11/28/2007
Health Officials Note Disturbing Trend in MSM HIV Infections
In an article published Wednesday in the Journal of the American Medical Association, Dr. Harold Jaffe, department of public health director at Oxford University, Dr. Kevin de Cock, head of HIV-AIDS at the World Health Organization and Dr. Ronald Valdiserri, chief consultant to the public health strategic health care group of the U.S. Department of Veterans Affairs, make note of the trend of increasing HIV infections among men having sex with men:
"The commentary looks only at trends in western countries, where men who have sex with men have always made up the lion's share of people living with HIV-AIDS. They noted there was a 13-per-cent increase in American MSM living with HIV-AIDS between 2001 and 2005. A 10-fold increase in syphilis cases among MSM in the United States over the same period is further evidence of an increased frequency in unprotected sex, the authors said. HIV-AIDS rates among men who have sex with men are also in the increase in Canada. David Boulos, a senior epidemiologist with the Public Health Agency of Canada, said Tuesday that MSM accounted for only about 37 per cent of new HIV infections in this country in 1996, an all time low. But since then the rate has again begun to climb, reaching about 45 per cent in 2005. Jaffe and his co-authors suggest the reversal is at least in part the product of complacency. 'Our feeling is that there's now a complacent attitude towards the epidemic in general and particularly in gay men. Somehow it's just being accepted that yes, of course, the epidemic is continuing,' he said from Oxford."
The UN recently cut the number of people it believes to be infected worldwide with HIV by 6.3 million cases. World AIDS Day is December 1.
Recently
SF Doctors Surprised and Concerned by Return of Kaposi's Sarcoma [tr]
Posted 11:15 AM EST by Andy Towle in AIDS/HIV, Health, Medicine, News | Permalink
Like it?
Subscribe to FREE Towleroad daily headlines with our RSS feed!
RECENT STORIES:
Comments
You can follow this conversation by subscribing to the comment feed for this post.
Paul, reread my last post. I am not suggesting to be proud of whichever disease will eventually conquer my life, I am suggesting to be proud of being ALIVE. And I know that between now and then my life will be fuller because I came to that realization. Paul, I hate to break it to you but you are going to pass on one day too. Stop thinking that you have TOTAL control over your life and you will be much happier in the end. Unless you live in a stimulus free, germ free, sex-less, emotion-less, "fitter happier more productive" meta-bubble, you have no control over it. You can lift all the weights you want and wear 1/2 a dozen condoms everytime you hook up, it may make you feel safer, but I ask, who has a better sense of reality and life when faced with the concept of death.
Posted by: Jake | Nov 28, 2007 4:02:42 PM
24play and Jake, I never said I was a health freak or that I expect anyone to live "pure" lives (whatever that means). I'm simply pointing out that getting HIV is extremely unpleasant and generally avoidable. I am not judging or castigating HIV+ people---I know tons of them, which is why I feel it's such a shame, especially among young people.
You can't debate that it's something nobody should want to have, and that it's something that will affect your health, sex life, relationships, and many other areas for the rest of your life, as well as the lives of everyone who loves you. And no, I don't want to or plan on living forever. I don't even fear death. I just wouldn't want to be taking extremely strong medications every day to avoid it, only to see their efficacy fail.
And 24play, there are certainly very clear-cut cases of irresponsible risk-taking. No one can argue that driving drunk, shooting heroin, or participating in meth-fueled bareback orgies are responsible behaviors. I've driven drunk, and I regret it. My friends have shot heroin and participated in orgies, then gotten HIV. And I can tell you they regret it.
Posted by: Paul | Nov 28, 2007 4:37:19 PM
Okay, Paul decides. I get it.
Be sure and send me a list of all irresponsible activities. I'll post it on my fridge as a reminder.
Posted by: 24play | Nov 28, 2007 4:41:57 PM
"No one can argue that driving drunk, shooting heroin, or participating in meth-fueled bareback orgies are responsible behaviors."
Um yeah, and they are illegal as well. Consensual sex is not illegal. Unprotected sex is not illegal. It may not be wise but it is a legal right that human being have, and they can do it how they please. If you chose to live in a culture of fear, then prepare to have that fear manage you.
"My friends have shot heroin and participated in orgies, then gotten HIV. And I can tell you they regret it."
