Both relationship-specific and structural factors influence whether coupled gay men living in New York City choose to use pre- and post-exposure prophylaxis (PrEP/PEP) for HIV prevention. Some men – particularly those in monogamous relationships – felt that discussing PrEP and PEP in the context of a relationship could threaten the relationship by raising issues of trust, while others felt that it had the potential to enhance sexual health and satisfaction.
Stigma from the gay community and healthcare providers around promiscuity also presented barriers to PrEP uptake. This qualitative research was conducted by Stephen Bosco, Dr Tyrel Starks and colleagues at City University New York and published in the Journal of Homosexuality.
Gay and bisexual men accounted for 66% of all new HIV diagnoses in the US in 2017. It is estimated that 35-68% of these infections happen within the context of a long-term relationship. This indicates that coupled gay men have the potential to benefit significantly from biomedical prevention strategies, such as PrEP (taken on an ongoing basis) and PEP (taken shortly after a suspected infection). However, only 7% of the potential 1.1 million gay and bisexual men who could benefit from PrEP were prescribed it in 2016. Black and minority men in the US remain most at-risk for HIV infection, while also having the lowest rates of PrEP uptake.
Stigma did not create AIDS. Yet it prepared the way and speeded its ravaging course through America and the world. First stigma delayed understanding of the disease: it’s a gay cancer, it’s a punishment from God, they brought it on themselves, so who cares? Then stigma delayed government action, research, and assistance for the sick and dying. Stigma made people afraid to get tested for HIV and treated. Stigma made people ashamed, isolating and alienating them from friends and family. Stigma cost people jobs, professional standing, housing, a seat on an airplane or in a dentist’s chair. Stigma made many afraid to live, and want to die. But then it began to make some brave people very angry and AIDS activism was born. The activists quickly realized that to end AIDS we must end stigma.
AIDS activism did more to fight the stigma on being gay or having AIDS than any other social force. In this way, AIDS activism, like the civil rights movement, became a great moral movement of our time, defending the innocent, restoring dignity to the violated, giving hope to the desperate, and reviving faith in the disillusioned. AIDS activism gave LGBT people courage, dignity, and power they had never held before. It inspired many to stand up and proudly proclaim who they are and who they love. Twenty-six of the world’s most advanced countries now recognize gay marriage and today a gay man openly married to another man is a prominent candidate for President of the United States.
Let’s talk about drugs—specifically, drugs that keep HIV-positive gay men like me “undetectable,” and the drugs used in PrEP (pre-exposure prophylaxis) that, when taken daily, can prevent HIV-negative gay men (and others) from becoming infected.
That’s essentially the theme for this year’s Gay Men’s HIV/AIDS Awareness Day—today, September 27—“The Conversation About HIV Is Changing: Talk Undetectable. Talk PrEP.”
But if we only talk about drugs to prevent and treat HIV, and don’t talk about the trauma behind gay men’s high-risk sexual and drug-use choices, we’ll see that same trauma continue to play out in our disproportionately high rates of crystal meth abuse, alcoholism, and other potentially harmful sexually transmitted infections besides HIV.
There is no question that today’s HIV drugs have dramatically changed the conversation about HIV. From the terrible illness and death that almost inevitably followed a positive HIV test 30 years ago, those of us living with the virus today can expect to live a virtually normal lifespan—so long as we adhere to treatment.
The campaign captures 24 hours in the lives of people affected by HIV stigma, which impacts everyone regardless of age, race, or status. The social media-driven campaign, now in its tenth year, is an opportunity for people to share a moment of their day and tell their story, while breaking down the barriers that stigma creates and raising awareness about HIV, as stated in a press release.
“Stigma can isolate and scare people,” said Positively Aware art director Rick Guasco, who created the campaign. “It can also prevent people from accessing care and treatment. A Day with HIV brings people together; it shows that we’re all affected by stigma, and that people living with HIV are just like everyone else.”
We encourage you to take a picture and post it to your social media with the hashtag #ADayWithHIV and include a caption that gives the time, location, and what inspired you to take the photo.
Images can also be uploaded to ADayWithHIV.com, where they will be considered for publication in a special section of the November/December issue of Positively Aware.
OAKLAND, Calif. — MPact Global Action for Gay Men’s Health and Rights has announced the launch of its fourth global survey on the health and human rights of gay men, bisexual men and other men who have sex with men.
The 2019 Global Men’s Health and Rights Survey (GMHR 2019) focuses on factors that impact the health of gay and bisexual men around the world including discrimination, access to services, and the criminalization of homosexuality. The survey also addresses issues of mental health, freedom of gender identity and expression, and social connection and wellbeing which have all shown to be indicators of broader sexual health.
“We are very excited to launch the GMHR 2019 and to continue to collect information that allows us to advocate for the needs of community members,” said Sonya Arreola, Senior Research Advisor at MPact. “It is critical that we are amplifying the voices of those most marginalized in the global response to sexual health and human rights. We anticipate that this survey will provide insight into the lived realities of key populations locally and globally, including gay and bisexual men, transgender people, people living with HIV, sex workers, and people who use drugs.”
Last launched in 2014, the previous iterations of the GMHR survey yielded more than 10,000 responses from around the world, revealing vital information about the state of homophobia, human rights and access to health services worldwide. As in the past, this year’s survey is designed to support knowledge generation, policy development, program implementation, and advocacy linked to the issues that matter most to community members at the local and global level.
I was living in the Castro in San Francisco in 1978 where optimism and liberation were in the air. Harvey Milk was an openly gay City Supervisor, gays and lesbians marched in the street for equal rights, and gay liberation was on display from Folsom Street to Golden Gate Park.
There was a real sense of belonging to a community. Our world shook when Harvey Milk and Mayor Moscone were assassinated by former Supervisor Dan White that year. Then it shook again when San Francisco became ground zero of the AIDS epidemic.
By 1985, the city was full of heartbreak and dying. My friends and I lived among it, terrified that we would be next. I was diagnosed with HIV that year, forever making 1985 a pivotal year.
Many of my friends who hadn’t been tested for HIV ended up in the ER at San Francisco General in respiratory failure. I was blindsided as an entire group of my friends and neighbors seemed to disappear overnight. There were no medical treatments, other than some antibiotics that seemed to prolong death for many.
For whatever reason, maybe by the grace of God, or good Italian food, I don’t know, I never got sick from HIV and I held on to hope for a better day. But my life and times would never be the same as it was back in 1978, before the shooting death of Harvey, when we felt liberated, before AIDS wiped out my entire phonebook.
According to the Centers for Disease Control and Prevention, an estimated 1.1 million people in the United States are living with HIV. In 2017, 38,739 people received an HIV diagnosis, and when they first heard the word “positive,” many were thrust into feelings of anger, sadness, denial and fear.
“There are some people who suspect they are HIV-positive but go a very long time without testing, and then there are other people who test for whatever reason and turn out positive,” says Mallory Johnson, a clinical psychologist and professor at the University of California–San Francisco School of Medicine and co-director of the NIH-funded Center for AIDS Prevention Studies. “Those tend to be the extremes of the experience.” Disbelief and shock, Johnson says, are the most common responses.
Of those living with the virus in the U.S., about 14%, or 1 in 7, are unaware of their infection. HIV weakens the immune system by destroying cells meant to combat infection and disease; AIDS is the final stage of the infection, when the immune system has been severely damaged. Not all HIV-positive individuals will develop AIDS – antiretroviral therapies and other medications now allow people with the virus to live long, healthy lives.