofty health goals for the nation to reach by 2010.

So how did we do?

By many measures, not so hot.

There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay.

But the nation has made at least some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And deaths rates from stroke, cancer and heart disease are all dropping.

As we move into a new decade, the government is analyzing how well the nation met the 2010 goals and drawing up a new set of goals for 2020 expected to be more numerous and - perhaps - less ambitious.

"We need to strike a balance of setting targets that are achievable and also ask the country to reach," said Dr. Howard Koh, the federal health official who oversees the Healthy People project. "That's a balance that's sometimes a challenge to strike."

Read the rest.

CDC Statement on National Gay Men's HIV/AIDS Awareness Day (today!)

NATIONAL GAY MEN’S HIV/AIDS AWARENESS DAY
September 27, 2009
Statement by Dr. Jonathan Mermin
Director, Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

September 27, 2009 is the second annual National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD). I applaud the efforts of the National Association of People with AIDS (NAPWA) and many other organizations throughout the United States who are participating in this important event. HIV touches all segments of American society—individuals, families, and communities, young and old, men and women, black and white. However, since the beginning of the epidemic in the United States, gay, bisexual, and other men who have sex with men have been disproportionately affected by HIV. Of all the people newly infected with HIV, men who have sex with men is the only risk group in the U.S. in which new HIV infections are increasing. While new infections have declined among both heterosexuals and injection drug users, the annual number of new HIV infections among men who have sex with men has been steadily increasing since the early 1990s.

A strong, vocal gay community and a solid commitment from gay and bisexual men were critical in reducing new HIV infections among men who have sex with men in the early years of the epidemic and ultimately changing the trajectory of the epidemic in the United States. This early success may have led some people to believe that HIV is no longer a threat for gay and bisexual men, leading to a complacency that mirrors a reduced sense of urgency found in the general public. However, men who have sex with men still account for nearly half of the more than 1 million people living with HIV in the United States, even though this population accounts for a very small percentage of all persons in the United States.

It has been 21 years since the U.S. Surgeon General mailed a brochure about HIV and AIDS to every household in the United States, ensuring that all Americans knew how to protect themselves and others from getting HIV. But many young people at risk for HIV infection today were not yet born in 1988. We must find new ways to prevent HIV, expand the outreach of effective interventions, and educate each generation of young people and their parents, teachers, and mentors. HIV should not be a rite of passage for young gay and bisexual men.

All gay and bisexual men, regardless of age, race, or ethnicity, are at risk for HIV; however, white men who have sex with men represented the highest estimated numberv(13,230) of new infections in 2006, followed closely by black men who have sex with men (10,130). Since the beginning of the epidemic, more than 274,000 men who have sex with men with AIDS have died.
There is no single, simple solution to the complex factors that continue to drive risk and transmission of HIV among gay, bisexual, and other men who have sex with men. Stigma and discrimination continue to be driving forces that keep individuals from being tested for HIV. We know that the vast majority of individuals who know they are infected take steps to protect their partners; so knowledge of HIV status is critical to preventing HIV transmission.

We must get the word out that the HIV epidemic among gay and bisexual men in the United States is not over. AIDS continues to claim the lives of far too many gay and bisexual men.

We know that HIV prevention works. However, in order to reduce the burden of HIV on the gay male population, we must not only expand access to prevention services, we must confront challenges such as complacency, homophobia, and stigma that gay and bisexual men continue to face. By working together, we will achieve the greatest impact on this epidemic. Please join me in supporting the second annual National Gay Men’s HIV/AIDS Awareness Day by recommitting and refocusing our efforts working with the population most severely affected by HIV in the United States.

People with HIV have 21-year reduction in life expectancy in US

via Aidsmap, by Roger Pebody

Despite dramatic increases in life expectancy in the decade since the introduction of combination therapy, Americans diagnosed with HIV are still dying an average of 21 years younger than their HIV-negative peers, report researchers from the Centers of Disease Prevention and Control in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

Read the rest.

