Peter Pointers Finds the Rotten Core in that Nasty Apple App

via Peter Pointers [Peter Pointers is LifeLube's gay health educator and is assisted by a group of qualified health specialists who work as a team to answer your health questions. Ask about your sexual health, physical health, mental/emotional and spiritual health.]

Apple has been receiving backlash for approving a “gay cure” iPhone app that recently hit the market. 

***As of yesterday, 3/22/11, Apple has yanked the application.  Here is a statement from an Apple spokesperson "We removed the exodus international app from the App Store because it violates our developer guidelines by being offensive to large groups of people." ***

The app comes from Exodus International, an organization that claims it is “the world’s largest ministry to individuals and families impacted by homosexuality that is committed to encouraging, educating and equipping the Body of Christ to address the issue of homosexuality with grace and truth.”  Exodus supports those who “want to reconcile their faith with their sexual behavior by providing resources like outside counselors and support groups.” 

Read the group's press release "Apple Suppresses Diversity by Pulling iPhone Application."

Apple had given the app a rating of “4+” stars which means that it has been found to contain “no objectionable content,”  but many people feel otherwise.  There has been an outpouring of disagreement with Apple’s assessment of the app and, as of 3/22/11, over 150,000 people have signed a petition on Change.org to have the app taken off of the market.  This petition was started by Truth Wins Out, “an organization that counters right-wing misinformation campaigns, debunks the ex-gay myth, and provides accurate information about the lives of LGBT people.” They believe the app’s message is “hateful and bigoted.”  You can see the petition at the Change.org website and more information on the story can be found here

Even though Apple has removed the application, there is still a need to look deeper into the truth behind “gay reparative” therapy?  To find answers, I turned to some highly respected American organizations. 

The American Psychological Association, the American Psychiatric Association, the American Medical Association, the American Academy of Pediatrics, the American Counseling Association, and the National Association of Social Workers have all issued statements or resolutions that oppose “reparative” or “conversion” therapies, also known as Sexual Orientation Change Efforts (SOCE).  Links to some of these statements can be found here.

The American Psychological Association (APA) also released a report in 2009 called the “Report of the American Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation.”  The report and reference for the summary of information below can be found here.

The APA has cautioned that research has not shown Sexual Orientation Change Efforts (SOCE) to be effective.  Most medical and mental health experts agree that sexual orientation is not a “reversible lifestyle choice” or mental disorder, but a normal and positive variation of human sexual orientation.  The American Psychiatric Association’s position statement not only opposes “reparative therapy” based on its lack of scientific evidence base, but also acknowledges that attempts to define homosexuality as a mental disorder are simply attempts to discredit further social acceptance of LGB individuals by religiously or politically motivated groups and individuals.  

In addition, research has shown some evidence individuals experience harm from SOCE including loss of sexual feeling, depression, suicidality and anxiety. 

It is considered unethical for mental health practitioners to promise that changing one’s sexual orientation is possible, and they are encouraged to understand the desire that some individuals feel to change their orientation as a result of having been affected by minority stress, discrimination, and anti-gay stigma. 

For these reasons, many feel that Apple’s previous approval of Exodus International’s iPhone app condones the promotion of an unethical, and potentially harmful, “gay cure” and contributes to anti-gay stigma and intolerance. 


Keep your eye on this story as it continues.

Critical reflections around PrEP: Questions, concerns, and next steps

by Keith R. Green, MSW (Co-Chair Elect, Chicago Black Gay Men’s Caucus)

As Project Director of the only U.S.-specific acceptability and feasibility pre-exposure prophylaxis (PrEP) trial in adolescents ages 18-24 - Project PrEPare - I must qualify the following statements by saying that my views are my own. They do not in any way reflect the thoughts or beliefs of the Adolescent Trials Network for HIV/AIDS Interventions (ATN), my current employer. My views on this topic are mine alone and, as a Black man who is sexually intimate with other men (diagnosed with HIV as an adolescent), they come from a very personal place.

Formalities aside, I should start by saying that I am very excited about the data that has come forth from the National Institutes of Health’s Pre-Exposure Prophylaxis Initiative (iPrEx). This international research study showed that the antiretroviral drug Truvada, when offered as a component of a comprehensive prevention package that includes condoms, counseling, and regular HIV/STI screening, was associated with a 44% reduction in HIV infections in participants who took it compared to those who took placebo. Additionally, a nearly 73 percent reduction in infections was seen in participants who took the study drug more than 90 percent of the time. I perceive PrEP to be a much needed weapon in our arsenal against the havoc that HIV is wreaking on gay, bisexual, and same gender loving communities, and this data demonstrating such a significant degree of efficacy fills me with hope.

I also very much appreciated the opinion piece that Dr. Kevin Fenton (Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention) wrote for CNNOpinion, outlining some of the cautions around this potential prevention option. I completely agree with him. This is just one study testing this intervention, and many unanswered questions remain, particularly with respect to what this data means for the populations most impacted by the epidemic in the United States.

Though the NIH iPrEX dataset is relatively large in numbers (2499 participants in total), U.S. men who have sex with men (MSM) are terribly underrepresented. In fact, less that 10 percent (less than 250 people) of the sample was from two U.S. cities combined (San Francisco and Boston). I have not seen the racial/ethnic background of the U.S. cohort—however, I think that it’s safe to say that the numbers get even smaller as it relates to people of color and young people of color in particular.

