GMHC Lauds CDC Recommendations for Routine HPV Vaccination for Boys

Gay Men’s Health Crisis (GMHC) strongly supports the Advisory Committee of the Centers for Disease Control and Prevention on Immunization Practices’ recommendation that boys should be routinely vaccinated against the human papillomavirus (HPV).  The recommendations state that boys should be routinely vaccinated at age 11 or 12 in order to reduce the risk of genital warts and certain cancers, including anal cancer. Gardasil had previously only been approved to help prevent genital warts and certain cancers for girls and women.

Compared to the general population, gay and bisexual men are nearly 20 times more likely to get anal cancer, and men who have sex with men (MSM) who are HIV-positive are up to 40 times more likely than the general population to develop anal cancer. In light of the disproportionate risk faced by MSM, and especially HIV-positive MSM, routine HPV vaccination is a tremendously important prevention initiative that will help protect men at high-risk of HPV infections and anal cancer. Routine HPV vaccination for boys will likely lead to a reduced incidence of anal cancer over time.

“The Advisory Committee’s recommendation for routine HPV vaccination for boys will go a long way toward protecting men from certain cancers, especially gay and bisexual men and HIV-positive men” said Nathan Schaefer, Director of Public Policy at GMHC. “In recent years, GMHC has strongly advocated for the approved-use of Gardasil for boys and men to prevent anal cancer, with particular attention to HIV-positive men who have sex with men who are disproportionately affected by anal cancer.”

In December 2010, the Vaccines and Related Biological Products Advisory Committee, an advisory committee to the Food and Drug Administration (FDA), approved Gardasil for boys and men ages 9 to 26 to help prevent against genital warts and anal cancer. The CDC’s Advisory Committee new recommendation for routine vaccination is the next step in protecting men from HPV and its associated health risks.  GMHC provided written testimony in advance of the advisory committee’s meeting, urging them to approve the vaccine for boys and men.

The Rape of Men

via The Guardian by Will Storr

Sexual violence is one of the most horrific weapons of war, an instrument of terror used against women. Yet huge numbers of men are also victims. In this harrowing report, Will Storr travels to Uganda to meet traumatised survivors, and reveals how male rape is endemic in many of the world's conflicts. 

 

Dying of shame: a Congolese rape victim, currently resident in Uganda. This man’s wife has left him, as she was unable to accept what happened. He attempted suicide at the end of last year. Photograph: Will Storr for the Observer

Of all the secrets of war, there is one that is so well kept that it exists mostly as a rumour. It is usually denied by the perpetrator and his victim. Governments, aid agencies and human rights defenders at the UN barely acknowledge its possibility. Yet every now and then someone gathers the courage to tell of it. This is just what happened on an ordinary afternoon in the office of a kind and careful counsellor in Kampala, Uganda. For four years Eunice Owiny had been employed by Makerere University's Refugee Law Project (RLP) to help displaced people from all over Africa work through their traumas. This particular case, though, was a puzzle. A female client was having marital difficulties. "My husband can't have sex," she complained. "He feels very bad about this. I'm sure there's something he's keeping from me."

Owiny invited the husband in. For a while they got nowhere. Then Owiny asked the wife to leave. The man then murmured cryptically: "It happened to me." Owiny frowned. He reached into his pocket and pulled out an old sanitary pad. "Mama Eunice," he said. "I am in pain. I have to use this."

Laying the pus-covered pad on the desk in front of him, he gave up his secret. During his escape from the civil war in neighbouring Congo, he had been separated from his wife and taken by rebels. His captors raped him, three times a day, every day for three years. And he wasn't the only one. He watched as man after man was taken and raped. The wounds of one were so grievous that he died in the cell in front of him.

To read the rest of the article, click here.

