Advice for those Newly Diagnosed with HIV

The impact of an HIV diagnosis can feel overwhelming. Some feel as though their life is ending. Luckily, with advanced therapies, living with HIV isn’t a death sentence like it used to be. In fact, those living with HIV can live relatively normal lives for years and even decades after first becoming infected. In addition, there is a large community of those living with HIV and plenty of available resources to get information, proper care, and support.

Here is some advice for those newly diagnosed with HIV:

First, take a deep breath. Now is the time to reach out for the support of friends, family, your partner, and those around you who care about you.
It’s important to start forming a strong relationship with your primary care doctor. Get all the blood tests and run whatever other tests your physician suggests. Luckily there are anti-viral drugs, known as a cocktail, that can bring your viral load down to undetectable levels.
You may have to change your lifestyle, incorporating more healthful practices such as eating right, getting more sleep, and exercising. Make sure you stick with it. This is your health we are talking about. t give up.
Get informed. There are lots of resources out there, including in your area. It can feel really scary, so get as much information and support as you need. If you are having trouble finding those who understand where you are coming from, find a support group in your area.
Remember that HIV is only an aspect of who you are. Don’t let it define you. Remember to take part in all the other aspects of your life such as your job/career, passions, hobbies, love, life, friendships and more.
HIV may get in the way some times and some people get overwhelmed by the fear and sadness. It’s important to allow yourself to grieve and work through all of the emotions. It really is a life changing event, but if you learn to manage it as just an aspect of your multi-faceted and fulfilling life than it becomes not such a big deal anymore. This isn’t a terminal diagnosis. You don’t have to die of HIV anymore. It takes work and effort. So you have to realize that this is going to change your life in some pretty significant ways.
If you have been rejected by your family, make your own new support group of friends. Support from those who understand and care about you is so important in this trying time. Developing and maintaining a positive attitude is really important.

Life doesn’t end at diagnosis. It’s just the beginning for some tremendous changes in your life. Don’t feel as though this is only an experience for you to learn from. Volunteer in organizations, donate to HIV/AIDS research, go to rallies and inform youth and peers of your struggles and how they can avoid contracting HIV. Remember that you aren’t dying of HIV. You are learning to live with it.

Do Gay Men Have Less Stable Relationships?

No one really knows why, but for decades, social studies have hinted that gay men are more promiscuous and less faithful in relationships. Formal studies that have been done to pick apart claims that gay men are less capable of committing to one person however have failed to prove anything. So why are we worried?

The HIV/AIDs epidemic is the major concern. Responsible monogamous couples have very little reason to worry about contracting HIV/AIDs or any other sexually transmitted disease, but young homosexual and bisexual men make up an astoundingly large percentage of new HIV/AIDs diagnoses, and these individuals tend to fall into a “high risk sexual behavior” category also. Although this is hardly proof that gay men are less monogamous, it certainly suggests that they are. There are other reasons to think that promiscuity is a real issue in gay male relationships; past studies that were done on monogamy and relationship security and satisfaction have found that when they compared lesbian, heterosexual, and homosexual relationships women reported feeling more secure and satisfied than men in general. No differences were found to be a result of sexual preference, just gender.

The reality is men usually feel less commitment than women do in relationships, and less satisfied. National surveys that track the prevalence of cheating in married couples have found that, in the U.S. and the U.K., married men are almost twice as likely as married women to have slept with someone other than their spouse. Since most gay couples aren’t married the odds that one of the partners will cheat could be even higher. It’s probably not a terrible thing that gay men are less committed.

Some ultimately suggest that monogamous partnership is unnatural. But, regardless, the contribution that young gay men make to the HIV/AIDs epidemic is something that needs to be taken more seriously. Condom use is not enough. Gay men must take the initiative to know their sexual partners’ history. Like all sexually active people with more than one partner, Gay men should be tested for STDs routinely. Psychologically healthy monogamy may be bogus, but we can’t pretend that having multiple partners is just as safe.

HIV And AIDS Among Youth And Young Adults

Youth and young adults between the ages of 13 and 24 in the United States are among the highest risk groups of being infected with HIV. The CDC reports that the greatest number of new HIV infections within this age group are among gay and bisexual males, with African-American and Latino males who have sex with other men being at even greater risk.

