Researchers Present Data on the Relationship of HIV Knowledge and MSM Internet Users

via PLoS One, by Bradley H. Wagenaar, Patrick S. Sullivan, Rob Stephenson

Introduction

Since the emergence of HIV as a global pandemic in the 1980s, men who have sex with men (MSM) have shared a disproportionately large burden of infection in many high-income countries in Western and Central Europe, Australia, and North America. Due to this recognized high burden, MSM represent a large target population for resources on HIV/AIDS prevention, treatment, and research in these areas. By contrast, Africa's HIV/AIDS epidemic has long been understood primarily as a “heterosexual epidemic”, with an estimated 80% of HIV infections being tied to heterosexual transmission. This focus has led to HIV/AIDS prevention efforts in Africa being targeted primarily to heterosexuals.

Recent epidemiological evidence has shown that MSM in Africa share a disproportionate burden of HIV infection. Prevalence estimates of MSM in Africa range from 1–4% of the general population, but high levels of HIV infection and a high prevalence of MSM also engaging in sex with women has led MSM transmission to be linked to over 20% of all HIV cases in several countries of the Middle East, North Africa, and West Africa. These data are at odds with the fact that most African countries have not dedicated any national HIV/AIDS funds to specifically target HIV/AIDS among MSM.

The 2009 UNAIDS report on universal access for MSM and transgender people highlights the global failure in addressing the needs of MSM regarding HIV/AIDS education, prevention, treatment, research, and care. One of the foci of this report is increasing access to HIV/AIDS prevention materials for MSM and transgender individuals. Although increasing HIV/AIDS knowledge alone is not sufficient to promote sustainable behavior change, accurate knowledge of transmission and prevention of HIV is necessary if MSM are to adopt risk reduction strategies.

Globally, reporting on HIV knowledge among MSM is sparse. Only 33 out of 147 low and middle income countries (LMIC) reported knowledge data through the 2008 United Nations General Assembly Special Session (UNGASS). Only 2 of these 37 countries reporting UNGASS HIV knowledge data were in Africa, with Nigeria and Mauritius reporting that only 44% and 48% of MSM respectively could “correctly identify ways of preventing sexual transmission of HIV and could correctly reject major misconceptions about HIV transmission”. Additionally, across all low and middle-income countries reporting knowledge scores, less than half of MSM held correct HIV knowledge.

Other studies from Sudan and Kenya indicate that MSM in Africa may have low knowledge regarding HIV prevention and transmission. More than half (55%) of a sample of MSM in Sudan and 35% of respondents in Mombasa, Kenya did not understand the link between anal sex and HIV infection. By contrast, over 90% of samples of MSM in Malawi, Botswana, and Namibia understood that HIV can be transmitted through anal sex with a man. However, of these samples, only 57%, 50%, and 85% respectively had ever received educational materials on preventing HIV transmission between men.

Data on levels and correlates of HIV/AIDS knowledge in Africa are essential to develop effective prevention and education strategies. Previous studies of HIV knowledge among MSM have focused on levels of HIV knowledge, but have not systematically examined factors associated with low knowledge. The present study aims to fill this gap by examining factors associated with low HIV/AIDS knowledge among MSM in South Africa and the United States using a validated HIV knowledge scale.

Read the Rest of the Study.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Congressmen Introduce Repealing Abstinence-Only-Until-Marriage Act

From AIDS Action

Senator Frank Lautenberg (D-NJ) and Representative Barbara Lee (D-CA) just introduced the Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act. This legislation would end the Title V abstinence-only-until-marriage programs that have used $1.5 billion in Federal funding since 1996, and transfer that funding to the Personal Responsibility Education Program (PREP) state-grant program.

The proposed change comes amid growing statistical evidence that abstinence-only-until-marriage programs have done little to decrease STD transmission among youth and has been ineffectual at reducing teen-pregnancy. In fact, teen-pregnancy actually rose by 3% in 2006 for the first time in more than a decade. A 10-year government study released in 2007 found that programs funded by Title V abstinence-only-until-marriage did not delay sexual initiation among youth.

PREP-funded programs offer a conmprehensive approach to sex education that includes information on both abstinence and contraception for the prevention of unplanned youth pregnancies and STD and HIV transmission. Programs must also provide sessions that cover healthy relationships, adolescent development, financial literacy, educational and career success, and healthy life skills. Various studies have shown that programs administered within this type of framework have been effective at cutting down on unintended pregnancies and STD transmission because participating youth are more likely to use some form of contraception at first intercourse even though rates of sex stay the same.