South Africa: A Timeline of HIV/AIDS Activism

Zackie Achmat, Co-Founder of TAC (second from the right) and colleagues

Photo: Lee Middleton/IRIN

The struggle continues

JOHANNESBURG, 4 October 2011 (PlusNews) - In a new book, Fighting for our Lives the Treatment Action Campaign (TAC), an HIV/AIDS lobby group, looks back on more than a decade of activism. IRIN/PlusNews presents a timeline of 12 years of highlights as the group translated action into wider access to HIV treatment:

1998 – The TAC is launched on the steps of Cape Town’s St George’s Cathedral with its first campaign - calling for the provision of the antiretroviral (ARV) Zidovudine (AZT) for pregnant, HIV-positive mothers to prevent mother-to-child HIV transmission (PMTCT). The organization's first statement also urges the government to develop a plan to provide affordable treatment for all HIV-positive South Africans;

March 1999 – After starting a petition for the introduction of PMTCT services, TAC members march on one of the country's largest hospitals, Chris Hani-Baragwaneth, in Johannesburg's largest township of Soweto. TAC protesters stage a lie-in at the hospital's gate;

June 1999 – Thabo Mbeki is elected president and Manto Tshabalala-Msimang is appointed health minister, ushering in an era of “government-endorsed AIDS denialism”, according to the book. Later, a Harvard University study will estimate that Mbeki's delay in rolling out ARVs caused the death of 300,000 South Africans in the next five years;

2000 – As the TAC imports the generic version of the antifungal medication, fluconazole, in defiance of pharmaceutical company Pfizer's patent, Médecins Sans Frontières establishes the country's first ARV treatment programme at a primary healthcare clinic in the Cape Town township of Khayelitsha. (Fluconazole is often used to treat opportunistic infections such as thrush and cryptococcal meningitis);

2002 – South Africa’s Constitutional Court rules in favour of the TAC, forcing the government to provide the ARV nevirapine to pregnant, HIV-positive mothers to prevent their unborn babies from contracting the virus. Later that year, Hazel Tau lodges a complaint regarding high ARV prices with the national regulatory body, the Competition Commission. She wins this complaint a year later;

2003 – The TAC launches its civil disobedience campaign. Later that year, 21-year-old TAC member Lorna Mlofana is murdered after revealing her HIV-positive status. The man convicted of her murder served a few years in prison before being released;

2004 – Government begins the slow roll-out of ARV treatment;

2006 – The TAC wins a court case that establishes the right of prisoners to treatment. As of July 2011, about 9 percent of the country's jails have ARV clinics on site;

2008 – Government releases new PMTCT guidelines for administering more effective dual therapy instead of single ARV treatment;

Mbeki is recalled from the presidency by the ruling African National Congress and Tshabalala-Msimang is replaced. Later that year, a moratorium on ARV treatment in South Africa’s Free State province commences due to financial mismanagement. The TAC launches protests at a local hospital in the province and parliament;

November 2008 - TAC reveals it is experiencing a financial crisis that would force it to retrench 20 percent of its staff and cut back its treatment literacy programme;

2009 – Jacob Zuma, the new President, signals an end to denialism and announces improved treatment guidelines, long lobbied for by the TAC and partners;

2010 – South Africa has the biggest treatment programme in the world targeting at least one million people.





Note:  The article was originally printed in PlusNews Global on October 4, 2011.  In 2003, GMHC had the extraordinary honor of hosting a speaking program with Zackie Achmat, Co-Founder of Treatment Action Campaign, and his colleague Nonkosi Khumalo.

Condom Use Can Come of Age: HIV Affects Us All

by Nathan Schaefer and Elizabeth Lovinger

Many people find it very difficult to imagine their parents having sex. As difficult as that may seem, it is probably even harder to imagine their grandparents being sexual. This is just one example of the complexities of sexuality. Most depictions of sex, especially those referencing sexually transmitted infections (STIs) and the need for protection, are of young people. This topic, however, must quickly become part of our national discourse on aging in order to keep older adults healthy.

Many older adults, especially those who have experienced divorce or the death of a partner, don't perceive themselves to be at risk for infections like HIV. Women past child-bearing age often don't think they need to use protection during sex, since pregnancy is no longer a concern. Doctors rarely ask older adults about their sexual health or activity, and gay men are especially unlikely to discuss sexual activity with a doctor. In New York City, half of all men over 50 who were diagnosed with HIV in 2007 did not report how they became infected. Clearly, there is widespread and dangerous silence about sexual activity and HIV amongst older adults.

