A snippet about circumcision

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Is one of these images more a-peel-ing to you?

Probably more in the gay male community than anywhere other than mohel school, circumcision is a topic almost everyone has an opinion about. And with us being in the ‘hood, I figured we could have an uncut discussion about it right here.

Think of it as group therapy: Are you foreskin or anti-skin?

Totally upfront here: I’m one of the majority who was bris’d as a babe. Hey, I was born on an army base, and the guvmint docs did it pretty much without asking permission. Anyway, it was the ’60s (1960s, haters — I wasn’t born in the Confederacy … well, I was, but only in the minds of the rednecks in Georgia at the time). As a kid, I didn’t know any better. I didn’t “miss” it (if memory serves, my dad was circumcised as well, so I “looked” like him). It was only as I got older that the subject came up at all. I was probably in my mid-20s before I’d ever seen an uncut male in person. It was kind of exciting.

Which brings up a point: A lot of guys I know have a near-fascination with uncut men. Mostly, they themselves are cut. It’s like some kind of taboo. Here’s the thing, though: I’ve never had strong feelings about it one way or the other. I’d imagine roughly half the men I’ve been with in a state of arousal were uncircumcised (in general, many of the African-American and Latinos I’ve dated). The ages of intact vs. untact varies significantly, as well. It’s not like only older men are cut and younger not; there seems little pattern to it.

Do I enjoy a circumcised penis? Hey, I’m not one to criticize any penis that shows an interest in me. I’ve had good experiences with cut men … and no-so-good. The same with the uncut. I try to judge on a wiener-by-wiener basis, without painting all tools with the same brush.

But I also have a strong libertarian streak in me. And news breaking this week that the Centers for Disease Control weighed in this week, for the first time, about the benefits of circumcision “health-wise” made me pause. The argument I heard mounted by one author of the policy explained how there are “few risks” involved in circumcision (swelling, bleeding, etc.) and that the benefits included a substantial decrease in rates of HIV contraction.

This, to me, is muddle-headed. The cut/uncut debate has nothing (or little) to do with health. It is first and foremost an issue of personal autonomy and, to an extent, aesthetics. It is a decision made by parents (often brand-new to having a son) about a tiny infant that ultimately affects a huge psychological issue he may have in his later life. For Jews, it is a sacrament that precedes inclusion in a faith community, which I don’t have a problem with. But what about people like my folks, who were basically told, “We’re snipping your newborn — be right back”?

And if the health benefits only manifest themselves when the child becomes sexually active — at a time of presumed physical and emotional maturity — why not leave it up to him, as a teenager, to decide for himself? Or just teach proper hygiene? Speaking from experience, that’s a good thing for anyone who’s sexually active.

There’s even the possibility that telling men (and their parents) that circumcision decreases the transmission of STIs leads to a false sense that cut men can be less careful about having safe sex. That’s not true — cut or uncut, you shove your willy in enough places unprotected, you’re gonna risk a disease. (And what about guys who are total bottoms anyway? Who’s thinking of them?!?!?)

So, let’s talk about it. Are you cut or uncut? Prefer one or the other in your partner? Have any mental scars from your parents decision?

—  Arnold Wayne Jones

HIV infections on rise among young gay, bi men, according to new CDC report

HIV infections are on the rise among young gay and bisexual men, according to statistics released this week by the Centers for Disease Control.

For the past decade, new HIV cases have remained stable at 50,000 per year. In 2010 there were 47,500 new infections.

New infections among young gay and bisexual men ages 13-24 rose 22 percent from 2008 to 2010. African-American young gay and bisexual men account for the largest number of new infections — 4,800 in 2010.

Gay and bisexual men accounted for 63 percent of all new HIV infections — an increase of 12 percent from 2008 to 2010.

The annual number of new infections in the U.S. has remained stable despite continued increases in the number of people living with HIV, indicating that HIV testing, treatment and prevention programs are making an important impact — but incidence still persists at far too high a level, according to the new CDC report.

The estimates are made to help the CDC focus HIV prevention efforts where the need is greatest.

The National Minority AIDS Council issued the following statement in response to the statistics:

—  David Taffet

Surviving HIV, facing Hepatitis C

As liver disease surpasses virus that causes AIDS as a killer, it should be a wake-up call for LGBT people to get tested, educated about risks

Webb-DavidAfter the emergence of HIV/AIDS and the devastation it caused in the 1980s, the identification of yet another deadly virus about the same time went virtually unnoticed by the general public.

