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Where’s The Outrage? HIV Rate Soars in Young Gay Men

| 18 Comments

I kept looking for a response, from anyone. How about an editorial in a major newspaper? How about an editorial in the gay press? How about the blogosphere?

Andrew Sullivan and Michael Petrelis, two of my favorite gay bloggers, didn’t say a thing about the new stats. They usually post long entries whenever they find a one year “trend” pointing to possible good news on HIV infections in gay men. I guess the latest news has them so stunned they don’t know what to say about it. Michael actually wrote an entry about the CDC’s press release, but didn’t list a single statistic from it. Instead, he thought it was much more important to know if the epidemiologist announcing the news was gay or not.

Oh wait, I found something on Towleroad.com – an eighteen word bullet in a long list of Andy Towle’s daily dish. It was ten bullets below the lead about “American Gladiators' first-ever gay contestant.” (To be fair, all these bloggers write extensively about AIDS issues – I’m just trying to push them a little to tackle the “gays behaving badly” headlines as well).

So what’s the big news? On June 27th, the CDC released stats showing that the number of young gay men being newly diagnosed with HIV infection is rising by 12 percent a year. The news was big enough for front section articles in both the Washington Post and New York Times. But I guess most readers, including many gay men, just read it and turned the page.

The data covered 33 states that had name-based HIV reporting from 2001 to 2006, including New York, Florida, New Jersey and Texas, all of which have historically high numbers of people living with HIV.

I guess it’s good news that when looking at gay men of all ages, those diagnosed only rose by 1.5 percent a year. Notably, the other demographic groups, heterosexuals and IV drugs users, saw substantial declines (falling annually by 4.4% and 9.5%, respectively).

The 12 percent a year increase is happening in gay men ages 13 to 24. It’s been falling 1 percent a year in 25-to-44-year-olds, and rising 3 percent a year in gay men 45 and older.

In the youngest age bracket of gay men, the yearly rise averaged 8% among Hispanics, 9% among whites, 13% among American Indians and Alaska Natives, 15% among blacks, and 31% among Asians and Pacific Islanders.

The “Second-Wave” Epidemic in Gay America

As the Washington Post article put it bluntly, the CDC report “appears to confirm impressions that a ‘second-wave’ AIDS epidemic is underway in gay America.”

Other studies back this up. A group at the University of Pittsburgh, led by Dr. Ronald Stall, conducted a review of HIV incidence rates from 1995 to 2006. An incidence rate is the number of new cases within a specified time period divided by the size of the population initially at risk. In Stall’s review, they looked at the percentage of gay men in the U.S. that were becoming HIV infected each year.

They found in their review of the entire published literature on new infection rates among MSM (Men who have Sex with Men, or how the scientific literature lists gay men) that the average incidence rate of HIV infection among gay men in community based samples in the United States approached 2.5% a year. They continued their analysis to estimate what this rate of new infections would mean within a group of young men who were all seronegative at age 20, but who seroconverted at a rate of about 2.5% a year through to the age of 40. By the time that this group of young men reached the age of 40, Stall's group estimated that approximately 40% would be HIV positive.

Dr. Stall's group also showed that these predicted rates of HIV infection are not significantly different from current HIV seroprevalence rates published by the CDC among MSM. For instance, the CDC estimates that 37% of gay men ages 40 to 49 are HIV positive.1

I emailed Dr. Stall to discuss his findings, and he concluded by saying “at current HIV infection rates now known to exist among gay men in the United States, we are likely to be reproducing very high rates of HIV infection across generations of gay men.”

What Now?

There are some leading AIDS activists, including Larry Kramer, that think prevention doesn’t work – that nothing can be done to stop this inevitable “second wave” of gay men living (and dying) with HIV.

I strongly disagree. As far as I can tell, we’ve never even tried. Ever since the early years of the AIDS crisis, our government has basically told the gay community “sorry, you’re on your own.” Homophobes in power, like Reagan and Helms and a complicit Congress, made sure that the CDC could never fund effective HIV prevention campaigns targeting gay men (a version of Helms’ “No Promo Homo” amendment is still ensconced in the CDC’s HIV Content Guidelines).

When the country finally demanded that Washington respond to the rising epidemic, Congress dramatically increased the AIDS research budget. A serious national prevention effort has never been launched, let alone contemplated.

Want to know how hard we’re fighting the spread of HIV now? The CDC's current HIV prevention and surveillance programs account for 3 percent of all federal HIV/AIDS funding. Three percent!

