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New STD Rates “Shockingly High”

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Today, the Centers for Disease Control and Prevention (CDC) released its 2010 sexually transmitted disease (STD) surveillance data.  This annual report of statistics and trends for the three reportable sexually transmitted diseases in the United States shows that STDs rates in this country are still shockingly high, particularly in communities of color and among gay men and other men who have sex with men (MSM).

“This new data shows a persistence of the same trends that we have been seeing for years—that MSM and communities of color are continuing to bear a disproportionate share of the STDs in this country,” said William Smith, Executive Director of the National Coalition of STD Directors. “We should also not lose sight of a number of new additional studies this past year on the link between STDs and acquiring HIV.  The 2010 STD data released today shows that we need to look closely at further investments in STD prevention as a means to prevent HIV as well,” continued Smith.

While the 2010 data shows that overall rates for syphilis went down compared to 2009, the first decrease in in ten years, rates among Hispanics went up just over nine percent in the last year and MSM still account for two-thirds of the syphilis in this country.  In addition, black men continue to have the highest rates of syphilis in the U.S., with young (20-24) black MSM seeing an increase of syphilis of a shocking 135 percent between 2006 and 2010.  Co-infection of those with syphilis and HIV also continues; between 25-54 percent of those with primary or secondary syphilis were also HIV positive.

“The good news is that there was a drop of 8.5 percent in the rate of black men diagnosed with either primary or secondary syphilis in 2010 compared to the year prior,” said Smith.  “While too early to definitely assess the cause for this drop, there has been a distinct appeal for several years now to help address the explosion of syphilis among black men, particularly among young black MSM, and we must keep up efforts to prevent increasing rates of STDs and HIV among this group,” concluded Smith.

Rates for Chlamydia continued to increase over the last year, as they have for twenty years.  This is in part due to increased testing which is increasingly identifying positive cases, of which there were more than 1.3 million reported in 2010.  Black women continue to have the highest rates for Chlamydia, as well as gonorrhea.  While there was only a small increase in the overall rates of gonorrhea, the rates of gonorrhea in Hispanics went up 12 percent compared to 2009.

Across all three diseases, communities of color and young people overall continue to be most affected, though even for all ages of whites, increases were seen for all three diseases in 2010.  Among whites in 2010, rates of chlamydia increased by 7.5 percent, 9.2 percent for gonorrhea, and 3.6 percent for syphilis in 2010 compared to 2009.

Smith concluded, “We hope the unacceptably high rates of STDs in this country continue to be clarion call for securing the sexual health of all people. This means that state and federal investments in STD prevention remain a critical need in these times of tight budgets and that as healthcare reform continues to move ahead, that partners in every sector ensure that the safety net for these services continues to exist.”

The full 2010 STD surveillance data can be found on the CDC website at: http://www.cdc.gov/std/stats10/default.htm.

My Online Dating Post on Qweerty

It’s Toot My Own Horn Time!

My Bilerico post on online dating companies and STD’s made it on to Qweerty today- along with some other commentary- it’s a good read: http://www.queerty.com/should-online-hook-ups-sites-take-responsibility-for-spreading-hiv-and-stis-20110825/

 

2011 GAY/BI HIV+ Men’s Health Retreat

 

To register, click here.

 

 

Joint Statement Regarding HIV Prevalence, Urgency For Gay/Bi Men

NEW HIV INCIDENCE ESTIMATES CONFIRM URGENCY TO ADDRESS CRISIS AMONG GAY MEN OF ALL RACES AND ETHNICITIES

Washington, DC – New HIV surveillance data released today by the Centers for Disease Control and Prevention (CDC) indicates that while the overall number of new HIV infections has remained fairly stable from 2006–2009, there continues to be cause for great concern about increasing numbers of new infections among gay men.

While the new HIV incidence estimates, published in the Public Library of Science Medicine, show that prevention activities in the United States have successfully held the number of new infections steady, the National Alliance of State and Territorial AIDS Directors (NASTAD)i and National Coalition of STD Directors (NCSD)ii, remain alarmed about the continued disproportionate impact of HIV and sexually transmitted disease (STD) infections among gay and bisexual men of all races and ethnicities in this country. New estimates indicate that the top most impacted populations include white gay men, Black gay men and Latino gay men, followed closely by Black women.

“An unacceptable increase of HIV incidence among gay men, particularly young Black gay men ages 13-29, requires an honest and critical examination of our prior efforts and a sharpening of our prevention-focused activities among gay men,” remarked Julie Scofield, NASTAD’s Executive Director. “We need to strengthen our communities by breaking down the silos across program and sector and by investing in targeted and innovative programming that promotes the health equity of gay and bisexual men of all races and ethnicities,” she added.

