National HIV/AIDS Awareness Day Highlights Epidemic’s Shifting Challenges

By Liz Massey - Sept. 25, 2014

As HIV/AIDS service providers throughout the United States prepare to observe National Gay Men’s HIV/AIDS Awareness Day on Sept. 27, representatives from local organizations dedicated to addressing the pandemic say that the key to successfully combating the disease in men who have sex with men (MSM) has broadened beyond a simple message of awareness into encouraging greater openness and dialog about HIV’s impact and a greater commitment to practice the activities that slow its spread.

National Gay Men’s HIV/AIDS Awareness Day was originally established by the National Association of People With AIDS in 2008.

Kit Kloeckl, executive director of the Aunt Rita’s Foundation, said that his organization’s observance of the awareness day this year was related to what it had learned while conducting focus groups this summer to better understand what prevention messages worked best with gay and bisexual men aged 21 to 29.

“We learned (from our focus groups) that there is a great deal of stigma against people living with AIDS,” he said. “Many of these men (said) that they would not engage with people who identified as positive.”

Aunt Rita’s and the Arizona Department of Health Services are partnering with the Greater Than organization to present a media campaign entitled “Speak Out,” which encourages MSM of all HIV statuses to begin an honest conversation about how the disease impacts their relationships, health, and communities.

Many things have improved for MSM since AIDS was first identified more than 30 years ago.

John Welch, the director of prevention and intervention services for the Southwest Center for HIV/AIDS, noted, “Clearly we’re in a much better place in terms of treatment and access to care. HIV testing has become easier, more efficient, and detects HIV infection much earlier than even a few years ago.”

Welch added that the number of treatment options have expanded considerably, and that HIV-positive men who are compliant with current medication regimens and use condoms during high-risk sexual activities are far less likely to spread the disease to others.

On the other hand, the stigma that HIV/AIDS carries with it — both within the gay/bi men’s community, as noted above, as well as in larger social groups that MSM may belong to — continues to impede prevention and treatment efforts.

Welch noted that from 2008 to 2010, new HIV infections jumped 22 percent among the youngest MSM studied, those between 13 and 24 years of age. He said he didn’t think that youthful arrogance or a lack of cultural memory about the darkest years of the AIDS crisis were to blame for this increase. Rather, he saw it as a symptom of a much more complex problem.

“HIV is not an issue that exists by itself, but is woven into many aspects of men’s lives,” Welch said. “Risk for HIV is embedded into so many other important issues – dating and intimacy, sexual desire and love, as well as alcohol and recreational drug use, homophobia, abuse and coercion, racism and self-esteem, homelessness, employment and discrimination.”

Another pocket of the gay/bi men’s community that continues to see high rates of transmission is among minority MSM. Kloeckl said that African Americans comprise about 3 to 5 percent of Arizona’s population, but make up 12 to 14 percent of the HIV population. Beyond economic disparities and a lack of access or fear of accessing medical care for HIV, Kloeckl mentioned that religious or culturally fueled stigma also made it difficult for African American as well as Hispanic MSM to get into treatment for HIV.

“African American men are often told they have HIV because ‘God is punishing them,’” he said. “It is particularly hard for young gay Black and Latino men to come out to their families, let alone have an honest conversation about sex and safe sex.”

One of the messages that HIV/AIDS organizations are promoting in conjunction with National Gay Men’s HIV/AIDS Awareness Day is for sexually active gay and bisexual men to set expectations about how they plan to protect themselves from the disease, and to discuss that commitment with potential partners, friends and family.

Kloeckl said that locally conducted research mirrored national studies that indicate that MSM are typically well aware of how HIV is transmitted and what constitutes high-risk sexual activity. But a gap exists between that knowledge and a determination to always discuss risk and use condoms.

“MSM aren’t unaware of the risks of contracting HIV,” Kloeckl said. “There is simply a lack of commitment to consistently use protection … Gay men feel less empowered to demand condom use, and don’t openly and honestly talk about HIV until they’ve actually started establishing a relationship with their partners.”

Another key to slowing HIV transmission is for sexually active MSMs to get tested for HIV regularly.

“Generally speaking, we’re at higher risk for HIV infection when we’re sexually active with someone who doesn’t know their status,” Welch explained. “People may be more likely to transmit HIV in the first six weeks after being infected — due to a high viral load during the acute infection phase — and some HIV antibody tests will not be able to detect the infection that early.” e