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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (July 1, 2005)
16 JUSt OUt • july 1.21X15 20500 NE Watson Rd Scappoose, OR 97056 Take a stroll through our 4 acres of display gardens. Then join us for a free Sunday workshop. For details, see our website. T he P rognosis of P revention Why is America failing while other countries are succeeding? by Bob Roehr For information call: 503/543*7474 X T T 7 e’ve fai,ed>” said % / Howard Grossman, % JE / pointing to the esti- ’L/ mated 40,000 new ▼ ▼ HIV infections a year in the United States, a number that has held steady for more than a dozen years. “Maybe it would have been much worse without our inter vention, but culturally, something is wrong, and we are not getting the messages across.” He spoke from his experience at the epicen ter of the U.S. epidemic, Manhattan, where for two decades he treated primarily gay men in his HIV practice, and now as executive director of the American Academy of HIV Medicine. Grossman tied the successes in Europe and Australia at controlling infection rates to simple U Open daily 9am- egon Camera Everything Photographic The result of flat funding of the Centers for Disease Control and Prevention during the past five years has often been a kind of whack-a-mole where the hammer of prevention Rinding comes down on one population and rates of infection fall, only to pop back up elsewhere. The latest case numbers from Florida, the state with the third-largest number of HIV infections in the nation, are a good example. From 1999 to 2004, the number of new HIV cases among blacks declined by 30 percent. Dur ing that same period they shot up by 23 percent among whites and 29 percent among Hispanics. “Prevention is not a one-shot deal. Each generation must be reached with HIV preven tion as they come of age. Both at-risk and infected populations need assistance maintain 2005 National wention Inference Richard Voss, gri abr Principal Broker / Owner Peninsula Realty 6110 N. Lombard St. Portland, OR 97203 Business (503) 286-5826 Cell (503) 804-9424 Ronald O. Valdiserri, deputy director of the National Center for HIV, STD and TB Prevention, addresses the 2005 National Prevention Conference in Atlanta. •Full Service Real Estate Office •On Site Real Estate School •Full Service Property Management- • Notary Services Se habla Espanol •Fax Machine Services •In office Closings •On site Mortgage Broker See oar aicitttcd ad ck titcj ei^ac richard voss<" century21 com www century2 1 peninsula com Each office is independently owned and operated EXPERIENCED PROFESSIONAL AFFORDABLE 503.493.9453 5416 N MARYLAND Near Downtown & the Pearl at the ILLINGSWORTH MAX STOP CHUCK FLOYD HAIR CARE SERVICES for WOMEN and MEN WWW.CHUCKFLOYD.ORG and explicit messages about using a condom every time. He also thought the American psy che of individualism, as opposed to a more soci etal perspective elsewhere, played a role. Steven Tierney, director of HIV prevention for the San Francisco [)epartment of Public Health, pushed for “targeted programs and serv ices for gay men” as well as increased federal Rinding for those activities. ing safer behaviors over the long term,” said Ronald O. Valdiserri, the CDC’s deputy direc tor of the National Center for HIV, STD and TB Prevention. P revention and P ositives A handful of studies from around the coun try suggests gay men, both positive and negative, appear to be serosorting—making calculated U niting A merican F amilies Congressman introduces new version of the Permanent Partners Immigration Act by Bob Roehr teve Boullianne and Olivier De Wulf threat of deportation looms over their heads. have been together for a dozen years, Belgium recognizes gay marriages, so the couple first in Belgium and then in San could live there, but it does not recognize their Francisco. They adopted Reece and adoption and hence their children. Laurent at 6 months and 6 weeks of “Ever since September 11 th we’ve been hav age, respectively. But the laws of the two ing coun difficulties maintaining Olivier’s visa, hav tries are threatening to tear apart this happy ing it removed and having to leave the country nuclear family. quite quickly. We’d like it to stop,” Boullianne De Wulf can only obtain a two-year visa to said. “We think it’s important for our kids to be live in the United States, and the perkxlic raised in the stable and wonderful community S decisions in choosing their sexual partners, engaging in certain acts and deciding whether to use condoms—based on HIV status and viral load. A study of 104 HIV-positive gay men at Fen way Community Health in Boston found that 64 percent believed that viral load affects their likelihocxl of transmitting the virus. If the per son has an undetectable viral load as measured in his bkxxl, then the risk of transmission is thought to be low. And they use that informa tion in deciding whether to use a condom. The calculation is not without risk, some- | times substantial risk. The genital tract is a sep arate compartment behind a blood barrier that some anti-HI V drugs do not penetrate very well. Furthermore, an STD in the genital tract can amplify HIV viral load significantly and lead to transmission, even though the person has an “undetectable” viral load as measured in his blood. The frequent asymptomatic nature of many STDs is why all sexually active patients should be screened for those infections, not merely for symptoms. A survey by the HIV Medicine Asso ciation found that physicians were most likely to screen for syphilis. That is because they only have to check off a box on the form for drawn blood; they don’t have to gather other samples and fill out an additional fonn. The fact that the transmission rate of HIV is dramatically lower through oral sex than through unprotected anal sex has shaped a per ception among many gay men that oral sex is relatively safe across the board. That is not true; the dynamics of transmission for HIV do not apply to other STDs. One of the CDC’s priorities is prevention for positives, using AI[)S patients’ regular visits with their health care providers as an opportu nity to discuss and hopefully reduce their risky sexual behavior. But surveys have shown that most HIV docs don’t do that, in part because of time pressures but also because they don’t feel they have adequate training in the area of prevention. “Getting providers to ask the first question is probably the most important component of all of the different curriculums that are out there. If we get people to ask, many times the conversa tion will flow,” said Mark Thrun, an HIV doc in Denver who has played a leading role in devel oping a training program for physicians. Grossman thought it was a good idea, but he worries that physicians simply do not have time to do all the things being asked of them, unless they receive additional compensation. JM B ob ROEHR is a free-lance reporter based in Washington, D.C. where we live now and not have our family threatened by deportation.” The family came to Washington to support the Uniting American Families Act, introduced by U.S. Rep. Jerrold Nadler, D-N.Y. An earlier version of the legislation was known as the Per manent Partners Immigration Act. “The United States should not indulge in wanton, gratuitous cruelty,” Nadler said. His bill “helps to address one of the many areas where unfair and unequal treatment creates undue hardships for gay and lesbian U.S. citizens.” It will treat a gay or lesbian permanent partnership the same as a civil marriage between a man and a woman for visa and immigration purposes. “My bill would add the term ‘or permanent part ner’ to the term of‘spouse’ everywhere that term is found in the Immigration and Naturalization Act.” House Resolution 3006 defines the term as “any person over 18 years of age who: is in a committed, intimate relationship with another
