Health Screening for Gay Men

via thehealthybear, by George Forgan-Smith

Hey there Guys,

I was recently sent an interesting question from a reader about gay men’s health checks…

As an older (well, not that old) gay man who has had a fairly long and complicated journey towards self-acceptance and becoming sexually active, beyond the basic considerations around safe sex (i.e. condoms), what should I be considering (like immunisation, screening, etc.) around managing my sexual health, and managing other health issues where gay men are at increased risk?

Really quite an interesting question. I sometimes think we forget that gay men can suffer with all sorts of health issues, not just those based around HIV.

Today I thought it would be good to give an overview of some of the health issues gay men may be at higher risk for as well as some ways to reduce or even avoid those risks.

By the very nature of our sexual expression, gay men are at a higher risk for exposure to diseases such as Hepatitis A and B and in some cases Hepatitis C.

Hepatitis A is spread from oral contact with faeces with practices like rimming potential ways of spread. Hepatitis B and C can be spread by sexual contact, blood contact and also sharing of toothbrushes and razors with people who are infected. 

While there is not vaccination available for Hepatitis C there are very good vaccinations for both Hepatitis A and B. I highly recommend all gay men consider these vaccinations.

Other vaccinations worth considering are the HPV vaccine to help prevent genital warts as well as oral and anal cancer.

The best time to consider this vaccine is before you have become sexually active however the there are recommendations that all gay men up to the age of 26 should consider the vaccination.

While it may be useful past this age there are concerns that it may not be as effective.

Gay or straight all men face similar medical issues as they age.

This includes heart disease, prostate problems, risk of cancers and other diseases as we get older. For this reason I recommend getting a good health check up as you enter your 40′s.

Currently the Australian government has a program for men aged between 45 and 49 to check for health risks like diabetes, cancers, obesity, depression, heart disease and other factors.

This is a fantastic initiative and I highly recommend talking to your doctor if you are between the age of 45 and 49. This is a great opportunity for a top to tail health checkup.

Read the rest

Odds for Detecting HIV Varies By Method, New Study Finds

via At a Glance

The odds for effectively detecting HIV in African-American men vary by method, researchers have found. The study, which appears in the Annals of Behavioral Medicine, suggests that HIV-prevention efforts must be multi-faceted, taking into account differences in within this demographic.

To do so, they examined three different avenues for testing among African American MSM in New York City and looked at which methods showed the highest rates of positive HIV tests. By linking a method for getting tested with positive HIV results, the researchers could then better understand which methods were most likely to identify new HIV cases.

The three approaches for HIV testing included the following:

·         Partner services, which involves identifying, locating, and interviewing HIV-infected persons to provide names and contact information of their sex and needle-sharing partners, notifying partners of their exposure to HIV, and providing HIV counseling, testing, and referral services to those partners;

·         Alternative venue testing, in which rapid HIV testing is conducted in bars, churches, or mobile units;

·         The social networks strategy, where HIV testers engage either HIV-positive individuals or those at high risk of seroconversion to become “recruiters.” Through active enlistment and coaching processes, staff build relationships and help recruiters engage people in their social circles into HIV testing.


Read more.

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.

Hide and seek

National HIV Testing Day: Where are the gays?

MASSACHUSETTS BLACK ELECTED OFFICIALS TO BE TESTED FOR HIV TO MARK NATIONAL HIV TESTING DAY

Join with AIDS Organizations to Urge
Massachusetts Residents to Know Their Status

BOSTON, June 26, 2007 — Members of the Massachusetts Black Legislative Caucus (MBLC) and Black State Elected Officials have pledged to personally take an HIV test in an effort to highlight the heavy toll the disease is taking on communities of color in Massachusetts and across the nation.

“We as Elected Officials are 100% committed to fighting the HIV/AIDS epidemic in every community,” said MBLC Vice-Chair Gloria Fox. “Today, we are focusing attention on the disproportionate impact the disease is having on Black and Latino residents. There is a major public health crisis happening right here in the Commonwealth of Massachusetts and the United States. We need to make sure the appropriate resources are available to end this epidemic.”

“I salute these courageous Black State Legislators for supporting HIV testing in Black communities across the Commonwealth and for offering a strong example by getting tested themselves,” said John Auerbach, Commissioner of Public Health for Massachusetts. “I also thank the collaborating AIDS organizations, namely AIDS Action, JRI Health, MAC and Healing Our Land, for facilitating testing for these public leaders.”