Why is this population increasingly at risk? There are a myriad of reasons, including a lack of sexual education and information promoting abstinence and delaying initial sexual encounters. These groups are also among the highest populations suffering from substance abuse, homelessness, and sexually transmitted infections.

Looking at global numbers, a young person becomes HIV-positive every 30 seconds. Studies have shown that the majority of youth and young adults in the U.S. are not afraid of contracting HIV, which equates to low testing rates and low rates of condom use. While there are an increasing number of HIV and AIDS awareness promotion programs, youth advocacy, and health counseling, the data translates to a dire need for greater outreach efforts.

The best way to prevent infection with HIV is abstinence. Secondly, reducing the number of sexual partners, avoiding unprotected sexual encounters, and being tested regularly are the most important steps you can take to prevent infection or spreading the virus. More than half of the percentage of youth infected with HIV/AIDS were not aware that they had the virus.

While many young adults are not concerned with contracting HIV, a large number are still in denial of the increasing risk of contracting and spreading the virus. Even if you think you are not at risk, it is recommended that you get tested regularly. Speak to a professional today, there are a number free test sites available as well as youth programs and counseling services .

Gay Men’s Health & Healthcare Providers

Have you ever had a healthcare provider who didn’t understand you?

Maybe you just didn’t feel comfortable with him, or maybe she was outright rude. Either way, having an open relationship with your physician is extremely important. Aside from the fact that you don’t want to work with someone looking down their nose at you, being able to raise concerns and discuss health issues openly and honestly is a major contributor to your long-term health.

As a gay man, there are a couple of issues that are particularly important to discuss with your healthcare provider.

#1 HIV/AIDS

Men who have sex with men are at disproportionately high risk for contracting HIV, in addition to other sexually transmitted infections. Many infections may not initially show symptoms so following up regularly for check-ups and discussing your sexual practices with your physician may end up making all the difference in the long run. Many healthcare providers are also able to provide you with other resources and referrals – when it comes to your doctor, it’s always good to talk!

#2 HPV

The serious effects of HPV have only recently hit the forefront of health news. HPV has many strains, but it is mostly known for being the virus that causes genital warts. Genital warts are generally easy to treat, your healthcare provider can prescribe a removal cream, or, if needed, laser treatment. The concern with HPV isn’t the genital warts as much as it is cancer. Unfortunately, there aren’t many other symptoms of HPV to warn you, but the virus is now being linked to increased levels of anal and oral cancer. Oral sex can transmit HPV to the mouth and throat, causing problems in the long run. The virus is also transmitted through anal sex, possibly causing anal cancer. While this is difficult to test in men, keep up to date with your check ups.

If you are a sexually active man, find a healthcare provider that you are comfortable with and check in regularly. Reach out to a professional today!

Alarming Facts About Meth In The Gay Community

Crystal meth has become an epidemic in the gay community, especially in larger cities where “party and play” (PnP) is a well known scene. While party and play can include any type of drug use combined with sexual activity, it usually refers to crystal meth. Following are some unfortunate facts regarding crystal meth use in the gay community:

Meth abuse is widespread

There are higher levels of drug abuse and addiction reported from gay men than heterosexual men. Crystal meth has become an all too common dangerous problem in the gay community within the last 20 years. In certain areas, arrests that have involved crystal meth have doubled, and higher rates have taken place in gay neighborhoods.

Meth is used in combination with other drugs

Many combine meth with other drugs. One trend that wreaks havoc on the body is “speedballing”, which is the mixture of drugs that have opposite effects (sedatives with uppers). The most popular speedball concoctions involve meth and Viagra or GHB. More recent data shows that combining crystal meth and viagra can speed up HIV production in the brain.

Meth and sex parties are growing in popularity

The increasing popularity of parties, which often include drugs, exists with a lot of help from social media sites such as Tinder and Grindr. These parties are regular in many parts of the US. Those who host the get-togethers might even advertise that there will be free meth provided and anonymous sex. This leads to many of the folks attending engaging in unprotected sex.

Meth is extremely dangerous for gay, HIV positive men

Of course, meth is dangerous for everyone, but is particularly harmful in the gay community. There is concern due to indications provided by data that crystal meth can greatly reduce the effects of HIV medication and/or create the “HIV SuperVirus”, which is a virulent strain of HIV.

