AIDS 2012: Meet Rig

via BETA, by San Fransisco AIDS Foundation

Rig Rush of the Black AIDS Institute is the “mobilization coordinator of everything gay black male,” an advocate of better and earlier sex education for youth—and a volunteer in a rectal microbicide trial.

Throughout the MTN-007 study, which looked at the safety and acceptability of a gel containing the HIV drug tenofovir (Viread), Rig had regular HIV tests, answered questions about his sex life, underwent rectal exams and uncomfortable biopsies—and helped bring another HIV prevention tool one step closer.

The charming Mr. Rush spoke with BETA about his experience in the trial, his advice for others considering joining a microbicide study, and what words of wisdom he would give to his younger self if he could.

Rig was also featured as one of IRMA's Friendly Rectal Microbicide Advocates.  Check it out here.

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*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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U.S. Policy Addresses HIV Epidemic in the LGBT Community

via HuffPost, by Charles Stephens

We finally are starting to scratch the surface of the depth of the HIV crisis among young black men who have sex with men (MSM). Late last summer the Centers for Disease Control and Prevention (CDC) announced the most recent HIV incidence numbers, indicating that young, black MSM were the only population in the United States that showed an increase. In the three-year period between 2006 and 2009, there was an almost 50-percent increase in HIV incidence in that group.

This information was startling. Those of us working in the field had suspected that the HIV incidence numbers among young, black MSM would be disproportionately high. But to know it, to hear it confirmed, was shocking. For a few months after the updated HIV incidence numbers were announced, there seemed to be a collective gasp, even as we struggled to crank out solutions. And since then there has been a persistent conversation among many sectors of the HIV prevention realm about next steps. Just what are we going to do next?

So it was this spirit of persistence to find answers that many of us brought to the White House LGBT Conference on HIV/AIDS in Atlanta, Ga. on April 19. Held at the Morehouse School of Medicine, the conference was as well attended as it was ambitious. On the campus of a historically black college, in a historically black community, the symbolism was as rich as it was breathtaking. Those of us who attended assembled dutifully, with both grace, because we were called, and urgency, because of the calling. Several White House officials, including Dr. Grant Colfax, the new director of the Office of National AIDS Policy, as well as numerous HIV experts, gathered to talk about the HIV epidemic today in LGBT communities.

Two groups that entered almost every conversation were young MSM and transgender populations. Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, shared his insights about the social and structural drivers of HIV, particularly among vulnerable populations and sexual minorities. He affirmed the commitment of the CDC to LGBT communities and announced some of the agency's next steps, including a roll-out of additional social marketing campaigns.

Homophobia must frame how we think about the devastating impact of HIV. This was a key insight to the entire conference. Anti-gay stigma, HIV stigma, and environments that dehumanize and demean sexual minorities and gender-nonconforming people create a perfect storm for HIV and other public health disparities. Young, black MSM and transgender people are vulnerable in a variety of ways, including to physical and psychic homophobic violence, familial and community rejection, discrimination, and a litany of other kinds of social stigma. These vulnerabilities fuel health disparities, particularly with regard to HIV. As Dr. Patrick Sullivan, an Emory University professor and researcher, stated, "homophobia is a public health hazard." In this sense, the scientific and social, negative health outcomes and human rights and, by extension, sexual rights, are not separate spheres but are intricately connected within a wider spectrum of issues we must work on together, and not separately.

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[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.]

U.S HIV Funding for Gay and Bisexual Men May Cause Concerns

via Funders Concerned About AIDS, by Sean Cahill



Over the past few years we have witnessed a number of advances in science-based HIV prevention and care policy and LGBT health policy in the U.S.

We have a first-ever National HIV/AIDS Strategy that prioritizes reducing the disparity affecting gay and bisexual men—who were 64% of new infections in 2009, although just 2% of the adult population.

We repealed a number of counterproductive policies dating back to the dark days of the 1980s and Senator Jesse Helms, such as ending the HIV entry ban, ending the ban on using federal funds for syringe exchange, and ending funding for abstinence-only-until-marriage education. Unfortunately, the latter two changes were short-lived. And we’ve seen long overdue increases in funding for Ryan White care, the AIDS Drug Assistance Program, HIV prevention through the CDC, and research at NIH, including promising biomedical prevention research.