Imagine a country where the President said it was a priority to fight the spread of HIV among gay men (or women, or African Americans). Imagine a country where the President asked Congress to appropriate $1 billion a year towards this effort.

A huge response would follow. Prevention programs that have been proven to work (there are dozens of studies showing that various types of programs actually work, like carefully tailored counseling programs) would finally be tried on a larger scale. The gay community would start to feel it had a fighting chance to lower infection rates, for good. We'd stop wagging our fingers and stomping our feet (the Larry Kramer approach, which obviously doesn't work), and get down to work.

It would be our “yes we can” moment.

Speaking of which, all of this just might be possible with Obama in the White House. He’s made the right promises with regards to increasing our nation’s prevention efforts, so the trick will be keeping his feet to the fire and forcing him to follow through. Bill Clinton sounded much the same when he first ran for office, but got little done while in the White House. To be fair, Clinton had a much more Republican Congress than Obama likely will.

But first things first. Where’s our outrage?

 

(1) HIV Prevalence, Unrecognized Infection, and HIV Testing Among Men Who Have Sex with Men --- Five U.S. Cities, June 2004--April 2005, MMWR , June 24, 2005 / 54(24);597-601.



Peter on:

18 Comments

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Comments on Peter Staley's blog entry "Where’s The Outrage? HIV Rate Soars in Young Gay Men"

Outrage??!! We're too busy scoping out high-risk sexual activity, denial and ignorance regarding the course of HIV infection, anonymous hook-ups with men whom we dehumanize, and the next sure ticket to foo-foo fabulousness to be outraged. Queermen curtailed infection rates for several years by placing a collective premium on safer sex, and our choices were reinforced by the suffering and death of friends with AIDS. Yet, somewhere we lost the shared value in feeling good and sharing physical intimacy without untenable risk, just as we were losing the spectre of death and dying among us.

We shouldn't blame a homophobic government, for it wasn't that friendly to us when we were succeeding in abating infections. Even with a Democratic president and Congress, government will remain on many levels in many places hostile to us and ignorant to tactics that work. We must, however, admonish one another to do what each of us can do to turn the tide on HIV:
1. get tested
2. protect yourself, if negative, in all that it entails -- no one else is going to do it, and "But he was hot, and I wasted" is a lame excuse
3. don't share, if positive; and
4. educate self and others.
Knowledge=power!

Maybe a new ad campaign with 2 guys whispering about a 3rd. One friend looks at the 3rd guy lustfully and whisperrs to his friend "He's gorgeous! I just KNOW he's DDF!" and then a box with an arrow under the gorgeous guy with a fake name, age and status "Darren Cutler, 25, HIV Positive" and then the tagline "You CAN'T tell just by 'looking'"

All is not lost! Safe sex is still enjoyable sex! Protection begins with you. Our organisation has a support group for MSM's, where they discuss issues that affect the and ways they can deal with them. The first thing being respect for their bodies and each other.
We trained some of them as Peer Educators and they do community outreach with their peers. It is hard work, but it is helping, because in our country buggery is a crime.

I think the most significant passage in this blog is the following:
"Homophobes in power, like Reagan and Helms and a complicit Congress, made sure that the CDC could never fund effective HIV prevention campaigns targeting gay men (a version of Helms’ “No Promo Homo” amendment is still ensconced in the CDC’s HIV Content Guidelines)."
Just exactly WHAT are the "amendment" restrictions on content? And WHERE is the OUTRAGE from the gay community on this? If the CDC is specifically preventing funding for any meaningful prevention because in its own stupid Puritanical way is forbidding the mention of sex, let alone GAY sex, then we need to DEMAND the removal of such language that strangles all meaningful prevention efforts. Helms is dead; Good riddance. Now, let's get rid of the legislative language that he left behind!

HIV rates soaring. No kidding. As a peer councilor, and have lived through the last 24 yrs with HIV, I'm here to tell you how could you not notice if you are even remotely involved with this community? Blame anyone you want to, they probably share in some of it. The onus is on US to educate our own population. With all the menforsexwantitnow internet hookups UB2 and HIV-, and DDF are mostly bullshit. I have seen people I know are positive and lie on profiles. I have had a disproportionate number of young adult males showing up for help after testing HIV Positive. There is still a stigma associated with HIV. It is still a secret in our population. No one wants to talk about it anymore. I understand the apathy society can have, it has been a long struggle, and a devastating one as well for a lot of us. The sooner each person is routinely tested for HIV in any blood work the sooner we slow this epidemic in our country. We do not stigmatize diabetics, people with high cholesterol, why we still treat HIV as ‘he who shall not be named’ I cannot understand. We need to take the mystery out of HIV now!