News and concern about Hepatitis C understandably took a back seat to HIV, and so the liver disease apparently grew exponentially because it was a slower killer and asymptomatic.

Spread mostly by blood-to-blood contact, HCV is now thought to infect as many as 170 million people worldwide, many or most of whom are unaware of their status because of the absence of any symptoms they are ill.

Often people do not become aware of their infection until significant damage is done to their liver, and cirrhosis or cancer develops and a transplant is necessary.

Now, more people die from HCV-related illnesses than those associated with HIV, according to a study from the U.S. Centers for Disease Control that was unveiled this week.

CDC officials warn that Baby Boomers, anyone born between 1945 and 1965, should get a test to determine whether they are infected with HCV.

Federal health officials estimate that two-thirds of the people infected with HVC are in this age group, and that half are unaware of it.

Medical researchers and practitioners theorized since the 1970s that another hepatitis virus existed in addition to Hepatitis B because some patients who no longer exhibited traces of HBV in their blood continued to show similar signs of liver malfunction.

Finally, in 1989 Hepatitis C was proven to exist, and widespread testing of blood for the virus since 1997 has revealed its frightening spread.

Many people in the LGBT community were unaware of the existence of HCV and only learned about it if someone they knew was diagnosed with it or, God forbid, learned they themselves had contracted it.

After dodging the HIV bullet and vowing not to place themselves at risk of contracting it, many people no doubt were shocked to learn there was yet another virus they could have contracted through blood transfusions, shared intravenous drug use and sexual activity.

What’s worse, there are concerns that the transmission of HCV might occur more easily than HIV through unsterilized medical and dental equipment, body piercings, shared personal items such as razors, toothbrushes and manicure tools — and no telling what else.

In contrast, HIV is thought to be less easily transmitted.

The possible presence of HCV was sometimes detected in the early 1990s among patients who got annual physicals because routine blood tests revealed irregularities in liver enzymes.

Further testing to identify the cause could reveal the presence of HCV when patients were in the care of doctors who stayed abreast of the medical developments.

It became clear HCV would become a chronic infection for most people who contracted it, and that it would eventually lead to severe health problems or death.

Only a few people would contract the virus and overcome it through the body’s natural processes, as is thought to be the case with some people who are exposed to HIV.

Two people of whom I have known and were HCV-positive illustrate just how widespread the virus could ultimately be.
One individual was a gay man who was a former heavy intravenous drug-user and HIV-negative, but nonetheless a member of a high-risk group.

The other was an older married female who didn’t even drink, let alone do drugs or engage in sex with multiple partners. She would surely be considered a member of a low-risk group, and I suspect she contracted the virus in a hospital setting long before its existence was known.

There are treatments available for HCV, but they unfortunately have different levels of effectiveness among patients, are expensive and can be intolerable to some people. Both of the people I knew were unable to tolerate the treatments. The heterosexual female has died, and I have lost contact with the gay man I knew who was HCV-positive. The last time I talked to him he had been declared disabled because of his HCV infection and the damage it had done to his liver.

In both cases, the months-long treatments that included injections and oral drugs caused flu-like symptoms and severe depression. They both abandoned the treatments.
Fortunately, other people managed to survive the treatments and the combination of drugs apparently eliminated HCV from their blood.

The very fortunate discovered the infections and received the treatments before irreversible damage was done to their livers as was indicated by biopsies.

At the time the two people I knew tried the available treatments, only a combination of pegylated interferon and ribavirin was available.

Those treatments initially were prohibitively expensive, but they are considered less costly now.

Today, there are new protease inhibitors available for treatment showing promise, but the cost is astronomical.

The new drugs, Victrelis at $1,100 per week, and Incivek at $4,100 per week, must be taken for months, and they also can cause hideous side effects.

It’s an agonizing situation, but most people are willing to spend whatever it costs if they can and endure whatever pain comes along in an effort to survive. That’s why it’s so important to get tested for HCV and to determine whether treatment is needed before it’s too late.
For others who are uninfected, don’t go there in the first place. Know how HCV is spread and avoid any possibility that it can imperil your life.

David Webb is a veteran journalist who has covered LGBT issues for the mainstream and alternative media for three decades. Contact him at davidwaynewebb@hotmail.com.

This article appeared in the Dallas Voice print edition February 24, 2012.

