Showing posts with label prevention. Show all posts
Showing posts with label prevention. Show all posts

Saturday, December 29, 2012

The BEST of Lifelube - "When Barebacking is Noble: The Ongoing Controversy around Serosorting" From Friday, April 6, 2007

Before you get to the article, a note on language. At the LGBTI Health Summit in Philly last month, I learned a great new term called "sero-adaptation" which was coined by this very cool, edgy Parisian HIV prevention group called The Warning"

Sero-adaptation includes, but is not limited to, the idea of "sero-sorting." It refers to a selection of harm reduction strategies that do not involve the use of condoms. These strategies may reduce the risk of HIV transmission, but are not a guarantee and require a clear-headed risk analysis, weighing the good, the bad and the ugly and making a decision around the amount of risk you and your partners are comfortable with.

So, what are some examples of sero-adaptation?

Sero-sorting - having condom-free sex with guys who share the same HIV status

Strategic positioning - determining who does what based on HIV status. For instance, the neg guys fucks the poz guy, which is less risky than the other way around.

Dipping - just sticking the dick inside a little bit and for a brief amount of time

Pulling out - kinda like the "rhythm method" of the 50"s, meaning withdrawal before cumming. Lot's of people become parents like this, and this is exactly how I myself tested poz, but it is less risky than actually allowing cum inside.

Lube - using a generous amount of the slippery stuff reduces friciton in one's tender, delicate anus/rectum and therby reduces the risk of HIV being offered a pathway in.

And of course, there are other sexual activities that can be done by people with same or different HIV statuses that do not involve fucking - sucking, rimming, water sports, JO, fisting, massage...

By the way, just for a moment of clarity, none of the above can be taken to offer complete or partial protection from other types of sexual transmitted infections...

--Jim

So here is that article already..

"When Barebacking is Noble..."


By Christopher Murray
[From the current issue of Circuit Noize, with thanks to the Gay Men's Health Listserv for posting...]


Last month, a virtual Vesuvius erupted when the popular New York gossip blog,Gawker , posted a link and then the next day an interview with a twenty-something gay guy in Manhattan who gets off on fucking guys without condoms.Confessions of a Bareback Top, his site, details his unapologetic adventures and is whack off material for some guys and proof of the end of civilization for others. The kink with the blogger, and those who identify with him, is the thrill we get when we break the taboo of safer sex.
The undeniable point of Mr. Bareback Top, is that while many gay men mouth lip service to safer sex practices, when push comes to shoving it in, so to speak, it's a different story. The bareback top loudly proclaims both his negative status and his assertion that it takes two to tango and that even if discussions before and during sex with his partners revolved around intentions to practice safe sex, once they acquiesce during the act, then they are just as responsible for what happens as he is, no matter how much they or others cry victim.
A storm of disapprobation not surprisingly followed the boost in the bareback blogger's profile. Gawker's comments file was crammed with postings suggesting he be put on the next train to Dachau, other gay men's health listserves picked up the drumbeat of dismay and disgust. But this controversy is only the latest concerning the practice of serosorting.
Defined as guys choosing only to have unsafe sex with others of the same HIV-status, serosorting has been ade facto reality in gay men's lives since the AIDS epidemic started, and before, if you count guys choosing not have sex with others they knew to have an STD or saying fuck it , if they knew they both had herpes, or whatever.

Serosorting, however, is a concept that is exclusive to considerations of HIV prevention. It's based on the premise that men need to know their status and that if they do, and then limit their unsafe behavior to only others of the same status, that HIV infections will fall. This assumes of course that people take steps to learn their status, that their status stays the same, that they are honest about their status, and that others are too. It is true, by the way, that people are more likely to have safer sex if they know they are positive. This is part of the innate civic-mindedness and altruism of gay men, we'll come back to that later.

Serosorting has recently been picked up by some advocates and taken out of the realm of decisions that gay men make on their own and promoted as a serious prevention strategy to be encouraged. Last fall, the San Francisco Department of Public Health launched their "disclosure" campaign that links knowing your status and talking about it with potential sexual partners to intentionally choosing partners of the same status. And Robert Brandon Sandor, the organizer ofBrandon's Poz Parties, a longstanding occasional sex club event for poz guys in New York, took up the charge, hosting a forum at the gay center in Manhattan on serosorting a month later. Brandon has run afoul of some local public health advocates for his championing of serosorting, as they claim his promotion of the concept is overly simplistic.
For Brandon, serosorting means, if you are poz, and only fuck without condoms with other poz guys, HIV won't be transmitted and will eventually burn itself out. Critics note that the world is more complicated then this with people not sticking to the system, assuming things about other people's status, and remaining vulnerable to other STDS.
This also lays the burden on poz guys to have unsafe sex – or maybe by extention of the argument sex, period – only with other positive guys, but also for negative guys or guys of unknown status to continue to have sex only with condoms.
It's easy to fall into a moralistic discussion about sexual ethics when considering serosorting. But in fact the issue is really one that has been around forever and complicated forever: assessing risk. A noted HIV researcher once told me about a guy in Los Angeles he spoke to who would have unprotected sex if his partner had clean matching socks on. The reasoning went that if he was a nice, clean enough guy to have nice, clean enough socks, they it's likely he wasn't a skank and therefore HIV-negative. Sounds pretty silly, but it's a risk assessment strategy, albeit a poor one.
We are all responsible for making decisions about how much risk we can tolerate. Just about any sex can lead to the transmission of an STD; bottoming for anyone carries some risk of exposure to HIV, no matter how minimal if we choose to engage in sex, a major part of being alive, then we are taking risk. If we have sex with people we don't know, or with people we do know, but whose status we can't be 100 percent sure of, we are taking a risk.

