Posts Tagged As: HIV/AIDS Prevention

Malawi Religious Leaders Spurn HIV/AIDS Outreach to LGBT Community

Jim Burroway

March 15th, 2011

Fr. George Buleya, Secretary General of the Episcopal Conference of Malawi

From Malawi’s Nyasa Times, we get this report about statements made by that nation’s Anglican Catholic and Muslim leaders concerning HIV/AIDS prevention, treatment and other outreach programs for the local LGBT community. Fr. George Buleya,  Secretary General of the Episcopal Conference (Roman Catholic) of Malawi said:

“I believe that there are no homosexuals who are born as such in Malawi but if at all there are some who claim to be, they are moved to do so because of poverty. By the way, why are you forcing us to accommodate homosexuals when there are many thieves, adulterers and a lot of people who do evil?

“Christianity does not work on sociology but morality. To us, we cannot punish those caught in the act but God will,” he said.

Questioned that this might as well retard their fight against the Hiv/Aid pandemic because they will not be able to reach out to the minority groups, Buleya said:  “Our effort is to reach out to the faithful and if they are not within our jurisdiction, then, we will not work with them.”

Interesting. For Buleya, the LGBT community isn’t even an opportunity for missionary work.

Muslim Association of Malawi (MAM) Secretary General Sheikh Imran Sharif Mohammed’s position is even worse:

“Homosexuality is sin and is punishable by beheading. The Holy Koran clearly states that any community which indulges in these acts is calling for calamities like those that happened to Sodom and Gomorrah,” said Mohammed, a lecture at the University of Malawi’s Chancellor College.

“Nobody can change our laws which are both in the Koran, as a primary source and Hadith as our secondary source. These people are enemies and there is no way we can condone them in our communities,” he added.

HIV test results in one minute

Timothy Kincaid

December 17th, 2010

The FDA has approved an HIV testing kit that gives results in one minute. The highly accurate (99.8%) test involves a finger prick, three solution process that gives results about as easy to understand as a pregnancy test (one blue dot, negative; two blue dots, positive).

I remember when test results took weeks – long, long weeks – and still now it can be an agonizing twenty minutes even for those who have no real reason to be concerned. And while there are testing vehicles on the street in West Hollywood every weekend, I’m sure that a 20 minute wait negatively impacts their draw.

But with one-minute responses, I suspect that there will be an increase in those who are willing to be tested and a reduction in the anxiety of those who do.

Another ill-contrived circumcision study

Timothy Kincaid

December 8th, 2010

Should there be any researchers reading, let me give you a bit of advice: gay sex and straight sex are not identical. While most heterosexual men do not have penises inserted into their anuses with regularity, this is not an uncommon part of the sexual practices of many gay men.

And further, the easiest way that a gay guy can become infected with HIV is through anally receptive unprotected sex. That isn’t new, surprising, or even contested.

Yep, HIV transmission among gay men in the US is primarily due to taking it bare up the butt. And any research which seeks to understand factors contributing to HIV transmission which does not consider that simple fact is a complete waste of money and time.

And today we get word of yet another Wasted Money Study on whether circumcision impacts HIV transmission between gay men. Reuters:

In a study of more than 1,800 men from the U.S. and Peru, researchers found that overall, the risk of contracting HIV over 18 months did not significantly differ between circumcised and uncircumcised men.

Over the study period, 5 percent of the 1,365 uncircumcised men became HIV-positive, as did 4 percent of the 457 circumcised men, according to findings published in the journal AIDS.

Well, gee, that information would be useful to know… if the study wasn’t conducted in a mind-numbingly stupid way.

Because, you see, that study doesn’t take into consideration whether the men were engaging in receptive or penetrative anal sex. I just assumes that gay men pass HIV to other gay men in some unknown and mysterious manner. Maybe by osmosis.

Well guess what? It really doesn’t matter one iota whether a bottom’s penis is circumcised, pierced, tattooed, or wearing a funny hat if he has semen up his butt. And any study that focuses only on whether a penis is circumcised – but not what you’re doing with it – is going to provide useless information.

I will give this study partial credit for even wondering, as a side note, whether circumcision impacts the transmission of guys who are using their penises in penetrative anal sex. And while they couldn’t bother to craft a study that looked at that issue, they did at least ask. Kinda.

And guess what?

