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Written by Louis Weisberg, Staff writer
Mar 25, 2010
AIDS service providers in Wisconsin plan to ask for increased HIV-prevention funding in the wake of new data showing the epidemic continues to disproportionately impact gay and bisexual men.
An analysis released by the U.S. Centers for Disease Control and Prevention in mid-March found the rate of new HIV diagnoses nationally among gay and bisexual men is more than 44 times that of other men and more than 40 times that of women.
The new CDC analysis also found the rate of primary and secondary syphilis among gay and bisexual men is more than 46 times that of other men and more than 71 times that of women. Syphilis infection facilitates the sexual transmission of HIV and is believed by the CDC to be a factor underlying a resurgent HIV epidemic among young African-American men who have sex with men (MSMs) in Milwaukee.
“While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations,” said Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
In Wisconsin, the HIV/AIDS epidemic “is driven to a greater extent by male-to-male sex than is the case nationally,” said Mari Gasiorowicz, an epidemiologist with the Wisconsin Department of Health Services’ AIDS/HIV Program. She used the CDC’s recent data to calculate that finding.
None of the new numbers surprise the state’s AIDS service organizations. About 54 percent of the patients served by AIDS Resource Center of Wisconsin are gay and bisexual men, according to chief operating officer Mike Gifford, even though the CDC estimates that MSMs comprise only 4 percent of the male population in the United States.
ARCW plans to seek one million dollars in new prevention funding for programs that specifically target gay and bisexual men. “That should be a combination of federal, state and local resources,” Gifford said.
ARCW will use the money to pay for prevention outreach personnel who will work within the gay community to “implement behavioral interventions that have been researched and tested and evaluated to be effective in reducing HIV risk behaviors,” Gifford said.
One example of such an intervention is “D-Up,” a grassroots program that identifies opinion leaders in targeted communities and trains them to become on-the-ground advocates for harm reduction. They counsel their communities on effective condom use and teach people how to negotiate safer sexual practices with their partners.
“It’s important for people to understand that this intervention and others that ARCW is proposing have been studied and have been found to reduce the rate of unprotected anal sex by 44 percent and increase condom usage on a regular basis by 30 percent,” Gifford said.
Karen Dotson, executive director of Madison-based AIDS Network, said her organization’s prevention outreach workers have helped counties in south central Wisconsin avoid the upward trend in HIV infections that are being observed in Milwaukee and elsewhere in the state.
“The number of new cases per year peaked there in 2006, but they have gone down for the last three years,” Dotson said.
Dotson said the collaborative relationships that AIDS Network has formed with other community clinics and local health departments have been instrumental to her outreach workers’ success. “It takes more than just us,” she said. “We have to have a collaborative effort and we do that.”
AIDS Network already has applied for new federal funding to target MSMs in its region. In the meantime, the organization is using unrestricted grants to maintain its prevention outreach services.
HIV-prevention funding in Wisconsin has remained frozen for several years, due largely to fiscal constraints. Gifford said that total government HIV-prevention spending in Wisconsin is about $3.2 million annually.
Additional funding is provided by foundations and individuals. Needle-exchange programs in the state, which have had a significant impact on reducing HIV-transmission among injection-drug users, are financed by the private sector, Dotson said.
But the economic downturn has eroded private as well as public funding, Dotson said.
“Foundation dollars are being diverted more to women and families,” she said. “We’re starting to see more of that, probably due to the economy. When you start looking at dollars for men and single men, that’s something that some foundations don’t believe in.”
The recent CDC analysis seems to have generated renewed interest at the federal level in HIV-prevention targeting MSMs.
“It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV-prevention efforts,” Fenton said.
But whether this awareness will translate into more prevention dollars remains to be seen.