According to the most recent Centers for Disease Control and Prevention (CDC) estimate, by 2015, more than half of all people living with HIV in the U.S. will be over 50 years of age. This projection is partly due to the scientific advances in treatment that allow those living with HIV to live longer, healthier lives. However, it is also due to the number of new HIV infections among people aged 50 or older. What is most troubling about this trend is that the likelihood that someone will be "dually diagnosed" with AIDS at the time of their HIV diagnosis rises dramatically with age. This means that people may be living longer and unknowingly HIV-positive. This is concerning from both an individual's treatment and a public health perspective.

Unfortunately, little medical expertise exists on HIV and aging. Physicians with an expertise in both geriatrics and HIV are extremely rare, and the geriatric infrastructure in the U.S. is wholly unprepared to face this epidemic. There is almost no federal research on how HIV treatment affects aging bodies, or the modes of HIV transmission amongst people over 50. No CDC-supported prevention model for older adults currently exists, nor does a federal testing campaign. The necessary HIV prevention conversations may be uncomfortable for some, and HIV stigma may deter older adults from testing. Nonetheless, these initiatives are desperately needed.

The lack of knowledge about HIV in geriatric care has led to extensive discrimination. In 2009, an assisted living facility in Little Rock, Ark. evicted a 70-year-old retired professor and minister, Dr. Robert Franke. Although this facility, Fox Ridge, advertised "round-the-clock care" for its residents, this promise rang hollow for Dr. Franke. After a lengthy paperwork process to describe his medical history, Dr. Franke moved into the facility from Michigan, hoping to finally live nearer to his daughter. The next day, when Fox Ridge staff noticed in his paperwork that he was HIV-positive, he was asked to leave. A lawsuit helped by Lambda Legal eventually settled out of court in September 2010, but the case raised awareness about the needs of older adults living with HIV. Dr. Franke and his daughter, Sara Bowling, were recognized for their fight against HIV discrimination and spoke about their experiences at an October 2010 White House meeting on HIV and aging. Slowly, thanks to advocates like the Frankes, this long-ignored public health issue is being addressed. But there is still much that needs to be done before HIV-positive elders receive the full care and attention they deserve.

The CDC can spearhead efforts for better care and prevention by collecting data on HIV amongst older adults, the effects of HIV treatment on aging, and the prevalence of HIV in gay and bisexual men and transgender women over 50. This research could inform a CDC prevention campaign, part of which should be a social marketing campaign to end HIV stigma and anti-gay stigma in nursing homes and senior centers. As part of this effort, staff at nursing homes and senior centers should be thoroughly educated in the unique needs of older adults living with HIV, particularly those who identify as LGBT. Doctors should also be encouraged to talk to their patients over 50 about sexual health and activity, making it clear that those conversations are confidential. As uncomfortable as it may be, medical providers have to embrace that their older patients are having sex.

Congress can play a crucial role in implementing these programs through the reauthorization of the Older Americans Act (OAA). This piece of legislation allocates funding "for community planning and social services, research and development projects, and personnel training in the field of aging." The OAA must be reauthorized in 2011 for implementation in 2012, and Congress could include funding to address HIV care and prevention services. The OAA could also include LGBT elders and those living with HIV as "populations of greatest social need" for more targeted programming. As the epidemic changes, our federal response must adapt.

Many things come with age, but HIV doesn't have to be one of them.

Learn more about HIV and aging at GMHC's website, and read our in-depth report, "Growing Older with the Epidemic." 

The article was originally published in the Huffington Post, as part of a new section, "Gay Voices," on September 28, 2011

When I Started HIV Meds: Step by Step on a Difficult Road

By Lillibeth Gonzalez

I was diagnosed with HIV in July 1992. Before starting HIV treatment, my T cells were 868 and I was in great shape, but I was angry at myself for trusting my husband and not wearing protection. I thought I was going to die, and I looked at my life from a different point of view. I started to hang out and drink. I didn't keep a good health regimen. That was the most ignorant decision I ever made. Due to that choice, my T cells went down to 0. I got tuberculosis, neuropathy, wasting syndrome, and had Pneumocystis pneumonia (PCP) four times.