While serosorting is a strategy that attempts to lower that risk, as Bareback Top makes clear, sometimes, for whatever reason, we are likely to be taking risk with less than complete information. 
Like we do when we are drunk, or high, or deeply in love, or deeply in lust, or inexperienced, or desperate, or stupid or lonely. How much risk we are willing to take is a combination of our mind's intelligent assessment and our hearts over-riding blindness to circumstance based on our desire in the moment. That leads back to the altruism issue. What alternately upsets and turns people on about Bareback Top is that he puts his needs for sexual satisfaction and thrill above others. He turns other people into objects, his playthings, and gets a kick out of when their intentions to protect themselves and others are undermined by their desire for hot sex and closeness with another human being. 

In his most recent posting, Bareback Top describes fucking a young guy without a condom and his assumption that it's the first time the kid has been fucked, He says that the kid was clearly in pain. But he did what he wanted and took care of his own needs, popping a nut up the guy's tender ass. Did he give the young man HIV? Probably not, presuming he's still correct that he doesn't have HIV. Did he give the kid any other STD, who knows? Did he use another human being for his own pleasure at the cost of his own and the other person's humanity? Sounds like. That occurs with a cost that Bareback Top has yet to become aware of. You pay for such cavalier games with a little piece of your soul.

Most of us have probably used other people at some time or another for our own gratification. That's called exploitation. The lucky among us learn to regret it.

Thursday, July 28, 2011

HIV researcher plans new PrEP study

via Chelsea Now, By Sam Spokony

[One major factual error in that article: “The longest any HIV-negative person has taken PrEP in a clinical study is 12 weeks.” For example in iPrEx, average follow up was 14 months. Otherwise, a very informative article.]

Few methods of HIV prevention have been as promising, or as controversial, as pre-exposure prophylaxis (PrEP). After a history of underground practice and off-label prescriptions, the approach has recently begun to receive serious attention from researchers, policy makers and health care advocates.

Under the guidance of Dr. Roy Gulick (director of the Weill Cornell Medical College HIV Clinical Trials Unit), a new experiment called the NEXT (Novel Explorations of Therapeutics) PrEP Study will begin this fall. It will include 400 at-risk, HIV-negative gay men, and will take place over 48 weeks at 12 sites across the U.S. and Puerto Rico.

The NEXT PrEP Study will differ from iPrEx in that its primary experimental group will receive a daily regimen of the drug maraviroc (brand name Selzentry). The control group will receive Truvada, and two other experimental groups will receive combinations of maraviroc and either tenofovir or FTC (the two individual drugs that make up Truvada). A major goal of the study, along with testing the HIV-prevention efficacy of maraviroc, will be to gauge the side effects of the drug on participants.

“The longest any HIV-negative person has taken PrEP in a clinical study is 12 weeks,” Gulick told Chelsea Now in a July 23 phone interview [This is inaccurate. The guys in iPrEx, for instance, were followed about 14 months - LifeLube]. “Now, since this is a drug we’re giving to healthy people, the next step is exploring further to prove that it is both safe and tolerable for them.”

Read more.

What's next for HIV prevention? Paying people to be healthy

via aidsmap, By Roger Pebody

Researchers are investigating the impact of offering financial incentives to people who are at risk of acquiring or passing on HIV, the International AIDS Society conference (IAS 2011) in Rome heard last week.


A large study in the United States is looking at whether a test-and-treat approach should be supported by offering incentives to newly diagnosed people who attend medical services and maintain an undetectable viral load.

In sub-Saharan Africa, a number of studies are investigating whether providing incentives to adolescent girls who remain in education reduces their long-term HIV risk.

Such approaches are not without their critics, but those participating in a conference symposium on the topic mostly felt that these interventions are trying to tackle structural factors and have the potential to be effective, especially when used alongside other prevention interventions.

“We shouldn’t look at behavioural economics as the new magic bullet,” commented Professor Quarraisha Abdool Karim of the Centre for the AIDS Programme of Research in South Africa (CAPRISA). “This fits into a broader combination approach,” she said.

As well as cash, incentives may take the form of food or shopping vouchers. They are sometimes called conditional cash transfers, and the approach is sometimes referred to as contingency management.

The idea is already widely used in the development field (often aiming to impact poverty or education), and increasingly in relation to health.


Read more. 

Friday, March 11, 2011

How is Brian Vanderheyden healthy?

Doing what I can to prevent disease and injury is how I stay healthy.

Prevention has been a focus of my life for the past half decade. I have awful family medical history and I have watched my grandparents, relatives and parents suffer from a variety of different diseases. Knowing that my gene pool is not the greatest, I have developed a passion over the years for health and improving my overall wellness.

I am currently a Community Health Education major at the University of Wisconsin- La Crosse. Community health focuses on primary prevention techniques to stay healthy. Primary prevention attempts to take measures to inhibit any disease or injury from occurring rather than treating or curing them. I do not believe that we can prevent everything that occurs in life but I have made many lifestyle and attitude changes that focus on my future health.

Experiencing high amounts of stress is an understatement for many college students including me. I am in my final semester as an undergraduate student, I’m adjusting to the city of Chicago (I just moved to here a couple weeks ago from La Crosse, Wisconsin to complete an internship at Howard Brown Health Center as part of my undergraduate degree), and I’m in the process of interviewing for graduate schools.

Plus I can’t forget the limited budget I am living on, the massive amount of debt I am accumulating, and the fact that I am starting the process of coming out to my family and friends.

So for me a huge part of how I stay healthy is really tuning into my mental health.

Learning about myself through years of self reflection has allowed me discover where I draw my energy from and how I recharge that energy on a daily basis. Burnout rates for college students are high and having experienced burnout a couple years ago; I have been actively doing what I can to prevent it from happening again.

