News from CDC

[Bilbo]

A CDC (Center for Disease Control) study of 5,719 men ages 15 - 29, found in a variety of locations, showed that 77% of those with HIV did not know that they were infected. Half of those had not been tested in the last year. Half did unprotected anal sex.

 

Another CDC HIV study shows that the rate of new infections is nine times higher among gay and bi men.

[chrismac]

Bilbo - thanks for bringing this survey to our attention. While I daresay most of the people who frequent and contribute to this board are both aware of safe-sex practices and employ them, it continues to shock me that so many young gay men seem oblivious to the facts on HIV and other STDs. On sites like Men4sexnow.com, mygaydar.com, etc. one can constantly find huge numbers of young men who claim to be HIV-, yet are willing to bareback and take loads. Hello? Just as sad, you see some guys only 21-25 years old who are already HIV+.

 

More and more evidence appears every day that indicates new resistant strains of HIV are on the rise. Thus, even people already infected, but who have treatable strains are at risk of becoming re-infected with a resistant strain. And yet so many of these people figure that well, "I already have it - so I'm free to engage in unprotected sex now."

 

Tragic are the stories of people who have engaged in safe practices for long periods of time, yet become infected anyway as no practice beyond abstinence guarantees 100% safety. Likewise those who finally find the love of their life, become monogamous, only to find out later that the partner lied about their HIV status and passed the virus on.

 

But what I see so much of now is just blatant stupidity. Openly inviting the virus - almost like a dare. I know the government isn't doing enough to publicly educate - but what are the gay community organizations doing to fill in the void? What, indeed, is it going to take for young people (and some older ones as well) to wake up?

 

:'(

[guyinsf]

For those of you who have not already heard of (or read) the book "Sexual Ecology" by Gabriel Rotello, I highly recommend this book. It has its flaws but I think Rotello's basic argument is persuasive.

 

I hope this summary isn't too far off-base: The decrease in new HIV infections in the "modern world" has little to do with HIV prevention efforts and more to do with "natural selection." HIV had already infected most of a certain age cohort who were likely to become infected. (These people were more likely to become infected for a variety of reasons, including the choice to have unprotected sex with multiple partners, the preference for sexual activities with an inherently higher risk factor, IV drug use, etc). A certain percentage of the age cohort was very unlikely to become infected (those who always chose to have few sexual partners, those who always preferred certain sexual practices which were inherently "less risky" in terms of disease transmission, etc). Once the virus approaches "saturation" in a given population, the transmission rate declines. Then, as a new generation of people become sexually active, HIV again spreads through this age cohort, resulting in a steady increase in HIV infections until the saturation point for that age cohort, after which another decline in infections will happen.

 

This really is a gross oversimplification of Rotello's theory, and I read the book about 5 years ago so I'm a little fuzzy on the details now. I cannot recall his statistical analysis, but it was well thought out and presented.

 

What is terrible is that HIV infection patterns in the gay community in the US are following the ebb and flow that Rotello describes. If his prediction is true, things are likely to get much worse before they begin to get better again (barring a real "cure" being found). While some attribute increased risk-taking behavior to the availability of "better" treatment options, I don't think it's the entire story.

 

I never did believe that the predominant prevention messages (use a condom every time or abstain from sex) were very effective except for a certain (small) percentage of people, just as "just say no" has not resulted in a decline of teen pregnancies. Both responses are very simplistic and do not take into account the complexity of human thought, emotion, and behavior as well as the societal influences. I am not implying that these prevention efforts should be scrapped altogether but I do believe that alternative responses are also required.

[chrismac]

Guy - an interesting premise that makes a certain amount of sense. I have heard much anecdotal evidence that many young gays today think that they can get HIV, just take a pill or two a day, and that's that. No big deal. That's what is so shocking to me. You have the youth factor that believes they are invincible anyway, plus there are the messages out there from barebacking sites that makes the practice seem hot and desirable at the same time.