I've dealt with many challenges: drug abuse; alcoholism; domestic violence, psychological and physical (coming from a dysfunctional family where my dad, an alcoholic, always beat my mom, I've had boyfriends and girlfriends who used to hit me); no support system; and all the stigma. I buried my sister and two brothers; I lost all three of them to AIDS. I lost my mom to breast cancer. I felt alone. I run into many people who feel the same. But you know what? All these obstacles helped me get stronger and always come out on top.

My doctor started giving me many different meds until I found one, or five, that worked. When I started taking medications I did not adhere to my dose (another stupid choice ... it's difficult since you're not accustomed to taking so many pills daily). I became "MDR," which stands for multiple drug resistance. It was very difficult; I was angry at myself for not adhering to the medication. I had to wait for a clinical trial that fit my criteria in order to participate (that experience was a horror, since you feel like you're running out of time). I do want to say that HIV treatment has allowed me to live longer. I have been taking Epzicom (abacavir/3TC, Kivexa), Intelence (etravirine), Isentress (raltegravir), Norvir (ritonavir) and Prezista (darunavir) for the past two years and I would not change anything. They have helped me live a well-adjusted life.

My son was 9 years old when I was diagnosed, but I didn't disclose to him until he was 12 years old since I didn't want my condition to interfere with his school work. I wanted him to concentrate on going to school and pursuing college. I did not want to leave him alone. Today he's 27 years old; he graduated with a bachelor's degree and has a great job in the financial sector on Wall Street. He is happy to see that I'm still alive. He has his own apartment, car, a great circle of friends, and he travels a lot. We go out to many places together and celebrate life; we just celebrated July 4th in the Poconos.

I raised my son with great values. He doesn't do drugs or alcohol, or smoke cigarettes. I'm so proud of him; my circle of friends and family are always telling me he's such a good son. He is my greatest support system; he inspired me to do what I do today. He used to tell me a lot of times, "Mom, why don't you go out there and do something -- rather than complain about it?" So I took his advice! I changed my lifestyle, went to school, got a job, and now I love helping others empower themselves. I have done everything I wanted to do prior to getting the virus. I have gone on a vacation, on a cruise, horseback riding, and in August I'm going away again.

I have received awards for what I do, and hope to God I can help end this epidemic and get people to listen and practice safer sex, to keep as many as possible from getting infected.

I would advise people just starting HIV treatment to seek help in maintaining a healthy lifestyle. Seek a support system. Attend groups, listen to what others are saying about their experiences, ask for suggestions, ask questions, be very curious about the different types of medications and their side effects. Ask your doctor to help you find the medication that will work with your lifestyle (for example, if you're active and always on the go, get a medication that's taken once daily). Take into consideration what will work for you.

Reevaluate your priorities: What is important to you? Living a healthy life? Hiding and living in denial for the rest of your life? Do you want to be happy or do you just want to make others happy? It's all about you; you are living with a virus that can be easily controlled but you need to make the correct choices; seek help in making these choices.

I hope I can help others make a wise choice, and a healthy one. AIDS is not a disease; it's an adjustable lifestyle that can work for you if you make it work.

Lillibeth Gonzalez works as a peer health educator at Gay Men's Health Crisis, Inc. (GMHC), one of the world's first and largest providers of HIV/AIDS prevention, care and advocacy.

Lillibeth's testimony first appeared on August 17 in thebody.com.

Dating with HIV: My Experience and Thoughts

by Kevin Maloney

I am now 18 months post my dual diagnosis of HIV and Hepatitis C, and 9 months post successful Hepatitis C treatment. I thought it was time to meet someone; no, not just for sex, but for something more.  You see since my dual diagnosis I have felt completely a-sexual, and I’ll admit, feeling a bit ‘tainted’ too.  Even HIV + guys are hesitant to meet me when I tell them I also ‘had’ Hepatitis C.

