LGBT Health Education Blog
The Centers for Disease Control and Prevention (CDC) recently updated their fact sheet on HIV among gay, bisexual and other men who have sex with men (MSM). The news, unfortunately, is not good. In the US, HIV continues to affect gay and bisexual men more severely than any other group. Among MSM, Black/African American men bear the most disproportionate burden of HIV and young men of color continue to represent increasing proportions of new infections. The fact sheet is available on our resource page (link).
A Food and Drug Administration (FDA) advisory panel yesterday unanimously recommended approval of an at-home oral HIV test. With the CDC estimating that around 240,000 Americans do not know they are HIV positive (link), an over-the-counter HIV test has promise for increasing the number of people who know their status and get connected to care; by extension, the test may also ultimately reduce new infections. HIV/AIDS disparately impacts gay and bisexual men, men who have sex with men (who may not identify as gay or bisexual), African Americans, and Latinos. The oral HIV test uses a mouth swab and is already approved for use by medical practitioners. Home use trials suggest it is less reliable than when used in clinical settings, yielding some false negatives, but the FDA advisory panel strongly agreed that the benefits outweigh the risks. They also stressed that if approved, testing materials should warn that negative results do not automatically mean the person is HIV negative, and should provide an 800 number connecting users to counseling and medical care. The FDA will make a final decision on whether to approve the home-testing product later this year.
The manufacturer's press release is here.
While today's news highlights the public debate on same-sex marriage, a 2011 study in the American Journal of Public Health (link) highlights the health care savings associated with same sex marriage. Researchers looked at data from over 1,200 gay and bisexual men in Massachusetts and compared their utilization of health care services in the 12 months before and the 12 months after same-sex marriage became legal there. Medical and mental health visits both decreased post legalization, and mental health care costs decreased by several hundred dollars per patient. Effects were similar for both partnered and non-partnered men. Researchers at our parent organization, The Fenway Institute, contributed to the study.
The Gay and Lesbian Medical Association's 2008 report, Same-Sex Marriage and Health, (link) collects a number of studies demonstrating the negative effects of denying same-sex couple the right to marry.
This week, The Global Forum on MSM & HIV announced its 2012 Global Men's Health and Rights Survey. Click here to take part in the second global survey in history on the health, happiness, and access to care for men who have sex with men (last year, 5,000 responses were collected worldwide). Survey results are used to improve global access to HIV prevention and care services.
Morehouse School of Medicine
Thursday, April 19, 2012
Last week, the White House Office of National AIDS Policy (ONAP) held a one day conference at Morehouse School of Medicine to highlight the issues of HIV/AIDS in the LGBT community. Former Surgeon General David Satcher stated in his speech that there is no greater health disparity than the impact of HIV on gay men.
Also of importance were discussions introduced by the ONAP Director Grant Colfax and CDC's Kevin Fenton on the growth of the epidemic among men who have sex with men (MSM) and transgender women, in particular young black MSM. According to recent statistics from the CDC, MSM accounted for 64% of new cases of HIV in the United States in 2009, and alarmingly there was almost a 50% increase among young black MSM. When considering this, it is important to keep in mind CDC researcher Greg Millett’s meta-analysis of HIV risk factors shows that black MSM do not engage in higher rates of risky behavior but that they do experience lower rates of testing, a higher prevalence of HIV in their community, and barriers to care. Recent evaluation of HIV among transgender women showed HIV rates as high as 27% (Herbst et. al). Regarding our understanding of the epidemic, David Malbranche, MD from Grady Hospital and Emory University presented an eloquent discussion on how we might think of intersectionality and the MSM community, raising interesting new perspectives on how intersectionality, long considered a source of LGBT health disparities, can also be viewed as a reason for resilience. The conference was a particularly good opportunity to develop an agenda; a great deal of work remains to create interventions that will make a difference regarding HIV and LGBT people.
On that note, Sean Cahill, the Director of Health Policy at the Fenway Institute has just written on this topic. His essay follows.
HIV funding and programming targeted at gay and bisexual men in the U.S.: Reasons for hope, and cause for concern
By Sean Cahill
Over the past few years we have witnessed a number of advances in science-based HIV prevention and care policy and LGBT health policy in the U.S.
We have a first-ever National HIV/AIDS Strategy that prioritizes reducing the disparity affecting gay and bisexual men—who were 64% of new infections in 2009, although just 2% of the adult population. We repealed a number of counterproductive policies dating back to the dark days of the 1980s and Senator Jesse Helms, such as ending the HIV entry ban, ending the ban on using federal funds for syringe exchange, and ending funding for abstinence-only-until-marriage education. Unfortunately, the latter two changes were short-lived. And we’ve seen long overdue increases in funding for Ryan White care, the AIDS Drug Assistance Program, HIV prevention through the CDC, and research at NIH, including promising biomedical prevention research.
The CDC-funded Seattle STD/HIV Prevention Training Center is providing a webinar on sexual health in men who have sex with men on June 7, 2012. Additional information is available here. Thanks to our friends at Sylvie Ratelle STD/HIV Prevention Center for tipping us to this training.