 

But I agree with the saturation theory. The pity (and hope, I suppose) is that most of the natural selection is based on an individual's choices rather than the inevitability that some will contract the virus and some will not out of no choice of their own.

[Guest wndrwoman]

>You have the youth factor that believes they

>are invincible anyway, plus there are the messages out there

>from barebacking sites that makes the practice seem hot and

>desirable at the same time.

 

 

Yes, and what I've always heard in my field (mental health) is the theory that 20 year olds don't have the same experiences that (now) 40 years olds had: of watching friends and partners die agonizing deaths from HIV.

It's great that there are newer treatments out there but it gives false confidence leading to high-risk behaviors.

[Guest seraph250]

Thank you for mentioning this.

 

It is a little strange that this thread is right next to another one that celebrates the joys of swallowing semen.

[chrismac]

More sobering news, out today from the Worldwide HIV/AIDS conference taking place in Barcelona:

 

http://www.cnn.com/2002/HEALTH/conditions/07/07/aids.us/index.html

[+ deej]

<<just as "just say no" has not resulted in a decline of teen pregnancies>>

 

Since it was a campaign against teenage drug abuse, I'm not surprised it hasn't reduced teen pregnancies. ;-)

 

Like you, I think the current "message" isn't enough. But another thing I think has happened is that over the last 20 years we've become jaded and aren't necessarily reinforcing the message with the vigor we once did.

 

The American Cancer Society is relentless in their anti-smoking campaigns precisely because more young people are "coming of age" all the time so the message needs to be there ALL THE TIME. It's the same with the safer sex message.

[chrismac]

>The American Cancer Society is relentless in their

>anti-smoking campaigns precisely because more young people

>are "coming of age" all the time so the message needs to be

>there ALL THE TIME. It's the same with the safer sex

>message.

 

Absolutely absolutely absolutely! That's my BIG question: where is the "gay community", if there is such a thing, on this issue? I'm not hearing much. I do see a lot of sites glorifying unsafe behaviour. Is it axiomatic that the next generation MUST go through the level of wasting and dying that the previous one did?

 

The reason ants don't have civilizations is because they die every year, and the next generation of ants has to start all over again. I'm beginning to think the so-called "gay community" is if anything at all, a colony of ants.

[Will]

Yes. See also the front page of the New York Times for today (July 8). You can get it online at http://www.nyt.com

[Will]

Sorry, that's http://www.nytimes.com

[+ deej]

>>The American Cancer Society is relentless in their

>>anti-smoking campaigns precisely because more young people

>>are "coming of age" all the time so the message needs to be

>>there ALL THE TIME. It's the same with the safer sex

>>message.

>

>Absolutely absolutely absolutely! That's my BIG question:

>where is the "gay community", if there is such a thing, on

>this issue? I'm not hearing much.

 

Well, I do my fair share. :-) I spend an inordinate amount of time (programming websites, helping out during events, etc.) supporting my pal Will Clark and his relentless fundraisers and events supporting AIDS charities and AIDS awareness.

 

The problem is particularly acute in the adult industry. Will has actually received death threats if he doesn't "shut up already" on the topic of safe sex. (I kid you not!)

 

There are large and very vocal factions in the "gay community" that don't WANT the topic of safe sex to get attention. They'd rather treat it like a 'dirty little secret'.

 

You can do your part. There are outreach programs, community support programs, etc., all over the country that are attempting to get the message out loud and clear. Find one in your area and donate something. It doesn't have to be money (although they typically need it pretty badly). It can be time. It could be a computer you've just replaced. Whatever they need. Ask them. They'll tell you.

 

There *are* people trying to get the message out. Support them.

[chrismac]

>There *are* people trying to get the message out. Support them.

 

Good point deej. I know many individuals (you and myself included) spend our time and what money we can to help in fighting the spread of HIV and other STDs. It's unfortunate, however, that there isn't a more organized effort now, as there was in the past, to get the message out in a much more public and vocal way.

