Gay men accounted for 64% of all new HIV cases in 2009, according to the Centers for Disease Control and Prevention, and Michael Lucas offers a solution.

By Michael Lucas, op-ed contributors

Here’s a sentence I never thought I would write: I’m in favor of a “don’t ask, don’t tell” policy. Not in the military, of course — those days are behind us — but in the bedroom. What I’m talking about, specifically, is HIV. And my point is that, at least when it comes to sex, we should talk about it less.

It amazes me that in 2011, so many people still won’t sleep with HIV-positive guys. But it’s true. Many HIV-negative friends have told me they won’t have sex with anyone they know to be positive. And I’ve heard from the other side too: from positive friends with horror stories about the difficulties they face in dating or even hooking up. For them, the quest for love and sex can be an obstacle course of thoughtless discrimination and rejection.

Don’t get me wrong. I understand that negative guys might get turned off when they hear that a hookup is HIV-positive. For most people, disease isn’t sexy. But there’s an easy solution to that problem: Just don’t talk about it. It might also ruin the mood if Mr. Right Now revealed that he had liver cancer, diabetes, sickle-cell anemia, or a family history of mental illness. But why would he tell you those things on a first date? And why would you ask?

The answer, some might say, has to do with managing the risk of contagion. But many people still seem to have outdated ideas about HIV transmission. One friend says that guys often get mad at him if they’ve kissed before he tells them he’s positive — lashing out as if he has put their lives in danger. Is this 1983? Do they also think they can get AIDS from toilet seats?

You can’t get HIV from kissing. In fact, it’s hard to get HIV even from sex — as long as you use a condom. I dated a positive guy for two years in the 1990s; we had safe sex almost every day, and I never seroconverted. Today, it is even more difficult to become infected through protected sex. Recent studies suggest that HIV-positive men who are taking their medications pose a vastly reduced risk of transmitting the virus.

But shunning HIV-positive people is not just phobic and unkind — it is also dangerous. Paradoxically, a supposed open discussion about HIV actually leads to a culture of HIV secrecy; it punishes men who are honest about their status, rewards those who lie, and discourages guys from getting tested (and treated).

What’s more, it perpetuates a growing trend toward barebacking by men who think that they can stay negative as long as they only hook up with other negative guys. I don’t know anyone who has seroconverted from safe sex with an HIV-positive partner — but I know several who have gotten HIV from boyfriends who were barebacking on the side.

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Not Anti-Catholic, Just Anti-Harm

By Joe Zuniga, op-ed contributor

There comes a point in Dan Brown’s bestselling thriller Angels and Demons, in which its protagonist, Professor Robert Langdon, in response to being queried about his faith, proclaims he is not anti-Catholic “just anti-vandalism” – in reference to a 17th century Pope’s desecration of male statuary whose phalluses were chiseled away in an act of prudery gone wild.

For some reason, this reference struck me only weeks after participating in a conference on HIV/AIDS prevention and care hosted last month by the Vatican’s Pontifical Council for Health Care Workers. As a former Catholic (now Episcopalian), I struggled at many points during this two-day conference to ensure my words and deeds did not seem anti-Catholic.

The Roman Catholic Church’s doctrine of intolerance related to condoms and homosexuality, not to mention its promulgation of a patriarchal society that leaves women powerless and vulnerable, are determinants of HIV’s spread worldwide, but especially in parts of the world with low health literacy. So, like Professor Langdon, mine was a message of solidarity in our global fight against disease, but clear in an anti-harm position.

As with Professor Langdon’s re-education in the importance of faith and doctrine, the 100 or so participants of what was billed an “international study conference” were presented with back-to-back lectures showing that regardless of moral arguments over an individual’s use of a condom to prevent disease, the Vatican still judges condom promotion a failure in the battle against HIV/AIDS. And at least three clerics – among them the president of the Pontifical Council for Health Care Workers – aggressively promoted their belief that the “abandonment of homosexuality” is HIV prevention.

As a gay man, and one who has come of age during the 30-year history of the global HIV pandemic, I joined several progressive conference participants in reminding others of our mutual responsibilities to respect the human dignity of each person. We must also hold each other harmless from violence, including the violence caused by HIV at the cellular and biological levels, and the emotional and spiritual violence embodied in the intolerance and ensuing stigmatization suffered by those individuals society classifies as “other” – which demeans their existence and facilitates self-destructive behavior.