The researchers did find some hints that circumcision could be protective among men who primarily had insertive sex with other men. Among men who said they’d had insertive sex with their last three male partners at least 60 percent of the time, circumcision was linked to a 69 percent lower HIV risk.

That difference, however, was not statistically significant, which means the finding could be due to chance.

But the truly stupid aspects of this Wasted Money Study isn’t limited to having no concept whatsoever about how HIV is transmitted. It also made these glaring errors:

Male circumcision is far more common in the U.S. than in most other countries, and 82 percent of the 462 American men in the study were circumcised, compared with just 6 percent of the 1,360 Peruvian men.

D’ya think that this may be a material difference in populations? That perhaps there are differences between the cultures, practices, or even extent of HIV exposure between the two countries?

All of the men in the study reported having sex with other men and were considered to be at increased risk of HIV infection because they were already infected with the genital herpes virus (herpes simplex type 2), which can make people more susceptible to HIV.

So we’re talking about men who potentially have open sores… which are known to be ways in which HIV enters the body… but all that can be ignored to discuss the results of circumcision.

None of which discouraged declarations based on the results of the “study”

Taken together, the results “indicate no overall protective benefit from male circumcision” when it comes to male-to-male HIV transmission, write the researchers, led by Dr. Jorge Sanchez of the research organization Impacta Peru, in Lima.

No, Dr. Sanchez, taken together the results indicate an incredibly stupid study which tells us absolutely nothing whatsoever about circumcision and HIV transmission and was a complete waste of time and money. I really hope that my tax dollars did not fund your folly.

We don’t really need studies that inform us that anally receptive men don’t reduce their HIV risk by becoming circumcised. They also aren’t benefited by having flocked wall-paper or a charming haircut.

But I, for one, would be interested in a study that looked at whether HIV transmission could be reduced by means of circumcision among anally penetrative men. That question has not been answered (this Wasted Money Study, notwithstanding) and it would be beneficial to know whether circumcision is a risk mitigator among this subset of gay men, and to what extent.

And, I guess they did add that recommendation to their nonsensical reporting of their results.

They add that studies should continue to look at whether circumcision affects HIV risk from insertive sex and do so in larger, more diverse study groups.

Yeah. Ya think?

HIV prevalence in urban gay/bi men

Timothy Kincaid

September 23rd, 2010

The Centers for Disease Control has conducted a study of 8,153 men who have sex with men in 21 U.S. cities and has made some observations about the HIV infection rate of gay/bi urban men. (Reuters)

Overall, they found that 19 percent of gay men are infected with HIV.

The study found that 28 percent of gay black men infected with HIV, compared with 18 percent of Hispanic men and 16 percent of white men.

Black men in the study were also least likely to be aware of their infection, with 59 percent unaware of their infection compared with 46 percent of Hispanic men and 26 percent of white men.

Age also plays a role. Among 18 to 29-year-old men, 63 percent did not know they were infected with HIV, compared with 37 percent of men aged 30 and older, the team reported in the CDC’s weekly report on death and disease.

I am beginning to consider that a comprehensive campaign needs to be planned to test every man who has sex with men. I would not write off a socially-coercive campaign based on “everyone will get tested on such-or-other week” or be the recipient of scorn and rejection. I’m just “thinking out loud” here, but it seems to me that the key to reducing HIV transmission is in reducing those who do not know and perhaps drastic measures may be required.

The logical (dangerous, nonsensical) conclusion of careless reporting on HIV

Timothy Kincaid

September 10th, 2010

As I noted earlier this week, the story of an HIV study out of Ghent, Belgium, has been reported in a very irresponsible manner. Now the conservative Christian zealots in the UK have latched onto the story and repeated it in a way that is so far from the original as to be laughable (if it wasn’t disgusting and dangerous).

Running the headline Young homosexual men are fuelling HIV in Europe, the Christian Institute has declared the following:

Men who have sex with other men are fuelling HIV infections in Europe, according to a new report supported by the UK’s largest sexual health charity.

The study noted that “unprotected sex between men” is often reported as the main transmission route for the virus. However, the study itself examined all homosexual contact and did not distinguish between protected or unprotected sex.

Medical experts note that anal intercourse is, by its nature, the most risky form of sexual activity.

This deliberate attempt to distort the science to suggest that there is no risk difference between safer-sex and unprotected sex is immoral and reprehensible. This is the exact opposite of the intention of the research and efforts to stop the spread of the virus.

