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AIDS Awareness Campaign Calls HIV a "Gay Disease"
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AIDS Awareness Campaign Calls HIV a "Gay Disease"
AIDS Awareness Campaign Calls HIV a "Gay Disease"
10-2-2006
Two articles about a controversial new condom campaign targeting gay men in Southern California:
The first, which is very brief, is from KABC; the second from the LA Times.
SoCal AIDS Awareness Campaign Calls HIV a "Gay Disease"
LOS ANGELES, September 30, 2006 - One of Southern California's most influential gay institutions has launched a controversial ad campaign that describes HIV as a "gay disease."
The L.A. Gay and Lesbian Center's ads are designed to reach gay men who have grown complacent about the illness.
The message "HIV is a gay disease" and the tag line "Own It. End It" will appear on billboards and in magazines.
Proponents of the campaign say the amount of attention AIDS awareness groups have paid on minority women and others has left gay men feeling a false sense of security. Gay men still represent most of those infected with HIV and AIDS in the U.S. and Western Europe.
Critics say the campaign could further stigmatize the disease and make heterosexual men and women less likely to seek treatment.
HIV Ads Embrace, and Stun, Audience
By Sharon Bernstein, Times Staff Writer
September 30, 2006
For 20 years, gay men have vigorously fought the contention that HIV is a disease of homosexuals.
But now, one of Southern California's most influential gay institutions has embarked on a controversial ad campaign with this stark declaration: "HIV is a gay disease."
With that message and the tag line "Own It. End It" on billboards and in magazines, the L.A. Gay & Lesbian Center says it is trying to reach legions of gay men who have become complacent about HIV and AIDS.
The campaign is an abrupt departure from the years of hard politicking against the idea of AIDS as a gay plague, a characterization that many -- including the Gay & Lesbian Center -- had argued marginalized victims and made it hard to reach others who were at risk, including thousands of minority women who have become infected in recent years.
The ads have stunned some in the gay community and the AIDS services world, who recall the early years of the epidemic, when anti-gay clergy railed against the condition and little money was available for research or prevention.
Some AIDS counselors worry that the campaign could further stigmatize the disease, making women and heterosexual men less likely to come forward.
So much attention is being paid to minority women and others who are at risk that gay men -- who still make up the majority of those infected in the United States and Western Europe -- have developed a false sense of security, backers of the ads say.
The problem of AIDS apathy among gay and bisexual men is of particular concern on the West Coast, public health officials say, where the overwhelming majority of HIV transmission is among men engaging in sex with other men.
In Los Angeles County, about 75% of HIV cases are among men who have had sex with other men.
The L.A. infection count is somewhat at odds with data from other parts of the country -- including several East Coast communities -- where infection is spreading rapidly among women and intravenous drug users.
"A very alarming silence has descended over our community with regard to HIV and AIDS," said Lorri L. Jean, chief executive of the Gay & Lesbian Center.
"We believe that most people in our community do not understand the degree to which this epidemic continues to be in Los Angeles largely an epidemic among gay and bisexual men," she said.
The ad campaign has drawn sharp criticism from some in the trenches of the battle against HIV, particularly those who work closely with infected women.
"I applaud the desire to have more personal responsibility in the gay community, but this is not the way to achieve it," said Michael Weinstein, head of the Los Angeles-based AIDS Healthcare Foundation.
..
[etc etc etc]
[emphases mine]
Bill Weintraub:
This is one more really wrong-headed attempt at HIV prevention via condoms.
"HIV is a gay disease"
Is HIV a gay disease?
No.
I'm a "gay" man.
I don't have HIV.
In the United States and Western Europe, and in many other places in the world, HIV is spread through IV drug use;
and via anal "sex."
So a sensible campaign targeting the gay male and other communities would go:
"HIV is an anal disease."
Because that's what it is.
Just as lung cancer is a direct consequence of smoking, so HIV infection is a direct consequence of anal sex.
Among "men who have sex with men," sexual transmission of HIV is at least 90% anal.
Some people, like Dr. Green, think it's 99% anal.
Among women who are not IV drug users, the disease is transmitted anally and vaginally.
However, as we've seen, per Drs Cohen and Halperin, anal is far more efficient than vaginal.
Translation: A woman is 10 to 20 times more likely to get the disease through anal than she is through vaginal.
In addition, the men who are infecting those women don't have vaginas.
So if they've been infected sexually, they've ALL been infected anally.
If you eliminate anal sex, you eliminate virtually all of the sexual transmission of HIV in the United States.
Because the gay-identified guys will no longer be getting infected -- in the case of LA, that's 75% of the new infections.
And the straight-identified guys who had been doing anal with other guys -- will no longer be getting infected.
Which means the women those guys sleep with won't get infected either.
The LA Times article confirms that, in a roundabout way, by citing findings in a new study out of NYC:
In the study, published last week in the journal Annals of Medicine, the city's public health officials interviewed more than 4,000 men.
Of the more than 90% who identified themselves as heterosexual, one in 10 later disclosed that they had had sex with a man within the past year.
Lead author Preeti Pathela said that means that any campaign aimed only at men who identify themselves as gay or bisexual could miss as many as 10% of the people it is meant to reach -- and keep their partners in the dark as well.
Interesting huh?
10% of the straight-identified guys *admit* to having sex with other guys.
How many do you think are doing it and NOT admitting to it?