New HIV infections are rising among young gay men

Gay men between the ages of 17 and 29 are reported to be the highest users of meth and the highest risk level is to those in the western states, under 40 and gay. These risks include that of acquiring HIV and crystal meth addiction. Even if one is HIV negative, use of crystal meth could potentially lead to them contracting HIV more quickly.

IV use is increasing among gay men

Research shows that there is a significant rise in IV meth use seen in gay men. The Antidote, which is LGBTI support service in the UK, reports that use has quadrupled between 2011 and 2013. Users are given an extreme rush and high with an IV trend that is known as “slamming”, which sometimes lasts for several days at sex parties.

Sex can seem boring after quitting meth

It’s is extra difficult for gay men to quit meth due to the effects it has on dopamine in the brain, leading to intense euphoric feelings and heightened sexual arousal.

Gay Black Men’s Pressure to Conform Leads to Higher HIV Risk

Familial and cultural pressure to conform to expected masculine behaviors leads gay black men to engage in riskier behavior, therefore increasing their risk of contracting HIV. This is according to a report out of the John’s Hopkins Children’s Center and published in Science Daily. This community of men feel distress and social isolation, according to the report, which may contribute to their decision to take part in such behaviors. The “compensatory” behavior according to researchers leads to riskier behavior and contributes to the higher infection rate among gay black men.

Gay and bisexual black men attributed to 4,800 new HIV cases in 2010, more than two times that of other male groups, says the CDC. Thirty five young, male participants took part in this study, recently published in the American Journal of Public Health. Openly gay and bisexual men took part in this study, as did young men who have sexual relations with men but don’t self-identify as gay or bi-sexual, also known as MSM. Adolescent medicine expert at the John’s Hopkins Children’s Center and the study’s lead author, Errol Fields, M.D., Ph.D., said of this study, “HIV risk is the sum total of many factors, but social and family stress is a well-known driver of all types of risk-taking behaviors, and our findings clearly support the notion this also holds true when it comes to HIV risk.”

There is a very traditional view of masculinity with strong anti-gay sentiment in the community where the participants grew up. These participants needed to prove their masculinity, hide homosexuality, and conform to social pressures. This makes them far less likely to take part in monogamous relationships and more likely to take part in unprotected sex. Black gay men also sought affirmation through sex which they weren’t getting from a close loved one in their life. Some also said that having unprotected sex showed trust and love for one’s partner. Since the community they were from expected them to act aggressive and free of any feminine behaviors, they were forced to either conform or be ostracized. Drug use, drinking, fighting and other such risky behavior was taken part in so as to prove their masculinity and fit in.

According to Dr. Fields, “The findings of our study reveal a clear clash between internal sexual identity and external expectations at a critical developmental stage,” As a result, “This clash creates loneliness and low self-esteem and appears to drive these boys and men to risky behaviors, sexual and otherwise.” These young men were also constantly worried that they would be found out. If they were found out they would lose their friends and family, so they needed their secret to be safe. “It’s a true catch-22 for these youngsters,” said Fields. “On one hand, they are dealing with the chronic anxiety of hiding their homosexuality, but on the other they face the prospect of becoming social pariahs if they come out as gay or bisexual.”

Dr. M. Mirza – 2014
lgbt health wellness .com

Alternative Treatments for AIDS

Alternative therapies sustain a certain level of support among patients and practitioners. Both allopathic and homeopathic clinicians have a credible place in the treatment of various disorders. But what non-conventional therapies, if any, exist for those suffering from HIV-related maladies?

According to the Centers for Disease Control and Prevention in America, the best recommendation is to find a balance between conventional and alternative applications. New drugs are being tested regularly in the attempt to find both a cure and a means for slowing the progression of sicknesses related to a compromised immune system. Early diagnosis is crucial to getting the jump on HIV, the virus responsible for the breakdown of human immunity and contraction of full-blown AIDS. The CDC suggests any number of modalities to alleviate symptoms of the disease, with intent to restore an element of vitality to the person suffering.