I don’t know how “Christian” these monsters are (they certainly seem to be outside the mainstream in the UK) but I’m sure their god has a very special place for them in the afterlife (and perhaps they should invest in asbestos jumpsuits).

More sensationalistic HIV headlines

Timothy Kincaid

September 8th, 2010

Here’s a Reuters headline from France:

HIV spread “out of control” among French gay men

And here’s the meat of the story:

Thursday’s study, published in The Lancet Infectious Diseases journal, found that HIV in France fell significantly from 8,930 new infections in 2003 to 6,940 in 2008.

But the number of new infections among gay men was stable despite a decline in other groups, and accounted for 48 percent of new cases in France in 2008.

To Reuters “stable” = “out of control”

Yes, France has unacceptably high HIV infection rates – nearly 10% of gay men. Yes, we need to address the increase in young gay men who seem to be receiving ineffective messaging. Absolutely.

But, really!

Getting the story wrong on HIV

Timothy Kincaid

September 8th, 2010

When I was a kid, we would sometimes play a game called “telephone” that went like this:

…the first player whispers a phrase or sentence to the next player. Each player successively whispers what that player believes he or she heard to the next. The last player announces the statement to the entire group. Errors typically accumulate in the retellings, so the statement announced by the last player differs significantly, and often amusingly, from the one uttered by the first.

Well it seems to me that there is a game of telephone going on in the mainstream (and other) media in which each retelling of the story gets further and further from the truth. The headlines are the most glaringly obvious:

  • The Guardian – September 6: Young gay men fuelling HIV epidemic, study warns
  • Daily News & Analysis – September 7: White homosexual men ‘still taking too many HIV risks’
  • Pink News – September 7: ‘Young, white gay men’ are ‘contributing’ to spread of HIV infections in Europe says report
  • UPI – September 8: White gay men take greater HIV risk

The UPI article, the most recent, tells us about a study at Ghent University

A significant number of new HIV infections occur through high-risk behavior between young white homosexual men, researchers in Belgium say.

It follows the rather breathless report from Pink News:

According to new research published today, reckless sexual behaviour among a subset of young gay men is fuelling the HIV epidemic in Europe and the UK.

According to open access journal BioMed Central (BMC) Infectious Diseases, a considerable number of new HIV infections in Belgium, where the study was conducted, were occurring as a result of high-risk sexual contact between young, white gay men.

Well there is a story that comes out of the Ghent University study, and it does discuss gay white youth. But the story coming from the study is hardly what you’d think reading the later reports. Here’s what happened:

Researchers at Ghent University in Belgium looked at regional HIV infection to see if they could identify trends. They looked at 506 patients who seroconverted in Belgium between January 2001 and March 2009 and analyzed them by race, sex, transmission cause, and HIV strain.

Sixty percent of those who seroconverted had HIV-1 subtype B and were mostly young gay Belgian men. In addition, this group also had statistically high levels of other STIs, including syphilis and chlamydia.

The other forty percent had other strains of HIV (18 variations identified) and were 60% African and 33% Caucasian. These transmissions were predominantly through heterosexual sex or intravenous drug use.

They also looked at the specific genetic attributes of various infections and found “clusters”, individuals with virtually the same virus. Among gay men (subtype B), clusters were small (3 to 10), but one cluster of 57 patients was found. Fewer clusters were found among non-B strains.

The conclusions from this study were that there are two distinct methods of HIV transmission in Belgium and that these two populations have little overcross. Young gay men who become infected get the virus from other local young gay men while Africans and other non-gay patients came to be infected through travel or migrated to Belgium with the virus.

  • * What this study did not find was that “white gay men take greater HIV risk”. The study told us almost nothing whatsoever about whether “white gay men” or “gay men of color” take greater risk, because the study had few gay men of color. Belgium is not known for its racial diversity (racism in Belgium is defined in terms of Dutch v. French speaking people). Nearly all of Belgium is white, so nearly all gay Belgians who seroconvert were also white.
  • Nor did it find a rampant disregard for safer sex among gay Belgians. A rough calculation suggests that only about 4% of gay Belgian men are living with HIV, a rate a third that of the US. In fact, it would appear that a small subset of young gay Belgians were behaving irresponsibly (perhaps specific social circles) and were consequently infected with a number of sexually transmitted diseases, including HIV.
  • Nor does the research of transmission rates and methods in Belgium tell us much about rates and methods in the rest of Europe and especially the rest of the West. This was a local study involving one Belgian city, not “Europe and the UK” or anywhere else for that matter.