That said, the way that this data has been represented in the U.S. media is deeply disturbing. And the fact that the U.S. Centers for Disease Control and Prevention (CDC) immediately issued a fact sheet regarding the implications of this data, complete with incomplete guidelines for use and considerations for roll out, without a clear research agenda around these objectives, is downright scary. (I want to reiterate that I appreciate Dr. Fenton’s opinion piece, but it came nearly a week after the fact sheet. I understand the intent behind both, but from what I’ve read, a caution statement released on the same day as the data would have been much more in order than a fact sheet.)

One of the key messages from the NIH study is that adherence to the PrEP regimen is paramount to its success at combating the virus. I admit that I do not know a whole lot about the cultural variances around adherence (in Lima, Peru compared to Brooklyn, New York, per se), but I do know that African Americans, particularly those here in Chicago where I live, have a very rocky relationship with antiretrovirals. Recent surveillance data issued from the Chicago Department of Public Health found that only about 43 percent of African American MSM who knew their HIV status at the time of that survey were engaged in care that involves antiretrovirals. The reasons behind this are not clear, but anecdotally, we can speculate about them. Primarily, I believe, it has to do with our fragile history with the healthcare system, and the lack of trust that we have developed as a result. A lack of trust that all Americans can probably relate to, considering the abundance of malpractice suits and recalled prescription drugs that abound in our country.

That said, many critical concerns come to mind when I think about how the use of Truvada as PrEP could play out in the real world, particularly for the populations most impacted by the epidemic in this country at this time. Rocky relationships with antiretrovirals have equated to decreased engagement with them among African American gay, bisexual men, and same gender loving men. 

Truvada is one of the most widely prescribed antiretrovials (mostly due to its convenient dosing schedule and its presence in Atripla – the once-daily ‘miracle pill’). Therefore, considering the troubled relationship that African American MSM in Chicago have with antiretrovirals in general, is it possible that there are increased levels of resistance to Truvada among HIV positive men in the community? And, if so, could it be possible that an African American gay, bisexual, or same gender loving man who decided to take Truvada as PrEP (as a primary prevention with or without other proven prevention options), is at greater risk of being exposed to virus that is resistant to Truvada, leaving him not as protected as he believes he is? And, if he becomes infected and is infectious until he is diagnosed, is there not potential for him to pass on more resistant virus to others in the process?

I need to be clear that I understand that these concerns could be generalized to other populations. Much of this could be true for gay, white men or men from Lima, Peru, and that’s my whole point. We don’t have enough information to make any assumptions, really!

There are so many critical questions that must be answered before we allow those seeking to avoid contracting HIV to become convinced of the safety and efficacy of Truvada as PrEP:
•    Will African American MSM take PrEP as it must be taken in order for it to work? (Which includes taking it as a component of a comprehensive prevention package that includes condoms, counseling, and regular HIV/STI screening?
•    Does the general public understand that PrEP must be combined with other safe sex practices to derive the greatest protection from HIV?
•    Are we communicating, completely and honestly, the full range of risks involved with PrEP? Or do we really understand the full range of risks, particularly as it relates to resistance and how the potential for it varies from population to population?
•    What are the long-term effects associated with taking antiretrovirals preventatively?
•    Are we communicating effectively the fact that PrEP is not the ticket to a free ride on the “Sex Express”? (Condoms and other proven prevention strategies MUST be used)
•    Are we still advocating for regular HIV/STI screening and the power of knowing one’s status?

It is my sincere hope that the HIV/AIDS advocacy community will raise its voice LOUDLY to these concerns, and that the powers that be at the CDC, NIH, and other research institutions will explore the warnings and thoughtfully design research studies with strong behavioral and clinical outcomes that have these questions in mind. The future of HIV prevention in our country is dependent upon it. 

*** A community forum to discuss the iPrEX data and its potential impact on the future directon of Project PrEPare will take place in the Michael Leppen Theater at the Center on Halsted, 3656 N. Halsted, on Wednesday, December 15th 2010 from 6:30-8:30pm. The discussion will be co-facilitated by Jim Pickett, Director of Advocacy for the AIDS Foundation of Chicago and Chair of the International Rectal Microbicide Advocates.

Monday Morning Perk-Up [That's Gay, Grindr]

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The 70's are the futue - gay hanky code comes to iPhone

via GayNZ.com 

The hanky code - a phenomenon popular in the 70s whereby men seeking men would display different coloured hankies in their back pockets according to their tastes - is getting a second life as an application for the iPhone.

"Suppose you were at a bar and you saw someone with a real hanky in their back pocket, you could just pull up the app real quick, click on the colour and it would give you the meaning," explains Jonathan Leach, the co-creator of the Hanky Code application. "The app also will light up your screen with a picture of whatever hanky you are so the iPhone actually becomes the hanky.

"If you're at acoffee shop or a restaurant somewhere and you're working on your computer you can have your iPhone to the left or to the right of your computer or your coffee and guys walk by and the notice it and they're like 'hmm'."

Traditional hanky colours and their meanings include light blue for oral sex, navy blue for anal sex, grey for bondage, gold for threesomes, and pick for sex using dildos.




Watch above for a handy hanky primer

Click hankycode.net for even more, and for the link to the iPhone app.