Invisible is Not Acceptable Meeting the Needs of Gay Men and MSM Here and Abroad

1. Invisible is Not Acceptable Meeting the Needs of Gay Men and MSM Here and Abroad June 21, 2010 AFC Board Meeting Jim Pickett

2. Global context

3. This presentation

6. MSM, HIV and the Road to Universal Access— How Far Have We Come? [amfAR 2008] • 128 countries reporting in 2008 on progress implementing 2001 Declaration of Commitment on HIV/AIDS: • Almost ½ reported no data on HIV among gay men and other MSM for any of the 5 requested indicators: • prevalence of HIV infection • rates of HIV testing • HIV knowledge • condom use • access to prevention programming • 62% of countries reported no HIV seroprevalence data among gay men/MSM

7. The Global Burden: Gay men and other men who have sex with men (MSM) • Gay/MSM are 19x more likely to be infected with HIV than general population • In North America, Western Europe, Latin America • Gay men and MSM make up most HIV infections • In many African, Asian and Latin American countries: • HIV among MSM significantly higher than general population • Most HIV infections due to unprotected anal intercourse

8. An act of unprotected anal intercourse is 10 to 20 timesmore likely to result in HIV transmission than an act of unprotected vaginal intercourse.

9. Source: From Promise to Product: Advancing Rectal Microbicide Research and Advocacy

10. Source: From Promise to Product: Advancing Rectal Microbicide Research and Advocacy

11. Shameless, indecent, against nature, contempt for religion, unnatural carnal knowledge… International LGBTI Association – May 2010 76 countries criminalize LGBT people (1 less from last year – thanks India) Death penalty Iran, Mauritania, Saudi Arabia, Sudan and Yemen (plus some parts of Nigeria and Somalia)

12. This obsessive homophobia... is totally absurd, and it’s also cruel... I’m really more and more convinced that homophobia is one of the top five obstacles to really stopping this epidemic. - Former UNAIDS Executive Director Peter Piot, 2008 IAC

13. National context

14. United States CDC 2010 • Gay men/MSM 44x more likely to be HIV positive compared to other men • Gay men/MSM 40x more likely to be HIV positive compared to women

15. United States Gay men/MSM • AIDS diagnosed more than half million • + 300,000 with AIDS have died since beginning of the epidemic • 5% to 7% men in U.S. reported having sex with other men • Yet, gay/MSM made up more than two thirds (68%) men living with HIV in 2005. • In 2005 study of 5 large U.S. cities, 46% of African American gay/MSM were HIV+

16. Budget Allocations for HE/RR by HIV risk group, 2007 N = 59 health departments

17. Budget Allocations for CTR by HIV risk group, 2007 N = 54 health departments

18. United States In 2009, only 20% of gay/bi/MSM had access to HIV prevention services, according to the CDC

19. Chicago

20. Chicago Gay Men/MSM • In 2006, more than 22,000 with HIV/AIDS • Diagnosed HIV infections in 2006 – 1,551 • 80% men, 20% women • 2000 – 46% new infections among gay men/MSM, 2006 – 63% new infections among gay men/MSM • In 2006, Black gay/MSM 28% of all diagnosed HIV infections, White 22% and Hispanic 11% infections • Of gay men, 42% Black, 36% White, 17% Hispanic

21. AFC’s response - global

22. IRMA

23. Advocacy goals • Increase and diversify funding • Increase research activities • Increase knowledge - For instance: • Learn more about heterosexual anal sex • Lear more about anal sex behaviours and practices in general • Lubricant safety

24. Global context

25. AFC’s response - national

27. Promoting Sexual Health: Potential Advantages of a Sexual Health Framework • Focus shifts from a disease-focus to a more positive health-based approach characterized by understanding of complex factors that shape human sexual behavior • Reduces stigma • Relevant to those seeking health (ie, everyone) • Helps enhance the efficiency and effectiveness of prevention messaging and services by bundling messages and services • Effectiveness (eg, platforms for “Childhood immunizations, “Heart health”) • Enhances ability to normalize conversations regarding contributions of sexuality and sexual behavior to overall health

28. Promoting Sexual Health: Potential objectives of CDC’s public health approach • Increase healthy, responsible and respectful sexual behaviors and attitudes  • Increase the awareness and ability to make healthy and responsible choices, free of coercion  • Promote healthy sexual functioning and relationships, including ensuring that individuals have control over and decide freely on matters related to their own sexual relations and health • Optimize and educate about reproductive health • Increase access to effective preventive, screening, treatment and support services that promote sexual health  • Decrease adverse individual and public health outcomes including HIV/STDs, viral hepatitis, unintended pregnancies, and sexual violence

30. AFC’s response - local

32. Division of labor

36. How are you healthy? Answers cover physical, sexual, emotional, mental, relational and spiritual health 131+ posts I have always been and always will be an irrepressible party girl, albeit a responsible one. These days I do more drinking than pills or powders but I still love to have fun. For me this means hydrating myself, having a game plan, and taking sensible precautions. For example eating protein bars, drinking supergreen juice, and allotting myself recovery time.

38. Goal is to increase access to HIV prevention and primary care services for African-American women, MSM and Youth on the south side.

40. Thank you