I agree that an Obama administration could give gays their "Yes we can" moment with regard to this serious problem of a second wave of HIV infected. I do think that it is clear that the problem is being ignored largely due to the memory of what the bigoted in America made of the first wave, under the Reagen administration: an excuse to further alienate and disenfranchise the gay community.

Obama is going to grease whatever wheel is sqeaking loudest to get to the white house. He is by far the biggest liar and best con artist I have ever seen. I am very impressed with the amount of people he has snow balled. I think it will be great to have a president who bearly would qualify to be governor of a large state much less president. Hell, next he is going to tell us all that he will legalize pot in the usa. Open your eyes fool!!!!!!!!!!!!!!!!
THIS MAN WILL DO,SAY,ACT AND WALK ANYWAY YOU WANT HIM TO UNTIL HE WINS THE ELECTION.

Hey Bobby learn how to spell before you call people names fool.

Now back to the topic. Viewing this through the the lens of 80's activism, while nostalgic, will solve nothing. If other HIV demographics continue to decline why the rise among gay youth? From Jesse on the cover of POZ, to supposed activists boasting their prowess in barebacking videos linked to in the forums, the answers are as plain as the nose on your face. We're not the solution, we're the problem.

I tend to agree with Kramer. The answer to this problem is not in the halls of Congress. Read the newly infected, their outrage is that they might have the discomfort of a side effect, not that they might die. That they might not be attractive, not in stopping the spread of HIV.

As with many social issues these days (war, environment) outrage is in very short supply.

I'm one of those whose partner was diagnosed as HIV+ a very long time ago, back well before there were any effective medications. I can't even remember what it was that he was prescribed but it was that white capsule with a blue ring around it in the middle of the capsule. I'm still convinced that it actually made him sicker; he lived for only about 14 months after his diagnosis, and was infected with terrible Herpes that ended up eating half of his nose and a good bit of his upper lip. I was diagnosed just after his death and thought for sure that I'd go about that quickly. In my case, though, the infection moved rather slowly and I was started on Epivir and Zerit, each twice a day, just after they came on the scene. Those two were effective for quite a few years. Just for the record I've been infected now for more than 28 years, and have had Hepatitis C for quite a few, along with Diabetes 2 for several. A couple of years ago my viral load began to rise and my CD4 count to drop. On the way to that point I had been receiving my treatment from the Infectious clinic at the Atlanta VA and I think that has been very lucky. Though I became rated as disabled, that clinic is one of the best in the Southeast. The VA is only a few miles from the headquarters of the CDC and about the same distance from Emory University, and all the doctors that work at the clinic are from one or the other of those.
Well, very near the time that my counts began to diverge from where they had been for years, Atripla came on the scene and my viral load reverted to undetectability and my CD4 count stabilized in the 400’s. The numbers have remained constant ever since. As it happens I have an appointment this Friday to visit the Advanced Liver disease Clinic, also at the VA, to evaluate my Hepatitis status. The hormone levels have been very slowly increasing, though I've been able to get by with a few MRIs rather than having a core sample taken. I have been following the progress of VX 950 with great interest as the clinical trial results thus far have been remarkably good. Unfortunately, it seems that the trials are all in Europe, but I'm in great hopes that there will be some in this country before too long. I think that with the proximity of the CDC and Emory as well as the fact that David Rimlin who is the director of the Infectious Disease Clinic at the VA is a well known researcher might facilitate the establishment of clinical trials in this area.
As far as the Diabetes, I had a couple of instances of critically low blood sugar, after which the Diabetes clinic told me not to use any more insulin, and with the use of Splenda and at least a bit of careful rationing of ice cream my blood sugar have been staying at a reasonable level.
So here I am nearly thirty years after I once expected to have passed on, reasonably healthy and having to take only one pill per day for my HIV. There are several others, but they are for things like depression and chronic nasal congestion. In all these years I never came close to having to take Protease Inhibitors or any of those other nasty things that we all read of having to take in huge quantities with rigid schedules. I'm now 57 years old which still surprises me, and I don’t seem to be deteriorating. I guess that some would say that I've been just a bit lucky.
Though it took me a few years to become fully aware of the importance of refraining from fluid exchanges with others and several years of using various substances that are generally frowned on, I have for a bit over twenty years been entirely celibate and that has led to a general condition of physical no physical functionality, but the interesting thing is that I really don’t miss it, and this makes it very easy to be entirely safe relative to others. I live a solitary life with no regrets, and it hasn’t been particularly difficult to maintain this situation. Who knows, at this rate I might even pass beyond late middle age and live to be what I used to think of as genuinely old. What a thought.
All this boils down to the fact that it really isn’t all that hard to live a long time and keep the HIV fully under control. I hope that this saga will serve to encourage others who are infected and help them to see that HIV doesn’t have to be really all that bad to live with.

