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Men who have sex with men (MSM) and who practice rectal douching before receptive anal intercourse have a higher risk of HIV and other sexually transmitted infections (STIs), including hepatitis B and C viruses (HBV and HCV), aidsmap reports.
Publishing their findings in Sexually Transmitted Diseases, researchers conducted the first meta-analysis and systematic review to assess the HIV- and STI-related risks associated with rectal douching among MSM. They included 28 studies published between 1982 and 2018 that included a total of 21,570 MSM participants. Forty-six percent of the studies were conducted in the United States, 35% were from Europe and the remainder were from South America, Asia and Africa.
Fifty-two percent of the participants reported rectal douching. Of that group, 52% reported recent condomless intercourse, and 58% reported a high number of recent sex partners.
The meta-analysis included 24 studies with a total of 20,398 participants. Men in these studies who reported rectal douching, compared with those who did not, had a 2.8-fold higher risk of HIV. After an adjustment for other factors that may have influenced this association, this figure was reduced only slightly, to a 2.74-fold increased risk.
The 15 studies that provided data about the link between rectal douching and other STIs indicated that the practice was associated with a 2.46-fold increased risk of such a diagnosis. In particular, rectal douching was tied to a threefold higher risk of HBV, HCV, chlamydia and gonorrhea. After an adjustment for factors that may have influenced the association between douching and all non-HIV STIs, the figure was reduced to a 2.27-fold increased risk.
Rectal douching may influence the risk of contracting HIV and other STIs by damaging the delicate rectal lining, flushing out protective bacteria in the rectum and transmitting infections through shared rectal douching tools.
The study authors stressed that long-term studies are needed to further explore the association between rectal douching and HIV and other STIs.
To read the aidsmap article, click here.
To read the study abstract, click here....
Read more: Rectal Douching Linked to Higher Risk of HIV, STIs, Hep B and C in Gay Men
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In an effort to support gender equality, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) pledged over $2 billion this year to support women and girls affected by HIV/AIDS.
Founded in 2003, PEPFAR has invested over $85 billion dollars so far in the global fight against HIV.
Nearly $200 million of the multibillion-dollar investment will be channeled into DREAMS programming for adolescent girls and young women, according to a PEPFAR press release. DREAMS is PEPFAR’s public-private partnership with organizations that include the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences, and ViiV Healthcare.
Since 2015, DREAMS has provided more than $800 million to women and girls living in Africa and the Caribbean, which respectively have the highest and second-highest prevalence of HIV in the world. Already, new HIV diagnoses among adolescent girls and young women in most of DREAMS’ intervention regions have dropped by more than 25%.
The new funding will continue to be used to prevent girls from contracting HIV at birth and throughout adolescence and provide treatment and cervical cancer screenings to HIV-positive women. Furthermore, PEPFAR’s investments will help address structural sexism and empower women and girls to take charge of their own lives by involving them in all decisions regarding their health care.
“We believe that every girl, every woman, deserves equality, health and the opportunity to realize her dreams,” said Deborah L. Birx, MD, the U.S. global AIDS coordinator and head of PEPFAR, in the release.
Since 2003, PEPFAR has saved 17 million lives and prevented millions of HIV infections.
In May 2018, PEPFAR celebrated 15 years. To learn more about its accomplishments, read “PEPFAR Helps Over 14 Million People Access HIV Treatment.” Below is a video marking the anniversary.
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Read more: PEPFAR Pledges $2B to Support HIV-Affected Women and Girls
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We have just experienced—it was June 5 to be exact—a day of great significance to people living with HIV. It was HIV Long-Term Survivors Awareness Day.
The day clearly means a lot to the estimated one in four HIV-positive North Americans, like myself, who have been living with the virus for more than 25 years. It tends to emphasize common experiences and common needs. That’s wise. To attempt to capture the diversity of that particular population is a tall order and not the order of the day. In fact that population is far from homogeneous, even though somewhat united by the history of the epidemic. The awareness day illustrates we can all focus on a common issue important to us as a community.
That degree of unity is rare.
In practical terms, members of the HIV community have little in common. In 2019, for example, just over half of us in North America have undetectable viral loads, the remainder either unaware they are infected or still on the path to undetectable. Meanwhile some (many?) present as though their lives are as normal as those of their HIV-negative neighbors; only an antibody test and their medicine cabinets would reveal them as different.