“Knowing one’s HIV status is essential to stopping the spread of this disease,” said Rep. Byron Rushing. “The two reasons to get tested are to get into care if you are HIV positive and to stay negative if you are HIV negative.”

“It’s powerful to have this group of legislators deliver today the important message of getting tested for HIV, and taking action on one of the most critical issues that face the people of the Commonwealth and the country,” said Gary Daffin, Executive Director of the Multicultural AIDS Coalition. “They’re here because they care!”

Key Facts About HIV and Black Americans:

* While Blacks comprise only 13% of the nation’s population, they account for 50% of HIV infections

* HIV is one of the leading causes of death for U.S. Black adults

* Blacks in Massachusetts are 10 times more likely to be infected with HIV than white residents.

* Black women are 39 times more likely to become infected with HIV than white women in Massachusetts.

* Among youth aged 13-24 across the nation, Blacks accounted for 61% of HIV diagnoses. In Massachusetts, Black and Latinos are more likely to be diagnosed during adolescence than their white counterparts.

* In one national five-city study, 46% of young Black men who have sex with men tested HIV positive. A majority of them did not know they were infected.

* 1/3 of Blacks in Massachusetts who test positive for HIV already have already progressed to AIDS diagnosis by the time they reach care.

[The above photo is of members of the Massachusetts Black Legislative Caucus and representatives from the collaborating organizations including AIDS Action Committee, JRI Health, Healing our Land Inc. and the Multicultural AIDS Coalition.]

HIV Legal, Medical and Service Providers Launch Guide to HIV Testing

In preparation for National HIV Testing Day, tomorrow, June 27, Lambda Legal, AIDS Foundation of Chicago, and the Center for HIV Law and Policy release fundamental principles for testing policy and program expansion.

(New York, June 26, 2007) — Today, Lambda Legal, AIDS Foundation of Chicago, and the Center for HIV Law and Policy launched a broadly-endorsed set of fundamental principles for HIV testing in honor of National HIV Testing Day, which is tomorrow, June 27.

Legal, medical, and service providers created a single set of principles that should guide HIV testing programs, emphasizing the fundamental principles that HIV testing must always be informed, voluntary, confidential, and supported by health care.

“We cannot lose sight of the people who will be tested,” said Bebe J. Anderson, HIV Project Director of Lambda Legal. “Respect for the civil and human rights of patients must be at the heart of successful efforts to increase testing.”

“Expanded testing can be valuable, but it must be well planned, high quality, and client centered,” said David Ernesto Munar, Vice President of the AIDS Foundation of Chicago. “As a Colombian-American living with HIV, I know only too well that testing is about much more than just the results and must include meaningful coordination with prevention, care, and support services, especially for those who receive an HIV diagnosis.”

“The evidence that thousands of diagnosed HIV-positive people are not in care and that about half of new infections unknowingly stem from newly-infected people that rapid testing can’t pick up, are strong indictments of the CDC’s push to speed-test everyone for HIV without counseling or ensuring people get into care,” said Catherine Hanssens, Executive Director of the Center for HIV Law and Policy.

On June 27, the annual National HIV Testing Day, millions of people across the United States are encouraged to get tested for HIV. The Centers for Disease Control and Prevention (CDC) have recommended that everyone between the ages of 13 and 64 get tested for HIV when they seek health care. In response to CDC’s push for expanded testing, Lambda Legal, AIDS Foundation of Chicago, the Center for HIV Law and Policy, and colleague organizations are issuing fundamental principles to direct the implementation of expanded voluntary testing for HIV.

The 15 guiding principles include:

-People living with undiagnosed HIV infection must be reached and offered testing.

-Any HIV testing program must provide the highest standard of care.

-Everyone offered testing must be educated about HIV and the significance of positive and negative test results.

-People who test positive for HIV antibodies must be linked to care. -Patients’ human rights and informed consent are consistent with, and not opposed to, the goal of expanded HIV testing. -Expanded HIV testing must be tailored to different clinical settings, populations, and patient needs.

-Clinicians, medical directors and other providers must receive training and education in making appropriate service referrals and linkages to care.

-Special attention must be paid to the prevention and care needs of at-risk populations.