Outrage?

Not in this community. We are too busy snipping at each other to care beyond personal scores.

It amazes me that anyone would give credence to the right wing tactics of attacking a person for their sexual past as a legitimate argument against their right to participate in the fight against HIV stigma and discrimination.

And that perhaps is part of the larger answer to your question, Peter.

Maybe the outrage is muted because of such rationales, and people are afraid to speak up because their current words and actions will never suffice compared to the salacious details of one's past.

It's ironic that even on this site where there seems to be a majority acceptance that HIV is a virus and not a moral judgement about sexual practices and sexuality that anyone would try to attach a stigma to another because they don't have a mainstream acceptable past.

That said, I personally, do not disagree that the promotion of bareback sex in videos, parties and most other areas (including joking about in on messages boards or congratulating a blog's author when he goes onto great details about bareback sex encounters) is in fact an issue in the minimizing the importance of safe sex among a whole generation of men.

But while it is comforting and easy to blame such things as bareback sex videos, Congress or whatever villian one can construct to personify the issue - the frank truth is that the community as a whole has failed.

We place high value on our ability to shade another, or make witty remarks, and we seem to exert righteous anger about issues that we feel offends us personally, but it all seems to end abruptly at the rhetoric stage.

How many of us are actually putting ourselves out there publicly (faces and names included) to talk to others about HIV?

How many of us willingly face the stigma, prejudices and attacks not just from the religious right, but from those who claim to be on the same side?

How many of us can cast the first stone?

And this brings my point full circle.

We as a "community" seems to have lost any sense of the meaning of that word beyond cliche sentiments and gestures. I realize that hindsight has a way of glossing over certain truths, but the days of gay men seeming to have a shared connection of fighting together to shape, nurture and defend our community (including the lives of our newest generations) seems to have fallen to the infighting that we have deemed as more worthy of our time and energy.

Thanks for this information, sickening and scary as it is. Two years ago, A friend and I took it upon ourselves to talk to a group of gay teens, ages 13-21. Over 100 showed up, so there was an interest and a need for information. I told them that HIV was a disease that you do not want to have.
It seemed to go well, as several went to get test soon after.

Why am I having to this? I am not an educator, I am not affiliated with n ASO. I"m just a regular guy wanting to tell my story and help my community in a small way.

I think the problem is a serious lack of education. There is no leadership, no consistant education program. I mean can anyone name one program directed to teens?

I will pick up the phone and do my speech again. I urge anyone in here that is HIV+ to just find a group in your community and go tell them your story. You will be amazed at the amount of questions you will get asked. Believe me, kids are starved to learn more. There just seems to be a serious lack of a forum to give them the chance to learn, and get involved and ask questions. If we wait until the election, and Washing, hell!! Thousands more will get infected.

Until then, a grass roots effort can help. I have seen the results. Every little bit helps. It just takes a little effort on our parts. You will be amazed how great the feeling is when you give back to your community. It is so amazing. You'll see. Trust me and give it a try.

Thanks Peter. This sad and tragic information will get me off my ass and start to work on the problem again. Just think how much good if just one person in each state, and each country, could donate one night to a group of teenagers, who are all starved for information in how to protect themselves.

Everyone wins. It beats bitching about life and doing nothing, after all!

I'm talking here as US foreigner, but also as someone who not so long ago (I'm 29) was in that age group.

There are a couple of reasons that are bound to influence the perception young gay men have of HIV and that didn't exist 10 years ago:

- HIV is no longer perceived as a deadly disease, but rather as a chronic condition, due to the appearance of HART.
- Young gay men usually have never had any HIV or AIDS impact in their social circle. (I'm 29 and had never knowingly met a pozzie myself til my diagnosis).

That means that young gay people are specially prone to underestimate both the prevalence of HIV and its effects in one's health.

That's why prevention campaigns, be them public or privately funded, are much more important now, we need them to compensate for those new factors.

I've read some studies about HIV epidemiology in my country, Spain, and it seems we have exactly the same trend as the US: HIV infections among MSM is the category of infection that has the least favorable evolution; and HIV infections among MSM are specially high in the younger groups, who report more risk practices.

It seems clear to me that something needs to be done.