True, some us of experience side effects—but some of us don’t. Some of us experience horrifying stigma, but some of us don’t. Some of us are traumatized by our diagnosis, but for some it’s business as usual. Some of us find that accessing treatment and care is a challenge, some of us encounter no problems. Some of us are intensely political, others wish we would just get on with life. Some wish living with HIV would be normalized, others are intensely opposed to that. For some, criminalization is a threat, others not. Then of course we harbor differences that arise from the colour of our skin, our gender and sexual orientation, our socio-economic background, our mental health, our housing, our experience (or not) with substance use—and many other issues. In short, a collective experience is hard to come by. Unity is hard to come by. Yet we strive for it constantly—and may need to do so more than ever.
That striving for unity is, of necessity, realized within a framework of diversity, arguably the hallmark of the global HIV community. The concept of a (sort of) unified community is thus realized rarely, if at all, unless for example we count those who are privileged to attend International AIDS Conferences. Even those events are characterized by multiple groups having multiple agendas. They emphasize that the search for common causes is not an impossible one (think Ending the Epidemic or even U=U), but ultimately we are a community of splinter groups. One could say we are not one community, but a collection of communities, of distinct epidemics each carrying the HIV umbrella.
Interestingly, the narrative from the 2020 International AIDS Conference, controversially slated for San Francisco, seems to indicate organizers too are struggling with the concept of unity vs. diversification of effort. “Now, we must come together and make common cause with other health issues,” they suggest. They stress the need for “resilience to avoid fragmentation in the response and to remain united and inclusive in order to meet our common challenges” (emphasis mine). (The subtext is that not enough people support San Francisco as a preferred conference location and will thus likely stay away - but that’s another story.)
Achieving unity is a balancing act, of course. Look around at your own nation’s response to HIV and it’s likely characterized by fragmentation. Some of that is a necessity, of course. Without local distribution of services and without recognizing the diverse needs of affected populations, the response to HIV would be weak indeed. But then there is the downside.
In Canada, we have a deeply fragmented response. There are over 100 AIDS Service Organizations and governments have sought ways to reduce the number they fund in what can seem quite arbitrary ways. Umbrella organizations like the Canadian AIDS Society and CAAN (the Canadian Aboriginal AIDS Network) have been victims of drastic funding cuts. The message is partly one that favours survival of the fittest. But it’s clear too that the government thinks the movement has become too fragmented, that the same effect can be achieved with the same money distributed differently. Meanwhile national organizations like the Canadian AIDS Society and the CPPN (the Canadian Positive People Network) have struggled to gain support for their efforts to adequately represent nation-wide constituencies. It seems that the community favours a fragmented response; governments are less keen.
That will make efforts like uniting with other health groups, hinted at by the International AIDS Society, difficult. If we constantly stress how different we people living with HIV are from each other, how can we join forces with other groups where the only common bond is a disability and the need for more money?
In Canada, for funding purposes, we have seen governments lump together HIV with Hepatitis C and other sexually transmitted blood-borne infections. I’ve never been a fan. The method of transmission seems a clumsy way of linking hugely different conditions. Nevertheless we have seen an HIV movement holding few cards roll over and accept it. Expect more of the same, but on a greater scale. The end of AIDS exceptionalism, from a funders’ viewpoint, is clearly in sight. And without a much more unified community there will likely be little that can be done.
As much, therefore, as the recent proclamations of the International AIDS Society make me uncomfortable, I think they have it mostly right with their call for unity. It applies on both a global, national and even local scale. We do need “to avoid fragmentation in the response and to remain united and inclusive in order to meet our common challenges.” The challenge of course, is in cultivating unity while honouring our differences and all that entails.
That’s why events like HIV Long-Term Survivors Awareness Day have an appeal. True, they focus on just some of us but they also speak to our common history and the events that brought all people living with HIV to where they are today. I think that finding common ground like this while respecting diversity pays off and is key to the survival of the movement....
