Category Archives: Commentary

Has the COVID-19 pandemic marked the end of casual sex?

Posted on by

From Boston Magazine online…

by JONATHAN SOROFF

Not long after the virus first hit, I was in a committed relationship, so casual sex wasn’t really an issue. When the relationship ended, though, I realized the impact of the disease on my sex life. Sleeping with random guys was off the table. Even making out with someone at a bar seemed risky. I felt ripped off. I’d been faithful, but he’d cheated, and after kicking him out of our apartment and getting tested (and, I believe, paying extra to expedite the lab results), I wanted to cut loose. I’ve always thought that beyond it being consensual and not involving minors or dire physical harm, there are no moral imperatives connected to sex, and because being a “gay man” means being at least partially defined by your sexuality, I believe it’s a gay man’s birthright and prerogative to exercise that sexuality freely.

This was the late ’80s. Not 10 years earlier, bathhouses and tricking were accepted and celebrated parts of gay life. In 1978, at the hormonally supercharged age of 13, I visited my uncle in San Francisco and had to hide my titillation walking down Polk Street, with all the leather-clad men who looked like Tom of Finland had drawn them. I secretly purchased a steamy memoir about hedonistic gay sex in Paris nightclubs, and snuck over to a convenience store on the other side of town to buy copies of Blueboy and Mandate magazines. Then, not long after, HIV slammed the door shut on all of that, delivering a sharp slap in the face to a horny twentysomething. Now, a possible death sentence came along with getting physically intimate with a stranger. It was unspeakably unfair, and frightening.

Fast-forward to today, and here we are again, it seems. Although I’m now happily married, I was pleased to know that casual sex was beginning to steam up in recent years, thanks to pre-exposure prophylaxis and hookup apps such as Grindr, allowing sex parties and cruising the dunes of P-town to once again become possibilities. But then the novel coronavirus came roaring in. As self-isolation became the new normal, I was reminded of my experiences as a young man during the dark days of the HIV/AIDS crisis, and I sympathized with my uncoupled friends who were suddenly saddled with unsought chastity belts, their libidos on lockdown. Not to make light of it, but among its many horrors, COVID-19 has turned out to be a total cock block. Once again, the idea of physical contact is married to mortal danger, making me wonder whether and how COVID-19 has affected singles’ sexual behavior. Are we headed right toward another pandemic-induced Victorian era?

Read the full article.

Many dating apps continue to ghost health officials

Posted on by

From Politico.com…

Many dating apps continue to ghost health officials and advocacy groups who seek their help fighting the epidemic of sexually transmitted diseases the platforms have helped bring about. Some of the sites, however, are starting to swipe right.

Even as rates of syphilis, gonorrhea, and chlamydia have climbed to record levels over the past few years, major dating apps and sites like Tinder have avoided taking action or even speaking up about the problem.

Latino and Black men less likely to use PrEP

Posted on by
From Instinct Magazine online…

Research says that men who have sex with other men make up 67% of new HIV infections. Then on top of that, 25 percent of Latino men who have sex with other men (MSM) will be infected with HIV in their lifetime. And, 50 percent of Black MSM will experience the same. That’s compared to 12.5 percent of white men. That said, men of color are less likely to use the HIV preventive drug pre-exposure prophylaxis or PrEP. Why is this?

A recently published study in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report tries to understand why this is happening. The study, led by Dafna Kanny of the CDC’s Division of HIV/AIDs Prevention looked through interviews with 4,000 men who took part in a 2017 HIV Behavioral Surveillance Survey.

As NBC writes, researchers believe the problem lies in accessibility issues to health care. Studies show health care providers are not prescribing Black and Latino men to PrEP. In addition, men of color are less aware of PrEP’s very existence. The CDC’s study found that 95% of white men, 87% of Latino men, and 43% of Black men are knowledgeable about PrEP. Then even worse, only 58% of white, 44% of Latino, and 43% of Black men said they discussed the preventative medication with a physician.

As Kanny told Reuters Health,“This type of research is critical to finding—and correcting — missed opportunities to offer PrEP to people at risk of HIV, particularly among African American and Latin gay and bisexual men.”

He said further: “It’s important for providers to take sexual histories of gay and bisexual men and to discuss PrEP as an option for HIV prevention with those who could potentially benefit from it,” said Kanny. “These discussions also help to destigmatize PrEP use, which is particularly important for increasing PrEP use among African American and bisexual men.”

