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.

Circumcision may protect HIV-negative gay men from syphilis

via Aidsmap, by Michael Carter

Circumcision protects HIV-negative gay men from infection with syphilis, Australian investigators report in the December 15th edition of the Journal of Infectious Diseases. However, circumcision did not affect the risk of acquiring any other sexually transmitted infection.

The study was conducted by investigators from the Health in Men (HIM) study. This is the same group of investigators who recently reported that circumcision may protect gay men with a “preference” for insertive anal sex from HIV.

Gay men are disproportionately affected by sexually transmitted infections and new methods of preventing them are required.

Observational studies conducted in heterosexuals have suggested that circumcision is protective against ulcerative sexually transmitted infections, including genital herpes and syphilis. In addition, the Rakai randomised controlled trial showed that circumcision protected against genital herpes, but not syphilis.

Read the rest.

Peter, I don't have symptoms - but should I be regularly checked for STDs?

[Peter Pointers is here 4 YOU, as a service to LifeLube readers - whatever question you may have regarding sexual health, physical health, mental/emotional and spiritual health - ask him. He will find the answers you are looking 4. Below is a recent Q&A you may be interested to read.]

Question: How do I know if I should be tested for syphilis, gonorrhea, chlamydia? I don't have symptoms but should I be tested regularly like I do for HIV?

Answer: Thank you for your question. I am happy to hear that you get tested regularly for HIV and think it's great that you are considering getting tested for STDs, also.

So, Howard Brown Health Center in Chicago recommends that men who have sex with men get tested for HIV every 6 months to a year. Similarly, they recommend getting tested for syphilis, gonorrhea, and Chlamydia each time you get tested for HIV, each year, at the start of a new sexual relationship, or at the onset of symptoms.

Just as a refresher, here is a good rundown of the symptoms of other STIs: click here. Some include burning during urination and any discharge from the penis or anus (especially on the inside of your underwear or pants).

Depending where you are located, there are places where you can get tested for STIs for free or low cost. One good source is www.hivtest.org, where you can search by zipcode for testing locations. If you have any trouble finding a place to be tested for STI's, let me know (include where you are located) and I will assist you the best I can!


Be Well,
Peter Pointers
Friend Peter on Facebook

Weak at the knees...

When we play, we live in the sensation!

By using condoms and lube, testing regularly for STIs, and remembering the more partners we have, the more often we should be test, we reduce our risk so we can give in to the moment.

From Australia's Acon and whytest.org, a great resource for info like:

What is an STI?
How would I know if I have one?
STI fact sheets: Viruses | Parasites | Bacteria | Fungi

God we love the Aussies!

Gay men make up 65 percent of syphilis cases

On Tuesday, the Atlanta-based Centers for Disease Control & Prevention released its National STD Surveillance Report for 2007. It shows 11,466 reported cases of primary and secondary syphilis, a 15.2 percent increase over 2006. Of those cases, a staggering 65 percent were among men who have sex with men.

Syphilis is often missed because its key early symptoms are a painless sore on the mouth, penis or anus that can go away without medication. While painless, those sores can dramatically increase someone’s chances of contracting HIV.

“Gay and bisexual men have been hearing the same prevention methods over and over again, and so it might not be effective anymore. Also with HIV medications there is a feeling of wellness and that might cause people to engage in more risky behavior."

Read the whole article on Southern Voice.

Q: How do I avoid getting syphilis?

A: Syphilis is on the rise in the Chicago-land area among men who have sex with men. Since syphilis can be transmitted by all forms of sex, including oral sex, it is important to know ways of protecting yourself against getting it.

First off, the risk for syphilis is directly related to the number of sex partners you have: The more sex partners, the greater the risk on contracting it. Having more sex with fewer partners reduces your risk of getting syphilis.

Also, of course, abstinence is the only surefire way to avoid getting syphilis or other STDs. However, if you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best bet for staying sexually healthy.

But we all know that advice only works for some of us. So, one of the most important things you can do, if you're sexually active with more than one monogamous partner, is get regular STD checkups at least every six months. Syphilis and other bacterial STDs (like Gonorrhea and Chlamydia) are curable with proper diagnosis and treatment.