Read more: What Do All People With HIV Have in Common? Answer: Very Little
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Saturday, June 8, marks the annual National Caribbean-American HIV/AIDS Awareness Day (NCAHAAD). Launched in 2006 by the Caribbean People International Collective (CPIC) and a working group of U.S. organizations, the day of observation aims to ensure that Caribbean-Americans have the support, resources and educational materials they need to treat or prevent HIV.
“NCAHAAD is a national mobilization effort designed to encourage Caribbean-American and Caribbean-born individuals across the United States and its territories to get educated, get tested, get treated and get involved,” the National Minority AIDS Council’s Sable K. Nelson wrote in a 2017 post. “It is also a time to reflect, memorialize and show compassion for those infected [with] or affected by HIV/AIDS.”
The Caribbean has the second-highest HIV prevalence in the world, after sub-Saharan Africa. It’s a problem exacerbated by homophobia, which keeps people from seeking medical attention, as well as by ignorance of the modes of HIV transmission.
Thanks to high rates of immigration, the HIV epidemic ravaging the Caribbean is affecting the United States, too.
“NCAHAAD is an opportunity to look across the diverse communities where Caribbean-Americans live and work to see how these communities can unite to better respond to the epidemic,” said Ryan Stewart-Fredrick, then-president of CPIC, in a 2009 interview with the HIV awareness website HIV.gov.
NCAHAAD events include free HIV testing clinics, education seminars and outreach projects in Miami and elsewhere.
For a list of all the 2019 HIV/AIDS awareness days, including a downloadable PDF, click here....
Read more: National Caribbean-American HIV/AIDS Awareness Day 2019
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HIV plays a surprising role in Madonna’s just-released video for her song “Dark Ballet.” That’s because the cinematic tale stars Mykki Blanco, a gender- and genre-defying rapper and performance artist who has been living with HIV his entire career and has often explored the subject in his work.
Mykki Blanco in Madonna’s “Dark Ballet”YouTube/Madonna
Madonna barely appears in “Dark Ballet.” Instead, Blanco plays a persecuted Joan of Arc, at times lip-synching as Madonna sings. The video, directed by Emmanuel Adjei, closes with a quote from Blanco: “I have walked this earth, Black, Queer and HIV positive, but no transgression against me has been as powerful as the hope I hold within.”
Why the Joan of Arc imagery, including burning at the stake? “She fought the English and she won, still the French were not happy,” Madonna said in Rolling Stone. “Still they judged her. They said she was a man, they said she was a lesbian, they said she was a witch, and, in the end, they burned her at the stake, and she feared nothing. I admire that.”
The closing words in Madonna’s “Dark Ballet” videoYouTube/Madonna
Madonna’s upcoming album, Madame X, drops June 14. Her latest work arrives as she spars with The New York Times Magazine for its recent profile on her. She took to Instagram to voice her beefs with the article—namely, that it focuses on her age and her material possessions:
Face creams and Frida Kahlo paintings aside, journalist Vanessa Grigoriadis did offer some interesting insight into Madonna. Such as this:
While [Madonna] was becoming a “creamy smooth pop icon goddess,” she said, she lost many friends to AIDS, including her ballet teacher from Michigan and the artist Keith Haring. She described the disease destroying her locals-only scene in Lower Manhattan. “I saw people starting to behave differently toward people who were H.I.V.-positive or who had AIDS—not wanting to shake their hands or eat chips out of the same bowl or touch the same doorknob,” she said. “It made me sad. It made me feel sick. It made me want to kick everybody’s ass.”
Then she started talking about Malawi, where more than 70,000 children were living with H.I.V. I had never heard her make an overt connection between being unable to save her friends in the early days and the philanthropy she has done in Malawi, as well as adopting four of her kids, but now she made the link clear. She quoted lines from a new song on her record: “Life is a circle. Death and loss brought me new life. Brought me to life. Brought me to love.”
In related POZ news, read “Mykki Blanco Explores HIV Stigma in the Music Video for ‘Hideaway’” and learn about his public disclosure of his HIV status in 2015 in this article.
And don’t miss our July/August 2016 cover story “The Re-invention Tour,” which profiles Salim “Slam” Gauwloos and Carlton Wilborn, two of Madonna’s Blond Ambition dancers who are long-term HIV survivors....
Read more: Madonna’s “Dark Ballet” Stars Mykki Blanco, HIV and Hope [VIDEO]
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