 

Sometimes you feel your voice and actions are being drowned out, and not heard by the new generation. I've actually had young guys tell me that HIV is "no big deal". It's "not a death sentence after all". Thankfully for most it is not, but there is a huge misperception out there that the new drug therapies work for everyone, side effects are minimal, blah blah blah.

 

Oh well, enough of the soapbox.

[+ deej]

>Sometimes you feel your voice and actions are being drowned

>out, and not heard by the new generation. I've actually had

>young guys tell me that HIV is "no big deal". It's "not a

>death sentence after all". Thankfully for most it is not,

>but there is a huge misperception out there that the new

>drug therapies work for everyone, side effects are minimal,

>blah blah blah.

 

It does feel like a losing battle some days. <sigh>

 

Number of AIDS cases worldwide: 40 Million +

Number of cures to date: Zero

 

I just keep reminding people of that last statistic.

 

I was really glad to see the national news covering the announcements coming out of Barcelona mentioned elsewhere in this thread. ANY public announcements are good.

[guyinsf]

I wasn't intending to imply that the campaign was titled "Just Say No." I just used that phrase to describe the strong abstinence message that is delivered to teens. Denying that teenagers are sexual beings and that many WILL chose to have sex, ignoring or giving short shrift to birth control (and disease prevention) puts teens at higher risk for STDs and unwanted pregnancies.

[Barry]

>Sometimes you feel your voice and actions are being drowned

>out, and not heard by the new generation. I've actually had

>young guys tell me that HIV is "no big deal". It's "not a

>death sentence after all". Thankfully for most it is not,

>but there is a huge misperception out there that the new

>drug therapies work for everyone, side effects are minimal,

>blah blah blah.

 

Also from Barcelona:

 

Resistance to nonnucleoside reverse transcriptase inhibitors climbed from zero in 1996 to 13.2% in 2001. Resistance to protease inhibitors climbed more than 5% during the study period, from 2.5% of patients in 1996 to 7.7% in 2001. The worst resistance was seen among nucleoside reverse transcriptase inhibitors, the oldest anti-HIV drug class that includes AZT, the first anti-HIV medication. Resistance to these drugs climbed from 7% in 1998 to 21% in 2001. "I think we are going to see continued increases [in resistance] over the next two years," warned Hecht.

 

The scientists blamed at least part of the problem on complacency among members of groups at high risk for HIV infection, including gay and bisexual men, who are engaging in unprotected sex more frequently and spreading drug-resistant strains of HIV to those newly infected. Hecht also said the resistance problem is being fueled by a growing misconception that currently available anti-HIV medications can easily control HIV infection. 'That idea needs to be called into question because some people are becoming infected with (a strain of) virus that is going to be much more difficult to treat," Hecht said.

[Bilbo]

I would ask that everyone urge all of the young (not necessarily gay) men you know (not necessarily sexually) to get tested twice a year. If we push twice, hopefully it will at least happen once. And it may seem strange considering what other risks they might be taking (no need to ask) that they might be avoiding needles. So one could at the same time tell them about the new tests that don't involve flebotomists. They work off of a saliva sample. In fact, you could sidle this into almost any conversation by first mentioning that there is a new saliva test. Perhaps enough people will not have heard about it and it will look for a second like the introduction of anything novel into the conversation.

[chrismac]

Bilbo - do you have any data on how accurate the new saliva tests are, compared to the Elisa and PCR tests?

[Barry]

>Bilbo - do you have any data on how accurate the new saliva

>tests are, compared to the Elisa and PCR tests?

 

HIV rapid testing has been found to be just as accurate as the EIA blood test. If someone tests positive they still have to go through the full battery of confirmatory tests.

 

With all tests the presence of HIV antibodies will often not be detected for an average of 25 days following infection so you can get false negatives.

 

Barry

[Bilbo]

Sure glad that Barry knew all that, I sure didn't, I'm just a nosy actor and semiretired callboy trying to take the semi out of that again.

 

"Have you heard about the new doctor doll? You wind it up and it operates on batteries." :+