Accurate reporting on such issues is important. Headlines declaring that “white gay men” are fueling an HIV epidemic only serves to further stereotypes about gay men in general. But more importantly, they distract from populations that could believe themselves to be outside that demographic and can impact the allocation of resources where they are most needed.

In Belgium, high-risk taking MSM (specific young white gay men) constitute the most important source of local onward HIV transmission in their region, and this is where prevention efforts should be focused. This study even argues for “a debate on the appropriateness of systematic treatment of MSM meeting some of the characteristics associated with a higher chance of being a transmitter.”

But in the United States, the subpopulation most highly impacted by local onward HIV transmission are African Americans – mostly gay but also heterosexual. There are various reasons why blacks are disproportionately impacted; but one big contributor was the flawed focus of early prevention efforts. By narrowing resources and prevention messages to white gay men and virtually ignoring minority populations, there was a false impression created that HIV/AIDS were a white gay mans disease.

We must be diligent to both provide the resources necessary for care and targeted prevention messages in the black community (and all communities impacted) and to derail any confusing and contradictory messages – like this one – that could be counter-productive.

Ottawa Police disclosed that gay man transmitted “infectious disease”

This commentary is the opinion of the author and may not necessarily reflect that of other authors at Box Turtle Bulletin.

Timothy Kincaid

August 24th, 2010

Gay groups in Ottawa are furious with the police for releasing information about a gay man’s sexual health, so furious in fact that they are refusing funds from a police fundraiser. (Citizen)

Several groups in Ottawa’s gay community will refuse funds to be raised by police at a pancake breakfast Monday, in protest over how officers publicly identified an HIV-positive man.

In an unusual move that infuriated the gay community, police publicly released a photo of Steven Paul Boone, 29, charged in May with aggravated sexual assault. Police say he failed to disclose his HIV status to another Ottawa man who contracted the disease after the two had unprotected sex several times.

The story began in May when Boone was arrested. (CBC)

Steven Paul Boone, 29, remained in custody Friday after being charged with nine counts of aggravated sexual assault, said an Ottawa police news release.

The charges were laid after another man alleged in April that he contracted an infectious disease after sexual contact with Boone in late January and early February. Police said they could not disclose the nature of the disease, including whether it was HIV, the virus that causes AIDS.

Although the police did not specifically state that the infectious disease was HIV, advocates felt that releasing the man’s photo was inappropriate.

By releasing the photo, [Brent Bauer, of the Ottawa Gay Men’s Wellness Initiative] said, police invaded Boone’s privacy, and spread fear among gays, who might now hesitate to get tested for AIDS.

Okay, to see if I have Bauer’s logic correct, he thinks that because a man who failed to disclose his HIV-positive to sexual partners was exposed by the police, therefore people will not want to get tested.

Oddly enough, that theory was put to the practical test. And failed spectacularly. What Bauer is not acknowledging is that between the photo being released and the pancake breakfast something else happened: five additional victims came forward. (Citizen)

A 29-year-old man accused of failing to disclose his HIV-positive to sexual partners has had his charges upgraded to include attempted murder.

The four counts of attempted murder were laid against Steven Paul Boone in relation to four of his alleged victims. Boone has also been charged with four counts of administering a noxious substance — HIV — to the four men.

Here we have a guy with at least six victims, four of which seroconverted. And Boone did not disclose his status to any of them even though, as it turns out, he had known of his HIV status for at least a year. And it is at least a reasonable assumption that three of them would not have known to get tested if the police had not released this guy’s picture.

Studies regularly confirm that – because most people are not despicable vermin like Boone – the biggest contributor to the continued spread of HIV is ignorance of one’s status. Not only are most HIV+ people responsible, but medications can reduce viral loads to the point where it might not be possible to pass on the virus.

But if these men had not seen Boone’s picture, they may not have gotten tested before endangering others.

I can appreciate that the community in Ottawa is offended in that they believe the police are not considering their complaint about the privacy rights of those who are HIV positive. And I appreciate the value of clear guidelines that protect the privacy of the innocent. But I find the defense of Boone to be difficult to fathom.