Today is National HIV Testing Day, an occasion for focusing on knowing one’s status and, if negative, remaining so; if positive, linking to treatment (which as a recent scientific breakthrough proves, is HIV prevention). Stigma, heterosexism, denial, and discrimination against gay men continue to fuel this global health crisis, mirroring much of what occurred at the dawn of the AIDS era 30 years ago. They fuel not only a deep HIV crisis, but also numerous other health crises among gay men, including high rates of other sexually transmitted infections; high rates of anxiety, depression, and mental health problems; high rates of substance and alcohol abuse; and a number of concomitant health concerns.

Before anyone can understand this reality, one must see a larger context of social exclusion and marginalization. Despite nearly three decades of advocacy on the part of gay communities around the world for appropriate legal rights and health care services, including HIV prevention and care, in most parts of the world gay men still have little or no access to either HIV services or gay-oriented general health services.

Read more.  If you’d like to get tested for HIV or other STIs, please visit our Testing Resources link.

By Frank Spinelli, MD
September is Prostate Cancer Awareness Month. What’s yours telling you?

Your boyfriend may be experienced at, uh, examining your prostate. But if you’re age 50 or older, it’s your doctor’s turn. Though there’s no evidence that gay men are at greater risk than straight guys, prostate cancer is the second-leading cause of cancer-related deaths in men (lung cancer retains the top spot). It affects about one in six during their lifetime, but the good news is that only one in 35 will die of it, thanks to effective screening. Early detection remains the best medicine.

According to the American Cancer Society, men in this age group should discuss screening with a physician. African-American men and those with a strong family history of the cancer should begin this discussion at age 45. Screening involves a physical exam of the prostate via the rectum (not a pleasure, but it lasts only a few seconds) and a blood test to measure levels of prostate specific antigen (PSA). Though recent studies have questioned the utility of PSA testing, I agree with current cancer society guidelines. Your doctor should explain the potential risks and benefits of screening beforehand, however.

A few words of advice: Avoid receptive anal play 24 hours prior to your doctor visit, because stimulating the prostate can elevate PSA levels. If your prostate is enlarged, don’t freak out. The vast majority of older men share your predicament. Similarly, an isolated increase in PSA levels isn’t automatic bad news either. Most doctors agree that tracking the trajectory of the increase is a better indicator, and a biopsy is the only definitive way to diagnose prostate cancer.

If you are diagnosed, talk to several doctors about treatment and study up on radiation therapy and the various surgical interventions available. Since prostate cancer typically is slow-growing, rushing into surgery during early stages of the disease is not always wise, particularly if you have existing serious health problems. Ask your doctor if observation is an option.

Gender Construct

I recently interviewed Dale, a transgender man, about the decisions he’s made. Dale opted to bind his breasts instead of undergoing a double mastectomy. In the coming months he’ll electively have a hysterectomy (removal of the uterus) and an oophorectomy (removal of the ovaries), and he’ll begin taking testosterone, which will increase his muscle mass and deepen his voice. Dale is undecided on whether to have genital reconstruction surgery. The procedure is more complicated than its male-to-female analogue, due to the difficulty of building a functioning penis from the clitoral tissue. Regardless of the procedures a person chooses to undergo, most clinicians working with transgender patients agree that a supportive network inclusive of a partner, family, and friends is vital to ensure satisfaction with the final outcome. The Transgender Health pages at LGBTHealth HealthCommunities.com contain more information on hormone therapy and female-to-male gender-reassignment surgery.

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The classified advertisement website Craigslist announced Saturday it would censor its ads for adult services.
The move came after a group of 17 attorneys general sent a letter to the Craigslist management to cease its adult services section. Now, the website shows a black “censored” bar over the space where “adult services” existed.
“The increasingly sharp public criticism of Craigslist’s Adult Services section reflects a growing recognition that ads for prostitution — including ads trafficking children — are rampant on it,” read the August 24 letter to Craigslist CEO Jim Buckmaster and Founder Craig Newmark.
Susan MacTavish Best, who handles press inquiries for Craigslist told CNN the company supports the attorneys general’s “desire to end trafficking in children and women through the internet or by any other means.” She added the company will work closely with them, experts at nonprofit organizations, and law enforcement.