Syphilis testing is free at the Howard Brown walk-in clinic and at outreach locations like Steamworks (on Tuesdays from 4-7) and Hideaway (ask for times and location).

Another thing you can do to reduce your risk of coming into contact with syphilis is keep an eye out for small painless chancres (shank-er) on your or your partner’s cock, ass, and mouth. A chancre usually shows up 2-12 weeks after being exposed. There may have more than one, or a person may have chancres and not notice them because they are inside the anus. They are usually not painful. The sores will go away after several weeks without treatment, but the person would still be infected and able to spread syphilis.

Check out GetTestedChicago for even more info and testing locations.

[thanks to Howard Brown Health Center for this info]

Syphilis in Chicago

Click GetTestedChicago for more info on syphilis.
Listen to the "Sex on the Superhighway" podcast about cruising on the internet with LifeLube and the Feast of Fools.
Send an anonymous, confidential e-mail notifying your partners that they have been exposed to a sexually transmitted disease.

Syphilis on rise among men with same-sex partners

Study: Sex partners often found online

By Deborah L. Shelton | Chicago Tribune reporter

Posted July 14, 2008

Men who have sex with men are more likely to turn to the Internet to find sex partners than meet them at bars or clubs, according to a new report by the Chicago Department of Public Health.

The trend is significant because health experts believe Internet hookups are helping to fuel a syphilis epidemic among men with same-sex partners.

The report was based on confidential interviews conducted as part of the health department's routine disease-surveillance activities. It was the first time more men said they met sex partners online than in places such as bars, said Dr. William Wong, medical director of the health department's division of sexually transmitted disease, HIV and AIDS.

The Internet is not the cause of the upsurge in infectious syphilis cases among men who have sex with men, but it increases the chances of disease transmission, said Deborah Levine, executive director of the Oakland, Calif.-based Internet Sexuality Information Services, a non-profit group that develops Internet technologies to prevent the spread of sexually transmitted diseases.

"If you go to a bar in a night, there might be 200 or 300 people there," Levine said. "You can go on multiple Web sites in a night and potentially meet thousands of people. The speed and sheer numbers allow for more possibilities for passing around infections."

In 1999, the Centers for Disease Control and Prevention launched a national plan to eliminate infectious syphilis from the United States. But even as rates among heterosexuals have dropped dramatically, sinking to a historic low, rates among men who have sex with men have soared.

The shift has set back local and national health campaigns aimed at preventing new cases of the disease.

The number of syphilis cases in Chicago hovered around 300 annually for about a decade. Until 2001, most of the cases were among heterosexual men and women.

Then the trend shifted. Last year 331 syphilis cases were reported in Chicago-71 percent of them among men with same-sex partners.

Nationally, about 36,000 cases were reported in 2006.

Syphilis is easily treated with penicillin in its early stages. Untreated, it can damage internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.

According to the health department survey, 34 percent of men diagnosed with syphilis last year at city health department STD clinics said they met their sex partners on the Internet, Wong said. That compared with 33 percent of men who said they met their sex partners at bars or clubs.

"Prevention does work, and the reductions over the last 10 years among women and the heterosexual community are an important advance," Wong said. "We are making progress. But syphilis is still around and there's still work to be done."

One concern is the increasing number of people diagnosed with syphilis who also are HIV-infected. Among heterosexuals diagnosed with syphilis at city clinics four years ago, 6 percent were infected with HIV. Last year it was 15 percent.

The majority of men diagnosed with syphilis at Howard Brown Health Center already are HIV-infected or finding out about their HIV infection at the same time of their diagnosis, said Daniel Pohl, the health center's manager of disease-intervention services.

Unprotected oral sex is mistakenly considered safe, but it can be risky in the case of syphilis if there are sores on the genitals or in the mouth, Pohl said.

"They think casual oral sex won't have repercussions," he said. "But with syphilis, it can."

Though the Internet has created new challenges, it also offers opportunities for intervention, Wong said.