I have long been an advocate for those impacted by HIV/AIDS. I was privy to the early debates over confidential v. anonymous testing and I am still not convinced that names-based reporting is the most effective policy (or at least not as it is currently administered).

But I believe we should be doing everything in our power to stop the continued spread of HIV within our community. That should drive our policies and our sympathies and if that means that we put the interests of the uninfected – even the irresponsible uninfected – ahead of those who are deliberately endangering others, I have no problem with that.

I don’t wish to threaten the privacy of the vast majority of responsible HIV positive people who would never dream of doing anything that would pass on this virus. But people like Boone are a danger and a threat to the members of our community and we are fools if we put their interests before our own.

Rethinking HIV Testing

This commentary is the opinion of the author and may not reflect the opinions of other authors at this site.

Timothy Kincaid

June 3rd, 2009

There is no good reason for any American becoming HIV positive today.

Which is not to say that there are not a lot of very understandable explanations why an individual might become infected. Social pressures, education, self perception, culture, diminished self worth, drugs and alcohol, and even trusting the word of a careless liar all play their part in the instances and circumstances that lead to poor choices and HIV infection.

And so infection rates stay consistently high in the gay community, and astronomical in some sub-populations. A study of HIV infection rates in Chicago found infection rates of over 17%* of gay men in that city. When looking at subgroups, the statistics become even more troubling:

Thirty percent of gay black men in Chicago tested positive, the study showed, while Hispanics and white men had rates of 12 percent and 11.3 percent, respectively.

A quarter of blacks aged 18-24 tested positive. More than 37 percent of blacks aged 25-34 – the highest of any age group – tested positive. The numbers are similar to national figures.

These are rates of infection that are simply unacceptable. And there\’s no reason, no justification, for 37% of any ethnic or age group to be infected with a virus that is detectable and preventable. Considering the weath in this nation and the billions spent on bailing out bankers and car makers, that black gay men have rates this high raises hints of racism, homophobia, and elitism.

But there is an explanation, one that makes sense to me; these men didn\’t know they were infected. Half of the infected gay men – and two-thirds of infected black men – were unaware of their HIV status.


Because they didn\’t get tested. They were “worried about the result.”

I understand that worry about what it means to be HIV positive can be a strong disincentive to get tested. As long as you don\’t know, you don\’t have to deal with it.

But I think this report, like all those I\’ve seen from the AIDS establishment, misses a component that is present with every HIV test that I or anyone I know has taken.

It isn\’t just finding out whether one is HIV positive. It\’s also going to some clinic (when they are open), filling out questionnaires, being grilled about the intimate details of your sex life, and then sitting in a waiting room where you are sure everyone is staring at you before being called into an office and being told by a total stranger whether you have a life-changing disease and, if so, reporting your name to the government.

It\’s an unpleasant process. And frightening.

And I think it might be time to begin considering a change. I think it\’s time to consider allowing people to test themselves in the privacy of their own home.

I know there are strong objections to this notion.

There is fear that inexperienced users will make mistakes and get false conclusions from improperly handled tests. There\’s also fear that at-home tests would not be sensitive enough to assure accurate results or may be too expensive.

But the current oral swab tests are pretty darned easy. If some scared teenage girl who missed her period can pee on a swizzle, surely a gay guy can run a swab over his gums.

Also, the oral tests are over 99% accurate. And there\’s little reason to think that they would be significantly less accurate in one\’s home than in the clinic. And if we as a city, state or nation, can afford to pay the clinic administators to provide free testing, I’m sure we can come up with some scheme to get the prices on tests affordable by those who need them; it just makes economic sense.

I will concede that some guys will ignore the fact that these tests only tell you whether you were infected before a three month (or so) window. Some will assume that a negative test means “100% negative today”. But this is also a misconception that can occur in a clinic and can be mitigated by careful packaging.

But the biggie reason given for opposition to the public availability to HIV tests that one can take and home and get immediate results is that in a clinic setting those who test positive can get counseling.

I appreciate the need for counseling. I\’ve even argued the merits of this approach.

But it\’s not working, folks. There are still thousands of guys out there that have been infected and do not know it. And they are not going to come into your clinic to find out. And maybe, just maybe, it\’s because they don\’t want to be subjected to your counseling.

I have come to believe that many of these “I don\’t know” guys might know their HIV status if they were able to anonymously purchase a little kit at the drugstore, take it home, and know the results in 20 minutes.