Read more about the issue and find links to the studies mentioned above

Read Representative Lee's press release

Read Senator Lautenberg's press release

Kenya Holds Major HIV/ AIDS Forum

via All Voices

The Fourth International Conference on Peer Education, Sexuality, HIV and Aids opens at the Kenya capital city of Nairobi from this Wednesday at a time when the country is making significant progress in providing healthcare for all.

The meeting, which will be attended by Peer Educators, trainers , Health Workers, NGOs and Facilitators will be held under the theme: HIV Prevention : Covering New Grounds is organized by national Organization of Peer Educators (NOPE). The meeting comes at time when NOPE is celebrating its tenth anniversary and enjoying the international mandate which was effected in July 2007. The organization develops and market wide array of professional and technical services aimed at addressing health and social needs.

For the full story click here.

Catholics and Condoms: Why What the Pope Says Matters

via The Body, by Jon O'Brien

During his 2009 trip to Cameroon, a country with an HIV prevalence rate of over 5%, Pope Benedict XVI made a shocking assertion on condom use to prevent HIV. He told reporters, "You can't resolve it with the distribution of condoms. On the contrary, it increases the problem."

Read the rest.

Few Young Men Counseled on Sexual Health, Study Finds

via TheBody.com

Adolescent males continue to be overlooked by health care providers in terms of reproductive health services, new research shows.

Dr. Arik Marcell, assistant professor at Johns Hopkins University School of Medicine, and colleagues compared data from the 1995 National Survey of Adolescent Males and the 2002 National Survey of Family Growth to determine whether improvements have been made in the delivery of STD/HIV counseling services to male teens. They found that fewer than one-quarter of boys ages 15-19 received STD/HIV counseling by a provider during the previous year, according to the 2002 survey of 1,121 young men. These results represent no significant change from 1995, when a similar proportion received such counseling.

Males who reported three or more female partners, anal sex with female partners, or oral/anal sex with male partners were more likely to have received counseling, with roughly one-third saying they had been counseled about STDs in 2002. A similar proportion of those engaging in risky sex received counseling in 1995, the study found.

However, even fewer young men, less than one-fifth, discussed contraception with a health care provider in 2002. That compares with nearly two-thirds of sexually active young women, according to other surveys.

"The medical system is really set up to serve women and maternal-child health in ways that aren't addressing young men's needs," said Marcell.

The study, "Prevalence of Sexually Transmitted Infection/Human Immunodeficiency Virus Counseling Services Received by Teen Males, 1995-2002," was published online in the Journal of Adolescent Health (2010; doi:10.1016/j.adohealth.2009.12.002).

When the Cellphone Teaches Sex Education

via the New York Times, by Jan Hoffman

Excerpt:

The North Carolina center permitted a New York Times reporter to read through some phone logs, after cellphone numbers and towns were redacted. The questions span the spectrum of adolescence itself, from the goofy to the ghastly. Many ask how to talk with parents about sexuality. Combining a teenager’s capacity to cut to the chase with the terseness of texting, they are often brutally direct:

“Do I love her or do I love the sex?”

“What happens if you swallow a piece of condom?”

Some questions could have been written to teen magazines 50 years ago:

“Why don’t girls like short guys?”

“how do u move yr tongue when u tongue kiss?” (“Kissing is not a science,” the reply notes. “Go at your own pace and you will figure it out.”)

But many questions vault past the basic training manual: “I like boys but I also like girls. What should I do?” (“Some people just like who they like. ... Only you can know for sure and only you know what is right for you.”)

Some reveal dangerous chasms of ignorance. Girls and boys alike ask about anal intercourse: Will it prevent pregnancy? Let a girl remain a virgin?

“If ur partner has aids,” one teenager asks, “and u have sex without a condom do u get aids the first time or not?”

Read the rest.

Sex Ed should actually talk about sex - and not just the scary stuff

High school kids are being taught about the birds and the bees with the same fear-mongering tactics many of us remember. But some health educators today are offering teens a more grown-up lesson: Sex isn't necessarily a bad thing.

excerpt from the boston globe

... Halfway through one of Megara Bell's classes, a ponytailed girl in a bright-green shirt asks the most basic of questions.

"Wait," she calls out. "What is sex?"

Bell is a Newton mother of three with short, spiky brown hair and a wry smile that suggests she would be hard to rattle. As director of the nonprofit Partners in Sex Education, she teaches about human sexuality at youth organizations, public and private schools, and juvenile detention centers around Greater Boston, and on this sunny fall afternoon, she's at an all-girls' residential school in Arlington. Six teens have gathered in a small, fluorescent-lit classroom, made name cards in pink and purple ink, and established ground rules like "It is OK to laugh." A game about decision making led to a question about how old a person must be to "have sex," which prompted, "What is sex?"