“Increasing HIV rates, coupled with increasing incidence of syphilis and a frequent neglect of rectal STD infections, underscore that we are not doing enough to prevent all STD infections and reduce their role in HIV acquisition,” said William Smith, NCSD’s Executive Director. “NASTAD and NCSD will continue to work with state and local health departments and other partners to develop and implement effective tools and initiatives to address all STDs among all gay and bisexual men,” he continued.In this peer-reviewed article, the CDC estimates 48,100 new infections occurred in the U.S. in 2009, with gay and bisexual men remaining the population most severely impacted by HIV and the only population in which new HIV infections have been increasing steadily since the 1990s. New infections among gay men of all races and ethnicities continue to increase as a proportion of all new infections, with those among young Black gay men ages 13-29 increasing by 48 percent since 2006. This new HIV surveillance data closely follows data released by CDC last month that showed a growing resistance of gonorrhea to antimicrobials, particularly in men who have sex with men (MSM). Gonorrhea is an STD that can facilitate HIV transmission.

In June 2010, NASTAD and NCSD released a Statement of Urgency expressing concern regarding the HIV and STD crises among gay men and other MSM of all races and ethnicities in the United States. Pursuant to the recommendations made in the National HIV/AIDS Strategy (the Strategy), the joint statement calls for greater investment (financial and human) and leadership to address the epidemic among gay men. Given CDC’s decision to cut $20 million from core HIV prevention funding, our federal partners must continue to work with state and local health departments to ensure that all existing resources are leveraged to improve HIV prevention and care and treatment.

NASTAD and NCSD, with support from MAC AIDS Fund, will soon launch a series of targeted activities within HIV and STD programs that will examine and address stigma in public health practice. These efforts will aim to increase comprehensive and appropriate access to prevention, care and supportive services for young Black and Latino gay men, particularly those at-risk for STD transmission. Additionally, these efforts will target social and sexual networks to promote positive sexual health messages and reduce stigma. NASTAD and NCSD will work with their respective members to establish and promote evidence-based practices and tools to educate state and local health departments, service providers and other key community stakeholders about the sexual health of gay men.
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i- Founded in 1992, NASTAD is a nonprofit national association of state and territorial health department HIV/AIDS program directors who have programmatic responsibility for administering HIV/AIDS and viral hepatitis health care, prevention, education, and supportive services programs funded by state and federal governments. For more information, visit www.NASTAD.org.

ii- The National Coalition of STD Directors (NCSD) is a partnership of public health professionals dedicated to the prevention of STDs. NCSD provides dynamic leadership that strengthens STD Programs by advocating for effective policies, strategies, and sufficient resources and by increasing awareness of their medical and social impact. For more information, visit www.NCSDDC.org.

Thought You Didn’t Have To Worry About Hepatitis C?

Hot on the heels of Godzilla Gonorrhea, comes further buzzkill from Science Daily:

Sexual transmission of hepatitis C virus (HCV) is considered rare. But a new study by researchers at Mount Sinai School of Medicine, working with the Centers for Disease Control and Prevention (CDC), provides substantial evidence that men with HIV who have sex with other men (MSM) are at increased risk for contracting HCV through sex.

Yeah. I know- what next? And while it bears further watching, it’s still not the end of the world:

“While hepatitis C is rarely transmitted among stable heterosexual couples, this is clearly not the case among HIV-infected MSM in New York City,” said Dr. Daniel Fierer, Assistant Professor of Medicine and Infectious Diseases at Mount Sinai School of Medicine. “MSM, and to some extent their health care providers are generally not aware that having unprotected receptive sex can result in HCV infection. The good news is that the cure rate for new HCV infections is very high with early treatment, but without regular testing of the men at risk, these largely asymptomatic infections may be missed and this opportunity lost.”
“Our study suggests that HIV-infected MSM should take steps to protect themselves and others by using condoms. Also, health care providers should be screening these men for hepatitis C, and public education and outreach programs should include information about these risks,” Dr. Fierer concluded.

And if you think you’re at risk, (for more info, click this link) you should talk to your healthcare provider and/or ask to be tested.

Your health is YOUR health. Advocate for it.

Gonorrhea: Not So Easy To Kill Anymore

Not anymore. . .

Think if you get the clap, you can just go get a shot or take a pill to be cured?

Not so fast, bucko. There’s now another reason to protect yourself:

Today, the Centers for Disease Control and Prevention (CDC) outlined laboratory trends from 2000-2010 that show growing resistance of gonorrhea to antimicrobials.  Gonorrhea, a sexually transmitted disease (STD), is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission. (Press release, National Coalition of STD Directors)

Yep. Gonorrhea. It used to be a serious disease, before antibiotics made it easy to treat. Now that we’ve been taking antibiotics for everything, resistance is setting in and we’re running out of effective drugs to cure it.

…cephalosporin antibiotics are the last line of defense for treating the disease, as the bacteria has developed resistance to all other antibiotics.  The highest level of resistance to cephalosporins, regardless of sexual partner, was found in the Western region of the United States, particularly Hawaii and California, as well as in men who have sex with men in all regions.