Healthcare providers should discuss U=U with all their HIV-positive patients

Posted on by

From aidsmap.com…

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV. The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

“Providers caring for patients with HIV should universally inform their patients about U=U as part of their routine care,” write Dr Sarah Calabrese of George Washington University and Professor Ken Mayer of the Harvard Medical School and Fenway Institute. “Conveying benefits and risks surrounding any treatment is fundamental to patients’ decision making, and this HIV treatment benefit should be no exception.”

Read the article on aidsmap.com.

Why are we so coy about sex education for gay teens?

Posted on by

From theguardian.com…

Society likes to keep gay teens sexless. It likes to maintain that gay content (even something non-sexual, like the representation of gay parents) is inappropriate for children’s TV or books. Those who complain say it’s too adult – implying that queerness, essentially, is all about sex, while straightness is just what a normal relationship looks like. It’s a weird dichotomy: straight people holding hands are non-sexual, while queer people holding hands is somehow the same as broadcasting pornography. The message is clear across all media: gays have to be kept sexless because they’re already too much about sex.

Read the full article by novelist Lev Rosen.

Stop blaming PrEP for the increase in STI rates

Posted on by

From LGBTQ Nation…

In an interview with the Los Angeles Blade about the new study, lead author Phillip Hammack, a professor at the University of California, Santa Cruz, debunked the notion.

“Our data don’t support the idea that we can attribute the rise in STIs to PrEP use, at least not in a direct manner. I personally don’t think that’s what’s happening,” said Hammack.

Instead, Hammack points at the rise of dating apps like Grindr, and a decrease in fear towards contracting HIV, as more likely causes.

“I would speculate it has more to do with a culture shift about sex,” said Hammack. “More people are having sex today. We’re in sort of a quiet sexual revolution when it comes to new identities, new labels, and sexual behavior.”

On the down side, the study also showed that only 4% of men who have sex with men are using PrEP. What’s more, many gay and bisexual men aged 18-25 aren’t getting annual HIV tests. 25% of men who have sex with men in that age range have never gotten an HIV test.

“I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did,” said Hammack in the William Institute press release on the study. “The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”

Read the full article.

Opinion: We need to talk about how Grindr is affecting gay men’s mental health

Posted on by

I’m a gay psychiatrist. Here’s why I went on Grindr to survey men.

By Jack Turban on Vox…

When I open the Grindr app on my smartphone, I see there’s a 26-year-old man with tanned abs just 200 feet away. He’s called “looking4now,” and his profile explains that he wants sex at his place as soon as possible.

Scrolling down, I find 100 similar profiles within a one-mile radius of my apartment in Boston. I can filter them by body type, sexual position (top, bottom, or versatile), and HIV status.

As a gay psychiatrist who studies gender and sexuality, I’m thrilled with the huge strides we’ve made over the past decade to bring gay relationships into the mainstream. The Supreme Court ruled that same-sex marriage is a constitutional right. Today in Boston, two men can walk down the street holding hands without consequence.

But I’m worried by the rise of the underground digital bathhouse. Apps like Grindr, with 3 million daily active users, and others like Scruff and Jack’d, are designed to help gay men solicit sex, often anonymously, online. I am all for sexual liberation, but I can’t stop wondering if these apps also have a negative effect on gay men’s mental health.

Since there’s little published research on the men using Grindr, I decided to conduct an informal survey and ask men why they’re on the app so much and how it’s affecting their relationships and mental health. I created a profile identifying myself as a medical writer looking to talk to men about their experiences. I received about 50 responses (including propositions).

It’s a small sample size, but enough to give us some clues about how Grindr is affecting gay men. And it doesn’t look good.

Read the full article on Vox.

Erie County Health Department: A little-known prevention tool can help reduce infection

Posted on by
From Lisa Szymanski, R.N. public health nurse with the Erie County Department of Health (via goErie.com)…

On the heels of World AIDS Day, I can think of no better time to talk about HIV prevention.

HIV is no longer the death sentence it once was. Today, people infected with the virus are living healthier and longer lives; there are well over 300 people living with HIV in Erie County alone.

But HIV can still have serious health consequences.

A little-known HIV prevention tool is available. We call it PrEP, or pre-exposure prophylaxis.

