Disturbing New Information on MSM and HIV

One of the most frustrating aspects of working in HIV is addressing the many myths (as well as conspiracy theories) surrounding it-the most persistent of which is that AIDS is a "gay disease." Clearly this myth started early in the history of HIV in the U.S., yet has persisted despite clear evidence of how HIV is transmitted and the growing diversity of those whom become infected. Moreover, it has been convenient for many to affix the label of "gay" to anyone who has had sex with the same gender. However, a startling new report from the Centers for Disease Control (CDC) may add additional fuel to that myth. A CDC study conducted in 21 cities tested over 8,000 gay and bisexual men participating in the 2008 National HIV Behavioral Surveillance System.

The study found that almost one in five men having sex with men (MSM) was infected with HIV and that almost half of them did not know it. Black MSM were infected at a rate of 28%, as compared to 18% for Latino men and 16% for Caucasian MSM. Black MSM were even less likely to know their status than other races (59% were unaware) with young black MSM, a shocking 71% of which were unaware of their status. There was also a high co-morbidity with HIV status and socioeconomic variables-with HIV + status increasing as education and income decreased.

Studies such as these point to the glaring need for new creative strategies, not to mention social marketing approaches, to attract more and younger MSM to get tested. Moreover, despite all of the hoopla about '"men on the down low" as the culprit for rising infection rates with women, we cannot overlook the fact that many of the men in this study were bisexual and therefore, may have female partners. Previous studies have shown us that when someone knows their HIV status they are more likely to practice safer sex. Hopefully a renewed focus on HIV prevention targeting MSM may lead to a sorely need national dialogue revealing the diversity and complexity of the topic. Perhaps that discussion will help dispel the myth.

World AIDS Day was on December 1, 2009- Did you notice?

Each year, despite the ever growing AIDS epidemic, it seems that media coverage of World AIDS Day steadily decreases. Started on December 1, 1988, the objective of World AIDS Day has been to increase awareness about the AIDS epidemic, raise money and to help to dispel the myths, sterotypes and prejudices that continue to abound. The theme for this year's World AIDS Day theme was 'Universal Access and Human Rights'.

According to UNAIDS estimates, there are now 33.4 million people living with HIV, including 2.1 million children. In 2008, 2.7 million people became newly infected with the virus and an estimated 2 million people died from AIDS. Approximately one-half of all people who become infected with HIV do so before they are 25 and are killed by AIDS before they are 35.2

2008 also achieved another somber milestone: HIV/AIDS is now the leading cause for women internationally. Maybe its just me, but as HIV/AIDS becomes younger, darker and impacts more women, is there any coincidence that it falls further off of our radar screen.

Demonizing HIV

AIDS activists have been buzzing lately about a new German HIV awareness advertisement depicting a woman having sex with Adolph Hitler. By now, I am sure you are wondering: what does the Fuhrer have to do with AIDS? Well, in the ad, which is available online, a heterosexual couple is seen having sex. The man's face becomes that of Adolph Hitler followed by a slogan describing AIDS as a "mass murderer. Print versions of the campaign also use Saddam Hussein as well as other despots.
The company that created the campaign, Das Comitee, defended the advertisement stating that it was meant to show "the ugliness of the illness."

I understand the philosophy of using 'shock value' to get people's attention. Its discomforting to realize that in 2009, we have to 'shock' people to make them aware of HIV/AIDS. However, the designers of this campaign are obviously missing something and it underscores the danger of developing public awareness campaigns in a vacuum-with vetting them with a diverse audience, especially people living with HIV. Now, I don't know for sure if that was done. However, given the tremendous stigma associated with HIV, I would hope that someone would have realized that many people viewing the ad would associate the people living with HIV with these dictators. Despite good intentions, it's the wrong message!

I just read a sobering story about the first person to be convicted in Idaho of knowingly spreading the HIV virus. This gentlemen, a term which I use loosely, who has served two jail terms for the same offense, is now facing new charges for the same offense. A grand jury on Tuesday returned an indictment charging him with seven counts of knowingly transferring the HIV virus. He has already served two separate jail terms of 3 and 7 years respectively. I hope that they finally put this serial perpetrator away. However, lost in this story is the fact that people continue to have umprotected sex and place themselves at risk despite the publicity about HIV and other sexually transmitted infections. Know your HIV status, but also insist that your partners get tested as well.

CONDOMnation I

On December 11, 2008, an FDA advisory panel unanimously recommended the approval of the FC2, a new female condom. The FC2 would be 30% cheaper than the current version, even though male condoms are much less expensive. A cheaper female condom, if widely distributed, could prevent tens of thousands of HIV infections worldwide in part because it allows women to take the lead in protecting themselves. Nationally, the rate of AIDS diagnoses for black women was nearly 23 times the rate for white women and high-risk sexual contact was responsible for 74 percent of those infections. Lets hope that the FDA gets it right and approves the new female condom soon.

Why Not Female Condoms?

Studies have repeatedly shown that although female condoms are widely accepted and that many women prefer them to male condoms, policy makers often fail to promote and invest in their use. The result has been the limited us of a powerful weapon to help fight HIV, other sexually transmitted infections and unwanted pregnancy. According to an Oxfam report presented Thursday at the XVII International AIDS Conference in Mexico City, titled "Failing Women, Withholding Protection," there are about three billion male condoms sold worldwide annually, compared with about 26 million female condoms.

Part of the problem is that female condoms are much more expensive than male condoms. However, why couldn't governments or businesses get together to develop a lower cost version. Or, what about governments using there considerable economic and political power to force manufacturers to lower their prices by offering to buy large quantities in bulk. Either way, this is another area crying out for real leadership.