Yeah, some will freak out. And panic. And there won\’t be a counselor in front of them.

But they will at least know their HIV status.

And if they were provided with the option to immediately call a hotline for information and counseling, they might do so. Or they could go to a clinic. Or go online.

But they would know. And there\’s a very good chance that they would not then go out and infect someone else.

And this approach would be useful not only to unknown virus carriers, but to those they come in contact.

I think that many a gay guy – or black woman – would say, “Yes, I know you say you\’re ‘clean\’. But put this in on your gums and get comfortable because nothing is in going in anything for the next twenty minutes.”

It’s is bound to reduce infections better than the “baby, just trust me” method.

I don\’t doubt the sincerity of those who wish to keep HIV testing in carefully controlled environments. And I am sure that some readers will object to this proposal, fearing that it would be a catastrophe.

And I\’ll even grant that I may be wrong. Perhaps allowing people control over their own HIV testing would result in more problems than it solves. Maybe I’ve understated some concern or forgot some consideration.

But with infection rates – especially unknown infection rates – as high as they are, it\’s time to look for new solutions. It\’s time to ask the question. And it\’s time to start the conversation over whether personal access to HIV tests could help bring down the incidences of unknown infections and help stop the spread of this disease.

– – –

* Though higher than our estimates of about 12% of gay men, this is consistent with our estimates. HIV infection rates in black gay men is far higher than other ethnic subgroups and with a population that is 37% African American, this skews the local average higher than the national average.

Addendum: This commentary does not attempt to address the specifics of the African-American community. I’m not qualified or adequately knowledgeable to address the exact circumstances leading to disparity in infection rates between ethic subgroups or to advance targeted solutions. Rather, this commentary seeks to start a discussion and new thinking about the lack of testing in infected populations of all races. For more information directed at HIV/AIDS in the African American community, see the Black AIDS Institute or the Minority AIDS Project.

Research: Anti-Gay Harassment in Childhood Leads To Poor Adult Health

Jim Burroway

January 28th, 2009

Mark S. Friedman, Michael P. Marshall, Ron Stall, JeeWon Cheong, Eric R Wright. “Gay-related development, early abuse and adult health outcomes among gay males.” AIDS and Behavior 12, no. 6 (November 2008): 891-902. Abstract available at DOI 10.1007/s10461-007-9319-3.

The Urban Men’s Health Survey (UMHS) has revealed a lot of useful information in the decade since it was conducted. Much of it “dismaying,” in the words of Ron Stall, who worked on the survey at the Centers for Disease Control and Prevention and is now at the University of Pittsburgh. Stall was one of four researchers from the University of Pittsburgh (joined by a fifth researcher from Indiana University – Purdue University Indianapolis) who analyzed a subset of that data and concluded that “experience of homophobic attacks against young gay/bisexual male youth helps to explain heightened rates of serious health problems among adult gay men.”

The UMHS was a telephone interview of a probability sample of men who have sex with men (MSMs) living in four cities: San Francisco, New York, Los Angeles, and Chicago. The survey was conducted between November 1996 and February 1998, with 2,881 UMHS participants being asked a wide-ranging battery of questions resulting in 855 variables. The results of that survey were fed into a database, which scores of researchers have been mining ever since for dozens of studies covering many different topics. Dr, Mark Friedman, who has previously investigated the link between anti-gay hostility and suicide among young gay males, led a team which poured over responses to key questions in that database to see if a link could be established between anti-gay hostility against young gay men and adverse health outcomes as adults.

Among the many questions in that survey, participants were asked about their experiences, if any, with parental physical abuse, gay-related harassment during childhood and adolescence, and forced sex. They were also asked about four gay-related identity milestones: the age at which they became aware of their same-sex attractions, age of first same-sex sexual activity, age of deciding that they were gay, and age of first disclosure that they were gay.

Participants were also asked about current depression, HIV serostatus, sexual risk behavior during childhood, partner abuse during adulthood, anti-gay victimization during adulthood, and suicide attempts during childhood.