“This new data outlines what state and local health departments have been seeing on the ground—that highly untreatable gonorrhea is near,” stated William Smith, Executive Director of the National Coalition of STD Directors. “There are currently no new drugs in development for this infection.  If this last class of drugs fails we will have no definitive treatment options for gonorrhea.  We call on researchers, government, and partners in industry to make the development of new, effective drug treatments for gonorrhea a public health priority,” continued Smith.

This is a big deal.

It’s important for sexually active persons to be screened for all STD/STI’s at least every six months, or more often if you have many sexual partners and/or have had unprotected sex- and that includes oral- gonorrhea can easily infect the throat. And, remember, any STD/STI increases the risk of contracting/spreading HIV. From the CDC:

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About 750,000 women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

In men, gonorrhea can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to infertility if left untreated.

Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily to someone else than if they did not have gonorrhea. (emphasis mine)

We’ve taken the cure for granted for too long. So- be careful out there.

Full article here.

Know Any Closeted Gay/Bi MT Men?

We want to know about your/their lives! A grad student at the U of M is working on a very worthwhile project to help us understand the reality of men in Montana who have sex with men (MSM) but are not out or do not identify as gay or bi. This is important work, so if you can assist us, it would be greatly appreciated. 

~

I am a researcher with the University of Montana collecting information about sexual health attitudes and behaviors. Specifically, I am interested in understanding more about men who are closeted or not open about having sex with other men.

I am looking to anonymously interview men who have sex with other men who live in Montana and are between the ages of 18 and 69.

I realize what a personal topic this is, so I want to emphasize that this study is completely ANONYMOUS. If you would be willing to participate in this study, you can contact me at (406) 552 – 2115 or amee1.schwitters@umconnect.umt.edu orum.menshealthsurvey@gmail.com. We can then arrange a time to conduct the (one) interview over the telephone or we can meet in person. The interviews will be audio recorded and then typed into a word processor. The audio will then be destroyed. Your name will NOT be associated with this study in any way, nor will your location or any identifying information be mentioned. As an incentive for your participation, I would like to offer you $25.00.

This study has been approved by the University of Montana Institutional Review Board (IRB 63-10) expires 03-2012 (A copy of the approved IRB application can be provided). Again, if you are interested or even potentially interested in participating in this study, please contact me at (406) 552 – 2115 or amee1.schwitters@umconnect.umt.edu or um.menshealthsurvey@gmail.com.

Thank you for your consideration.
Amee Schwitters, MPH
PhD Candidate
University of Montana
Department of Anthropology

Another Reason To Start HIV Treatment Sooner?

Science Daily is reporting on a study by UC San Francisco that indicates that the rate of infection among men who have sex with men (MSM) could be significantly reduced by treating HIV immediately upon diagnosis and expanding HIV testing:

If HIV-infected adults in San Francisco began taking antiretroviral treatments as soon as they were diagnosed, the rate of new HIV infections among men who have sex with men would be cut by almost 60 percent over five years….

The finding is published in the April 15, 2011 issue of Clinical Infections Diseases.

The decision of when to begin treatment with antiretroviral drugs is a subject of some debate, with the experts evenly split on whether to begin antiretroviral therapy immediately upon HIV diagnosis or waiting until a patient’s CD4 cell count drops below 500 cells per microliter….”Our clinicians recommended initiating antiretroviral therapy to all of our HIV positive patients based on our assessment that delaying treatment allows the virus to do damage to major organs systems and would lead to poorer outcomes for patients. It is too early to tell if this shift in treatment strategy last year by our clinic and the Department of Public Health has had any impact in preventing HIV infections,” said (study co-author) Havlir.

Starting retroviral treatment early makes sense- it reduces the risk of transmission significantly and probably keeps people healthy and alive longer. And isn’t that the point?

Read the full article here.

University of California – San Francisco (2011, April 13). HIV rate in San Francisco could be cut sharply with expanded treatment, study predicts. ScienceDaily. Retrieved April 15, 2011, from http://www.sciencedaily.com/releases/2011/04/110413093219.htm

Specialized Training for IDU and MSM

I’m off to Fairmont Hot Springs for the next two days to do some specialized training for HIV testers about the particular needs of  an often stigmatized part of the Montana population, MSM (Men who have sex with men- not all define themselves as gay or bi) and IDU (users of IV drugs).

These populations aren’t necessarily the same- or different, either, but we’re doing a day for each to get testers better acquainted with their needs. This involves a lot of work around withholding judgment and helping to reduce risky behaviors while playing to the strengths of the client.

Our job is to raise awareness, reduce risky behavior, get those most at risk for HIV in to testing- and if they test positive, to ensure they get into care.

If you have a minute today, think about us, and breathe a prayer for success.