Tuesday, November 30, 2010
World AIDS Day
World AIDS Day happens every year on December 1st. On this day, the entire world makes a large effort to remind everyone on this planet that there is still a preventable disease infecting large numbers of people. That this disease has further been spread through ignorance, discrimination, stigma, poverty, incarceration, alcohol and drugs and many other social and psychological issues. That HIV/AIDS activism still is needed today because every year, individuals on the national, state and local level have to explain to politicians newly elected why providing funding for HIV medication will help stop the spread of HIV and keep thousands of people healthy. Every year, small organizations have to fight for the small amount of money they get each year to provide the necessary services for their community. And every year, individuals living with HIV/AIDS know that another year has passed and because of them and other individuals, are healthier now then they were 10 years ago. And all of us come together and take a moment to remember those who have left us this year. and in years pass. We take a moment and light a candle, wear a ribbon, or approach one of our friends and say " Let me tell you about a friend/partner/family member I had who taught me a lot about not only HIV but about loving life."
So please join AIDS Network, UW Clinics, Madison/Dane County Public Health and the University of Wisconsin as we recognize World AIDS Day.
Monday, November 15, 2010
I am HIV Positive and I Don't Blame Anyone - including myself
This is a reposting of an amazing article done by Kirk Grisham.
To view the original post, please go HERE.
I am HIV positive, and I don’t blame anybody for it—not myself or anybody else.
He didn’t rape me and he did not trick me. It was through our unprotected sex that I became HIV positive. Since seroconverting, I have been very conscious of the language I use to discuss transmission, particularly my own. To say “he gave me HIV” obscures the truth, it was through a mutual act, consensual sex, that I became HIV positive. When speaking to him a couple months after my diagnosis I gathered that he knew he was positive when we had sex. But that is beside the point; my sexual health is mine to control, not his.
We are encouraged to think about prevention and transmission in terms of responsibility. Someone must be at fault. Culturally, we hunt for secret villains. Today’s “down low” black man is but the latest boogeyman at which we’ve pointed our fingers—the latest of the so-often racialized monsters at which we can direct HIV blame rather than have honest conversations about sex and relationships.
In recent weeks, another recurring villain has re-emerged: the HIV-positive criminal who callously infects others. Last month, long-standing accusations that baseball legend Roberto Alomar hid an alleged HIV infection from his wife and girlfriends returned to the news. This summer, German pop star Nadja Benaissa made international headlines as she was tried for failing to disclose her HIV status to sex partners. These stories rarely fail to steal the news spotlight, and often throw local communities into HIV panics.
There must be a reason they are so resonant, right? They are evidence that HIV transmission from knowingly positive persons is rampant, right? Wrong. The reality is that the vast majority of HIV infections occur between two consenting people who believe they are doing nothing more risky than making love—or, at least getting laid.
People who know their HIV status are actually more likely to use condoms than not. The Centers for Disease Control and Prevention reports one snapshot study that found 95 percent of those living with HIV infection in 2006 did not transmit the virus to others that year. Another CDC study, released in September, found that while one in five “men who have sex with men”—public health jargon for gay and bisexual men—in 21 major cities has HIV, nearly half of those men (44 percent) don’t know it. The agency estimates that the majority of new infections each year result from sexual contact in which the positive person does not know he or she has HIV.
HIV disproportionately affects African Americans, regardless of sexuality. They account for half of the people living with HIV/AIDS, but just 13 percent of the overall U.S. population. Studies also suggest African Americans are least likely to know their HIV status, with the younger being less aware. Similar patterns exist among men who have sex with men, of all races. No talking and no testing, just finger pointing.
The communication problems that help drive these trends don’t stop with finding monsters to blame. People I love and talk to about my status do not always have the language or tools to express their grief and worry. They ask things like, “How could you be so irresponsible?” Or, “How could you fuck up like this?”
This language hurts, but more importantly it shifts the discussion from meaningful conversation about risk and vulnerability to simplistic directives: if only people used condoms, transmission would cease. But this idea relies on a complicated array of misconceptions and idealistic assumptions of equality, equal access to information, and how to use that information to stay HIV negative.