Dr. Mark Friedman and associates used the responses from these questions from 1,383 men aged 18 through 40, and divided them into three categories (early bloomers, middle bloomers and late bloomers) according to how participants answered questions based on the four gay-related identity milestones. Then, by looking at the answers to the other questions, they were able to demonstrate three principle findings:

1) Gay males who developed early with respect to their sexual orientation were much more likely to experience anti-gay harassment and sexual abuse during adolescence than middle bloomers and late bloomers. This might be something of a “duh” conclusion since it stands to reason that those who are more visibly gay draw more attention than those who aren’t, and those who are visibly gay earlier have more time in which to experience anti-gay harassment and sexual abuse. Nevertheless, it’s important to establish this finding statistically, because it leads to the next finding.

2) Those early bloomers were also more likely to anti-gay victimization, depression, and become HIV-positive as an adult. Taken alone, this finding might play into the hands of anti-gay activists who contend that gay youth should remain closeted and continue to deny their true experiences for as long as possible. Well, not so fast, because…

3) While early bloomers were more likely to experience adverse health outcomes as adults, it wasn’t just because they were early bloomers. Friedman and associates found that harassment and violence were very common experiences among all young gay and bisexual males. Regardless of “bloomage,” 74% reported experiencing anti-gay harassment and 24% experienced parental physical abuse before the age of 17. And these experiences were capable of statistically predicting specific negative health outcomes as adults:

  • Early gay-related harassment was found to be positively associated with gay-related victimization in adulthood;
  • early parental abuse was found to be positively associated with partner abuse, gay-related victimization, depression, attempted suicide and becoming HIV-positive;
  • and early forced sex was positively associated with adult partner abuse, depression, engagement in high-risk sex, and becoming HIV-positive.

The men in this survey became adults, on average, in the mid 1980’s. We don’t know whether adolescents today experience statistically the same levels of abuse and harassment as adolescents did then. But the authors conclude that regardless of the extent of anti-gay harassment today, that:

“…a compelling case can still be made that the three sets of findings above, as a whole, support the hypothesis that the experience of homophobic attacks against gay youth contribute to health disparities among gay men. … [T]his suggests that their experience of abuse is related to homophobia and that these experiences in part determine the adult health problems that gay men often experience.

“To summarize, some of the health disparities of gay and bisexual men may have their genesis in these individuals’ childhood and adolescent years given that these disparities are already in place by early adulthood. The findings described above support the hypotheses that the disparities appear to be due, in part, to the timing of [gay-related development] and the violence these individuals experience related to being gay during their formative years.”

This week is National No Name Calling Week, sponsored by the Gay, Lesbian and Straight Education Network (GLSEN). According to GLSEN’s non-representative survey of 6,209 middle and high school students, 86% of LGBT students experienced harassment at school in the past year, 61% felt unsafe at school because of their sexual orientation, and 33% skipped a day of school in the past month because of they felt unsafe. This survey isn’t statistically representative nationwide, but that’s beside the point. They found an awful lot of harassed and frightened kids out there.

Of course, Focus On the Family is against No Name Calling Week, complaining that it has a hidden agenda. And they’re right; it does. The “hidden agenda” consists of safer youth and healthier adults, which Focus continues to oppose at all costs. After all, they’ve invested a lot of energy in maintaining the image of gay men as depressed, suicidal and unhealthy. Now we know that their own policy solutions will only serve to perpetuate that image.

No More Dog Whistles: Introducing the Obama LGBT Scorecoard:

This commentary is the opinion of the author and does not necessarily reflect those of other authors at Box Turtle Bulletin.

Jim Burroway

January 22nd, 2009

We’ve had eight years of listening for dog whistles. We learned quickly that whenever President Bush or members of Congress spoke, we had to dissect every utterance, split every infinitive, and scoop every dangling participle to try to discern the secret message that was being sent to the base. For all of his assaults on English, President Bush was particularly adept at speaking that unique language which only his base could understand without raising the ire of moderates.

Along the way, we learned that the Dred Scott decision somehow related to abortion and that God prefers commas over periods. We analyzed every message, the way the CIA dissects audio tapes from Osama bin Ladin in case there might be a secret message for a far-flung branch of Al Qaida — which, coincidentally, just happens to be Arabic for “the base.”

And I think that affected to how we approached statements from erstwhile allies as well. Was that a flinch we saw when “Don’t Ask, Don’t Tell” came up? Why won’t she come straight out against “DOMA”? Why can’t he come out more forcefully against Prop 8? Every statement became a possible clue, and every omission appeared to boom louder than words.