With everything going on in my life right now, time management and staying organized is how I have reduced a lot of the stress I feel on a daily basis. I have developed an organization system that helps identify what I need to get done each day, throughout the week, and what tasks have the highest priority. Having a plan in place is what helps me stay on task and not forget anything.

Another lifestyle change I have made is incorporating “Me Time” into my day, every day. “Me Time” can really consist of anything but it’s something where I can escape from reality for a short period of time and devote it to bettering myself (mentally, physically, spiritually, etc). I always set time out of my day to work out. I am a fitness guru and love all types of physical activity. I find happiness and a spiritual connection when I make a mind/body connection during my workouts.

In addition to exercising, I also try to incorporate another activity at night before I go to bed to relax from the day. Whether this is watching one of my favorite TV shows, reading a book, meditating, going on a walk, etc., I need this time to self reflect on myself and my day. I try every day to become a better person and self reflection is how I best achieve this. It helps me become aware of my strengths and areas of improvement that I want to work on in the future.

Besides recharging my energy from “Me Time,” I also tend to draw energy from the people around me especially my close friends and family. I have the best friends/family in the world (in my opinion of course) and I value those relationships more than anything. Every relationship is so special to me and I know that my friends and family would do anything for me as I would for them. Having that support system has gotten me through rough periods in my life including my recent coming out in terms of my sexuality.

Improving overall wellness in all areas of my life (intellectual, mental, emotional, spiritual, physical, social, etc.) is extremely important to me.

Wellness and being healthy is so much more than eating right and exercising.
While I do those things, it does not stop there for me.

I believe the other areas of wellness are crucial and are an important part of my overall health and how I stay healthy!

-- Brian Vanderheyden
Chicago


How are you healthy?

Join in the conversation.

Tell us HERE. Send a pic to the same place.
And we'll blog it, right here.
Gay men and all allies welcome to participate.

Read past posts.
Learn more about the campaign

Monday, July 6, 2009

HPV Vaccine Found to be Effective in Men

New research suggests that Gardasil, the vaccine developed to protect women against some strains of the cervical cancer-causing human papilloma-virus (HPV), is also effective in preventing HPV infections in men.

The clinical trial, conducted by researchers from the University of California, San Francisco (UCSF) with financial backing from Gardasil manufacturer Merck, may help to get the vaccine approved for use in men in Canada.

Results of the trial were presented at the 25th annual International Papillomavirus Conference in Sweden in May. Lead researcher Joel Palefsky noted that Gardasil appears slightly less effective in preventing HPV infection in men than in women.

“The numbers right now look not quite as good as the girls’ but still very, very good,” says Palefsky. “The vaccine was nearly 100 percent effective [in women] so you obviously can’t do better than that.”

Read the rest at Xtra.

Wednesday, April 8, 2009

Every 9 1/2 minutes...

First National CDC HIV/AIDS Communication Campaign in More Than a Decade


via Out in America

Every 9 ½ minutes another person in America becomes infected with HIV. Officials from the White House, Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) announced [yesterday] a new five-year national communication campaign, Act Against AIDS, which highlights this alarming statistic and aims to combat complacency about the HIV/AIDS crisis in the United States.

According to CDC data released last year, about 56,000 Americans become newly infected with HIV each year — significantly more than was previously known — and more than 14,000 people with AIDS die each year in the United States.

Read the rest.

[NOTE de LifeLube: The site is pretty lite on the gays and, natch, features a "focus on abstinence." Otherwise, it seems pretty informative in a bland, governmental sort of way. Supposedly this campaign will have a second phase that will focus on the most impacted communities in the United States - and at that point gay men, particularly gay black men, should receive some much-needed attention. After all, it is gay men of all races that bear the biggest HIV/AIDS burden in this country - always have. Let's just see... We are certainly tired of having this issue officially ignored in favor of more politically palatable populations.]

Monday, February 2, 2009

It takes you




Homophobia is like racism and anti-Semitism and other forms of bigotry in that it seeks to dehumanize a large group of people, to deny their humanity, their dignity and personhood. This sets the stage for further repression and violence that spreads all too easily to victimize the next minority group.

Coretta Scott King



Thursday, August 28, 2008

Fuck safer - options beyond latex are in the works



What is a rectal microbicide?

Currently in development, a microbicide is a cream or gel, or maybe a douche or an enema, that could be used to reduce a person’s risk of HIV infection vaginally or rectally. Rectal microbicides could offer both primary protection in the absence of condoms and back-up protection if a condom breaks or slips off during anal intercourse. For those unable or unwilling to use condoms, rectal microbicides could be a safe and effective alternative means of reducing risk, especially if they were unobtrusive and/or enhanced sexual pleasure enough to motivate consistent use. Such alternatives are essential if we are to address the full spectrum of prevalent sexual practices and the basic human need for accessible, user-controlled HIV and STD prevention tools.

Who is IRMA?

Since its creation in 2005, International Rectal Microbicide Advocates (IRMA) has seen significant growth and success. Convened by the
AIDS Foundation of Chicago, the Canadian AIDS Society, the Community HIV/AIDS Mobilization Project and the Global Campaign for Microbicides, IRMA is currently a network numbering over 600+ advocates, policymakers and leading scientists from 50+ countries on six continents (indicated by the countries in color above) working to advance a robust rectal microbicide research and development agenda.

Monday, April 7, 2008

The Power of the Panties





What if your stinkables really did have the last word?

Too many of us miss the opportunity to talk to our partners about STD/HIV prevention and other ways of maintaining a rockin' sex life.

Perhaps whimsy is the way...