—  Kevin Thomas

New HIV stats from CDC indicate more young people continue to become infected

According to a new report released this month by the Centers for Disease Control and Prevention, 39 percent of all new HIV infections are among young people aged 13-29. Persons aged 15-29 make up only 21 percent of the population.

HIV disproportionately affects young gay and bisexual men and young Hispanics and African-Americans. Infections among young black men increased 48 percent.

In 2009, the last year for which statistics are available, 8,294 young people were diagnosed with HIV and 75 percent of those were aged 20-24.

In a National Youth Risk Behavior Study, more adolescents are having sex at a younger age — 46 percent of high school students have had sex and 5.9 percent reported their first sexual intercourse at age 13 or younger.

The report faults homophobic educational programs for part of the problem:

“Young MSM [men who have sex with men] may be at risk because they have not always been reached by effective HIV interventions or prevention education — especially because some sex education programs exclude information about sexual orientation.”

—  David Taffet

Big changes ahead for ASOs

AIDS agencies have to look for ways to branch out if they want to survive and thrive under health care reform

Tammye Nash  |  Senior Editor
nash@dallasvoice.com

An estimated 1.2 million people in the United States are living with HIV infection, and 20 percent of them are not even aware of it, according to the Centers for Disease Control. And a CDC report released in early August suggests that there are about 50,000 new HIV infections each year.

And yet, federal funding for HIV/AIDS services have remained flat for the last five years — from funding for medical services to research dollars to money for support services — according to Raeline Nobles, executive director of AIDS Arms Inc.

And that means, Nobles and Resource Center Dallas Executive Director and CEO Cece Cox agreed this week, that the nonprofit, community-based organizations that have been the backbone have to look ahead and keep their options open to remain viable.

Changes in the way that federal funds through the Ryan White CARE Act are distributed — requiring that 75 cents of every Ryan White dollar be used for core medical services — give an edge to nonprofits that operate clinics. And that means that AIDS Arms, which just opened its second clinic last month — is “more competitive at the national, state and local levels,” Nobles said. “With the number of people who are uninsured and living at poverty levels, access to any kind of medical care is a priority. So if you are providing those kinds of services, it does give you an edge.”

Agencies that don’t provide those kinds of services, she added, can get in on that competitive edge by collaborating with those that do.

“There’s really no new money to sustain new agencies,” Nobles said. “AIDS is definitely off the docket in terms of diseases people seem to be concerned about. In fact, any HIV provider across the country who is not considering all their options is in a great deal of denial, and that may well come back to bite them rather severely.”

There’s also health care reform to consider, with several parts of the law passed in late 2010 still to be implemented. That reform, said Cox, is changing the face of community health clinics, like RCD’s Nelson-Tebedo Clinic, and HIV/AIDS service programs.

“Our nutrition program is a good example,” Cox said. “It has really been hammered in terms of federal funds, so we have focused on supporting the program through the community, foundations and corporations. … It is an amazing puzzle we have pieced together, even with cuts in traditional funding streams. But we have managed. We have done the things we felt we had to do.”

And there are more changes coming. Nobles said that if the Ryan White funds survive beyond 2013 when more health care reform measures go into effect, “it likely won’t include any money for outpatient services like we offer” at the Peabody Clinic and the new Trinity Clinic.

“So we have to take a look at what we do best, and we can use our model and globalize it into different areas. We have to become even more sustainable. Diversification of business is key to survival,” Nobles said. “It can’t just be about HIV and AIDS any more.”

Nobles said “serious discussion has been going on at AIDS Arms for at least two years, at the board and staff levels” about how the agency can expand its focus beyond HIV/AIDS and remain viable.

“We have to diversify our business plan. The situation has been serious for awhile and it is becoming even more serious for our board,” Nobles said. “We hope to have, by early 2012, a final business plan in place to move into the future.

“Health care reform is a great thing for a lot of people, but it poses real challenges for the nonprofit sector. You have to stay ahead of the curve, or health care reform will run right over you. We definitely want to stay ahead of that curve,” she continued. “The HIV nonprofit community has the best model of care and support the U.S. has ever seen. That model can be globalized to include care for other disease — heart disease, cancer, diabetes.”

Cox said that staff and board members at Resource Center Dallas also began planning for the changing future some time ago, and its current capital campaign to build a new facility is part of the plan.