SPECIFIC THERAPIES

When prescribed a regimen of pharmaceuticals, three additional categories of treatment are typically recommended for nearly all levels of disease: mind-body, nutrition and physical therapies. Certain types of massage have proven effective in alleviating symptoms related to chronic aches and pains, and for assisting circulation of bodily fluids and nerve activity. The ability to maintain control of one’s mind is critical to any approach; a sense of well-being and peace must be actively cultivated. Research has shown that discoveries in biofeedback and thought reinforcement have measurable positive effects on all people. Dietitians agree that the tried and true adages hold up: we are what we eat, garbage in – garbage out. Those suffering with more seriously compromised immune systems will likely benefit from a targeted nutritional supplement approach.

Remember that an ounce of prevention is worth a pound of cure. Being in good health doesn’t excuse us from keeping vigil; sickness seems always to be looking for a chink in the armor. Regarding the holistic approach to healthiness, be sure to get the opinions and recommendations of qualified practitioners and the people they’ve treated. Such input will prove invaluable to recovery.

Closing in on AIDS Cure

The Centers for Disease Control and Prevention (U.S.A.) maintains there is no cure for AIDS as of 2011. The CDC points encouragingly to the preventative shot in the arm which has thus far apparently eluded researchers. The prescribed course for managing the disease is a selection of drugs considered successful in prolonging the life of the patient. The established mainstream considers anecdotal evidence more harmful than useful, sometimes going so far as to bring practitioners to court on charges of fraud.

Electrified Blood

In the early 1990s, Steven Kaali and William Lyman, researchers at New York’s Albert Einstein College of Medicine, evidently discovered a way to disable HIV by applying a specific electrical current to blood infected by the virus. They built on the understanding that everything in nature possesses its own resonant electrical frequency. Their findings were reported in a few publications, and a patent was issued on a mechanism for delivering this electric therapy. Speculation abounds, though, that their research was sealed or destroyed, and the men silenced. Robert Beck, physicist who applied their findings, continues to proclaim the veracity of their results even today. Beck and many others now consider blood electrification to be an appropriate response to the entire gamut of systemic diseases.

Are heavily capitalized pharmaceutical corporations keeping the public in the dark to everything but the drugs they peddle? It stirs the emotions to think so. To determine whether therapies are quackery or not requires impartial and accurate investigation. Whatever the facts turn out to be, it rests with every man and woman to apply themselves in due diligence, that we may be confident in the treatments we accept for managing whatever it is that ails us. More information on this and related non-conventional treatments is widely available on the world wide web.

Understanding Anal Cancer Screenings

It is a rare disease, but anal cancer does exist and deserves our attention.

The cases of anal cancer are a lot more prevalent in gay and bisexual men or, “men who have sex with men” (MSM). Unfortunately, most MSM’s have not been tested or know that any screenings are out there, and do not know much, if anything about anal cancer. Medical professionals are actually divided on whether they should even screen for it and how they would do so. Currently, there isn’t any standardized protocol for anal cancer screening.

Facts about anal cancer:

Anal cancer is diagnosed in approximately two out of every 100,000 people in the general population every year.
MSMs who are HIV negative are 20 times more likely to receive an anal cancer diagnosis (about 40 per 100,000 people)
MSMs who are HIV positive are up to 40 times more likely to receive this diagnosis (about 80 per 100,000 people)
The same strains of Human Papillomavirus (HPV) that cause cervical cancer in women also cause anal cancer
In MSMs, HPV is transmitted through both protected and unprotected anal intercourse and skin-to-skin contact. HPV is very common– approximately 75 percent of all sexually active adults acquire HPV; not all HPV infections lead to cancer.

A number of men don’t have any apparent symptoms of HPV, but possible symptoms include:

Genital warts affecting the anus, penis and/or peritoneum
Abnormal discharge from the anus
Bleeding from the anus and rectum
Itching of the anus; pain or pressure around the anus
A sore or sores that do not heal, around the anus

Since the cervix and anus are similar, biologically, and both are target areas for HPV infection, a pap smear can be used test the anus for pre-cancerous cell changes and cancer. More and more health activists and gay physicians believe this procedure could reduce the incidence of anal cancer as significantly as it has with cervical cancer in women.