The National Coalition of STD Directors published national guidelines on Internet-based interventions to help health departments use the Web in outreach activities. [Read the related LifeLube interview with one of the authors of those guidelines - Stephan Adelson]

The Chicago health department has tried different strategies-from beefing up its Web site with information about syphilis, to posting banner ads on other Web sites and launching a Web site called inSPOT, which is run in partnership with Internet Sexuality Information Services.

The site combines the concept of an electronic greeting card with information about STDs.

Men can send an anonymous, confidential e-mail notifying their partners that they have been exposed to a sexually transmitted disease.

Click GetTestedChicago for more info on syphilis.

Listen to the "Sex on the Superhighway" podcast about cruising on the internet with LifeLube and the Feast of Fools.

Examining Bathhouse Policy, NYC Says HIV Infections Up - and Points the Finger

Health dept. memo suggests sex clubs could be closed with circumstantial evidence

After saying for years that new HIV infections among gay and bisexual men are high, but stable, a city health department memo given to Gay City News is asserting that new HIV infections among those men are increasing.

"New York City is now experiencing an increase in syphilis and an increase in HIV infection in men who have sex with men," Dr. Thomas Farley, a special advisor to Dr. Thomas R. Frieden, the city's health commissioner, wrote in the November 2007 memo.

The six-page memo, titled "Policy Regarding Bathhouses and Other Commercial Sex Venues in New York City,"was drafted for Frieden and explores the options for dealing with sex clubs and bathhouses.

Read the rest in Gay City News.

Read Joe.My.God's post titled "NYC Mulls Closing Bathhouses, Sex Clubs."

This is an unfortunately hard line approach. What do you think? Would you want to see bathhouses shut down in your city?

No more STD flavors of the month!

by Mark Hubbard

Recently, I was brainstorming possible topics for a statewide meeting of HIV advocates. As the chair, I always prefer to respond directly to the interests of our members. Our previous meeting in May could be described as a high point and the group has been relatively quiet since, so I was having trouble.

As I read through the various emails I receive daily, it occurred to me that syphilis might be of interest. I thought perhaps we could discuss it from two angles - providing practical knowledge of syphilis symptoms, testing, and treatment, and discussing what (if any) connection between syphilis and HIV infection rates exists or is important. (I freely admit I'm skeptical based on the west coast history.)

It seems I hit that one out of the park.

Less than a week later, responding to an August 12 New York Times story describing a rise in the city's syphilis cases, one of those lists entered into a passionate debate about the latter angle. Posts seemed to fall into two categories: "of course a rise in syphilis cases predicts a rise in HIV infections!" or "we learned in San Francisco and L.A. that simply isn't so."

While I can see the simple logic of making a connection, I firmly believe the matrix of factors driving STI infection is much more complex. I just don't think it's generally useful or productive to tie syphilis to HIV infection. I'm convinced that the very fact that there are such outbreaks and the very fact that the discussion is occurring results directly from "flavor of the month" thinking and a dearth of comprehensive STI / sexual wellness initiatives.

Choosing two STI's to highlight isn't much better than choosing one (I'm so sick of HIV-focused tunnel vision). One good reason is that any syphilis campaign that emphasizes an HIV connection risks leaving positive persons turned off and tuned out. Another is that otherwise great HIV doctors who provide care around the globe often "get it" about gay rights but don't really "get it" about gay sex. They don't consider or even feel comfortable discussing the sexual choices their patients are making outside of the rote HIV framework (if at all) and often they don't discuss, much less routinely screen for other STI's.

My wish is that we stop framing health promotions, warnings, etc. in terms of recent epi trends based on data which we know are a) delayed, b) subject to reporting issues, c) not complete without non-reportable STI's, and d) not accompanied by behavioral data that would make them useful.

I understand that this game has its origins in the lack of funding (so funding ends up being largely tied to those "flavors of the month.") Yet I wish we'd stop endorsing by participation a system that juggles STI's individually. Then let's find / demand funding for, and help create sustainable comprehensive sexual wellness programs.