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Study Finds PrEP Is Safe in Gay and Bi Men

by David Evans Pre-exposure prophylaxis (PrEP) with tenofovir (found in Viread, Truvada and Atripla) is safe for men who have sex with men (MSM), according to a U.S. study presented Friday, July 23, at the XVIII International AIDS Conference (IAC) in Vienna.

PrEP is one of the most promising prevention tools on the immediate horizon. With PrEP, HIV-negative individuals take antiretroviral drugs to prevent becoming infected with the virus. The first PrEP studies are testing tenofovir alone (Viread), while several later studies are testing tenofovir plus emtricitabine (Truvada). Currently, all studies are looking at daily ongoing use of the drugs, but future trials are planned with intermittent dosing. The first efficacy results are expected later this year, but researchers from the Centers for Disease Control and Prevention (CDC) in Atlanta presented findings from a safety study at this year’s IAC.

For that study, CDC-4323, Lisa Grohskopf, MD, from the CDC and her colleagues enrolled 400 HIV-negative MSM. All reported having had anal sex with a man at least once during the previous year. The men were recruited in Atlanta, San Francisco and Boston. The majority were white, while 15 percent were African American, 9 percent were Hispanic and 4 percent were Asian or Pacific Islanders. Ultimately, 373 completed the course of the study.

There were four arms of the study. Half of the men in the study began taking tenofovir or a placebo right away. The second half were followed without study drugs for nine months and then given tenofovir or a placebo. This helped the researchers better understand how a person’s risk behavior might change after beginning to take PrEP. The study was not designed to determine whether tenofovir could prevent HIV transmission, only whether or not it was safe compared with a placebo. All of the men were tested for HIV regularly and received rigorous HIV prevention counseling and condoms throughout the study.

Grohskopf and her colleagues found that men taking tenofovir had no more side effects than men taking a placebo. Two side effects of primary concern have been kidney and bone problems, which has been found in a small number of people with HIV who have taken the drug as treatment. Grohskopf’s team measured the men’s creatinine clearance—a measure of kidney function—and did bone scans to detect any potential problems in that regard. The team found no additional kidney or bone problems in those taking tenofovir, compared with a placebo.

CDC-4323 was also designed to measure how the participants’ HIV risk behavior changed during the study. Though data on this issue is still being analyzed, Grohskopf reported that a preliminary analysis found that taking PrEP did not appear to lead study participants to forgo condoms or take other HIV risks.

“We didn’t find any increased risk of harm in medical terms, and on the behavioral side the preliminary work we’ve done also suggests there is no increased risk,” Grohskopf told Reuters News.

Given the promising results from a large tenofovir microbicide study—with a 39 percent reduction in HIV transmissions in women who used the tenofovir gel—establishing the safety of oral tenofovir provides even more hope that this strategy could be employed if the efficacy studies are successful.

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An elderly gay man who was prevented from seeing his dying partner in the hospital social workers will receive $600,000 in a settlement, reports the Mercury News. Clay Greene, 78, of Guerneville, Calif filed a lawsuit against Sonoma County’s Public Guardian program earlier this year, claiming he was discriminated against because of his sexual orientation.

Greene accused the county’s social workers of denying him hospital visitation rights to see his partner, Harold Scull, despite medical declarations, powers of attorney, and signed wills that named each other as spouses. The couple was not married nor registered as domestic partners. The lawsuit also alleged that after Scull died, Greene was forced into a nursing home by social workers, who then sold many items of the couple’s personal property.

Gregory Spaulding, the attorney who represented the county, denied the discrimination claims, but he admitted mistakes in selling the couple’s property. According to the county, Greene was kept away from his partner because of previous domestic violence allegations. According to a sheriff’s report, Scull went to authorities with a black eye, claiming Greene threatened to kill him. However, no formal complaint was lodged against Scull.

“The county remains confident in its position that there was no discrimination in this case,” Spaulding says. Under the law, property worth $5,000 or less can be sold by officials to cover medical expenses, but the sale of the couple’s property brought in more than $25,000 at auction. “Errors in that case have led to revised policies at the Public Guardian’s office,” Spaulding says.