If you look at the CDC figures, it seems this could well be an increase in Black (as we say over here, African-American do you say over there? CDC says "Black, non-Hispanic") young gay men.

Will the A+F generation of employed, insured gay men gonna put in the pockets and contribute? And pressure gay lobby groups to make HIV among young, Black gay men an issue?? And put these young men in the driving seat? Or not? Cos from this side of the pond federal or state dollars for a worthwhile prevention initiative seems an unlikely proposition. And young guy's gonna listen to some old queers telling them what to do eh?

A thought experiment... the strategy of "Let's get tested TOGETHER
BEFORE we have sex, for A VARIETY of STDs."
A sexual health checkup reduces ambiguity and can be
like anything else potential sex partners might do together.

List of other Outrages the Media is ignoring. You should be pissed at the media,it is their responsibility to make the public aware of problems such as rising HIV rate among gays. The media is not celebrating the fact that W has done more for HIV among Africans and Africa than any person in History,according to Bob Geldork. I think it is a disgrace if we are spending one dollar in Africa if US citizens are not getting appropriate education and treatment for HIV. Maybe we should pay people to have safe sex?

1.Congress and Dems refusal to drill for more oil on US property,which would immediately lower price of oil and strengthen the dollar.

2.Ws bait and switch in Iraq. Went in looking for WMD and ended up nation building.

3.Dems and Reps support of man made global warming in attempt to get votes from the uneducated. Global temps have been in a downturn since 1998 and the five highest temp years of last 120 years were before 1910.

4.We have a candidate for President who spent the last 20 years in a church that preached hate,racism, and an anti american doctrine. I wonder what that church thinks of gays? Can you imagine the media outrage if this guy was a republican or Mormon?

5.Barney Frank,Chris Dodd,and Franklin Raines looting and destruction of Fannie Mae and the resulting financial crisis.

6.Democratic attempts to aid enemy in Iraq and the medias failure to report it and failure to report success in Iraq.

7.The Republican candidate for President was part of the Keating 5(only rep involved). He trashed the first amendment with his Camp Finance bill to protect him from criticism when running for Pres. He is no different than Obama or Hillary,he will do anything or say anything to get elected. We have no idea what he really believes.

These are just a few of the outrages I can think of that arent being reported on by the US media.

Dear Peter:

The CDC stats you wrote about in the above post are - and need to be - an important reminder of how HIV/AIDs continues to affect a growing population.

We are writing from WITNESS, a human rights organization that uses video and online technologies to open the eyes of the world to human rights violations (learn more about us here: www.witness.org). We are reaching out to you because you are a part of the blogosphere actively sharing your thoughts/ insights and information about HIV/ AIDS. Our latest initiative called the Hub (http://hub.witness.org), a participatory website for human rights media and action, will be focusing on the issue of HIV/AIDS during the AIDS2008 conference in Mexico City, Aug 3-8, 2008.

We are writing to see if you might participate in any of the following ways:

- Providing us with a guest blog: Preferably with a video, photographic or audio component, for posting on our blog (http://hub.witness.org/en/blog). As the focus of our work is addressing issues through a human rights framework, we would highlight any strong human rights-related posts that you create. (We are open to a wide variety of video types, including those that use humor, animation, or audio/ visual slide shows, etc.)


- Embedding media from the Hub onto your blog: We have some existing HIV/AIDS-related video already on the Hub, which you are free to embed on your blog before then. To see HIV/AIDS-related media, check-out our spotlighted media at http://hub.witness.org/AIDS08Group


- Join the Hub: We'd like invite you to join the Hub community - a rapidly growing community using video to create change - to feature your blogs and work. Traffic to the Hub has been growing regularly - the 1,200+ human rights-related media on the Hub have been seen over 5 million times and we have had nearly 25 million hits since our launch in December 2007.

Lastly, some of the WITNESS staff will be attending AIDS2008 - please let us know if you or any of your colleagues are going to be there - we'd like to meet you. To learn more about WITNESS, the Hub and our efforts at AIDS2008, please visit http://hub.witness.org/AIDS08.

Please be in touch with any questions.


Sincerely,

Sam Gregory
Program Director

&

Bukeni Waruzi
Program Coordinator for Africa & the Middle East

WITNESS | www.witness.org
The Hub | hub.witness.org

thoughtful post. thank you.

i am an admirer of your work. i wonder if it would be possible to reprint this post in the next edition of our local poz newsletter- (coming out in september)? full credit would be given to you, of course.

rr

Our outrage is masked by self-loathing...

http://www.thenewgay.net/2008/09/approximate-living.html

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