Internet Sexuality Information Services, Inc. (ISIS), a not-for-profit organization dedicated to promoting sexual health, and Brickfish™, a social media advertising platform, are inviting people to design intimate apparel to help get the word out about preventing HIV and other sexually transmitted diseases, and developing lifelong healthy relationships.

The “In Brief” campaign, located at invites entrants to develop their own art and slogans for boxer shorts, women’s underwear, or t-shirts containing a message about sexual communication, including preventing HIV and other STDs.

The Grand Prize winner will receive a $1,000 scholarship or cash equivalent, and twelve pairs of underwear.

Friday, November 2, 2007

National LGBT Leaders Renew Commitment to Fight HIV/AIDS


Call for Urgent Response From NIH, CDC and LGBT Community to Devastating Impact on Black Gay Men

Washington, DC, October 30, 2007: Leaders of the LGBT equality and civil rights movement issued an urgent statement five days after gathering in Washington, DC, regarding continuing signs of the unabated impact of the HIV epidemic across the United States. The leaders are calling for a renewed effort to address the HIV epidemic and its devastating impact, especially in black gay communities. The gathering was convened by the National Black Gay Men's Advocacy Coalition and the National Coalition for LGBT Health.

"When the AIDS crisis began, the LGBT community came together with great force," said Darrel Cummings, Chief of Staff at the LA Gay and Lesbian Center, a member of the National Coalition for LGBT Health’s board of directors which led the call for the gathering. “But with the advent of effective treatments, the growth of organizations focused just on HIV, and as the epidemic has moved into communities of color, HIV has largely fallen off the agenda for the leading LGBT civil rights groups."

A 2005 study from the US Centers for Disease Control and Prevention (CDC) in five major cities showed that 46% of black gay men had acquired HIV and that 67% of them were unaware of their HIV status. Surveillance data released by the New York City Health Department in September 2007 and other recent reports has heightened the concern of the leaders about the epidemic’s continued impact, especially among black gay men.

"It is shameful that 25 years into the epidemic, the National Institutes of Health has not done the research and the Centers for Disease Control and Prevention has not given us the tools to stop the impact of HIV in black gay communities,” said Ernest Hopkins, Policy Committee Chair for the National Black Gay Men’s Advocacy Coalition and director of federal affairs at the San Francisco AIDS Foundation.

Of 129 interventions developed to address HIV in African Americans, only one has been designed or adapted for black gay men. Additionally, very little research has been conducted to determine the actual costs of high rates of HIV among black gay men in the United States.

"Our communities cannot accept that our lives are not worth the effort to engage in the research, prevention and care necessary to improve our health and better our lives,” the leaders’ statement reads.

Other LGBT leadership organizations participating in the meeting and their representatives were: Arcus Foundation (Cindy Rizzo), Gay and Lesbian Alliance Against Defamation (Rashad Robinson), Gay and Lesbian Medical Association (Joel Ginsberg), Lambda Legal (Kevin Cathcart and Bebe Anderson), Log Cabin Republicans (Patrick Sammon), National Black Justice Coalition (Earl Plante), National Stonewall Democrats (Jon Hoadley) and the Task Force (Matt Foreman).

Also participating in the meeting were Hutson Innis, a member of the National Coalition for LGBT Health’s board of directors, Rudy Carn, chair of the National Black Gay Men’s Advocacy Coalition, and A. Cornelius Baker, National Policy Advisor for the National Black Gay Men’s Advocacy Coalition.

Statement of National Leadership Organizations in the Lesbian, Gay, Bisexual, Transgender Equality and Civil Rights Movement on the HIV Epidemic in Black Gay Communities

As a concerned group of leaders in the lesbian, gay, bisexual and transgender equality and civil rights movement, we gathered in Washington, DC on October 24, 2007 to focus our attention to the continuing and unabated threat of the HIV epidemic in our communities. We are expressly concerned about the impact of HIV among black, gay men.

Our concerns are fueled in part by the startling Centers for Disease Control and Prevention (CDC) study released in June 2005 showing a 46 % infection rate among black gay men in 5 major cities, surveillance data from the New York City Health Department in September 2007 showing a 33% increase of new HIV diagnoses over the past six years among gay men under age 30, and recent publications and presentations from Dr. Ron Stall at the University of Pittsburgh and Gregorio Millet at the CDC [visit LifeLube.org to see] demonstrating the many challenges remaining in bringing the HIV epidemic under control. The lack of an urgent response to this health crisis among a vulnerable group of our citizens is shameful and inexcusable in the United States. Our communities cannot accept that our lives are not worth the effort to engage in the research, prevention or care necessary to improve our health and better our lives.

We call on the leaders of our nation’s LGBT organizations to join us in placing an aggressive response to the HIV epidemic among black gay men at the center of our agenda. We also call on all sectors of society, including government, media and philanthropy, to urgently address this disturbing situation across our country. Our organizations have pledged to move forward in coalition with the National Black Gay Men’s Advocacy Coalition, the National Coalition for LGBT Health and others in the coming days and months to turn the tide of this epidemic and the devastating impact it is having in the lives of so many in our communities.

Arcus Foundation

Gay and Lesbian Alliance Against Defamation

Gay and Lesbian Medical Association

Lambda Legal

Log Cabin Republicans

National Black Justice Coalition

The Task Force

(as of October 29, 2007)

Tuesday, October 9, 2007

PreventionJustice.org is live - endorse the statement TODAY


2007 PREVENTION JUSTICE MOBILIZATON


ENDORSEMENT STATEMENT

We are united in demanding leadership in the fight against HIV/AIDS and justice in prevention policies.