Spaulding acknowledges the county settled the case Thursday to avoid further expense. “It just made economic sense to stop the bleeding,” Spaulding says. “To end the case and avoid all expenses and costs.”

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By Advocate.com Editors

President Obama issued a Father’s Day Proclamation Friday that includes gay dads. Read an excerpt below.

From the president’s proclamation: “Nurturing families come in many forms, and children may be raised by a father and mother, single father, two fathers, a step father, a grandfather, or caring guardian. We owe a special debt of gratitude for those parents serving in the United States Armed Forces and their families, whose sacrifices protect the lives and liberties of all American children. For the character they build, the doors, they open, and the love they provide over our lifetimes, all our fathers deserve our unending appreciation and admiration

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By Jamie Larson

The Hudson High School prom made history this past Saturday when openly gay best friends were named prom king and queen.

Seniors Charlie Ferrusi and Timmy Howard won their respective crown and tiara by a landslide Saturday and said the support they received from their peers and school administration has been fun and humbling.

“It’s a really big step for Hudson but also for the gay community in general,” Howard said Wednesday. “To have this happen in our city is pretty exciting.”

Ferrusi said he and Howard started thinking about running about a month ago. While there were some students who were in opposition to their idea many more approved and the boys decided to go for it.
By prom night the overwhelming majority of students cast their votes in the open ballot race. They won by such a wide margin the school didn’t crown any runners up.

In 2008 Augie Abatecola ran and won the race for Hudson prom queen but he was denied the crown by school officials. This time around Ferrusi and Howard decided to run their plan by advisors and Principal Steven Spicer beforehand.

The school officials said they wouldn’t interfere with the student body’s vote and gave the boys their blessing.

“We’re proud of all our students,” said Spicer Wednesday. “They know they have the right to pick whoever they want. It was exciting for them and it was exciting for Charlie and Tim.”

One of the hardest parts of the experience, Ferrusi and Howard said, was deciding who would run for king and who would be queen. Both added they had the full support of their families.

While they were pretty sure they would win due to the buzz around school the boys said they still weren’t sure everyone would vote for them.

“First of all it’s Hudson High School,” said Ferrusi. “For me to win king was crazy. For Timmy to win queen was insane. We both researched it online and never found any story of two gay guys winning both king and queen.”

In recent years across the U.S. openly gay and lesbian teens have clashed with school officials at prom time.

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Gay Malawi Couple Separated in Jail

By Julie Bolcer

Steven Mojenza and Tiwonge Chimbalanga, the Malawi couple sentenced to 14 years in prison last week for holding a public engagement ceremony, have been placed in separate prisons after spending months in the same facility.

According to CNN International, Monjeza was moved from the facility where the men had been held since their arrest in December.

“It was not clear why Steven Mojenza was moved from Chichiri prison, where he had been serving time with his partner, Tiwonge Chimbalanga,” reports CNN International. “The pair was sentenced last week to 14 years in prison after being found guilty of gross indecency and unnatural acts.

“Though in separate cells at Chichiri, the men were able to see each other briefly ‘from time to time,’ said Peter Tatchell, a London-based gay rights activist who has been advocating for the men.”

A Malawi-based human rights campaigner told CNN International that Monjeza was not the only prisoner moved to another facility, and that he would learn more when he visits Monjeza in the new prison Thursday.

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Partner Benefits Hearing Next Wed

By Kerry Eleveld

A committee markup has been scheduled for the Domestic Partner Benefits and Obligations Act, which will provide benefits to the domestic partners of federal government employees. Markups are the process by which congressional committees finalize the language of a bill and then vote on the legislation. If the bill is voted out of committee, it heads to the floor for a full House vote.

The House Oversight and Government Reform Committee will mark up DPBO on Wednesday, November 18, at 2 p.m.

Overall, next week will be a busy one for LGBT issues: In addition to the DPBO markup, the House Education & Labor Committee will mark up Employment Non-Discrimination Act legislation on Wednesday, November 18, at 10 a.m.

And on Thursday, November 19, at 9:30 a.m., the Senate Armed Services Committee will hold a confirmation hearing for Clifford Stanley, a retired general who has been nominated as undersecretary of Personnel and Readiness — a key post in the Department of Defense that oversees the “don’t ask, don’t tell” policy.

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