Tuesday, June 21, 2011

AIDS and young MSM

 

http://daleoleary.wordpress.com

The Band Plays On

Dale O'Leary

June 2011

 

            It has been 30 years since the first reports of a strange new disease that was killing gay men. This June the CDC issued its annual report on the AIDS epidemic and the news is not encouraging. In spite of all the efforts at prevention, the number of HIV infections identified in men who have sex with men (MSM) continues to rise and the trend is even more ominous among young MSM and black MSM. In 2008 in the 40 states that report to the CDC, 6,071 MSM died of AIDS (This report does not include the states of CA, OR, WA, MT, VT, MA, MD, DE). Of those newly diagnosed with HIV, 77.8% were MSM.[1]

            Efforts at prevention of HIV infection among MSM have failed and yet those in charge keep calling for more of the same. The reason for the failure is simple: gay AIDS activists have from the very beginning of the epidemic opposed every proven public health strategy for preventing the spread of a sexually transmitted disease.

            Randy Shilts, a reporter who later died of AIDS, chronicled the early years of the epidemic in his monumental work, As the Band Played On. If you aren't up to plowing through the 600 pages of Shilts' book, rent the movie. Both document the failure by so many to respond appropriately to this deadly threat. While the gay AIDS activists want to blame the government for not acting quickly and funding research adequately, there is enough blame to go around. The book and film make it clear that the gay community itself fought common sense measures to save lives.

            Near the end of the book Shilts writes:

 

"Although the gay AIDS activists were fond of lecturing people that 'AIDS is not a gay disease,' they had in fact treated the epidemic almost solely as a gay disease, the private property of a community that would base public health policy on its political terms. [2]

            Their political terms were simple: they would accept no measure which limited their sexual freedom; they were more afraid of discrimination than the disease;

             Those at the CDC charged with tracking the epidemic recognized immediately that gay bathhouses operating in major metropolitan areas were facilitating the rapid spread of the yet unnamed disease. When it was suggested that bathhouses in San Francisco be closed, the gay community fought back. They absolutely refused to consider any strategy which undermined their absolute sexual freedom. While the bathhouses eventually did close because customers stop coming, the gay community merely switched to circuit parties – giant weekend gatherings were sex and drugs were a key attraction – and internet hookup sites like Manhunt.

            When it was clear to the experts that the disease was spread by blood products, gay AIDS activists fought restrictions on blood donations by MSM. As a result, 1000s of transfusion recipients and hemophiliacs were infected before the blood banks finally acted.

            When a test for HIV infection was available, gay AIDS activists were more worried about confidentiality than saving lives. They opposed routine testing, contact tracing, and partner notification – strategies used for other STDs.

            The gay AIDS activists insisted that condoms were the solution, even though every study found that even after intensive education those engaging in high risk behavior usually failed to use condoms consistently over time.

            Gay AIDS activists pushed educational programs for school children, programs which often focused more on promoting the gay agenda than preventing disease. The failure of these programs is apparent. According to the latest CDC surveillance report:

 

From 2006 through 2009, among adult and adolescent males, the annual number of diagnosed HIV infections attributed to male-to-male sexual contact increased… From 2006 through 2009, the rates among persons aged 15–19 and 20–24 increased.[3]

 

            As a result of the gay AIDS activists' political pressure, AIDS in the US is still a gay disease.

            But it gets worse: 42% of the newly infected MSM are black and 63% of the newly infected age 13-24 are black Why is there no outcry from those who play race politics? Why are black men disproportionally becoming infected? Are they more likely to have sex with men? Is the fact that black men are more likely not to live with their biological father a cause? Are black men more likely to be victims of childhood sexual abuse? Are they more likely to engage in hustling (prostitution)? Are they becoming infected in prison?

            And even worse, a study of unrecognized HIV infection among young MSM found that 77% of those infected did not know they were carrying the disease and could therefore spread it to others. Among young black MSM, 91% did not know they were infected.[4] And young black MSM are more likely to also have sexual relations with women thus spreading the disease to female partners and children.[5]

            It is long past time to take AIDS prevention away from the gay AIDS activists and start using proven STD prevention strategies: mandatory testing on all those with other STDs, contact tracing, partner notification, and real AIDS education. It's time to stop the music.

 



[2] Randy Shilts,  And the Band Played On, (NY:  St. Martins, 1987) p.550

[4] Duncan MacKellar, et al., "Unrecognized HIV infection, risk behaviors, and perceptions of risk among young men who have sex with men," Journal of acquired Immune Deficiency Syndrome, (2005) 38 (5): pp. 603-614

[5] Gregorio Millett et al., "Focusing 'Down Low': bisexual black men, HIV risk, and heterosexual transmission," Journal of the National Medical Association, (2005) 97 (7): p 525-595.

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