Miami Herald Examines Issues Surrounding HIV Status Disclosure Among MSM

The Miami Herald on Monday examined issues that some HIV-positive men who have sex with men face when determining when to reveal their status to potential partners. According to the Herald, a recent study from the Gay Men's Health Crisis found that half of U.S. residents surveyed said they believe that HIV/AIDS contributes to discrimination against MSM. In addition, discrimination in the MSM community toward HIV-positive MSM is not discussed widely, according to the Herald. This stigma often leads to a fear of disclosure among HIV-positive MSM, which can contribute to high-risk sexual activity and the spread of HIV.

Spencer Lieb, senior epidemiologist at the Florida Department of Health Bureau of HIV/AIDS, said, "Non-disclosure is one of the challenges of HIV prevention." Reports in Florida show a 48% increase in newly recorded HIV cases in Miami-Dade County from 2006 to 2008, as well as a 74% increase in Broward County. Lieb said these figures could point to an enhanced reporting system. However, the Herald reports that the increase in new cases also could be in part because of increased HIV/AIDS complacency. Linda Simon, a psychotherapist with the Miami Beach Community Health Center, said that among some MSM, disclosing their HIV-positive status is a "struggle," because "on the one hand they want to be responsible, but on the other they want to protect themselves from breaching confidentiality and rejection" (Roth, Miami Herald, 4/6).

The Gay Men's Health Crisis study is available online.

California HIV/AIDS Group Launches Internet-Based Program Aimed at MSM

The Palm Springs, Calif.-based Desert AIDS Project has launched an Internet-based education and prevention program aimed at men who have sex with men, the Desert Sun reports. The program was launched ahead of the area's White Party Easter weekend, according to the Sun. "With the White Party literally in our backyard, we feel a responsibility each year to get out the message about safer sex while not throwing the proverbial wet blanket on the fun people are here for," David Brinkman, AIDS Project executive director, said.

The program, called "I-Connect," allows project staff to distribute information about safer sex, HIV testing, mental health and substance abuse counseling on several Web sites, according to a release. In addition, some staff plan to be in the lobby of the host hotel for the White Party throughout the weekend, according to Brinkman. The AIDS Project aims to reach about 3,000 people during the program's first year. MSM are the primary attendees of the White Party, and Palm Springs has one of the largest MSM populations per capita in the U.S., according to the Sun (Brambila, Desert Sun, 4/3).

Increased HIV Risk Linked to Binge Drinking Among MSM in New York City

Binge drinking -- or the consumption of five or more alcoholic beverages on one occasion -- may be contributing to an increased risk of HIV among men who have sex with men in New York City, according to a study released Monday by the city's Department of Health and Mental Hygiene, the New York Times' "City Room" reports. For the study, titled "Alcohol Use and Risky Sex in New York City," the city's health department used data from its 2007 Community Health Survey and the National HIV Behavioral Surveillance project (Chan, "City Room," New York Times, 1/5).

According to the study, 24% of MSM in New York reported engaging in binge drinking at least once monthly, compared with a rate of 15% among the city's total adult population (Bindrim, Crain's New York Business, 1/5). The study found that binge drinkers were 50% more likely than non-binge drinkers -- and three times more likely than non-drinkers -- to report having two to four sexual partners in the previous year. In addition, 40% of MSM who engaged in binge drinking reported having five or more sexual partners in the past year, compared with 21% of non-binge drinking MSM. The report also used data from the surveillance study, which is based on interviews with MSM at gay bars and is not necessarily "representative of the gay population as a whole," according to the "City Room." This data indicate that 27% of MSM who had casual partners reported being under the influence of alcohol during their last sexual encounter, and 12% reported being under the influence of both alcohol and drugs. In addition, 48% of MSM who reported having 20 or more sexual partners in the past year reported being under the influence of alcohol during their last sexual encounter. The study also found that 65% of MSM who consumed alcohol were likely to use a condom during receptive anal intercourse, while 86% of non-drinking MSM were likely to use a condom during receptive anal sex.

Thomas Frieden, New York City's health commissioner, said, "Heavy drinkers are more likely to have multiple partners -- increasing their risk of HIV, [STIs] and unplanned pregnancy." According to Frieden, the prevalence of HIV and syphilis is rising among MSM in New York City ("City Room," New York Times, 1/5). Frieden added, "Many New Yorkers recognize that drinking increases the risk of injuries and auto accidents, but they may not recognize these other risks." Sean Cahill -- managing director of public policy, research and community health at Gay Men's Health Crisis -- said there is a "wide body of evidence" that consuming alcohol can lead to "lowered inhibitions and impaired judgment." He added that "people forget" that a "legal substance" such as alcohol can lead to an increased risk of HIV. According to Cahill, addressing binge drinking among MSM in New York City might prove difficult, because "gay bars are a site of social interaction and a site of community" among many MSM in the city.

The study also reported on binge drinking among teenagers and found that more than 25% of teens who drank alcohol in the last month reported having multiple sexual partners, compared with 11% of teens who did not drink. In addition, 60% of teens reported using condoms during sex while under the influence of drugs or alcohol, compared with 72% of teens not under the influence. About 14% of teens reported binge drinking during the past month (Crain's New York Business, 1/5).

Rising HIV Prevalence Among MSM in Hong Kong

The senior medical director of Hong Kong's Centre for Health Protection, Raymond Ho Lei-ming, on Tuesday warned residents that HIV prevalence in the region is increasing among men who have sex with men, Hong Kong's Standard reports (Chui, The Standard, 9/17).

According to Ho, a study released last year found that HIV prevalence among MSM in Hong Kong is about 4%, up from a 1% HIV prevalence rate in previous years. Ho said prevalence among MSM in the region could top 30% by 2020 if current trends continue. According to Ho, sex parties and low condom use have been attributed to the increased number of cases. "If we don't do anything, we are looking at a worst-case scenario," Ho said (Benitez, South China Morning Post, 9/17). He called for people at risk of HIV infection to get tested and for greater condom use and other HIV prevention measures (Standard, 9/17).

Loretta Wong Wai-kwan, the CEO of AIDS Concern, a volunteer organization offering HIV/AIDS support and prevention programs in Hong Kong, said that the number of HIV/AIDS clinics in Hong Kong has remained stagnant over the past decade. She added, "How do the existing human resources or facilities cope with the increasing case load?" (South China Morning Post, 9/17).

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