It is recommended by them that all MSMs, especially those who are HIV positive, receive testing every 1 to 3 years, depending on their CD4 count and immunology wellbeing. Their recommendation for HIV negative MSMs is for testing every 3 years. Other physicians don’t believe all MSMs need to be tested due to the small number of cases, facility shortages for follow-up procedures, and the cost, pain and fear of looking at small changes in cells (dysplasia). In addition, the number of insurance policies that would cover pap smears for the anus is low.

Even though the AIDS Institute of New York recommends that HIV positive gay men “and others with history of HPV disease” be tested annually, there appears to be little agreement about the importance and practicality of offering all MSM clients this testing.

Dr. M. Mirza, lgbt health wellness .com – 2015

Gay and Bisexual Men and HIV Risk

Should the Education System Feel Responsible?

The discussion of homophobia and the actual risk of HIV to the population is always a heated debate, but it becomes a muddier and more frustrating topic when words like “men who have sex with men” (MSM) and “bisexual” are used—and these words are used frequently in studies conducted by the Center for Disease control on AIDs and HIV. The statistics on diagnoses of HIV in 2010 indicate that gay, bisexual, or MSM men whom comprise about 2% of the population account for about 63% of diagnoses in the United States. But the word “about” is the confusing part. It is not exactly clear how many of these men are straight men that have engaged in homosexual acts, and perhaps one might wonder if these men are admitting to homosexual behavior because they are seeking treatment for HIV. Are we certain these men were included in the estimated 2%? Most new diagnoses of HIV occur in young men between 13-24 years of age… they comprised a jaw-dropping 72% of the gay and bisexual men diagnosed with HIV in 2010. Of these individuals, an incredibly large percent of them are African American male youth from disadvantaged backgrounds. Their reported sexual orientation is not the reason that they have contracted the disease, but rather a lack of sexual education and resources for gay men and youths is to blame.

HIV is not a consequence of homosexual behavior, but a consequence of risky sexual behavior (and in some cases drug use). Is that what men who have sex with men are doing, inflating the CDC’s estimates of homosexuals and bisexuals with HIV? Perhaps, but not because MSM are given to more wanton sexual behavior. This term can describe a situation where a man is sexually attracted to another man for any number of reasons but still identifies as straight. He isn’t bisexual because he doesn’t judge himself to be bisexual, and from a positive psychological perspective of identity this is what matters. He may think he is only capable of committing to a woman in a romantic way, or he may not feel equally attracted to both sexes, but either way he is not homophobic and in denial of his identity. In all probability these men have diverse sexual habits because of the broad category of relationships it can describe.

Obviously some high-risk sexual behaviors, particularly those occurring between men under the influence of drugs or alcohol, are being thrown into this category of men who have sex with men. These encounters would probably not meet most standards for “romantic” behaviors between men, and it is horribly unfair that they are counted among the estimates for new diagnoses of HIV in gay and bisexual men. The rampant homophobic attitudes that prevent awareness campaigns and resources from being accessed in some communities would like us to think that all gay men are having random encounters. The bitter irony is that this fear-mongering promotes carelessness, especially in younger people who need to be educated on what exactly “high-risk sexual behavior” is.

It’s an unsavory topic, but teenagers are having sex. The academic world has come a long way in its attitude towards homosexuality recently by including LGBT alliance and awareness groups in schools, but we need to take a more aggressive attitude towards sexual education in schools. Sexual education needs to be taught in every classroom, and the earlier that teens get it the better off they are. The LGBT community is not taking up enough time in classroom discussions of sexuality. The education system cannot tiptoe around topics like “men who have sex with men” and “homosexuality”. There is no end to the number of mistakes a teenager can make without appropriate guidance from the education system. We were all there once… we have to be honest with ourselves. Blaming stupidity and thinking that the actions of wayward teens don’t affect us is our right, but the astoundingly high numbers of new HIV diagnoses portray the denial of these youths by our culture—they are parallel minds that we just won’t accept responsibility for. Rather than scapegoating the underprivileged communities that raise them, efforts to raise LGBT awareness need to expand beyond home. Community effort needs to mean national effort and then global effort. Bridging the gap between LGBT communities and underprivileged communities created by HIV is the key to fighting this epidemic. If there is anything you can do, don’t hesitate.