PrEP helps HIV-negative adults greatly reduce their risk of infection. It consists of a medication, Truvada, taken once a day.

If used as prescribed, the U. S. Centers for Disease Control and Prevention states that daily PrEP reduces the risk of getting HIV from sex by more than 90 percent or higher if combined with other risk-reducing behaviors. Among people who inject drugs, it reduces the risk by more than 70 percent.

The CDC is recommending PrEP for people who are HIV-negative and diagnosed with a sexually transmitted disease in the past six months. It is also recommended for those who have an HIV-positive sexual partner, heterosexual men and women who do not regularly use condoms during sex with partners of unknown HIV status, and gay or bisexual men unless in a mutually monogamous relationship with a partner who recently tested HIV-negative.

PrEP is also recommended for people who have injected drugs and have shared needles or been in drug treatment in the past six months.

You must take an HIV test before beginning PrEP and every three months while you’re taking it. There are several health-care providers in the Erie area who are now prescribing PrEP to their patients.

The cost of PrEP is covered by many health insurance plans, and a commercial medication assistance program provides free PrEP to people with limited income and no insurance to cover PrEP care.

Talk with your doctor or health-care provider to determine if PrEP is right for you. For more information, you may contact the Erie County Department of Health.

Gay guys: you’re douching wrong

Posted on by

From voice.com…

…you don’t truly need to clean out before riding the baloney pony all night long. It all comes down to anatomy. As Dr. Goldstein told me, stool resides in the sigmoid colon, the part of the large intestine closest to the rectum and anus. There, you’ll find a muscle that keeps poo from going into the rectum and through the anus until you’re actually ready to, you know, poo. That means there shouldn’t be any stool where the top’s dick is going, unless your top is hung like Jon Hamm times Justin Theroux.

You’re probably about to say, “Yeah, but when I douche all kinds of poo comes out.” You’re not wrong. The thing about enemas and irrigation devices is that they were made for people with actual constipation issues, not bottoms. When we douche, the force of water propelled into the colon goes past the area that actually needs to be clean for sex, up into the sigmoid colon. That fills the feces up there with water, and then washes it all out, which is the point of the enema in the first place. An enema cleans out way more than you need to for sex, making your butthole even dirtier in the process. And many people do this repeatedly, until the water comes out clear. That’s like draining a whole pool just to get a few leaves out when you could be using a skimmer instead. (Though it’s possible for a dick to enter the sigmoid colon depending on one’s individual anatomy, it’s not common.)

Read the full article.

Three reasons why language is important in media coverage of HIV

Posted on by

From the HRC… (by Diego Mora Bello, HRC Global Fellow)

Stigma and discrimination continue to be common barriers for people living with HIV. Fortunately, the media can play an important role in helping to remove these and other barriers. In my own survey of Latin American news articles mentioning HIV and AIDS, and in meeting with media professionals and advocates, I found that Latin American Media has room to improve its use of correct and destigmatizing language when talking about people living with HIV. Covering HIV both correctly and responsibly is important, because doing so is an essential part of raising awareness, debunking common myths, and giving voice to an already marginalized group of people.

The importance of using correct and responsible language in journalistic coverage of HIV inspired me to research this topic and share my findings. The ultimate goal of HIV in the Media is to report on this subject in a scientifically accurate and responsible way that inspires others to follow suit.

Based on my research, here are the top three reasons why language is important when covering HIV and AIDS in the media.

Read the full article on the HRC Website.

AIDS United: Republicans’ American Health Care Act will “worsen treatment and care for people living with HIV”

Posted on by

Press release from AIDS United…

AIDS United opposes the American Health Care Act as released by House Republicans on March 6th. The American Health Care Act would, if passed, strongly affect and potentially worsen treatment and care for people living with HIV and the provision of HIV prevention services for people at risk for infection. AIDS United works toward an end to the HIV epidemic by reaching outcomes described in the National HIV/AIDS Strategy and the many state-specific efforts to curb and finally end the epidemic. These outcomes include reducing HIV incidence, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities.