HIV prevention efforts in the United States have focused on identifying and changing the individual behaviors (unprotected sex, unsafe drug injection, childbirth and nursing) that contribute to the spread of the virus. These efforts include examining “risk factors” (other behaviors or traits that increase the odds of practicing risk behaviors), populations that are most likely to engage in these behaviors and the levels of these behaviors that lead to greater risks for transmissions among individuals.

However, a focus on these efforts alone failed to achieve the CDC’s goal of reducing HIV transmission by half. In fact, in some communities, HIV/AIDS rates may once again be on the rise.

In order to address HIV from a prevention justice standpoint to lower HIV rates, we must examine the community and structural conditions that increase risks for individuals or groups. Social and structural risk factors are sometimes acknowledged in programs, research and policies. But we have little in the way of assessment tools, prevention or intervention strategies that address the structural, social and systemic problems that increase the risks for certain groups of individuals more than others.

For example, unsafe sex between men is a risk-taking behavior. Homophobic environments that demonize any sex between men diminish their options to make healthier choices. We have no way of knowing whether the opportunity to have unsafe sex is a more powerful component of risk than the societal impact of homophobia, or vice versa. Furthermore, the fact that the prevalence of HIV is already so high in some communities (nearly 50% Among African American men who have sex with men (MSM) in seven cities studied by the CDC, for instance), means that the same level of individual risk behavior among such men exposes them to five or even ten times the risk as would the same behavior among other MSM.

Is a resource-poor Black woman with children is more likely to contract HIV because she “chooses” to have intercourse raw, or because she chooses to do so in order to keep the man who pays her bills, feeds her kids and keeps the roof over their head? Which is the greater influence for transmission?

These are just two examples of the scenarios putting indivdual risk alongside systemic vulnerability that play out in the lives of many people every day. A prevention justice approach calls for the evaluation of societal factors as well as the individual behaviors that heighten the risk for HIV transmission or acquisition. And a prevention justice approach incorporates both individual and structural approaches for more effective HIV prevention strategies.

The quest for a “magic bullet,” solution, whether a single behavioral or biomedical intervention, is not likely to end the AIDS crisis. We urgently need theories, assessment tools and hybrid prevention strategies that address risk in the context of vulnerability and that directly address the root causes of vulnerability.

These four key principles that must be reflected in a focused, justice-based HIV prevention strategy that can actually stop HIV/AIDS:

1. WE NEED THE TRUTH AND THE TOOLS: UNIVERSAL ACCESS TO SEXUAL HEALTH EDUCATION, HARM REDUCTION AND HIV PREVENTION

  • Prevention justice asserts the fundamental right of all people to expect every effective approach to be employed to prevent HIV transmission. Everyone at risk of transmitting or acquiring HIV must have access to scientifically based, culturally and linguistically-appropriate sexual health, harm reduction and HIV prevention information, materials and tools.
  • The federal government bears primary responsibility to fund these efforts at adequate levels (at least $2 billion per year across programs), and must end bans on funding for effective programs such as syringe exchange. The next President of the U.S. should develop a results-oriented AIDS strategy that incorporates prevention justice principles and policies.
  • If political and cultural barriers impede such access (such as bans restricting access to sterile needles/syringes, and condoms in prisons and jails; comprehensive, accurate sexual information and skills for school youth or detainees; or the gag rule on naming “harm reduction” in federally-funded research and programs), then funders and providers of prevention services must also provide significant funds or strategies to remove these barriers.


2. IT’S NOT ONLY WHAT YOU DO, IT’S WHO YOU ARE: HIV/AIDS AS PROOF POSITIVE OF INJUSTICE:

  • All prevention campaigns and strategies must include explicit goals to lessen and eventually eliminate structural risk factors that lead to community-level or population-level vulnerability, such as homelessness, high rates of incarceration, domestic and other gender-based violence, lack of adequate access to high-quality health care and/or a living wage or income.
  • They must include plans to eliminate any significant disparities among populations in HIV prevalence and risk, including those associated with race and ethnicity, immigration status and language, gender and gender identification, sexual orientation, nationality, age and area of residence. The greatest disparities must receive the greatest resources and priority of effort to eliminate.

3. AIDS DOESN’T DISCRIMINATE… BUT SOCIETY DOES: END VULNERABILITY BY AFFIRMING THE DIGNITY AND RIGHTS OF ALL:

  • All HIV prevention efforts must include an affirmation of the dignity and rights to equality of every individual (including those living with HIV/AIDS) and must actively confront social, cultural and legal norms that prevent or impede realization of such rights and dignity, such as racism, sexism, and homophobia; HIV and drug-use stigma; or discriminatory legal status.
  • Any programs that claim to prevent HIV by attacking the dignity and rights of individuals — such as abstinence-only-until-marriage programs that encourage sexism, homophobia and AIDS stigma — must be defunded and repudiated.
  • Since rights are meaningless without the means to realize and use them, all HIV prevention must include or ally with efforts to provide every human with the economic and other material necessities of life, including adequate housing, employment or income, physical and mental care, food and nutrition, and drug treatment – the lack of which have been shown to drive HIV spread.


4. DON’T BLAME US OR SHAME US FOR WHAT YOU DON’T KNOW: RESOURCES, ETHICS, AND COMMUNITY INVOLVEMENT IN CRITICAL RESEARCH AND MONITORIING

  • Communities and programs lack the resources and tools to fill the gaps in our knowledge base on HIV prevention. The HIV prevention research endeavor must be funded in sufficient quantity and diversity as to promptly solve critical unanswered questions and provide essential missing tools and technologies. Research must focus on providing tools to assess community vulnerability and structural risk and to guide the design of efficient, comprehensive, multifactorial prevention strategies, as well as investigating new individual behavioral or biomedical interventions.
  • Further, government and private entities engaging in research and policies must provide timely, understandable and accurate information on their work and proposals, actively soliciting and integrating diverse community input into resource allocation and policy formulation.
  • The basic elements of counting and describing people living with, or risk for HIV infection (surveillance categories and systems, testing, case reporting, partner notification and counseling) must not blindly follow previous, narrow medical public health models, but must reflect the other principles described above. These systems and methods must be designed and implemented with awareness of their direct or indirect impact on individual dignity as well as community health and vulnerability.
Click here to go to the site, learn more, endorse the statement.