The guiding principles and list of endorsing organizations will be used to inform public officials and HIV advocates as they work to expand voluntary HIV testing programs and policy at the local, state, and federal levels of government. To date, the guiding principles have been endorsed by: Association of Nurses in AIDS Care (ANAC); AIDS Foundation of Chicago; AIDS Legal Council of Chicago; the Center for HIV Law and Policy; Community HIV/AIDS Mobilization Project (CHAMP); Gay and Lesbian Advocates and Defenders, Inc. (GLAD), the Health and Education Alternative for Teens (HEAT) and Family, Adolescent, and Children Experiences at SUNY (FACES) programs of SUNY Downstate Medical Center, HIV/AIDS Legal Services Alliance (HALSA); Hudson Pride; Human Rights Watch, the Hyacinth AIDS Foundation, Lambda Legal; Sisterhood Mobilized for AIDS/HIV Research & Treatment, Inc. (SMART), and Joseph Sonnabend, M.D.

For the full report, please visit www.lambdalegal.org. The report is also available at www.aidschicago.org and www.hivlawandpolicy.org.

Preventing HIV: Ethics, Activism, and Promising New Strategies

... at the Center on Halsted on Wednesday, June 27

FREE EVENT

The Center on Halsted and AIDS Foundation of Chicago will be presenting a special day-long speaker series on the evolving tactics and emerging challenges facing HIV prevention initiatives. The three-part event will feature presentations from amfAR’s acting director for public policy Dr. Monica Ruiz, Louise Binder of the Canadian Treatment Action Council and Voices of Positive Women, and Seattle methamphetamine expert Susan Kingston of the King County Department of Public Health. Separate registration is required for each section.

Visit www.aidschicago.org/preventingHIV to reserve your space today!

Additional Event Information:

• Free HIV testing will be provided throughout the day by Howard Brown Health Center and BEHIV.
• NAMES Project Chicago will display 250 panels of the AIDS Memorial Quilt in the gymnasium of the Center on Halsted.
• Breakfast and lunch will be served and an evening reception will follow the final segment. ALL FREE.

The event is being held in conjunction with National HIV Testing Day and will be hosted at the Center on Halsted’s new home, 3656 N. Halsted.

Visit www.aidschicago.org/preventingHIV to reserve your FREE space today!

This is my story.1 - National HIV Testing Day

NAPWA's National HIV Testing Day campaign is all about the personal...
[National HIV Testing Day is Wednesday, June 27, 2007]

click images to enlarge

This is my story.2 - National HIV Testing Day

NAPWA's National HIV Testing Day campaign is all about the personal...
[National HIV Testing Day is Wednesday, June 27, 2007]

click images to enlarge

Targeted HIV testing more effective than CDC mass testing proposal

A targeted campaign of testing and counseling aimed at those who are at high risk for HIV would be more effective than the mass patient screening proposed by the Centers for Disease Control and Prevention (CDC), according to an analysis by David Holtgrave, PhD, an expert on HIV prevention at the Johns Hopkins Bloomberg School of Public Health. Holtgrave determined that the CDC’s testing strategy is likely to cost $864 million for one year. For the same price, a targeted testing and counseling approach would identify more than three times as many people with HIV and could prevent four times as many new HIV infections compared to the CDC’s testing strategy. Holtgrave’s study is the first to examine the cost-effectiveness of the CDC’s testing plan and is published in the June 2007 edition of the journal PLoS Medicine.

The CDC estimates that 25 percent of Americans with HIV do not know they are HIV positive. Because they are unaware, they do not seek treatment and are at greater risk of spreading HIV to others. To identify more Americans with HIV, the CDC has recommended that doctors in the United States test all patients aged 13 to 64 for HIV at every health care visit, unless the patient opts out, or specifically declines to be tested. In order to meet the demands of more testing, doctors can forgo the HIV risk reduction counseling that usually accompanies HIV testing.

“While the CDC’s recommended opt-out testing offers some public health benefit, the data shows there would be substantially more benefit from a more targeted program that includes rather than discards risk reduction counseling—including more diagnosed infections and more transmissions prevented,” said Holtgrave, who is professor and chair of the Bloomberg School’s Department of Health, Behavior and Society.

Using standard methods of cost-effectiveness analysis, Holtgrave estimates that CDC’s recommended opt-out testing program would cost $864 million. For the same cost, a program of targeted counseling and testing would diagnose 188,170 new HIV infections, compared with 56,940 that would be detected through CDC’s testing plan, assuming 1 percent of the population tested is HIV positive. Additionally, targeted counseling and testing would prevent an estimated 14,553 new HIV infections at a cost of $59,383 per infection prevented, compared to 3,644 from opt-out testing at a cost of $237,149 per infection prevented. Further, Holtgrave says that targeted testing and counseling perform better than opt-out testing in several key outcomes even when the rate of HIV infection in the community is 0.3 percent.

