JAMA Reports HIV Spike Among Gay Men

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AIDS Healthcare Foundation (AHF), today expressed alarm over a Journal of the American Medical Association (JAMA) article that reported a startling 13% increase in HIV/AIDS cases among men who have sex with men (MSM) in the United States over the past four years. The article prompted AHF to renew its call for effective and sustained prevention efforts and a fast tracking of routine HIV testing nationwide. The JAMA article, which examines the upward trend among MSM in Western countries with a focus on the United States, attributes the uptick in infection rates to a rise in unsafe sex due to, among other factors, reduced fear over the disease's potentially deadly consequences, lack of awareness of HIV status and substance abuse issues, particularly the use of methamphetamines and alcohol.

According to The Reemerging HIV/AIDS Epidemic in Men Who Have Sex With Men by Drs. Harold W. Jaffe, Ronald O. Valdiserri and Kevin M. De Cock (JAMA, November 28, 2007-Vol. 298, No.20): "A venue-based study of more than 5000 MSM aged 15 to 29 years in 6 U.S. cities found that 10% of the men were infected with HIV; of these men, 77% were unaware of their infection (91% of black MSM with infection were unaware of being infected). Of men reporting that their last HIV test result was negative, 8% were found to be infected (21% of black MSM reporting a negative test result were found to be infected). Almost 60% of men who were unaware of their infection considered themselves to be at low risk for HIV infection."

"Despite the fact that we have effective medications today to keep people alive and well and their HIV disease under control, I am alarmed and saddened by this latest report because HIV, while treatable, is not curable and requires lifelong care," said Dr. Homayoon Khanlou, Chief of Medicine for AIDS Healthcare Foundation. "More than a quarter of a million people in the U.S. still do not know they are HIV-positive: they simply haven't accessed testing or treatment opportunities. HIV is a preventable disease, and I urge everybody to get tested and know their HIV status."

"I hope this report serves as a wake up call and as a catalyst to fast-track an overhaul of the HIV testing process nationwide," said Whitney Engeran, III, Director, Public Health Division for AIDS Healthcare Foundation. "Sustained and focused prevention efforts and effective risk-reduction initiatives must be scaled up across the country if we are going to reverse this trend in infections. Better leadership is required at all levels: federal, state, local and within communities themselves. The efforts should not only be made when the spotlight is on, such as after a report like this one. We need a sustained, unified commitment that doesn't flag when the numbers begin to decrease."

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The JAMA article cited the need for social marketing campaigns that emphasize personal responsibility, and cited the recent nationwide "HIV Stops with Me" campaign.

A post-campaign survey of AIDS Healthcare Foundation's own most recent prevention initiative, the innovative "Stay Negative" social marketing campaign, demonstrated the campaign's remarkable success in reaching its target audience and achieving its objective to create an effective health education and risk reduction campaign to raise awareness among gay males in Los Angeles County that HIV infection is still a serious threat.

Among the results of the "Stay Negative" campaign, created by Fraser Communications, and funded in part by the U.S. Centers for Disease Control and Prevention (CDC) and the County of Los Angeles Department of Public Health, Office of AIDS Programs and Policy is the fact that it achieved high resonance and appeal among a broad audience, most notably acrossethnic boundaries, with 8 in 10 African Americans and Latinos reporting that they related to the advertisements. Most importantly, the ads proved motivating, increasing levels of intent to include HIV testing in respondents' overall health regimens. After viewing the advertisements, more than 55% considered including HIV testing in their overall health routine. The level of intent was even higher for Latino and African-American men at 65% and 72% respectively.

"We are particularly proud that the key messages of the 'Stay Negative' campaign -- be healthy, stay negative, get tested -- successfully broke through to its target audience, despite an atmosphere of fatigue and complacency that often surrounds safer sex messages twenty-five years into the AIDS epidemic," said Michael Weinstein, President of AIDS Healthcare Foundation, upon the release of the post-campaign survey results earlier this year. "The success of 'Stay Negative' proves that it is possible to reach a wide, racially diverse audience with a clear and compelling message to have fun, be safe and make staying healthy a priority. With its broad appeal, this initiative could become a model for HIV/AIDS social marketing campaigns nationwide."

This JAMA report comes on the heels of a dramatic decrease in global HIV numbers (likely due to new methods of data collection and projections), and an alarming recent increase in STDs in the US, and as the CDC prepares to host an HIV prevention conference next week in Atlanta.

"Global numbers seem to be going down. U.S. numbers are rising rapidly in certain populations as this report shows," added AHF's Weinstein. "It's time for us to stop guessing and radically scale up testing so we can have accurate numbers to ensure an effective response to the epidemic. We need to make screening for HIV for all populations a routine part of medical care and normalize the process of HIV prevention, testing and treatment."

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