Of course they regret it but trust me there was ALOT of emotion and destruction and pleasure leading up to that moment. Do they regret that? Did they consider that before hand? Who can say, we cannot judge the actions of anyone other than ourselves. I'm not claiming becoming HIV+ is a panacea - I found out less than a year ago and I have never been more depressed or confused in my young life (I'm 32). But I won't let it control my destiny. I control that. And for so many gay men that are emotionally and socially out of control, it can be a hidden blessing indeed.
Posted by: Jake | Nov 28, 2007 4:56:21 PM
Paul: thanks for your comment. When I said emotion, I kind of meant it as the opposite of logic. Animals look to be safe, secure, etc. Most don't rationalize in the way the humans do. And I think those sort of "baser" drives play into human emotional states. Thanks for challenging that. It's hard to be precise with quick posts.
Jake: sorry to hear that you're positive, but glad that you've used it as an engine for growth! That's very Buddhist/Zen, etc.
To everyone else: I guess I can understand both perspectives. People should be concerned about risk taking, but that doesn't mean that you want to denigrate folks. It's a tough line to walk.
I guess I think that this just goes to the point of my original post which was that people are HUMAN. To hope that people behave in ways that won't hurt them is a good thing. But, to get upset when people behave as they do . . . . I'm not sure that's entirely productive. It kind of denies reality and denying reality always causes problems. Have a good rest of the week everyone!
Posted by: Brandon | Nov 28, 2007 6:15:30 PM
Interesting article. More interesting comments. I think what we have to understand is that STDs will be among humans as long as we exist. Sex is driven by very basic & very strong instincts, and human emotions add a complicated layer of motivations that lead many individuals to unprotected sex. That's life. Humans are all also prone to biases. HIV+ people are biased in a way that justifies their existence, and HIV- people use the "responsibility" rhetoric. I fall under the latter type. I've always pride myself in my rationality, my intelligence, and my calculating manner in which i see the world; however, I realize not everyone is like that--from a biological perspective that is. For example, there are individuals who are hardwired to be more entertaining and outgoing than I am.
Anyway, long story short, it takes experience to become humble with peoples differences and not try to superimpose a moral score on everyone's actions--after all, at the of the day, we are still only animals responding to external stimuli and innate predispositions.
Posted by: Miguel | Nov 28, 2007 6:58:44 PM
Miguel is the voice of sanity in what is obviously a very passionate, and opinionated, discussion!
Posted by: Danny | Nov 28, 2007 8:58:34 PM
Danny, agreed. Miguel's comments are most welcome.
I just want to clarify that I was never attacking anyone, and that whatever behavior people engage in is obviously their choice. I just can't applaud the consequences of those choices; they make me sad. And please recognize that message comes from someone who has made a mountain of poor, risky choices in his life.
Posted by: Paul | Nov 28, 2007 9:16:47 PM
Jake, cut the bullshit. On the one hand, you wrote that "becoming becoming HIV + was one of the best things to happen to me."
You attributed a number of beneficial changes in your life to being infected with the virus. You says you've "never been mentally emotionally or physically more solid," and that "becoming HIV+ makes you cherish life and take care of yourself in ways you never were capable of understanding before."
After typing that happy horseshit, you had a truth attack and wrote, "I'm not claiming becoming HIV+ is a panacea - I found out less than a year ago and I have never been more depressed or confused in my young life (I'm 32)."
Eventually you'll figure out what the hell to do with your life. In the meantime, please do a favor for others with whom you might share your bodily fluids: Inform them that you are HIV+ before having sex with them, and then be sure to avoid regifting the virus.
Sorry to be so "judgmental," but tough shit. I lost too many people, including my partner well AFTER the new drugs came out. In 2004, to be exact. I'm glad you're not going to let it control your destiny, or more to the point you think you won't.
But Jake, you just might not have any choice in the matter. You seem to think you've mastered life and death. The hell you have. Get real. Or don't get real. But just don't infect anyone else.
Posted by: Anon | Nov 29, 2007 4:14:45 AM
Jake, I'm a 22 year old recent college grad from an Ivy League school, HIV negative despite lots of great sex. After a dozen years of sex education indicating that HIV is a near-death sentence (which I've never fully bought into, btw), I'm curious about how you view it so positively. I've been out since I was 13, and have always acted responsibly because I never wanted to be infected with, well, a death sentence---and I'm sorry if that wording offends you. I know that you can live a long time, but often in an unpleasant way (meds, discrimination, short-sighted family, friends, and strangers).