The American Health Care Act undermines these goals. The replacement of premium subsidies with refundable tax credits will hurt the ability of low income people, including people living with HIV, to afford up-front payment of health plan premiums. Under this system thousands of people will lose coverage. These people will then be subject to a 30 percent penalty in their future cost of coverage because of continuous coverage requirements. These same requirements will hurt people who lose their jobs and will also make it more difficult for people to change jobs or move across the country. The bill also places a higher cost burden on older Americans by allowing higher premium as people age. This will result in much higher costs and lower access to care for lower income people. Finally, the bill effectively repeals Medicaid expansion in under three years at the end of 2019. Such a repeal will result in a loss of health coverage for millions of Americans, including people living with HIV and other chronic conditions.

Read the full press release.

Let’s stop shaming black men

Posted on by

From the Advocate.com…

Last February, the Centers for Disease Control and Prevention released a report predicting that, if things don’t change, one out of every two gay or bi black men will become HIV-positive in their lifetime. This statistic has been repeated endlessly, usually in connection with reasons why HIV rates are higher among African-American men who have sex with men. To be fair, there are a wide range of factors that play a part in raising HIV risks, including poverty, drug use, childhood sexual assault, and depression.

“We cannot separate the high infection rates among black gay men from several ills that continue to plague our society,” Greg Millet wrote for The Advocate in 2015. “Discrimination, poverty, stigma, and lack of access to health care all affect health care utilization for black gay men. As a result, a substantial proportion of black gay men remain undiagnosed, and others who are diagnosed and without the financial means to access medications will remain virally unsuppressed.”

Many of these factors also impact heterosexual black men, so what’s at the root of the disproportionate HIV rates for their queer brothers? One prevalent argument is that — because of excessive homophobia in the black community — black gay and bisexual men have low self-esteem. That lower self-esteem leads them to be more promiscuous, engage in riskier sexual behaviors, and even use drugs; which explains why HIV rates among black men who have sex with men is so high. Makes sense? Problem is, it’s also wrong.

Read the full article on Advocate.com.

LGBTs would be disproportionately affected by the repeal of the ACA

Posted on by

Matt Baume writes in the Huffington Post:

If the ACA is repealed, as Republicans are trying to do, not only would 32 million people lose health care, according to the Congressional Budget Office, but LGBTs would be disproportionately affected. And “disproportionately affected” is a phrase which here means “get sick and die.” For example, HIV treatment can cost thousands of dollars per month. Insurance companies that don’t want to pay for that treatment could just refuse to cover all gay people on the basis that gay men are more likely to be HIV positive. Or they could raise monthly premiums just for gays. Or they could create a lifetime cap, so you pay into their system and then as soon as you need expensive treatment, they drop you. All this was legal until the ACA banned it.

National Youth HIV & AIDS Awareness Day: The realities of our lives

Posted on by

From the HRC blog…

The Centers for Disease Control and Prevention caused a media firestorm when it announced that Black men who have sex with men in the United States now have a 50 percent chance of being diagnosed with HIV in their lifetime.

Youth and HIVBut for us, this is not some abstract statistic. It is the reality of our lives. And it is not the whole story either. Often lost in mainstream coverage of HIV are the ways stigma and discrimination put young people like us at increased risk for HIV – while also limiting our ability to get tested or seek treatment.

How can we take steps to reduce the spread of HIV if our schools failed to offer comprehensive sex education? How could we be expected to take advantage of Pre-Exposure Prophylaxis – the once-daily pill regimen that can prevent HIV – if there were no providers in our communities willing to prescribe it? How could we be expected to adhere to our medication and reach an undetectable viral load if we were constantly worried about where were going to put our heads at night? Or, what food we were going to eat? These are the questions young people are grappling with as we continue to make-up more than 25 percent of all new HIV transmissions in the U.S. These are the questions that demand answers.

But rather than scaring young people into submission with reminders of how terrible things used to be, we should be empowering them to make smarter, healthier choices. Young people don’t need to be shielded from the truth about HIV and AIDS. What we need is love, compassion, and mentorship from the people around us. What we need are laws and policies that affirm all of who we are. Only then will an “AIDS-free generation” ever truly be in sight.

Continue reading on the HRC blog.

Test-and-treat could slash new HIV infections among gay men

Posted on by

From POZ.com…

Testing men who have sex with men for HIV and immediately treating those who are HIV positive could greatly reduce new infections among the MSM population as a whole, at least in the Netherlands, Medscape reports. Publishing their findings in Science Translational Medicine, researchers analyzed medical records data as well as genetic information about the virus in 617 recently diagnosed Dutch MSM, in order to make estimates about the likely source of their infections.