MSM, Gay, and Bisexual Men and HIV Risk: Should the Education System Feel Responsible?
Dr. M. Mirza – lgbt health wellness .com – 2014

Should You Take PrEP?

When we first learned how to combat the HIV/AIDS epidemic of the 80’s and 90’s, safe sex was the only surefire answer to prevent HIV infection. PrEP or Pre-Exposure Prophylaxis is a new recent development you can take to avoid contracting HIV. It must be taken daily, but it has been proven effective according to the Centers for Disease Control and Prevention (CDC). Remember to continue using condoms; PrEP does nothing for STD’s like chlamydia, syphilis and others diseases on the rise.

Truvada is the brand name of this medication, which combines two anti-retroviral drugs. If not taken daily the chances of contraction rise greatly. When talking to your doctor about PrEP, be honest as to whether you can reliably take this medication every day. Taking it one time before a particular act does not mean it will prevent the spread of HIV.

If you believe you are at risk, follow these guidelines to help ensure you stay HIV free:

If you have a relationship with a partner who is HIV positive, you should ask your doctor about PrEP.
Anyone who is not in a monogamous relationship and is gay or bisexual who has had an STD within the last six months or has unprotected anal sex should take PrEP.
Anyone who has unprotected sex with more than one partner whose HIV status is unknown, those who use intravenous drugs, sex workers or those that have bisexual male partners should use PrEP.
A patient must get a doctor’s prescription before going on PrEP. Those who are prescribed PrEP must have normal kidney function, have a negative HIV test, show no signs or symptoms of HIV and have never had hepatitis B or have taken the vaccination against it.
After receiving a prescription and taking it daily, a patient must have a checkup once every three months for counseling on how they are doing and how well they are adhering to the medication, assessments of side effects, HIV testing, kidney function check and more.
Even though you are on PrEP, no method is 100% effective. One should still continue to get tested for HIV. A Truvada prescription costs between $1,300 to $1,700 for a month’s worth of pills. If you are considering PrEP, check with your insurance company and physician or urologist to see if the medication is covered. To avoid HIV practice safe sex and limit your number of partners. Protect yourself; you are worth it.

Dr M. Mirza
lgbt health wellness .com – 2014

What Are Young Gay Men’s HIV Prevention Needs?

Are young gay men at risk?

Unfortunately, yes. Accumulating research shows alarmingly high HIV prevalence rates among young gay men and high rates of sexual risk-taking, suggesting that young gay men in their 20’s are forging a “second wave” of the AIDS epidemic. During the 1980s, the median age at HIV infection was older than 30 years. It dropped to 25 years during the period from 1987 to 1991. From 1987 to 1991, one in every four newly infected individuals in the US was age 22 or under.

A recent study of 425 gay men aged 18-29 in San Francisco, CA found that 18% were already infected with HIV, with a seroincidence rate of 2.6% per year: among the 27-29 year olds, 29% were HIV+. Another study which sampled young gay men aged 17-22 from public venues such as bars, street corners, dance clubs and parks found 9% of the men to be HIV positive. Young African-American men were found to have especially high HIV seroprevalence (21%). A study of gay men aged 18-24 in New York City found 9% HIV positive.

What places young gay men at risk?

In contrast to studies with older gay men which demonstrate dramatic reductions in HIV risk-taking behaviors, a variety of studies show that young gay men are engaging in high rates of unsafe sex. In a survey of gay men aged 18-25 in three medium-sized West Coast communities, 43% of the sample reported having engaged in unprotected anal intercourse during the previous 6 months.(7) A study of gay and bisexual adolescent males in Minnesota found that 63% were at “extreme risk” due to unprotected anal intercourse or intravenous drug use. A San Francisco telephone survey showed that 44% of gay men under the age of 30 had engaged in unprotected anal intercourse during the previous year, compared to 18% of the men over age 30.

What contributes to risk taking?

A complex array of factors – at individual, interpersonal and community levels – contributes to the high sexual risk-taking of young gay men. Since the bulk of AIDS cases among gay men is among men aged 30-40, many young gay men perceive AIDS as a disease of older men and feel it is safe to have unprotected sex with other young men. Most young men know how HIV is transmitted and men who engage in unprotected sex do label their behavior as putting themselves at risk for AIDS. Nonetheless, with their feelings of invulnerability typical of youth, young men may feel the negative consequences “won’t happen to me”.