It is irresponsible to just tell people to use condoms without acknowledging that conditions like poverty, patriarchy and homophobia play roles in the so-called risks we all take. Even with people who have seemingly escaped these broader contexts—say, a working-middle class white man such as myself—stigma can prevail. Stigma that is produced by homophobia and general ignorance, yes, but also by American society’s desperate need to discipline and punish, to affix blame on individuals rather than confront the systems in which individuals live. So the AIDS epidemic becomes a challenge of personal responsibility rather than a damning indictment of global public health. That personal responsibility, however, is tricky: I bore no responsibility for the epidemic, until I had HIV, when it became entirely my problem.
When I used to get tested at the city clinic, they would tell me that people stay negative by disclosing their negative status. Having a conversation is paramount—negotiating whether and how you want to use protection, talking about the last time you were tested and asking the same of your partner. This dialogue cannot be taken for granted, but for many, before these conversations can happen, we need the tools to do so. So here, we lead by example. Three people of varying HIV status offer their own testimonies on how they think about their sexual health, and what it means.
To view the original post, please go HERE.
I am HIV positive, and I don’t blame anybody for it—not myself or anybody else.
He didn’t rape me and he did not trick me. It was through our unprotected sex that I became HIV positive. Since seroconverting, I have been very conscious of the language I use to discuss transmission, particularly my own. To say “he gave me HIV” obscures the truth, it was through a mutual act, consensual sex, that I became HIV positive. When speaking to him a couple months after my diagnosis I gathered that he knew he was positive when we had sex. But that is beside the point; my sexual health is mine to control, not his.
We are encouraged to think about prevention and transmission in terms of responsibility. Someone must be at fault. Culturally, we hunt for secret villains. Today’s “down low” black man is but the latest boogeyman at which we’ve pointed our fingers—the latest of the so-often racialized monsters at which we can direct HIV blame rather than have honest conversations about sex and relationships.
In recent weeks, another recurring villain has re-emerged: the HIV-positive criminal who callously infects others. Last month, long-standing accusations that baseball legend Roberto Alomar hid an alleged HIV infection from his wife and girlfriends returned to the news. This summer, German pop star Nadja Benaissa made international headlines as she was tried for failing to disclose her HIV status to sex partners. These stories rarely fail to steal the news spotlight, and often throw local communities into HIV panics.
There must be a reason they are so resonant, right? They are evidence that HIV transmission from knowingly positive persons is rampant, right? Wrong. The reality is that the vast majority of HIV infections occur between two consenting people who believe they are doing nothing more risky than making love—or, at least getting laid.
People who know their HIV status are actually more likely to use condoms than not. The Centers for Disease Control and Prevention reports one snapshot study that found 95 percent of those living with HIV infection in 2006 did not transmit the virus to others that year. Another CDC study, released in September, found that while one in five “men who have sex with men”—public health jargon for gay and bisexual men—in 21 major cities has HIV, nearly half of those men (44 percent) don’t know it. The agency estimates that the majority of new infections each year result from sexual contact in which the positive person does not know he or she has HIV.
HIV disproportionately affects African Americans, regardless of sexuality. They account for half of the people living with HIV/AIDS, but just 13 percent of the overall U.S. population. Studies also suggest African Americans are least likely to know their HIV status, with the younger being less aware. Similar patterns exist among men who have sex with men, of all races. No talking and no testing, just finger pointing.
The communication problems that help drive these trends don’t stop with finding monsters to blame. People I love and talk to about my status do not always have the language or tools to express their grief and worry. They ask things like, “How could you be so irresponsible?” Or, “How could you fuck up like this?”
This language hurts, but more importantly it shifts the discussion from meaningful conversation about risk and vulnerability to simplistic directives: if only people used condoms, transmission would cease. But this idea relies on a complicated array of misconceptions and idealistic assumptions of equality, equal access to information, and how to use that information to stay HIV negative.