And how many more do you think want to do it?
I love it when people tell me that bisexuality is restricted to a tiny minority.
So: we know that guys who identify as straight are putting themselves and their partners at risk.
Indeed, if you think about it, it's homo anal which is the problem.
Because homo anal is how guys get infected.
An uninfected straight guy can penetrate a woman anally without giving her HIV.
So, and again, it's anal among men which is fueling the rise in sexually transmitted HIV among gay and other MSM, and among WOMEN.
What about this "new" campaign targeting gay men:
As in, "HIV is a gay disease. Own It. End It."
The idea apparently is to promote personal responsibility.
And we're all in favor of that.
But the message can be read in a different way.
"HIV is a gay disease.
"I'm gay.
"Therefore I should acquire HIV."
We know there are gay men, in particular YOUNG gay men, who think that way.
And who get infected.
"HIV is a gay disease. Own it. End it."
As in rear-end it?
Then you really own it.
Can you imagine how much money was spent developing those few words, and how much more money will be spent promulgating them?
REALITY:
Gay men have had more than 20 years of intensive condom campaigns.
They know HIV is a problem among gay men.
It's not a secret.
There's no point to this new campaign, other than a bureaucracy trying to justify its existence.
But the effect of this campaign will be to re-inforce the identification of gay with anal.
"HIV is a gay disease."
We've had 20 years of this sort of negative social engineering, and all it's done has been to increase both prevalence and incidence of HIV among MSM, and to cement the identification of gay with anal.
Can condom campaigns ever succeed?
No.
Not given the efficiency figures for anal HIV transmission coming out of Drs Cohen and Halperin.
It's not possible.
Cohen: "you can't win against anal intercourse. ... Anal intercourse is a really bad sexual practice for HIV transmission. It changes the equation."
The old figures said that your chances of getting HIV from any one episode of receptive anal with an infected partner were one in 200.
Cohen's figures, which are new, puts those chances at one in eight.
Halperin, as I interpret him, puts the figure at one in two or one in three.
Once again, see What are they thinking? for the sources of those figures.
Condom campaigns assume that the efficiency of anal HIV transmission is so low that condom failure and "lapses" in condom use will result in a few, but not many, new infections.
But if the efficiency of anal HIV transmission is high -- which we now know it is -- those campaigns would require 100% compliance -- all condoms all the time -- to stop the epidemic.
And that will not happen.
Plus there would have to be ZERO failure -- no breakage, no slippage, nothing.
Not possible with anal:
This review indicates that consistent use of condoms results in 80% reduction in HIV incidence. Consistent use is defined as using a condom for all acts of penetrative vaginal intercourse. Because the studies used in this review did not report on the "correctness" of use, namely whether condoms were used correctly and perfectly for each and every act of intercourse, effectiveness and not efficacy is estimated. Also, this estimate refers in general to the male condom and not specifically to the latex condom, since studies also tended not to specify the type of condom that was used. Thus, condom effectiveness is similar to, although lower than, that for contraception.
Citation: Weller S, Davis, K. Condom effectiveness in reducing heterosexual HIV transmission (Cochrane Review). In: The Cochrane Library, Issue 1 2003. Oxford: Update Software.
Many studies have demonstrated that receptive anal sex is most strongly associated with prevalent and incident HIV infection in MSM and carries the highest per-contact risk of acquiring HIV. This study found that URA [unprotected receptive anal] with either HIV-positive or unknown serostatus partners explained one quarter of new infections in this cohort. Surprisingly, we also found an independent increase in the risk of HIV seroconversion among men reporting PRA [PROTECTED receptive anal] with an HIV-positive partner. This finding likely represents a combination of overreporting of condom use and unrecognized condom failure by the receptive partner. Condom failure rates are particularly increased among MSM who use condoms infrequently, substance users, and those failing to use appropriate lubricants.
The Surgeon General of the United States:
Are condoms strong enough for anal intercourse?
The Surgeon General has said, "Condoms provide some protection, but anal intercourse is simply too dangerous to practice."
Condoms may be more likely to break during anal intercourse than during other types of sex because of the greater amount of friction and other stresses involved.
Even if the condom doesn't break, anal intercourse is very risky because it can cause tissue in the rectum to tear and bleed. These tears allow disease germs to pass more easily from one partner to the other.
That's the reality of condoms:
Cochrane: 20% failure rate with CONSISTENT use in VAGINAL.
Buchbinder et al: Only a 1% difference between anal with a condom and anal without a condom -- which they attribute to "condom failure."
Carmona: Even with a condom, anal too dangerous to practice.
Anal + Condoms = HIV infection.
When you put together the high efficiency of HIV transmission via anal with condom failure due to the far higher friction and stress; breakage and slippage which are present even in vaginal; incorrect use; and inconsistent use -- and you factor in the disinhibiting effect of condoms -- what you get is what Dr. Cohen said: "You can't win against anal."
So: Here's a campaign which tells the truth and makes sense:
HIV is an anal disease.
You can't win against anal.
If our "HIV prevention experts" combined that message with promotion of FROT and mutual masturbation -- the rate of new infections would plummet.
That's the truth.
By contrast, the "HIV is a gay disease" campaign is a waste of time, it's a waste of money, and whether you understand this or not, it's an attack upon you and every other Man who Loves Men.
Bill Weintraub
© All material Copyright 2006 by Bill Weintraub. All rights reserved.
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