Young men are often in an exploratory phase with regard to sexuality which may entail high numbers of partners and a willingness to try a variety of activities. Due to inexperience, young men may be less competent in negotiating low-risk sex and less knowledgeable about making safe sex activities enjoyable. Coming out as gay can also be a period of great emotional turbulence, resulting in low self-esteem and depression which may reduce their feelings of self-efficacy and motivation for safe sex.

Further, protecting one’s health is not necessarily a young gay man’s top concern. Interpersonal motivations may be more pressing – wanting to fit in, to find companionship and intimacy. However, interpersonal issues can also contribute to unsafe sex. For young gay men, unsafe sex is most likely to occur with a boyfriend – someone whose affection is very important to them.(7)

The social structure and norms of the young gay subculture may not be entirely conducive to safer sex. In many communities, gay bars and public cruising settings provide the main opportunities for young gay men to meet and socialize. Yet each is highly sex-charged and the bar scene’s emphasis on alcohol sets the stage for engaging in sex while high – consistently found to contribute to unsafe sex.

What works for young gay men?

Despite enormous need, only a handful of programs specifically targeting young gay men have been designed and evaluated. Individualized risk-reduction counseling followed by peer education and referrals to drug, counseling and health services were reported to be an effective strategy for decreasing unprotected anal intercourse among gay male adolescents in Minneapolis, MN. In New York City, an intensive, multi-session small group intervention was offered to gay youth aged 14-19 seeking services at a community-based agency for gay youth; the more sessions youth attended, the more dramatic the changes in risk behavior.

Community-level programs can reach large numbers of young men. One successful program promoted a norm for safer sex among young gay men through a variety of social, outreach and small group activities designed and run by young men themselves. Rates of unprotected anal intercourse dropped from 40% to 31% after the intervention. The program found that young men engaging in unsafe sex who were unlikely to attend workshops were more likely to be reached through outreach activities – such as dances, movie nights, picnics, gay rap groups, and volleyball games.(13) STOP AIDS’s Q Action, in San Francisco, CA, is a community organizing model that promotes HIVprvention by putting the power for designing and implementing interventions directly into the hands of young gay men.

Youth-oriented media can also be used creatively to reach large numbers of young gay men. In Australia, ads promoting HIV prevention peer support groups appeared in popular youth magazines across the country. Over 1,300 young men responded. Follow-up questionnaires showed that 73% had not told a family member about being gay, and 48% had told no one. Direct mail was also found to be highly successful for sending AIDS and sexuality information to gay adolescents in rural, isolated, or culturally difficult environments who would otherwise not access support.(14)

What needs to be done?

Since there are multiple factors that contribute to HIV risk-taking among young gay men, multi-level prevention programs are necessary – programs that impact variables at individual, interpersonal and social system levels. Funding, designing, implementing and evaluating HIV prevention programs for young gay men must be a high priority to halt the AIDS epidemic.

The myth that the gay community has been saturated with AIDS prevention services is in serious need of debunking. New young men will come out each year who have not been exposed to prevention campaigns of previous years, thus HIV prevention for young gay men must be ongoing and dynamic.

Engaging, creative programs are needed that address HIV prevention within the contexts of young gay men’s lives, incorporating issues of self-esteem, coming out, substance use and interpersonal and social needs. Community-level and peer outreach programs are especially promising, and services for young gay men of color are particularly needed. Since previous sexual history is a strong predictor of current risk-taking behavior, intervention at an early point in a young man’s sexual initiation will be maximally effective.

Societal homophobia may impede implementing effective prevention programs for gay youth and may discourage young gay men from accessing prevention services.Political concerns must not interfere with HIV prevention services for young gay men. A comprehensive HIV prevention strategy uses multiple elements to protect as many of those at risk of HIV infection as possible. Targeting young gay men with AIDS prevention messages and services is not “condoning” or “promoting” homosexuality, it is acting responsibly in the face of a grave public health threat. Unless action is taken quickly, we will lose a new generation of gay men.

caps.ucsf.edu/YGMtext.html – 2000