This continued after the election. I was certainly part of it. Why Rick Warren? Why not Gene Robinson? And why was Gene Robinson’s invocation omitted from the broadcast? Why didn’t Obama give us a shout-out in his Inaugural address?

Well, we can stop listening for dog whistles. We can stop jumping up and down in excitement whenever he mentions gays, and we can stop pouting when he doesn’t. Because when the web site switched hands at 12:01 Tuesday afternoon, a very important document appeared: an LGBT civil rights agenda.

I said then that it looks like a very good scorecard on which we can judge the Obama administration. In fact, the more I look at it, the more I’ve concluded that no gay rights organization could have created a better scorecard in their wildest dreams.

That’s why I decided to condense it into a simple checklist form. And here it is: Barack Obama’s LGBT Civil Rights Scorecard. It’s the one he himself signed up to. And it’s one that I intend to refer to often over the next four years.

I doubt there will be immediate action on any of these items. After all, I can see how a crashing economy and a war in Iraq might be something of a distraction, to say the least. With people losing their jobs, homes, and health care, there’s a lot that needs to be done.

But I have to admit that I labor under the possibly mistaken impression that our elected representatives can walk and chew gum. They should be able to squeeze in a few of these promises in due course amongst the other things that need to be done. But even I know that we can’t sit back and assume that all of those wonderful politicians who made so many swell promises will actually get right on all those promises they made. I mean, c’mon — they’re politicians.

Besides when we’re talking about civil rights, the door has never opened because someone pulled the door open from the inside. It’s always been opened by a strong push from that outside.

That’s where we come in. They signed up for an impressive checklist. But it’s up to us to hold them to it.

Dallas County Overturns Condom Distribution Ban

Jim Burroway

January 14th, 2009

Dallas County, Texas — yes, that famously conservative Dallas — has voted to overturn a 14-year-old ban on county health care workers distributing free condoms. Republican Maurine Dickey joining Democrats Jim Foster and John Wiley Price, to overturn the ban on a 3-2 Tuesday morning.

Republican Commissioners Kenneth Mayfield and Mike Cantrell, both of whom supported the ban in 1995, voted against overturning it, saying they feared it could lead to condoms being distributed in schools. But Dickey, who wasn’t on the court in 1995, said she was more concerned about the high cost of treating people with HIV/AIDS.

According to a report prepared by the county’s Health and Human Services Department, which recommended overturning the ban, the lifetime cost to treat someone with HIV is more than $600,000. “I think we need to put the taxpayers first,” [Commissioner Maurine] Dickey said. “If we prevent two people from getting AIDS in Dallas County, we will have saved over $1 million of the taxpayers money.

Circumcision Less Helpful in Reducing HIV in Gay Sex

Timothy Kincaid

October 7th, 2008

JAMA is reporting that circumcision, which may eliminate HIV transmission in heterosexual sex by up to 50%, is less helpful in male-male anal sex.

The study’s authors wrote that circumcision appears to provide “not statistically significant” protection from HIV in men who engage in anal sex with other men. The researchers said however that more research may be necessary to quantify the amount of protection — or lack thereof — provided by circumcision.

It seems counter-intuitive that a virus’ ability to infect a man would be impacted by the gender of his partner, assuming penetrative-only sex. Somehow I suspect some relevant questions were not addressed.

National HIV/AIDS and Aging Awareness Day

Jim Burroway

September 18th, 2008

It’s today. I had no idea.  But it’s a great thing. After all, even though infection rates have remained relatively level, people over 50 now make up the fastest-growing segment of those living with HIV. This is mostly attributable to the fact that people with AIDS and HIV are living longer. What was once a death sentence is now a very serious chronic illness. And as people age — part of the aging process is already about losing immunity — managing HIV/AIDS while simultaneously managing the ordinary effects of aging is a delicate balancing act.

Newsweek as a great series of articles online:

You can learn more about issues of aging and the LGBT community at SAGE.

Scientists Pessimistic on AIDS Vaccine

Jim Burroway

April 25th, 2008

Britain’s The Independent newspaper surveyed more than 35 leading AIDS scientists in the U.K. and the United States found that most of them blieve that a vaccine against HIV may never be possible. Only four were more optimistic than they were five years ago. Thirty-five seems like a very small sample to go on, but The Independent, ever proud of its own exclusive polling, is touting this as “the latest in a series of setbacks in the 25-year struggle to develop an HIV vaccine.”

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