So, wonderful, where does that put me in the dating scene?  Someone would really have to be desperate to meet me!  Recently I met someone by the name of ‘Dustin’. He smoked, and I said I would NEVER date a smoker, but I have been desperate to make a connection with another positive individual.  I thought I could ignore the smoke.  He was handsome, professional, similar in age, and a sweet talker, among, *uhm, other things….

I hear the knock on the door, I’m a bit nervous, I look through the blinds (pictures match), and open the door to meet him.  He reeked of smoke. We had some drinks, but all I could smell was the smoke emanating from him.  Almost immediately I had withdrawn all interest, and my body language turned very cold. He got the hint, and excused himself.

I’ve met one other person since that night, and a non-smoker! While the physical connection was there, I couldn’t allow myself to open up. Again, my body language turned cold, and he too left. Why am I having such difficulty meeting people, why can’t I open up, why does my body language turn so cold, why can’t I let anyone in? Before HIV I always had fear of rejection, having HIV compounds this fear.  I feel like damaged goods.

I am also stuck in the mindset that I would never date anyone who is HIV negative, and think how could I ever be in a serodiscordant relationship? I would not want to give to someone else what I have, no matter how small the chance. I wouldn’t wish HIV on anyone. I know that limits the pool of potentials as well.  Since day one of my diagnosis I made a commitment to myself to always disclose my HIV status when it comes to dating, maybe this is my dilemma?

I’ve allowed my emotions over my status dictate my single life. I had withdrawn and isolated from the World. I am trying to slowly build the confidence again to meet someone, and crawl out from under the shadows of my illness. As alone as I feel with my diagnosis; I hold out hope. I have been in three relationships prior to my HIV diagnosis, and one for over 2 years. I’ve traveled the world, been on many adventures, have a creative and intellectual mindset, caring, kind, honest, and have a super loveable personality.

I keep the hope of meeting someone, because I know that really loving someone means loving them for who they are and accepting the whole package.  I guess you would call that a soul-mate and I believe that person is out there somewhere.  So, today I make a commitment to myself to never settle for less than my heart’s desire. And to anyone reading this with HIV/AIDS or any other chronic illness; YOU deserve to be treated with love, kindness, sensitivity and respect and YOU shouldn’t settle for less.

 

Usually I am the one to offer tips and advice, but when it comes to dating and HIV I feel hopeless. I hope whoever is reading this will chime in.  Are you in a relationship? How long have you been together? How did you meet? How long after your diagnosis did you feel comfortable seriously dating someone?  Until next time….

Sexless in Seattle,

Kevin Maloney

Twitter: http://www.twitter.com/riseuptohiv

Facebook: http://www.facebook.com/riseuptohiv

My Experience at the 21st House of Latex Ball

By Steve Lewis

Photo by Rebecca Smeyne for the Village Voice

The Latex Ball, held this past Saturday at the crumbling Roseland Ballroom, was everything—yet it fell short. It was all that a Ball could be, but for me it was defined more by what was missing than what actually occurred. It began as all Balls do, just a little later than you can stand but as it commenced and lived, the drama and the performances were breathtaking.


To the newbies who tagged along with me, it was Nirvana, a realization of a world only glimpsed at in a Malcolm McLaren or Madonna video, or in Jennie Livingston’s 1990 documentary, Paris Is Burning.

Jennie came to The Latex Ball and said a few words. She also produced a very excellent tribute to Paris Dupree, who was the last of the “great mothers” of the Houses of the Ballroom community. Paris Dupree was missing Saturday night. Her passing and the passing of so many others this year and in recent years set a sad tone at the usually happy gathering. The short documentary captured the essence of a legend. Her attitude for the ages underscored the meaning of the whole affair. The Latex Ball is sponsored by GMHC and besides the competitions and awards and performances, they provided education about AIDS and HIV, free on-premise testing and, as far as I can tell, handed out about a million condoms to participants.