I'd like to see long term efforts that frankly link all STI's with what they really have in common: dick-, ass-, and mouth-sex and related choices. I'd like to see a campaign that references the complete list of things every one of us as gay men should know about our sexual health. And finally, when someone goes in for testing, I'd like to see an evidence-based decision-making process embedded in a culturally sensitive protocol that's funded generously enough to avoid forcing triage when deciding what testing is appropriate.

I'm thankful to see MSM rise back to the top after a long period of being categorized as a lower funded risk category / priority in good old Tennessee, USA. I am afraid however that the few resulting new dollars will be used to fund more of the same boring cookie-cutter initiatives we've seen in the past (and I'm afraid we will continue to spend nearly zero dollars on STI prevention social marketing.)

Meanwhile, if any of you knows of a knowledgeable community advocate who can present both sides of the issue and back them up with facts please let me know.
Peace,
mark

[Mark Hubbard is a volunteer who works for just about everyone and is employed by no one working in the field in Middle Tennessee. He is the Chair of the Tennessee Association of People With AIDS and the community liaison for the Vanderbilt AIDS Clinical Trials Center Community Advisory Board. Send him a note here.]

Fabulous animation courtesy of ACON. Check them out!

Syphilis on backs of buses in Chicago

Chicago is no longer the syphilis capital of the U.S., something that might be hard to believe if you’ve recently been stuck behind a Chicago Transit Authority bus.

Syphilis "Syphilis is back!" warns a taillight ad on 65 CTA buses, part of a four-week public health campaign targeting the gay community in the Chicago neighborhoods of Lake View, Andersonville, Rogers Park and Edgewater.

Read the rest in the Chicago Tribune.

SYPHILIS IS BACK!

Syphilis is not a big deal - it's curable after all. But you gotta know you have it! Many of us do not recognize the symptoms. So, if you are sexually active, it is smart to make regular syphilis testing part of your routine. Click above to learn more.

Raw Sugar - Jim Pickett feasts with the fools and goes rectal

LifeLuber and Rectal Fanatic Jim Pickett was the guest-du-jour on the fabulous and award-winning Feast of Fools podcast yesterday and blathered about rectal microbicides, bareback porn, crystal meth, syphilis, Chris Evans (below) and gay moths.

Click here to read the blurb and to download the Podcast.

Chris Evans is our sunshine.

Fausto and Marc are the Feast of Fools.

Syphilis is creeping up in NYC

[this post comes to you via NY1. the fabulous ad above can be seen in Next, HX and Gay City News]

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Health officials are continuing to see a disturbing increase in a sexually transmitted disease that once looked like it was close to being eradicated.

Now within just the first quarter of the year, they report what could be a surge in syphilis cases. NY1 Health & Fitness reporter Kafi Drexel filed the following report on what's being done to try to stop it.

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Within in just the first few months of the year New York City health officials say syphilis cases took a dramatic jump; they doubled in fact. From January through March, doctors reported 260 cases compared to 128 over the same period in 2006.

The numbers may still seem small in a city of eight million people, but health experts say the increase is enough for serious concern.

“Although you think of syphilis as something that you see in military training films from World War II, World War I, it's still very much present,” said Department of Health Assistant Commissioner Dr. Susan Blank. “We worry about syphilis because it can make it easier to get or spread HIV, which is really a very big concern.”

While there's been a slight increase among women, men make up the majority – 96 percent of new cases. And officials say most of those cases are among men who have sex with men in the Chelsea area of Manhattan. Half of those newly diagnosed are also infected with HIV.

The latest numbers have already prompted a new advertisement campaign from the Gay Men's Health Crisis encouraging syphilis screening and treatment.

“We need to make sure men check themselves out, as well as being concerned about the transmission that may happen with a partner,” said Bill Stackhouse of the Gay Men’s Health Crisis. “People should be using condoms and people should be safe.”

Syphilis is curable with penicillin. Left untreated, however, there can be serious health consequences like permanent neurological damage, still birth, mental retardation, blindness or deafness to the newborns of women who may unknowingly be infected.

“Ideally this is just an aberration, but we can't count on that,” said Blank. “Every New Yorker has a role to play in protecting themselves against syphilis and other sexually transmitted disease.”