An estimated 71 percent of the new HIV cases transmitted from undiagnosed men, 22 percent from men who were diagnosed but not on antiretrovirals (ARVs), 6 percent from men who had started treatment, and 1 percent of diagnosed men who had not been linked to medical care within 18 months. About 43 percent of the transmissions derived from men infected for less than a year.

The researchers estimated that 19 percent of the new HIV cases could have been averted if MSM tested annually for HIV and if those who tested positive were immediately provided treatment. (Half of the at-risk men tested at least annually.) Two-thirds of cases could have been averted if all men testing positive received ARVs and if Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) was provided to half of all men testing negative.

The researchers concluded that their findings support making PrEP available worldwide.

To read the study abstract, click here.

HIV testing ad causes controversy

Posted on by

From OUT.com…

An ad for FreeHIVTest.net that appeared earlier this spring has caused controversy in Los Angeles, San Francisco, and other areas where it has appeared on billboards and on public transportation kiosks. In the “white” version, the AIDS Healthcare Foundation’s ad features a gay couple in bed, covered only by a sheet and looking ashamed of what they’ve just done. A blond man clutches his pillow and looks suspiciously over the shoulder of the other man who appears to be almost catatonic. Above them, written in big letters is, “Trust Him?”

 

trusthim_gayaa_1094x335After the campaign launched this spring in Los Angeles, it’s been slated to appear in Oakland, California; Washington, D.C.; Columbus, Ohio; and Broward County, Florida. In a press release, AHF president Michael Weinstein explained:

“In today’s tabloid culture when it can seem that the game called ‘Life’ should be more appropriately tiled ‘Lies,’ the old adage holds true now more than ever, ‘It’s better to be safe than sorry.’ While infidelity is nothing new, the level of risk in contracting STDS from bed-hopping partners is at an all-time high. We want to remind couples that STDs linger around much longer than a wandering eye and that secret sexual experiences can often produce much more than what one bargained for.”

For some, it’s just a cautionary PSA about the realities of HIV and the importance of getting tested. For others, it’s been seen as a scare tactic to shame people out of having sex and demonize people with HIV — and many have spoofed the ads.

Continue reading.

Advocate.com: 11 bad habits killing LGBT people

Posted on by

From the Advocate.com…

ThinkstockPhotos-466033241X633We’re in the midst of LGBT Health Month, a time to take stock of the many health issues specific to our community. While we have plenty of people trying to do harm to us because of our sexual orientation or gender identity, we often don’t do ourselves any favors when it comes to self care. Here are the bad habits we should have given up last century.

10 questions to ask yourself before you begin HIV treatment

Posted on by

puzzle man_white backgroundFrom thebody.com…

An HIV diagnosis comes with its very own set of questions to ask yourself and decisions to make. Among the biggest is: When should you start treatment? It’s a Russian nesting doll of a decision, with many other questions tucked inside. Here, in no particular order, are 10 of the most important questions to ask yourself before you begin taking HIV medications.

Get Started

26th World AIDS Day: Get in there, do something, change things

Posted on by

From Huffington Post…
by

red ribbonPre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) have successfully returned sexual health to the national and international headlines. Not since the early years of the HIV epidemic has there been so much constructive dialogue, progress, and involvement by the public.

Long-term survivors, HIV organizations, scientists, public-health experts, and the generation that never knew a world without HIV joined hands on the 26th World AIDS Day in an effort to educate and advocate in commemoration of those we have lost to HIV and the people living with the infection today.

While a few still wage a lonely and wasteful fight against science and progress itself, it is time to acknowledge that we finally have the opportunity to move on from a monotonous, one-way conversation and use these new tools as catalysts for serious and much-needed change.

Of course, it doesn’t help when one of our favorite Star Trek actors throws all logic overboard and simply dismisses today’s generation as lazy, complacent and irresponsible, but it certainly shows that we haven’t progressed much since President Reagan’s infamous call to abstinence 27 years ago.

Six of the estimated 39 million people we lost worldwide to HIV were my friends and mentors. All six would have agreed with Meryl Streep’s Margaret Thatcher when she says in The Iron Lady, [I]f something’s wrong, they shouldn’t just whine about it. They should get in there and do something about it. Change things.”

Keep reading on Huffington Post.