Wednesday, August 15, 2007

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.

Friday, August 10, 2007

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.

Monday, July 2, 2007

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 .


Friday, May 11, 2007

NOT-SO-GREAT EXPECTATIONS






From Housing Work's AIDS Issues Update

May 11, 2007

The Bush administration shocks AIDS advocates by abandoning its U.S. HIV-prevention goals; CDC official admits infections likely already on the rise.

Gerberding throws her hands up.

The same week that President Clinton brokered a groundbreaking deal on generic AIDS meds for developing countries, the Bush administration threw up its hands when it comes to stopping HIV in the U.S.

The Centers for Disease Control stunned attendees at its CDC/HRSA Advisory Council (CHAC) meeting with the last-minute announcement of its plan to dramatically reduce prevention goals for the next five years. Whereas in 2000 the CDC set the goal of reducing new infections by 50 percent by 2005, the "Addendum to the CDC Prevention Strategic Plan Through 2005" released this week only seeks to reduce new infections by 10 percent by the year 2010.

"We're disappointed," says Sean Barry, director of prevention policy for Community HIV/AIDS Mobilization Project (CHAMP), who attended the meeting. "The CDC is giving up on presenting a professional, needs-based vision of what resources they need and then mapping out targets. Even Bush's global AIDS initiative PEPFAR is aiming to prevent millions of infections. In the U.S. we're not setting those ambitious targets."

It's not clear why the CDC made such a dispiriting change in its prevention goals especially since only two months ago it released its (highly criticized) plan for a "heightened response" to halting the epidemic in the African American community. The addendum claimed that the new scaled-back prevention objectives still focused "on eliminating racial and ethnic disparities in new HIV infections."

"Half of new infections are among African Americans. Even if you reduced only those infections by 10 percent, you'd still have big disparities," says David Munar, associate director of the AIDS Foundation of Chicago, adding, "This is a disappointing retreat from an achievable goal. All we have to do is appropriate and direct resources to effective programs, and we're doing neither."

More infections, fewer dollars

As troubling as the eviscerated prevention target is the likelihood of a rise in HIV infections in the U.S. According to Barry, Rob Jansen, the CDC's deputy director of HIV/AIDS Prevention, said that the U.S. will be "lucky" if there's not an increase in HIV infections in the coming years. Munar backs up that assessment. "The CDC has been doing extensive research to update its incidence estimates. It was supposed to be released last year and may be this year. But anecdotal evidence already suggests infections could be substantially higher," he says.

Under fire from meeting attendees, Jansen and Kevin Fenton, director of the CDC's National Center for HIV Prevention, explained that the CDC hadn't achieved its goal of reducing new HIV infections by 50 percent because the agency assumed it would get more prevention dollars over the years — but that never happened. The CDC's prevention budget has declined 17 percent since 2001, when the first strategic HIV-prevention plan was approved. However, the agency recently found $45 million in additional 2007 prevention funds and will be issuing grant request guidelines soon. It is expected that new dollars will be aimed at routine testing.

Fenton also said that Bush's Office of Management and Budget criticized the CDC for its goals. Barry thinks the CDC needs to see the writing on the wall: "They're still acting as if the Republicans control the Senate and Bush can interrogate any agency he wants to. It's the CDC's job to say, 'We can do more.' They've backed away from that."

Fenton, Jansen and others at the CDC did not return the Update's calls.

The CDC's budget woes are not likely to end any time soon. It's facing budget reductions for fiscal year 2008 despite the fact that director Julie Gerberding says she needs $1 billion increase in funding for the agency to do its job.
More bad timing

The CDC heightened the ire of CHAC committee members by releasing its new prevention targets on Friday afternoon, May 4, giving those on the committee little time to evaluate it before the advisory council meeting began on Monday, May 7. "I think the CDC was trying to rush a decision on this," says Barry. They're a couple years overdue in amending the plan—so it's not like they haven't had time to work on it. They knew this would stir up resentment and opposition."

Conference attendees proposed numerous revisions to the CDC plan, which also set goals for the numbers of people getting tested, the scope of prevention, care and treatment services, and the monitoring of the epidemic and success of programs aimed at stopping it.

Committee-member resistance led CDC officials to say they would "stay up late" Monday night and come back with a revised proposal. The revision compromise says the goal is to "reduce new HIV infections by a minimum of 5 percent a year" while keeping the 10 percent by 2010 objective, and "incorporate... resource strategies and constraints to further explain the achievement of past and new goals."

Barry was unimpressed by the changes and could only grasp at a future silver lining. "We're on the verge of a presidential election. I can only hope that this setback in the federal government's commitment to prevention can be used to draw a distinction between the path we're on now and the path the next president needs to take us on."



Thursday, April 12, 2007

AIDS and Circumcision - NY Comish's Letter to NYT



April 12, 2007

To the Editor:

Re “City Health Dept. Plans to Promote Circumcision to Reduce Spread of AIDS” (news article, April 5):

The New York City Health Department has not planned, developed or announced a campaign to encourage at-risk men to get circumcised. Like other domestic health agencies, we are encouraging people to discuss and study this issue.