I'd just like to understand how you view your positive diagnosis as having contributed to a positive change in your life. I'm pleased that you, your friends, and presumably your therapists have helped you reach that conclusion. It's just hard for me to understand how succumbing to HIV (and the inevitable AIDS) gives you so much strength.
I guess my real questions are, Are you truly happier being positive? And if so, how? And do you think these benefits were only possible through a positive diagnosis?
I don't mean to be rude, but it boggles my mind.
Posted by: Robert | Nov 29, 2007 4:42:18 AM
Im young, well 26, and I have no desire to catch the disease and do everything in my power to prevent it. Just because the drugs are keeping people alive longer, it doesn't mean they are a walk in the park. The side effects are horrifying.
Posted by: Travis | Nov 29, 2007 12:15:25 PM
For God's sake! Aint nobody here even come close to sayin' they're going to go out and spread anything to anyone.
All Jake is saying is that he matured after receiving such sobering news--matured faster than he believes he would have without the diagnosis.
Sometimes "tough love" or "being realistic" are just other terms for being mean and nasty.
Posted by: Derrick from Philly | Nov 29, 2007 12:38:54 PM
Derrick from Philly, you seriously are amazing. Thank you so much for that response. All I can say to the previous posters is that you can not know what it is like to be in my position until you have been there. I feel like I have been given a second chance at life. I am doing it with dignity and substance. Jake isn't even my real name - I'm using an alias because of the kind of closemindedness that I sense is out there. I have only told only one other person - my best friend - and the love and respect that I get from him is so real and amazing that you could all take a cue from him. I can't change anyone's opinions and I am sure as hell not going to go out there and be dishonest to anyone I may sleep with (you know, like the dude who did this to me in fact did. I am just saying this. Once you find out, it's like, a VERY sobering moment. You can rise up or you can descend into sorrow and pain. I will rise up and I hope that my few choice words on here have done a little to help people sense that. I really would expect more compassion from my gay peers but as we all know that just cannot be counted on. World AIDS day is December 1rst. That used to mean shit to me too, but it doesn't anymore. Take 5 minutes out of your busy Saturday and reflect on this disease. And ask yourself what would you do if you got it. It's no inevitable at all. But it is Treatable. And HIV is more a mental disease than physical one for many people. Find compassion and love in your souls as I have been forced to do and you will never look back.
Posted by: Jake | Nov 29, 2007 12:50:35 PM
Take five minutes out of the day and reflect on the disease? Oh, please. How about take five minutes out of my day and NOT reflect on the disease?
I miss the people who have died, and I miss 'em every day. They were my friends, and one of them was my partner of 20 years, a monogamous guy (one of the rare ones) who got it from his very first partner, who played around behind his back. I don't expect you to mope around and hang your head in shame, but you ticked me off when you did the "AIDS is a blessing" rap.
"Jake," it's not a blessing. And whoever told him that he's being Buddhist, um, no. Anyone who's ever been to Catholic school can tell you about being instructed into the wonders and nobility of suffering.
AIDS is a disease, pure and simple. HIV isn't any more noble than variola (smallpox) or vibrio cholerae (cholera). Yes, it can be treated, but it cannot be cured. Get HIV, and you've got it forever. And those drugs, among other things they fucking eat out your liver.
Don't talk to me about compassion. I've displayed more compassion in real life, on the ground, than you'll know. But Jake, if you want do some good, you won't run around telling people that getting the news that you're infected was one of the best things to happen to you. It wasn't. It was one of the worst things to happen to you, and you know it.
You can also tell people, including those in long-term relationships, that they don't have to seroconvert. I didn't, and my partner and I had plenty of sex. My new partner also is HIV+, which did not rule him out for me even though I'm HIV-negative. But if he were to have told me that becoming HIV+ was the best day of his life, I'd have told him to take a hike. Not because I think he carries the mark of shame, but because I wouldn't want to hang out with a lying idiot.
Posted by: Anon | Nov 29, 2007 1:48:05 PM
Okay, some third thoughts after talkiing to me partner. He reminds me that AIDS is a different experience now than it once was. When we were younger, people died. Now it's manageable, and my partner thinks that people don't take it as seriously for this reason.
He says the drug side effects aren't as harsh as they used to be, because the doctors have learned that they can reduce the dosages compared to what they used to use. So, when I wrote that the drugs "fucking eat out your liver," that's no longer the case.