Hearing on HPV Vaccine for Boys: Public Comments Welcome

via POZ

Should the federal government pay for the Gardasil HPV vaccine for boys and young men covered by government-funded health programs? The Advisory Committee on Immunization Practices (ACIP) of the U.S. Centers for Disease Control and Prevention (CDC) is holding a public hearing October 21 and 22 in Atlanta to discuss this important question and would like to hear from concerned community members, both in person and in writing.

Gardasil was approved in 2006 to help protect young women from the strains of human papilloma virus (HPV) that are most likely to cause cervical cancer and genital warts. Current guidelines recommend treating girls before they become sexually active, because a majority of women become infected with HPV within a short time after sexually activity has commenced.

The Food and Drug Administration (FDA) is now poised to approve the same vaccine to protect men from the same HPV strains that cause anal and penile warts and cancer. The FDA is expected to approve the vaccine’s use in preteen and teenage boys who have not yet become sexually active.

FDA approval is more scientific than political. The same is not true, however, when it comes to government decisions to pay for certain components of medical care. When ACIP recommended that government funds be used to vaccinate girls and young women, conservative activists objected strongly, claiming that the vaccine promoted promiscuity.

HIV and gay men’s health activists anticipate similar controversy at the ACIP hearing to determine whether the government should pay for the vaccine to protect men.

The mobilization of HIV and gay health activists is due, in part, to the fact that men who have sex with men have the highest rates of HPV infection and are likely to need the vaccine the most. Conservative groups are also expected to advocate against the government recommending payment for the vaccine, suggesting that it will promote both promiscuity and homosexuality.

Information about the ACIP hearing, which is open to the public, can be found on the CDC website. Written comments can also be submitted to the ACIP by e-mail at acip@cdc.gov.

The CDC Says, "Swab that Booty!"

The CDC recommends screening of at-risk men who have sex with men (MSM) at least annually for urethral and rectal gonorrhea and chlamydia, and for pharyngeal gonorrhea. Although the standard method for diagnosis is culture, nucleic acid amplification (NAA) testing is generally more sensitive and favored by most experts. NAA tests have not been cleared by the Food and Drug Administration (FDA) for the diagnosis of extragenital chlamydia or gonorrhea and may not be marketed for that purpose. However, under U.S. law, laboratories may offer NAA testing for diagnosis of extragenital chlamydia or gonorrhea after internal validation of the method by a verification study.

To determine sexually transmitted disease (STD) testing practices among community-based organizations serving MSM, CDC and the San Francisco Department of Public Health gathered data on rectal and pharyngeal gonorrhea and chlamydia testing at screening sites managed by six gay-focused community-based organizations in five U.S. cities during 2007. This report summarizes the results of the study, which found that three organizations collected samples for NAA testing and three for culture. In total, approximately 30,000 tests were performed; 5.4% of rectal gonorrhea, 8.9% of rectal chlamydia, 5.3% of pharyngeal gonorrhea, and 1.6% of pharyngeal chlamydia tests were positive.

These results demonstrate that gay-focused community-based organizations can detect large numbers of gonorrhea and chlamydia cases and might reach MSM not being tested elsewhere. Public health officials could consider providing support to certain community-based organizations to facilitate testing and treatment of gonorrhea and chlamydia.

Read the rest at the CDC.

Gay and AIDS community condemn Frieden CDC appointment

“The bad news is that [Frieden’s] propensity to ignore the concerns of affected communities may hinder his ultimate success in achieving the goals of aligning public health with the best that science has to offer.”

via Housing Works, by David Thorpe

This week’s appointment of New York City Health Commissioner Thomas Frieden to head the Centers for Disease Control and Prevention (CDC) provoked dismay among AIDS advocates and the gay press in New York City and beyond (with some exceptions).

As Health Commissioner, Frieden tried to do away with informed consent for HIV tests, made an Orwellian power grab for the medical information of people living with HIV, and infamously mishandled the so-called AIDS “superbug” case in 2005. As head of the CDC, Frieden may try to bully states into adopting routine testing without informed consent and will almost certainly take a step away from the real concerns of real people living with HIV/AIDS.

Read the rest.

Of interest in Gay City News:
Policy Regarding Bathhouses and Other Commercial Sex Venues in New York City