“Nobody seems to have all the answers right now. The feds won’t say what they will and what they won’t fund. So savvy business people are already thinking, ‘If this funding goes away, what can we do instead?’” Cox said.

“Everybody feels like the challenge working in the nonprofit sector is that you are always aware there is so much more that needs to be done,” she added. “But doing more requires more space, more staff, more resources. And to have that, you have to build the business in a way that is sustainable. And you have to remember, nobody can do everything.”

Both Cox and Nobles are quick to remind that even though their agencies are “nonprofits,” they are businesses nonetheless, and have to be operated with an eye toward success.

“There has been, and probably still is, the mindset about nonprofits. People expect the nonprofits to be there to provide all these services without caring about costs,” Cox said. “But the fact is, nonprofit or not, these agencies have to be run like a business. You have to anticipate, plan ahead. You have to put the structures in place and you have to invest. We make large investments in our staff and in technology. For-profit business sell stock and they answer to their stockholders. We get our money from our donors, and we have an obligation to let our donors know what we do with their money and to let them know we use it responsibly.”

This article appeared in the Dallas Voice print edition November 11, 2011.

—  Kevin Thomas

Out Youth gets $25K from Sir Elton’s foundation

Out Youth Austin today announced that the organization for LGBT youth has received a $25,000 grant from the Elton John AIDS Foundation for Out Youth’s K.Y.S.S. (Knowing Your Status is Smart) program for HIV prevention, testing and counseling for young people, ages 12-19, in Central Texas.

The group received a $25,000 grant for the same program in March from the London-based Red Hot Organization. The Elton John AIDS Foundation is based in New York.

Out Youth Austin Executive Director Candice Towe called the latest grant “a tremendous Christmas present” for the organization.

Monrovia Van Hoose, Out Youth’s clinical director who oversees K.Y.S.S., said, “It’s critical that GLBTQ youth have regular access to confidential HIV testing and counseling. Staff, clinical interns and volunteers have received intensive training to provide testing and counseling for HIV and other sexually transmitted infections.”

According to a 2009 report from the Centers for Disease Control, 48 percent of Americans ages 13-24 who are infected with HIV are unaware of their HIV status. In 2008, CDC noted that American youth are at “persistent risk” of HIV infection, and that many are “not concerned” about the risks of infection.

—  admin

Dallas rate of new HIV infections higher than national average

New statistics released by CDC examine infection rates in MSM in 21 major metro areas

DAVID TAFFET  |  Staff Writer taffet@dallasvoice.com

In September, the Centers for Disease Control issued new HIV statistics for men who have sex with men in 21 metropolitan areas.

They tested 8,153 men and found HIV prevalence was 28 percent among blacks, 18 percent among Hispanics and 16 percent among whites. In Dallas, 461 men participated in the study.

The statistics were worse for Dallas than the 21 cities as a whole. Nationally, 19 percent of those tested were positive. In Dallas, 26 percent were positive. About 44 percent of those who tested positive in the full survey were previously unaware of their status. In Dallas, 54 percent were previously unaware.

In Houston, the same percentage tested positive as in Dallas, but only 23 percent were previously unaware of their status.

Only Philadelphia, Detroit and San Juan had higher percentages of participants than Dallas who did not previously know their status. Each of those cities scored more than 70 percent unaware. Only Baltimore and New York City revealed a higher percentage of new HIV infections than Dallas or Houston.

The study found that HIV prevalence dropped with higher education levels and with higher income levels.

Positive testing increased with age but those in their 30s were most likely to be unaware of their status.

For more on the report go online to cdc.gov/mmwr/preview/mmwrhtml/mm5937a2.htm?s_cid=mm5937a2_w

This article appeared in the Dallas Voice print edition October 08, 2010.

—  Kevin Thomas

More on the latest HIV stats from the CDC

cdc_logo(2)Jennifer Horvath from the Centers for Disease Control and Prevention contacted me about my article on National HIV Testing Day that appeared in Friday’s paper.

She sent along a ton of additional statistics and clarifications. The data, of course, is not as simple as a few sentences in the paper.

First of all, our secondary headline said, “New report from CDC says most recent data shows that MSM continue to make up the largest percentage of new infections.” Of course we meant new diagnoses. Some people go years after being infected without being diagnosed. That’s what National HIV Testing Day is all about. Know your status.

And as a reminder, if you haven’t had a test recently, free testing is available all this week in a variety of locations as well as on the actual day.

—  David Taffet