And you're not a lying idiot. I truly apologize for that comment. Yet, at the same time, I do wish you'd take a long, hard look before protraying your HIV infection as some sort of "blessing in disguise."
On that point, I won't back off. It's not a blessing. You have a fatal infection whose effects are being held in check by drugs. There is nothing good about it. If people need a near-death rush to focus their minds, they should take up skydiving instead.
Posted by: Anon | Nov 29, 2007 2:13:43 PM
Anon, please shut the fuck up, you self-righteous bastard!
Posted by: Jorge | Nov 29, 2007 2:25:22 PM
And Robert, I guess 35 is the new 22, huh?
Posted by: Jorge | Nov 29, 2007 2:27:40 PM
ANON,
God Bless your partner. I hope you two stay together forever because he obviously knows how to tame a lion. Gracious.
Posted by: Derrick from Philly | Nov 29, 2007 2:36:42 PM
After reading and re-reading the string of comments to this post last night, I went to bed both saddened and sickened by the HIV disparity shown here. This morning I woke to the realization of how far we have NOT progressed in dealing with this human catastrophe.
Having tested positive 5 years ago, at the age of 40, I can attest to the fact that HIV is a life changing experience. Has it been the best thing that ever happened to me? No. Has it been the worse? No, again. Has it changes the way I live, and love? Without a question. And contrary to what seems to be popular belief here, not everyone who is infected became so as a result of meth-fueled bareback orgies. Yes, “bad” things do happen to good people.
My heart goes out to Jake. The “tough love” you’ve endured here has been lacking in the compassion you deserve within the gay community. Although everyone’s experience with seroconverting is different, I can tell you from experience that the first year is the most difficult. I hope that you are working with your doctor to manage your long-term health. The silver lining that you’ve found in the looming grey cloud that HIV has brought into your life is a testament to the resilience of the human spirit. May it serve you in dealing with the challenges of life for a very, very long time.
As Saturday is World AIDS Day, I encourage everyone to get tested—whether you think you need it or not. This simple, brave act is the only cure we have for this disease in the foreseeable future.
In beating HIV, KNOWLEDGE IS POWER.
YOUR status, practice SAFER sex, and have an honest CONVERSATION about your sexual health with your partners. Statistics show that a majority of HIV is transmitted by people who are unaware of their positive status. If everyone got tested every 6 months (whether they thought they needed to or not) we could remove a lot of the fear and stigma surrounding this disease, and get treatment to those who are newly infected which would in turn lower HIV infection rates within our community.
Posted by: my2cents | Nov 29, 2007 3:21:16 PM
Excuse me, but what's "brave" about getting tested? If you're having sex with multiple partners, or with one partner who is or might be having sex with multiple partners, you should get an HIV test. Even if you don't think your monogamous partner is messing around on the side, you probably ought to get an HIV test just to be sure. This isn't brave, it's basic common sense.
I don't think anyone here has argued that all HIV transmission is the result of meth-fueled, bareback orgies. But, guess what? Some of it is. Meth is a big problem in some segments of the gay community. It boggles my mind that people would want to get high on distilled cold medicine (so much for gay peoples' exquisite taste, huh?) but you can't argue with facts on the ground.
I hope Jake does well. I wish him no ill whatever. And if you read my tough messages, I didn't judge him for contracting HIV. I don't see the point in that. What got to me, and still does, is his implicit portrayal of getting infected as some sort of revelatory experience.
Sorry, but I'm not buying into that line of daytime TV show patter. I was never much of an Oprah fan. I think what's really eating some of you is my failure to go all soft and gooey here and do the Deepak Chopra mysticism for the masses treatment. Look, it's an infection, not some kind of a gift. If saying that makes me a self-righteous bastard, well, I've been called worse.
Posted by: Anon | Nov 29, 2007 5:24:09 PM
You know, ANON, "brave" to some, is considered "common sense" to others. The main reason many people don't get tested is because of the fear of knowing they're positive--and having to break out of their Peter Pan lifestyles because of it. Ignorance is not only blind, it kills.
Sorry you're feeling singled out regarding the comments made to Jake... I went out of my way to write a comment that would not instigate another state of hystronics from you. If you re-read the thread, there are plenty of others who read him the riot act.