In LGBT health policy—an overlapping area of concern as about 600,000 people living with HIV in the U.S. are gay and bisexual men and transgender women—we’ve got a public health strategy, Healthy People 2020, that prioritizes for the first time ending LGBT health disparities. President Obama has guaranteed hospital visitation rights for same-sex partners, offered domestic partner health insurance to civilian federal employees, and Secretary Sebelius is adding a sexual orientation question to the National Health Interview Survey. This is all great news, and we are grateful to our allies in government who have worked with community leaders to accomplish these important advances.

However, as the HIV epidemic among gay and bisexual men, and especially Black gay men, rages—with 30,000 gay men newly infected each year, 60% of them Black and Latino—federal government funding targeted toward gay and bisexual men and transgender women is not matching the demographics of the epidemic. Furthermore, critically needed, bold policy initiatives that address key structural drivers of vulnerability among gay men are lacking.


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[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.]

Treatment outcomes among different ethnic groups similar for UK gay men

via Aidsmap, by Michael Carter

HIV treatment outcomes among gay men in the UK are similar across ethnic groups, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

The study showed that gay men from black and minority ethnic (BME) populations were approximately 17% less likely to initiate antiretroviral therapy than white gay men. However, after starting treatment there were no differences by ethnicity in treatment outcomes.

“The provision through the NHS [National Health Service] of publicly funded HIV care with universal access has resulted in equitable utilisation and outcomes of HIV care across different ethnic MSM [men who have sex with men] groups,” comment the investigators. “Nevertheless we have shown that there are disparities in the uptake of cART [combination antiretroviral therapy] and the reasons for this warrant further study.”

Gay men remain one of the groups most affected by HIV in the UK. Prevalence of the infection differs significantly according to ethnicity and is higher among BME gay men compared to white gay men.

US research showed that differences in health insurance status meant that MSM from minority racial populations were less likely to access healthcare compared to white MSM.

In the UK, however, the NHS provides universal and equitable access to healthcare. Despite this, there is some evidence suggesting that BME patients are more likely to report dissatisfaction with their care and longer waiting times for appointments.

Investigators from the UK Collaborative HIV Cohort (UK CHIC) therefore analysed differences in retention in HIV care, uptake of antiretroviral therapy and HIV treatment outcomes between MSM according to ethnicity.

The study involved 16406 gay male patients who received care between 1996 and 2008. The analysis of HIV treatment utilisation was restricted to individuals who were seen after 2000. Examination of treatment outcomes was restricted to the subgroups of individuals who received care after 2007.

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[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.]

Fearing No Evil

Via Poz, by Regan Hofmann with Oriol R. Gutierrez Jr.

David Kuria works for the Gay and Lesbian Coalition of Kenya where he risks his life daily to provide safe sanctuary and advocacy for the rights of lesbian, gay, bisexual and transgender people in Africa and around the world.

Now, he is running for Kenya’s Senate. A basic tenet of his work is showing that a global push for gay rights helps bolster the fight against HIV. His dream? A day when no LGBT person has to choose between being openly gay—or being killed.

In October 2009, David Bahati, a member of Uganda’s parliament, proposed an “Anti-Homosexuality Bill” (a.k.a. the “kill the gays bill”). It was an attempt to legalize a phenomenon spreading around the world: hate crimes against gay people.

Homosexuality is currently illegal in Uganda (and can result in up to a 14-year jail sentence); Bahati’s proposed bill intensifies the criminalization of homosexuality by introducing the death penalty for people who have previous convictions, are HIV positive, or engage in same-sex acts with people younger than 18. The bill also includes provisions for Ugandans who engage in same-sex relations outside the country—people can be sent back to Uganda for punishment.

Not that there are many safe places to go; laws against same-sex relations exist in nearly 80 countries. Finally, the bill outlines penalties for individuals, companies, media organizations or nongovernmental organizations that support LGBT rights. (As in, if you know your neighbor’s gay and don’t say so, you can get into huge trouble yourself.) It engenders nothing short of a witch hunt.

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[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.]

Today is National Black HIV/AIDS Awareness Day

National Black HIV/AIDS Awareness Day, February 7th of every year, is a national HIV testing and treatment community mobilization initiative targeted at Blacks in the United States and the Diaspora. There are four specific focal points: education, testing, involvement, and treatment. Educationally, the focus is to get Blacks educated about the basics of HIV/AIDS in their local communities. Testing is at the core of this initiative, as it is hoped that Blacks will mark February 7th of every year as their annual or bi-annual day to get tested for HIV. This is vital for those who are sexually active and those at high risk of contracting HIV. When it comes to community and organization leadership, getting Blacks involved to serve is another key focus. We need Black People from all walks of life, economic classes, literacy levels, shades and tones as well as communities (large and small) to get connected to the work happening on the ground in their local areas. And lastly, for those living with HIV or newly testing positive for the virus, getting them connected to treatment and care services becomes paramount.