The world I live in seems to be becoming less aware of AIDS and HIV as if it were a disease that those “other” people get. It can’t affect me because I’m white, or I can’t get it because I’m older and haven’t gotten it yet, and I can’t get it because I’m straight or safe most of the time, are some of the many misconceptions we as a community have accepted. I think after decades of the crisis taking a toll on our world, we have relegated the problem to the dark corners of our consciousness and tune out the billboards and TV commercials there to help us understand. Although aggressive treatments have made survival a reality for most and living a good life possible, the stigmas and real dangers of HIV and AIDS still persist. At the Ball, speaker after speaker recounted the lost and pleaded with the audience to grasp this concept.


Missing at the Ball were the many groups of people I have seen there before. The Chelsea boys were not in the house, nor were the flamboyant crews that I’ll call the Patricia Fields, Kenny Kenny and Susanne Bartsch crowd. Even the mainstream crowd, that over many years came in to peek, didn’t show. The gathering was mostly Black and Hispanic and mostly young. It has almost always been this way but this Ball lacked the outsiders (one of which, I must have appeared to be). This happened despite a broader understanding and awareness of the House or Vogue Ball culture. Indeed, a lot was missing Saturday night but so much creativity and talent did attend. I saw some of you there and I hope you enjoyed it and discovered this universe of tradition and love that has always obsessed me. I attended my first ball in the early ‘80s and never wanted to miss another. I constantly annoy Ball community members about when the next one will occur. I will attend the KIKI Ball on October 28th. If you want to know more about this society and future Balls visit myballroomlife.com or the GMHC website.

I have lost hundreds of friends and a relative or three to the AIDS/HIV epidemic. The Ball was an important opportunity to educate young people as well as oldsters like myself on the continuing problem of the epidemic. The young Hispanic and African American crowd that were in attendance are at particular risk. I saw a statistic saying that although the African-American population represents about 10 to 13% of the American, population close to 50% of the people diagnosed with HIV/AIDS were African Americans. Although the mainstream American universe seems to be believe this scourge is something under control, the dangers still persist. Flyers and posters underscored the dangers of making bad sexual decisions while under the influence. It is true that many strains of the virus are being treated with increasing success but many individuals do not react well to treatment and the virus continues to evolve into prevention resistant strains. The Ball was sponsored by the GMHC who have always been there to support and educate. They continue to fight this good fight and deserve the recognition and our support.

The Ball was magical. The competitions were fierce and winners graciously took home their trophies and kissed and hugged those who fell short. We went through packs of throat lozenges as we screamed and jumped up and down with awe. We lived for the outfits, costumes, and ensembles. We gasped as “Voguers” leaped higher in the air than ever before. We teared up as the role of the missing and gone was recited. Someone scolded and shouted “Do not forget Willi Ninja!!!” when the list was recalled. How could Willi Ninja be forgotten? Time and numbers make us forget the unforgettable. Willi may not have invented “Vogueing,” but he took it to an undeniable place. I adored him. He was gracious and intelligent and fun. When he was at the door of the Sound Factory, or some other joint, I looked forward to chatting with him.
 
Many in the Ballroom community fought their way up from a very low place to find acceptance from the community and from themselves. The Houses provide refuge from a backward world and an opportunity to find out who they are and how to express themselves and make their mark. Leaving behind a legacy was a much discussed topic at the Ball. Names of icons, legends, and those who passed too early were recited on stage and talked about in the crowd. Paris Dupree was the last of the original five mothers of the modern Houses. She was preceded by Angie Xtravaganza, Pepper LaBeija, Avis Pendavis and Dorian Corey. Others spoke of Danielle Revlon, Catiria, Nicole Iman, Danny Xtravaganza and the recent passing of Leo Xtravaganza, Leo Milan and so many more. With all that we have learned, people are still dying too young, too soon. It’s easy to slip up, forget or risk just this once but if I took anything from the glorious 21st annual Latex Ball it was I want to see the 31st and the 41st Anniversary Ball. I pray for a time when we get to a point where GMHC isn’t involved anymore because their mission has been accomplished. Have fun, play safe.

Steve Lewis' second of two articles was posted on August 22 at blackbookmag.com