Doctors say the way to do that is using latex condoms for every sex act, limiting numbers of partners, and more routine screenings for those at higher risk – including gay men and anyone infected with HIV.

Severe Form of Syphilis Recorded Among MSM, MMWR Study Says

From the Kaiser HIV/AIDS Daily Report

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=45953

A serious form of syphilis is appearing among some men who have sex with men, according to a study published in the June 29 edition of CDC http://www.cdc.gov/ 's Morbidity and Mortality Weekly, Reuters http://www.alertnet.org/thenews/newsdesk/N28314225.htm reports. Symptomatic early neurosyphilis is a rare manifestation of syphilis that usually occurs within the first year of infection, according to Reuters. Although syphilis can be cured with antibiotics in its early stages, neurosyphilis can lead to blindness or stroke, according to Thomas Peterman, a study author from CDC's Division of STD Prevention http://www.cdc.gov/nchstp/dstd/aboutdiv.htm .

Peterman and colleagues tracked 49 HIV-positive MSM who had symptomatic early neurosyphilis in Chicago, Los Angeles, New York city and San Diego from January 2002 to June 2004. Sixty-three percent of the participants were non-Hispanic whites, 18% were non-Hispanic blacks and 14% were Hispanic. Their average age was 38. CDC cited the study as further evidence that MSM, many of whom are HIV-positive, are the driving force behind the increase in the number of cases of syphilis in the U.S. during the past 10 years (Dunham, Reuters, 6/28).

According to CDC officials, the number of syphilis cases in the U.S. reached an all-time low in 2000. However, the number of cases has risen annually from 2000 to 2005, the most recent year for which the agency has figures. CDC analysts estimate that in 2000, MSM accounted for 7% of syphilis cases in the country but accounted for more than 60% in 2005. According to CDC, syphilis incidence in the overall population was 2.1 cases per 100,000 people in 2000, compared with three cases per 100,000 people in 2005, or 8,724 cases (Kaiser Daily HIV/AIDS Report http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=44746 , 5/8).

The study's findings also indicate that some MSM are engaging in sexual practices that can spread HIV and other sexually transmitted infections. "These are primarily infections that people are probably getting because they're not using condoms," Peterman said. He added that there are a "number of studies that continue to show that there are some HIV-infected and some uninfected men who have sex with men who continue to have large numbers of (sexual) partners and anonymous sex. This is one of the consequences of that." According to Peterman, study participants in some cases said that because they have HIV, they did not need to practice safer sex. "I think the bigger message is that we need to get control of syphilis," Peterman said, adding that curbing the STI would "require safe-sex behavior, reducing the number of partners and using condoms with those partners." He recommended that MSM get tested for HIV and other STDs at least once annually (Reuters, 6/28).

Online http://www.kaisernetwork.org/images/paper_icon.gifThe study is available online http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5625a1.htm .

HIV and alcohol, syphilis and gay men, Brazil and drug costs

A couple of interesting stories from the always great aidsmap. Click on the headline for the full story.

Brief intervention on HIV and alcohol risk encourages safer sex
Researchers have found that a single counselling intervention that includes an exploration of the risk of alcohol use in sexual contexts may have an impact on HIV prevention by reducing sexual risk behaviours. The study is published in the April 15^th edition of the Journal of Acquired Immune Deficiency Syndromes. Considerable evidence exists that alcohol use contributes to the spread of sexually transmitted infections (STIs) including HIV.

Majority of US syphilis cases are now in gay men
Almost two-thirds of syphilis cases in the United States in 2003 were in gay men and other men who have sex with men, according to a study published in the June edition of the American Journal of Public Health. A fall in the incidence of syphilis of over 50% amongst heterosexual men and women between 2000 and 2003 was more than offset by a significant increase in the incidence of the infection amongst men who have sex with men.


Brazil demands 60% efavirenz price cut, or may break patent
The Brazilian government announced yesterday that it had taken the first step towards issuing a compulsory license to import Indian generic copies of the anti-HIV drug efavirenz. The decision came after efavirenz’s manufacturer Merck & Co refused to sell the drug to the Brazilian government at the same price recently agreed with the Thai government.