Learn more.

[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.]

Is Homophobia a Factor in the HIV Racial Gap?

from Reuters, by Amy Norton

Among gay men in the United States, blacks are more likely than whites to believe that homosexuality is "wrong" - and these feelings might be contributing to the black men's higher risk of HIV infection, researchers suggest.

According to the U.S. Centers for Disease Control and Prevention, in 2006 African-Americans accounted for nearly half (45%) of new infections in the 50 states and the District of Columbia. Also, according to recent estimates, they account for a disproportionate 24 percent of reported HIV cases among gay and bisexual men in the U.S. The reasons are not clear. Studies have not found a higher rate of risky sexual behavior among black men versus white men -- but a range of factors are likely at work.

The current study was an attempt to look at one possible social factor: the stigma attached to homosexuality.

Using data from a U.S. health survey conducted periodically since 1972, the researchers found that, in general, African-Americans were more likely than whites to report a negative attitude toward homosexuality.

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Elevated HIV Prevalence Despite Lower Rates of Sexual Risk Behaviors

from AIDS Patient Care and STDs, by Magnus et al.

The District of Columbia (DC) has among the highest HIV/AIDS rates in the United States, with 3.2% of the population and 7.1% of black men living with HIV/AIDS. The purpose of this study was to examine HIV risk behaviors in a community-based sample of men who have sex with men (MSM) in DC.

Data were from the National HIV Behavioral Surveillance system. MSM who were 18 years were recruited via venue-based sampling between July 2008 and December 2008. Behavioral surveys and rapid oral HIV screening with Western blot confirmation on positives were collected. Factors associated with HIV positivity and unprotected anal intercourse were identified. Of 500 MSM, 35.6% were black. Of all men, 14.1% were confirmed HIV positive; 41.8% of these were newly identified HIV positive. Black men (26.0%) were more likely to be HIV positive than white (7.9%) or Latino/Asian/other (6.5%) men. Black men had fewer male sex partners than non-black, fewer had ever engaged in intentional unprotected anal sex, and more used condoms at last anal sex. Black men were less likely to have health insurance, have been tested for HIV, and disclose MSM status to health care providers. Despite significantly higher HIV/AIDS rates, black MSM in DC reported fewer sexual risks than non-black.

These findings suggest that among black MSM, the primary risk of HIV infection results from nontraditional sexual risk factors, and may include barriers to disclosing MSM status and HIV testing. There remains a critical need for more information regarding reasons for elevated HIV among black MSM in order to inform prevention programming.

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Community meetings on National HIV/AIDS Strategy

via National Black Leadership Commission on AIDS

As part of his National HIV/AIDS Strategy, President Barack Obama  mandated that Executive Branch departments and agencies with HIV/AIDS programs come up with an implementation plan for the strategy within  150 days (by Dec. 9). The National Black Leadership Commission on AIDS,  in collaboration with other national organizations and local leaders, is hosting community meetings in New York, Washington, D.C., Jackson, Miss., Atlanta, Los Angeles and Detroit from Sept. 16 to Oct. 12.

The purpose of the meetings  is to elicit input and recommendations to ensure that the National HIV/AIDS Strategy adequately addresses the unmet prevention, treatment and care needs with the African-American community. We are seeking participation in these meetings from clergy, health practitioners, persons living with HIV/AIDS, community-based organizations, direct service providers, community activists, policy makers and other concerned citizens.
More information

Malawi: Judge convicts gay couple

via Associated Press, by Raphael Tenthani

BLANTYRE, Malawi — A judge convicted a gay couple in Malawi Tuesday of unnatural acts and gross indecency after a trial that drew worldwide condemnation of this southern African country's colonial-era laws on homosexuality.

The verdict is "extremely disturbing," said Michaela Clayton of the Namibia-based AIDS & Rights Alliance for Southern Africa, saying it could encourage anti-gay sentiment in the region as well as set back the fight against AIDS. Gay people forced underground in Africa are unlikely to seek counseling and treatment for AIDS, she and other activists said.

 

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Should we care about MSMs?

via Jamaica BSERVER, by Patricia Watson

"The threats of criminal indictment and socio-religious discrimination against man-to-man sexual relationships have contributed to the increased vulnerability of MSMs to HIV," said Cruickshank.

 "Consequent to such discrimination, many MSMs are afraid of going to a pharmacy to purchase condoms and personal lubricant which are sometimes so precariously placed close to the cashier, in full view of other customers. Hence, negotiation of safe sex becomes seriously compromised."