It is irresponsible to just tell people to use condoms without acknowledging that conditions like poverty, patriarchy and homophobia play roles in the so-called risks we all take. Even with people who have seemingly escaped these broader contexts—say, a working-middle class white man such as myself—stigma can prevail. Stigma that is produced by homophobia and general ignorance, yes, but also by American society’s desperate need to discipline and punish, to affix blame on individuals rather than confront the systems in which individuals live. So the AIDS epidemic becomes a challenge of personal responsibility rather than a damning indictment of global public health. That personal responsibility, however, is tricky: I bore no responsibility for the epidemic, until I had HIV, when it became entirely my problem.
When I used to get tested at the city clinic, they would tell me that people stay negative by disclosing their negative status. Having a conversation is paramount—negotiating whether and how you want to use protection, talking about the last time you were tested and asking the same of your partner. This dialogue cannot be taken for granted, but for many, before these conversations can happen, we need the tools to do so. So here, we lead by example. Three people of varying HIV status offer their own testimonies on how they think about their sexual health, and what it means.
Thursday, November 11, 2010
Project Inform creates booklets for those newly diagnosed with HIV
Source: Project Inform
Project Inform created this series of three publications to address commonly asked questions and issues that people face as they come to terms with their diagnosis of HIV or AIDS and begin to address their health needs, including making decisions about starting HIV meds.
After you’ve tested positive
(booklet 1 of 3)
This booklet helps guide individuals on basic things to do after finding out they’re HIV-positive, with an emphasis on understanding HIV infection, getting into care, and finding a support network.
Considering treatment & your health care
(booklet 2 of 3)
This booklet explores decision making about HIV health, from considering treatment to talking things out with a support network and doctors to thinking more broadly about personal health needs.
What you should know about when to start & what to use
(booklet 3 of 3)
This booklet focuses on the issues related to taking HIV medications, including deciding when to start and what to use, planning ahead, considering how treatment may affect one's life, and finding an HIV-experienced doctor.
Friday, November 5, 2010
HPV Vaccine Cost Effective for Men who have Sex with Men
Courtesy of Medpage Today
I hope that this information is legitimately considered by Public Health departments and vaccinations of men who have sex with men does happen. The statistics regarding rates of Anal Carcinoma in men who have sex with men and even more so with men who are HIV + already proved the dire need for vaccinations to occur in this population. I guess human life isn't as persuasive as cost analysis. I'm glad someone was able to do that for those who see money over prevention.
Here's the article:
Vaccinating men who have sex with men (MSM) against human papillomavirus (HPV) may be a cost-effective approach to the prevention of anal cancer and genital warts, according to a study using decision-analysis models.
In a best-case scenario, when the vaccine is given to MSM at age 12 years, before any exposure to HPV has occurred, and assuming 50% vaccine coverage and 90% efficacy, the cost effectiveness ratio for each quality-adjusted life year (QALY) gained was $15,290, according to Jane J. Kim, PhD, of the Harvard School of Public Health in Boston.
Even if the vaccine was given later -- for instance at age 26 and exposure to HPV was assumed -- the cost-effectiveness ratio remained below the minimum benchmark of $50,000 per QALY gained, at $37,830, Kim reported online in Lancet Infectious Diseases.
In 2009 the CDC's Advisory Committee on Immunization Practices recommended the use of the quadrivalent HPV vaccine to prevent genital warts for boys and men ages 9 to 26 years, but stopped short of making it a routine vaccination because cost-effectiveness data were lacking.
The vaccine subsequently was shown to be effective in preventing anal lesions in MSM, so the CDC and its advisory committee decided to reconsider the issue.
With the goal of providing guidance on the cost effectiveness of HPV immunization in MSM, Kim performed mathematical modeling in a variety of scenarios, assuming a cost per vaccination of $500, to estimate gains in QALY and expenses avoided for both anal cancer and genital warts.
Variables included age at the time of vaccination and exposure to HPV, incidence of anal cancer in a specific population, and whether the benefit included costs per case of anal cancer or also for genital herpes.
In most scenarios the cost-effectiveness ratios were below $50,000 per QALY
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