There's a little snickering, but the ponytailed girl presses ahead, explaining that if they're going to talk about how old you have to be to do certain things, she wants to know exactly which things falls under the rubric of "sex."

"OK, great question." Bell nods at the girl and explains that when "sex" is used to refer to a behavior (as opposed to, say, the male or female sex), it's usually referring to vaginal, anal, or oral intercourse. She defines all three.

"Does foreplay count?" someone shouts. "No!" another girl replies at exactly the same moment a third asks, "What is foreplay?"

The teens start talking over one another: "My friend said . . ." and "I know this dude who . . ." and "What I heard was . . ." Bell steers them back to the main task at hand.

The girl's question epitomizes the murky definitions, and murkier goals, that have plagued US sexuality education since its beginnings in Chicago nearly a century ago. We don't all agree which behaviors constitute "sex," and we agree even less on what sex means. Seen through different eyes, sex can be a pleasurable activity, a sacrament, a means to procreation, an ecstasy, a disappointment, or a source of shame -- the list goes on. These conflicting, deeply personal attitudes toward sex make it difficult to articulate a curricular vision for public schools, where all opinions must be honored...

Read the whole item.

Youth still reluctant to test for HIV - Tanzania

via Daily News - Tanzania

A research carried out in Zanzibar, for example, shows that many girls opt for anal sex to preserve their virginity. Prof Njogu said, “If we create an atmosphere that is welcoming, youthful, informal and culturally appropriate for all the youth using the services, we could help these girls a lot from this problem.”

The youth have bigger risk of getting early pregnancy and contracting sexually transmitted deseases (STDs) but unwilling to access services facilities, a research has revealed. Delivering a paper during the ongoing Media Workshop on Maternal, Newborn and Child Health MNCH in Dar es Salaam on Friday,

Professor Kimani Njogu said traditionally, maternal and child health and family planning clinics were designed to serve childbearing and child spacing needs of married women. Nevertheless, due to cultural sensitivities, the services were withheld from young, unmarried people. Prof Njogu is a Media analyst and a researcher from Kenya.

Read the rest.

Panel: Stigma hinders HIV treatment

BY SETH BLOMELEY - via Arkansas Democrat Gazette

A fear of coming forward by people with AIDS in the Arkansas Delta will make it more difficult for the state to help them, a researcher said Monday.

Katharine E. Stewart of the University of Arkansas for Medical Sciences’ College of Public Health told the Arkansas HIV / AIDS Minority Task Force during its meeting at the Capitol that among blacks in the Delta there is a “stigma” associated with people who have AIDS.

Stewart also said that the task force needs to think about what recommendation it might make regarding sex education. She said children sometimes think and talk about sex as early as the second grade, and it’s important for parents or teachers to get them good information before they get bad information from their peers.

For instance, she said, she taught a human sexuality class for 13 years and she recalls three times when female students approached her and said they didn’t have to worry about getting sexually transmitted diseases because they only have anal sex. The students said they were taught that anal sex isn’t really sex because you can’t conceive a baby through it and because of that they didn’t think condoms were necessary.

Stewart said that’s wrong, and it illustrates the problems in a modern society where good information is readily available but people don’t want to talk about it because it makes them uncomfortable.

The task force was created by Act 842 of 2007 by Rep. Willie Hardy, D-Camden. The task force is developing recommendations for Gov. Mike Beebe by Nov. 1. Its next public forum will be in West Memphis on Sept. 22.

Stewart said STDs and HIV are disproportionately high among blacks.

To illustrate this, she said that Lee and St. Francis counties, which have a high percentage of black residents, have gonorrhea rates about twice the statewide average of 168 cases per 100, 000 people.

Throughout Arkansas, she said, the rate of HIV among blacks is five times greater than among whites.

People with AIDS and other sexually transmitted diseases often are drug users who don’t use condoms and are low-income, she said.

Sometimes, poverty-stricken women trade sex for money to feed their families and are in no financial position to demand that partners wear condoms, Stewart said.

Furthermore, people in Lee and St. Francis counties lack access to medical care, she said.

Stewart said she’s studying how best to intervene with and educate rural blacks who refuse to use condoms and who believe they aren’t at risk of contacting HIV. She said it’s important to get community members involved because of a stigma attached to the disease.