Saturday, March 13, 2010

Brody's Notes & Scribbles... CDC Analysis Provides New Look at Disproportionate Impact of HIV and Syphilis Among U.S. Gay and Bisexual Men

By Brody Levesque (Bethesda, Maryland) Mar 13 | A good friend & colleague of mine, who, like myself,  is a journalist who also happens to be Gay, invited me to a late supper last evening. During the wide ranging discourse over a variety of topics broached in our conversation, we both settled in on one in particular  that we discussed at length. He & I had received a press release from the Centers For Disease Control Wednesday afternoon March 10th, that disclosed that once again there is a pandemic of HIV-AIDS plus syphilis spreading in the U. S. Gay population. 
Dr. Kevin Fenton, M.D., director of CDC's National Centre for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, stated in the release:
"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognised, this analysis shows just how stark the health disparities are between this and other populations. It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritise the needs of gay and bisexual men with HIV prevention efforts."
According to the CDC's findings the data, presented at CDC's 2010 National STD Prevention Conference, finds that the rate of new HIV diagnoses among men who have sex with men (MSM) is more than 44 times that of other men and more than 40 times that of women. The range was 522-989 cases of new HIV diagnoses per 100,000 MSM vs. 12 per 100,000 other men and 13 per 100,000 women.
The rate of primary and secondary syphilis among MSM is more than 46 times that of other men and more than 71 times that of women, the analysis says. The range was 91-173 cases per 100,000 MSM vs. 2 per 100,000 other men and 1 per 100,000 women.
In regard to solutions and raising awareness of this epidemic, Dr. Fenton said:
"There is no single or simple solution for reducing HIV and syphilis rates among gay and bisexual men," said Fenton. "We need intensified prevention efforts that are as diverse as the gay community itself. Solutions for young gay and bisexual men are especially critical, so that HIV does not inadvertently become a rite of passage for each new generation of gay men." Preventing HIV and STDs among gay and bisexual men is a top CDC priority. CDC provides funding to health departments and community-based organizations throughout the nation to implement proven behavior-change programs for MSM and will soon expand a successful HIV testing initiative to reach more gay and bisexual men."
Solutions? Problematic at best given that the most recent generations of young Gay men,  who in many cases were born after the tremendous losses and anguish of the original crisis, do not seem to either be aware of the severity of the problem or possibly even care. They seem to have taken that attitude since medications are available to combat HIV-AIDS and there are those successfully living with the disease because of medical advances. Which makes the following ancillary topic even more pertinent.
Yesterday there appeared on The Bilerico Project an outstanding Op-Ed by a gentleman who can articulate the concerns about this problem eloquently and with great authority, for you see, he himself is HIV positive. I contacted him to get his permission to reproduce his Op-Ed here which I do with great pleasure. From The Bilerico Project's  Greg Smith:

By Greg Smith (Butte, Montana) Mar 12 |  At the National STD Prevention Conference on Wednesday, the CDC (Centers for Disease Control and Prevention) released some astonishing data regarding rates of infection among MSM (Men who have Sex with Men).
The data indicate that rates of HIV infection among gay men and other men who have sex with men (MSM) are more than 44 times higher than rates among heterosexual men and more than 40 times higher than women. Rates of syphilis, an STD that can facilitate HIV infection and, if left untreated, may lead to sight loss and severe damage to the nervous system, are reported to be more than 46 times higher among gay men and other MSM than among heterosexual men and more than 71 times higher than among women.
Disturbing statistics indeed. But for all this darkness, there's a light on the horizon:
"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said Kevin Fenton, M.D., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts. (emphasis mine)
Listen up: "Prioritize the needs of gay and bisexual men with HIV prevention efforts." That means at the head of the line, the top of the list, etc. That means that they are publicly saying that what has been done in the past to target MSM is not working. To my knowledge this has never been said before by the CDC. I don't want to blow this out of proportion, but this may change the face of outreach and prevention efforts in the U.S. I'm an optimist, but I'm also a realist.
It's not going to happen without our help.
As MSM, PWH (Persons with HIV), LGBTIQ, allies, families, friends, we not only have to hold our state and local agencies and organizations to this, we have to help figure out what's gone wrong. So let's get started.
These are completely preventible diseases. We are not preventing them (granted, I have one of them). For openers, I'll throw out some questions:
  • Have we stopped caring about ourselves and our partners? Have we lost our self-respect?
  • Have we simply accepted that as gay/bi/dl(down low) men, this is the price we pay?
  • Do young gay men know what a pain in the ass it is to have HIV? Are PWH telling them?
  • Are we STD ignorant?Syphilis can be just as deadly as HIV.
  • Are men just stupid in the face of sex?
  • Are we just tired?
  • What can we do to stop the infection of our community? What will work?  
Gregory Smith, MA, is a gay, HIV+ native Montanan, a Rome-educated former priest, now a mental health therapist, health educator, firm and gentle activist, spiritual adventurer and witty optimist who loves to write.  
Smith served as an original member of the Montana Governor's AIDS Advisory Council, advocating for early testing and working to address homophobia in rural medical centers. As a therapist, he has worked at Seattle Counseling Services in Seattle, the oldest LGBT mental health agency in the country. Smith currently serves with the Montana Gay Men's Task Force presenting at & co-facilitating Men's Health Retreats facilitates two HIV+ support groups, and also works as a private therapist. He speaks at events throughout the northwest, telling his story and educating others about being gay, HIV, intimacy/relationships and other topics.

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