Because circumcision has the potential to decrease H.I.V. transmission by more than half, we hope that men who choose the procedure will have access to it. A campaign to promote circumcision in this country would be premature without stronger evidence, but the time is right for a communitywide dialogue.

Thomas R. Frieden, M.D.

New York City

Health Commissioner

New York, April 9, 2007

Click here for the actual letter.

Monday, April 9, 2007

NYC Health Commish - Not so quick on the SNIP SNIP




So today the New York City Health Commissioner Dr. Thomas Frieden issued a memo talking about the media's misrepresentation around his reported plans to roll out a circumcision program in NYC, in part saying, "we have not suggested or planned any initiative or campaign. Quite to the contrary, I indicated in an interview with the New York Times (the source of the misrepresentation) that I very much doubted that even 1% of men at high risk in NYC would undergo the procedure." Click here for the full memo in PDF format. A couple of community forums are being planned, sources say the first will be at NYC's LGBT Center on April 26th from 6-8p with more forums coming to the Bronx and Brooklyn.
---Jim
ps - check out the mothership of the International Rectal Microbicide Working Group for more info on circumcision - www.IRMWG.org - on the right side of the page under "additional info."

Friday, April 6, 2007

GMHC Statement on Adult Male Circumcision and HIV Prevention


NEWS RELEASE

FOR IMMEDIATE RELEASE Press contacts: Lynn Schulman, 212.367.1210

April 6, 2007 Noel Alicea, 212.367.1216

Statement on Adult Male Circumcision and HIV Prevention

Recent media reports on adult male circumcision and HIV prevention have centered on efforts to promote circumcision among men at high risk of AIDS in New York City, including gay men and other men who have sex with men. These efforts come on the heels of findings that adult male circumcision might significantly lower—but not eliminate—a man’s risk of acquiring HIV during vaginal sex.

In December 2006, the National Institutes of Health announced the findings from three research studies demonstrating that adult male circumcision reduced men’s risk of acquiring HIV through vaginal intercourse. Gay Men's Health Crisis recognizes the importance of these findings, which make adult male circumcision the first biomedical HIV prevention tool since the female condom was introduced 13 years ago. However, GMHC would also like to highlight the gaps in knowledge presented by these findings. We will be closely following further research to determine what long-term impact these findings will have. In order to be effective, any recommendations associated with these findings will need to balance scientific research with cultural considerations.

The Trials:

The recent circumcision trials were conducted in countries in sub-Saharan Africa with low rates of circumcision, very high HIV prevalence and significantly higher rates of female-to-male HIV transmission rates than in the United States. In the US, the highest rates of sexual transmission are in two categories: among men who have sex with men, and among women infected by heterosexual contact with men. The adult males participating in the trials were circumcised by trained professional health care workers, and received extensive counseling and latex condoms. Previously, three other clinical trials demonstrated similar findings.

What these findings mean:

The data shows that male circumcision may reduce the risk of adult males to contract HIV through vaginal sex. Key areas not addressed by these findings:

· The effect of circumcision on HIV transmission for gay men and other men who have sex with men is unknown.
· The effect of circumcision for anal intercourse is unknown.
· It is unknown whether circumcision in HIV-positive men protects their male or female sexual partners.

It is important to state categorically that circumcision does not eliminate the risk of acquiring HIV. In order to be well protected against acquiring and transmitting HIV and other sexually transmitted diseases all sexually active men, whether or not they are circumcised, should engage in practices that lessen risk, including using latex or polyurethane condoms with water-based lubricants. Condoms continue to present the most effective, inexpensive, non-invasive and readily available method for preventing HIV transmission among sexually active individuals.

We are eager to work with public health officials at the Centers for Disease Control and Prevention and the NYC Department of Health & Mental Hygiene to determine how the findings of these and other scientific-based HIV prevention studies can be most useful to members of our communities.

Additional information about circumcision is available at:

http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm

http://www.aidsvaccineclearinghouse.org/MC/index.html

# # #

Gay Men’s Health Crisis (GMHC) is a not-for-profit, volunteer-supported and community-based organization committed to national leadership in the fight against AIDS. Our mission is to reduce the spread of HIV disease, help people with HIV maintain and improve their health and independence, and keep the prevention, treatment and cure of HIV an urgent national and local priority. In fulfilling this mission, we will remain true to our heritage by fighting homophobia and affirming the individual dignity of all gay men and lesbians. We provide services and programs to over 15,000 men, women and families that are living with or affected by HIV/AIDS in New York City. For more information, please visit www.gmhc.org

When Barebacking is Noble: The Ongoing Controversy around Serosorting

Before you get to the article, a note on language. At the LGBTI Health Summit in Philly last month, I learned a great new term called "sero-adaptation" which was coined by this very cool, edgy Parisian HIV prevention group called The Warning"

Sero-adaptation includes, but is not limited to, the idea of "sero-sorting." It refers to a selection of harm reduction strategies that do not involve the use of condoms. These strategies may reduce the risk of HIV transmission, but are not a guarantee and require a clear-headed risk analysis, weighing the good, the bad and the ugly and making a decision around the amount of risk you and your partners are comfortable with.

So, what are some examples of sero-adaptation?

Sero-sorting - having condom-free sex with guys who share the same HIV status

Strategic positioning - determining who does what based on HIV status. For instance, the neg guys fucks the poz guy, which is less risky than the other way around.

Dipping - just sticking the dick inside a little bit and for a brief amount of time

Pulling out - kinda like the "rhythm method" of the 50"s, meaning withdrawal before cumming. Lot's of people become parents like this, and this is exactly how I myself tested poz, but it is less risky than actually allowing cum inside.

Lube - using a generous amount of the slippery stuff reduces friciton in one's tender, delicate anus/rectum and therby reduces the risk of HIV being offered a pathway in.