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Prepping for a prevention trial, and unexpected homophobia

Prepping for a PrEP trial
Critical observations before the study even begins
via Positively Aware, by Keith R. Green

I asked him how he addressed homosexuality during his church prevention work. His response made my head spin.

I recently accepted a position as Project Director for a research study designed to assess the initial acceptability and feasibility of a pre-exposure prophylaxis (PrEP) trial among young men who have sex with men (YMSM) in Chicago.

The concept of PrEP, in a nutshell, involves administering medications used in the treatment of HIV (particularly Viread or Truvada at this point) to “high risk” HIV-negative individuals, in hopes of preventing transmission of the virus. Several PrEP trials are currently underway across the globe, many of which will likely demonstrate the efficacy of both Viread and Truvada as biomedical interventions for the prevention of HIV.

Though young men who have sex with men, particularly those of color, continue to contract HIV at alarming rates, these current trials ironically have very few young men enrolled in them. Therefore, if in fact these studies are able to prove the effectiveness of PrEP, we will know very little about its implementation within the population that could benefit most from this technology. The PrEP study that I am involved with seeks to provide some insight into this.

For this study, we will attempt to recruit 99 YMSM between the ages of 18 and 22, and to follow them for six months.

There are three separate arms in the study. All participants will go through an intensive evidence-based behavioral intervention and then be randomized to one of three groups. One group will receive once-daily Truvada, another group will receive a placebo (or sugar pill), and yet another group will receive nothing. Participants will be regularly monitored for HIV seroconversion, behavioral disinhibition (getting buck wild sexually because they feel that they are protected by PrEP), and any adverse effects (among a host of other things).

Aware of my search to hire research assistants who will largely be responsible for recruiting and retaining participants, a close friend recommended a friend of his for one of the positions. Trusting the judgment of my friend, I followed up on his recommendation and called his friend to arrange an interview.

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Where are the black gay men?

via Housing Works

Two weeks ago individuals and organizations across the nation marked National Black HIV/AIDS Awareness Day. Judging by many of the articles, press releases and events commemorating the day, however, you might never guess that the highest percentage of new HIV infections in 2006 was among black gay men.

Why, even on a day dedicated to black AIDS awareness, do black gay men remain a footnote?

“It’s symptomatic of the problem we face of ridding our community of HIV in order to break the back of the epidemic,” said Ernest Hopkins, policy director of the Black Gay Advocacy Coalition. “The most heavily impacted population by percentages is black gay men. If you want to talk about this epidemic you have to start there, and then move very quickly to black women, or you’re not doing your job.”

Two events that got advocates talking were the National Black Leadership Commission on AIDS (NBLCA)’s forums in New York and in Washington, D.C. (the latter included black ministers from the D.C. area).

The New York forum extensively covered women, incarceration and drug use, while gay men and homosexuality were mentioned in passing and only as they related to women being infected by men who have sex with men. The theme of the BLCA event was “HIV/AIDS and Black Women,” but the question remains why, on National Black HIV/AIDS Awareness Day, one of the highest profile African-American groups failed to address the most-affected black demographic.

“A lot of us left the session angry and we weren’t sure why,” said Kristin Goodwin, Housing Works Director of New York Policy and Organzing. “There was nothing wrong on the surface, but it was distressing the way the event made women seem like victims and didn’t even account for gay men who don’t have sex with women.”

NBLCA President C. Virginia Fields told the Update that her speech at the event was intended to be broad-based. “I was focused on the community. I think when you talk about the disease, you talk about all people,” she said, adding that there was particular focus on women and children because “that’s the population I find often does not get mentioned.” Fields also said that “it’s crucial that black gay men be part of the conversation not just around AIDS, but making homophobia unacceptable.”

Celebrity scandalette

Another Black AIDS Day dust-up involved Sexuality Information and Education Council of the United States (SIECUS), which solicited its board member, ER star Gloria Reuben, to write an op-ed for Huffington post about AIDS in the black community and the need for comprehensive sex education.

People were upset because Reuben didn’t mention gay men, or men period, in her piece.

“HIV/AIDS in this country is a man’s disease – about ¾ of the epidemic – most of which is among gay men of all races, and particularly among gay black men and gay Latino men. Not mentioning this fact in one sentence, or even a phrase, is absolutely unacceptable,” Jim Pickett of the AIDS Foundation of Chicago wrote in a message to the Federal AIDS Policy Partnership (FAPP) listserv.

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