“It is important that everyone living with HIV knows their serostatus so that they might access life-saving HIV treatment. The question now is to determine the most effective testing strategies for identifying people with HIV. Our work sought to answer that question,” said Holtgrave.

###

Contact: Tim Parsons paffairs@jhsph.edu 410-955-6878 Johns Hopkins University Bloomberg School of Public Health

For public health news updated throughout the day, click here. .

MSM Fighting the Stigma Monster

By Sharon Egiebor
First Published: 4/16/2007 BlackAIDS.org
Even though HIV/AIDS is being discussed from the church house to the state house to the White House to the jailhouse, stigma still keeps many African American men who sleep with men from getting tested and seeking medical care, according to leading researchers. African American men, those who identify as gay and those who sleep with men but do not identify themselves as gay (MSM), are increasingly being diagnosed of HIV/AIDS at higher rates than men of other ethnicities. “There can be many reasons for the increases,” said Dr. Jose Nanin (pictured), director of education and training for the Center for HIV Educational Studies and Training (CHEST) at Hunter College, City University of New York (CUNY). “The big reason right now is the speculation of seeing HIV linked to so much stigma in our community.” Click here for the rest.

Does Counseling Matter in the Context of HIV Testing?

Testing, testing, testing - MUCHO emphasis on HIV testing these days. There has been MUCHO debate around the role of counseling in the HIV testing context - is it a barrier to care, does it have any value to any of the participants (like the person getting tested), and what would happen if it disappeared? One of the LGBTI Health Movement's most wonderful, steady leaders, Stewart Landers, mused over the issues and shares some of his thoughts here for LifeLube.

Please leave a comment if so inclined.

Jim

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I think it's not a coincidence that the move to reduce or eliminate counseling as part of HIV testing comes at the same time many are pushing for "routine" or other forms of expanded HIV testing.

The main barrier to widespread HIV testing has been providers' discomfort or lack of willingness to "go there." That is many do not want to talk to their patients about a stigmatized disease that may suggest behaviors they (the provider) are uncomfortable discussing or providing counseling or other information about.

Removing counseling requirements and requiring only opt-out consent procedures potentially allows many providers to check off the HIV test box when they draw blood and never mention it to the patient. Docs who would do this (and I really do love most docs I've known in my life) are also the ones who are least likely to want to deliver a positive test result in person to a client but leave it to their staff, phone or even, heaven help the newly infected person, mail.

While there may be anecdotal information and some pretty good research that most negative people don't change behavior based on negative results, there is pretty good research that positive people do change behavior after receiving positive test results and those changes are in the direction of risk reduction. Whether those changes are the results of counseling or the well taught human trait to avoid harming others is hard to separate, because up until recent times, almost all people received counseling with their HIV test results.

I had to give out 2 or 3 positive test results in my time as an HIV counselor (in the late 80s with virtually no treatment and much more stigma), and I agree people don't hear or absorb much information at the time of a test result. However, a good HIV counselor knows that it is also the affective behavior of a counselor that is important - empathy, patience, a willingness to listen (though many clients seek to "disappear" as quickly as possible after getting a positive test result.) There are also techniques that are used such as making plans with a client about who they were going to talk to next, what they were going to do over the next 4-24 hours, the next week and even month, just so they understood that their life would go on.

Each positive test result is somewhat unique, so it's hard to describe exactly the strategy counselors employ. With the current emphasis on moving people directly from a positive test result into care, people who give test results are often situated at the same location where people receive medical or case management services. In those cases, when the client is not anonymous, a counselor can make appointments for medical or case management services and someone (usually not the counselor, but in some cases it is the counselor) will follow-up with the client to make sure they show up to get those services.

Getting a positive test result for HIV is still a shocking piece of news for most people. It changes the course of their lives - how they think about partnering, parenting, sexuality, survival, work and much more. While I'm all for the mainstreaming of AIDS care and the de-stigmatization of the illness, I often find myself in a quandary about how we do that and still acknowledge all the life changing aspects of the illness.

---Stewart

BIO - Stewart Landers, JD, MCP, has been a senior consultant at John Snow, Inc. (JSI) since 1994. He consults on issues related to HIV/AIDS, substance abuse treatment and lesbian, gay, bisexual, transgender and intersex (LGBTI) health. Mr. Landers has also been an activist for LGBTI rights and health, and was co-convener of the 2004 National LGBTI Health Summit. In addition to his consulting duties, Mr. Landers serves as an associate editor of the American Journal of Public Health for LGBT Health, HIV/AIDS, community planning and evaluation studies. He has recently launched his own blog: Landers Health Report.