Posted by: my2cents | Nov 29, 2007 5:56:08 PM
ugh! the drama of it all! Thank goodness I work in a lab. As a 23 year-old who has always practiced safe sex and is now in a committed relationship (my partner and I got tested for STDs just in case before doing away with the condom), I cannot understand the apathy of some of my peers towards venereal diseases. Their attitude is that it's all treatable--as if meds fell from the sky. As I mentioned in my previous post, not everyone can be as objective and unemotional as moi. On the down side, that makes me quite boring in some settings. The advantage of these other people is that they can go through life having more "fun" and be all caught up in the moment of things. But there are consequences to that also. In addition, I'm aware the young are more susceptible to irrationalities... but. That's it. you cant change human nature. And it's up to the scientists like me to bail them out from certain death. They should just be lucky to live in the U.S. and not a third world nation where people die of AIDS everyday.
Posted by: Miguel | Nov 29, 2007 9:29:41 PM
I don't feel as if you singled me out, but I do think I was included among those here whose tough comments have been deemed uncompassionate.
I don't think it's "histrionic" to push back at that. If anyone's been histrionic, it's Jorge, who told me to "shut the fuck up, you self-righteous bastard."
Histrionic or not, I think the thing to do is to demystify HIV and AIDS. People ought to be more rational all the way around. Strip this one to its essentials and we're talking about venereal disease. Like gonorreha or syphilis except that it never goes away.
When someone writes that it was one of the best things that every happened to him to find out that he contracted an incurable case of VD that will require him to spend tens of thousands of dollars on medicine that he'll have to take every day for the rest of his life, I think it pretty much demands that someone ask him what planet he's living on.
I'm old enough to remember when the clap was the most serious thing that could happened, or so people thought. We laughed about it. But even then, I don't ever recall talking to someone who said getting the clap caused him to cherish every moment of his life.
I do recall a guy who got hepatitis. That was a bad one. He was fucked up for a year, and he couldn't drink anymore. My current partner had Hep-C before I met him, and the treatment for that one just about makes you want to kill yourself.
Oh, and so I don't sound like I'm too high on the horse here, I had gonorhhea and syphilis, and a hepatitis scare. One of them was while I was living in a small town and got laid about once every year. Maybe that's why I'm not judging Jake for getting HIV. When my first partner and I got tested -- at my "brave" insistence -- I fully expected to test positive and him to test negative. I was shocked to my socks when it turned out exactly the opposite.
I'm just saying this: let's not sugarcoat this one with all the usual Oprah stuff about how having an incurable case of VD opens the doors of perception. I really think that's a stinking, steaming load of bullshit. Someone has to say it even if they're called a self-righteous and histrionic bastard for doing so.
Posted by: Anon | Nov 29, 2007 9:39:16 PM
I'm puzzled by the comments posted by Jakes statement.Why is it that gay men can't accept his coming to terms with his situation and feel a need to judge? My straight friends are more understanding and accepting than the gay people i know and i have been HIV+ 7 years no medication. probably helped that I thought it changed my life in a positive way too. So, good for you Jake, all the best mate.
Posted by: tim | Nov 29, 2007 9:49:30 PM
I'm the one who made the comment about being Buddhist. If you're not familiar with Buddhist philosophy, I'm not sure I can give a primer, but one of the four "reminders" in Buddhism is that human existence is precious. When you think about existence being precious, you often act differently. You'll ask that hot guy out at the gym instead of waiting because you know you don't have forever. People with near death experiences often change because they've come face to face with their mortality. Facing death and realizing your mortality often makes one, using another Buddhist concept, more mindful of life.
Additionally, one of the other basic precepts is that your mind controls how you think. If something happens that challenges you, and you think "Damn, this sucks. I'll never survive." You probably won't make it. Or you can think, "this is a challenge and I'm going to cope."
Bottom line, Jake did have a choice. He could have crawled into a hole or used the diagnosis as a catalyst for change. He chose to use it to change. Good for him.
This doesn't mean that having HIV is a "gift." I really don't think that's what Jake really meant. I think what he is saying is that HIV was a transformative catalyst for HIM. I think it's just proof that "negative" experiences can be transformative if you allow them to be. Weren't people a lot nicer right after 9-11? That was a terrible event, but behavior changed (at least for a short time after the result).
It's sad, but sometimes it takes painful things to get humans to change.
Jake, I wish you the best.
Posted by: Brandon | Nov 29, 2007 10:25:17 PM