And of course, there are other sexual activities that can be done by people with same or different HIV statuses that do not involve fucking - sucking, rimming, water sports, JO, fisting, massage...

By the way, just for a moment of clarity, none of the above can be taken to offer complete or partial protection from other types of sexual transmitted infections...

--Jim

So here is that article already..


"When Barebacking is Noble..."


By Christopher Murray

[From the current issue of Circuit Noize, with thanks to the Gay Men's Health Listserv for posting...]



Last month, a virtual Vesuvius erupted when the popular New York gossip blog, Gawker , posted a link and then the next day an interview with a twenty-something gay guy in Manhattan who gets off on fucking guys without condoms. Confessions of a Bareback Top, his site, details his unapologetic adventures and is whack off material for some guys and proof of the end of civilization for others. The kink with the blogger, and those who identify with him, is the thrill we get when we break the taboo of safer sex.

The undeniable point of Mr. Bareback Top, is that while many gay men mouth lip service to safer sex practices, when push comes to shoving it in, so to speak, it's a different story. The bareback top loudly proclaims both his negative status and his assertion that it takes two to tango and that even if discussions before and during sex with his partners revolved around intentions to practice safe sex, once they acquiesce during the act, then they are just as responsible for what happens as he is, no matter how much they or others cry victim.

A storm of disapprobation not surprisingly followed the boost in the bareback blogger's profile. Gawker's comments file was crammed with postings suggesting he be put on the next train to Dachau, other gay men's health listserves picked up the drumbeat of dismay and disgust. But this controversy is only the latest concerning the practice of serosorting.

Defined as guys choosing only to have unsafe sex with others of the same HIV-status, serosorting has been a de facto reality in gay men's lives since the AIDS epidemic started, and before, if you count guys choosing not have sex with others they knew to have an STD or saying fuck it , if they knew they both had herpes, or whatever.

Serosorting, however, is a concept that is exclusive to considerations of HIV prevention. It's based on the premise that men need to know their status and that if they do, and then limit their unsafe behavior to only others of the same status, that HIV infections will fall. This assumes of course that people take steps to learn their status, that their status stays the same, that they are honest about their status, and that others are too. It is true, by the way, that people are more likely to have safer sex if they know they are positive. This is part of the innate civic-mindedness and altruism of gay men, we'll come back to that later.

Serosorting has recently been picked up by some advocates and taken out of the realm of decisions that gay men make on their own and promoted as a serious prevention strategy to be encouraged. Last fall, the San Francisco Department of Public Health launched their "disclosure" campaign that links knowing your status and talking about it with potential sexual partners to intentionally choosing partners of the same status. And Robert Brandon Sandor, the organizer of Brandon's Poz Parties, a longstanding occasional sex club event for poz guys in New York, took up the charge, hosting a forum at the gay center in Manhattan on serosorting a month later.
Brandon has run afoul of some local public health advocates for his championing of serosorting, as they claim his promotion of the concept is overly simplistic.

For Brandon, serosorting means, if you are poz, and only fuck without condoms with other poz guys, HIV won't be transmitted and will eventually burn itself out. Critics note that the world is more complicated then this with people not sticking to the system, assuming things about other people's status, and remaining vulnerable to other STDS.

This also lays the burden on poz guys to have unsafe sex – or maybe by extention of the argument sex, period – only with other positive guys, but also for negative guys or guys of unknown status to continue to have sex only with condoms.

It's easy to fall into a moralistic discussion about sexual ethics when considering serosorting. But in fact the issue is really one that has been around forever and complicated forever: assessing risk. A noted HIV researcher once told me about a guy in Los Angeles he spoke to who would have unprotected sex if his partner had clean matching socks on. The reasoning went that if he was a nice, clean enough guy to have nice, clean enough socks, they it's likely he wasn't a skank and therefore HIV-negative. Sounds pretty silly, but it's a risk assessment strategy, albeit a poor one.

We are all responsible for making decisions about how much risk we can tolerate. Just about any sex can lead to the transmission of an STD; bottoming for anyone carries some risk of exposure to HIV, no matter how minimal if we choose to engage in sex, a major part of being alive, then we are taking risk. If we have sex with people we don't know, or with people we do know, but whose status we can't be 100 percent sure of, we are taking a risk.

While serosorting is a strategy that attempts to lower that risk, as Bareback Top makes clear, sometimes, for whatever reason, we are likely to be taking risk with less than complete information.
Like we do when we are drunk, or high, or deeply in love, or deeply in lust, or inexperienced, or desperate, or stupid or lonely. How much risk we are willing to take is a combination of our mind's intelligent assessment and our hearts over-riding blindness to circumstance based on our desire in the moment. That leads back to the altruism issue. What alternately upsets and turns people on about Bareback Top is that he puts his needs for sexual satisfaction and thrill above others. He turns other people into objects, his playthings, and gets a kick out of when their intentions to protect themselves and others are undermined by their desire for hot sex and closeness with another human being.

In his most recent posting, Bareback Top describes fucking a young guy without a condom and his assumption that it's the first time the kid has been fucked, He says that the kid was clearly in pain. But he did what he wanted and took care of his own needs, popping a nut up the guy's tender ass. Did he give the young man HIV? Probably not, presuming he's still correct that he doesn't have HIV. Did he give the kid any other STD, who knows? Did he use another human being for his own pleasure at the cost of his own and the other person's humanity? Sounds like. That occurs with a cost that Bareback Top has yet to become aware of. You pay for such cavalier games with a little piece of your soul.

Most of us have probably used other people at some time or another for our own gratification. That's called exploitation. The lucky among us learn to regret it.
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