NEWS - 2008

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Study: "Second-wave" HIV hits young black gays
MONDAY, June 30, 2008 (The Advocate)

The federal Centers for Disease Control and Prevention released a new study Thursday that could indicate a "second-save" AIDS epidemic, The Washington Post reported.

Positive HIV status among young gay men has been rising 12 percent each year since 2001, the study showed, with the steepest increase among young black men.

"These men represent a new generation that has not been personally affected by AIDS in the same way that their older peers have," Richard Wolitski, acting director of HIV/AIDS prevention at the CDC, told the Post.

Not enough is being done to prevent the spread of the infection, according to Phill Wilson, head of the Black AIDS Institute in Los Angeles. "When you see a 15 percent yearly increase, that is an epidemic that is out of control," Wilson told the Post. "And yet we don't see a response that recognizes it is an epidemic out of control."

Ron Simmons, president of Us Helping Us, an AIDS organization for gay black men, suggested that powerful antiretroviral therapy might have lessened the fear of AIDS within the gay community.

"I can remember going to a funeral every four or five days. Now if you talk to some of these young men, they say, 'If I do get infected, I will simply take the blue pill or the pink pill, like my friend,'" Simmons told the Post.

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June 27 is National HIV Testing Day
FRIDAY, June 27, 2008

National HIV Testing Day (NHTD) is an annual campaign produced by the National Association of People with AIDS (NAPWA-US) to encourage at-risk individuals to receive voluntary HIV counseling and testing.

The Centers for Disease Control and Prevention (CDC) estimates that 180,000 to 280,000 people nationwide are HIV-positive but are unaware of their status. HIV counseling and testing enables people with HIV to take steps to protect their own health and that of their partners, and helps people who test negative get the information they need to stay uninfected.

Across the country, thousands of HIV counseling and testing sites, state and local health departments, and community-based HIV/AIDS service providers will participate in NHTD events, by holding health fairs, providing community and media outreach, hosting special testing-related events or operating extended hours. Some of these events may be scheduled in the days and weeks surrounding NHTD. Campaign materials including posters, for use by these groups have been developed by NAPWA and are availlable for order or to download.

NHTD organizers will also reach out to communities at increased risk of HIV infection, including African American and Latino populations, both of which are disproportionately affected with HIV when compared to other demographic groups in the United States. The campaign also highlights this Web site, which allows users to locate HIV testing sites in their area.

Founded in 1983, the National Association of People with AIDS (NAPWA) is the oldest national AIDS organization, as well as the first network of people living with HIV/AIDS in the world. NAPWA believes in making a difference in the lives of its constitutents by providing information and resources; telling our collective stories in HIV from the past, present, and future; and being the trusted independent voice of people living with HIV. NAPWA is intimately aware that early diagnosis makes a world of difference in an HIV-positive person's quality of life. During National HIV Testing Day, NAPWA works with communities to reduce AIDS social stigma through public messages and culturally-appropriate education materials.

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HIV resurges in men who have sex with men: cases climb 12 percent among group of U.S. boys and men ages 13 to 24
THURSDAY, June 26, 2008 (Reuters)

A new analysis of HIV diagnoses among men who have sex with men points to a troubling increase in new cases among young men, U.S. health officials reported Thursday.

Public health experts use the term "men who have sex with men," or MSM, because many of these men are not strictly homosexual or even bisexual.

Between 2001 and 2006, male-to-male sex was the larget HIV transmission category in the U.S., and the only one associated with an increasing number of HIV/AIDS diagnoses, according to a report from Centers for Disease Control and Prevention.

The jump was highest - an increase of 12.4 percent - among boys and men between the ages of 13 and 24 years who had sex with other males, particularly among ethnic minorities.

"To reduce transmission of HIV among MSM of all races/ethnicities, prevention strategies should be strengthened, improved, and implemented more broadly," CDC health officials wrote in their Morbidity and Mortality Weekly Report.

Testing is important, they add, because "after persons become aware that they are HIV positive, most reduce their high-risk sexual behavior."

The report describes trends in diagnoses of HIV/AIDS in 33 states that have confidential, name-based HIV case reporting.

Of 214,379 diagnoses during the study period, 46 percent were among MSM. The rate of new diagnoses declined in all other transmission categories - injection drug use, high-risk heterosexual contact, and other routes of transmission.

Among all MSM, the estimated annual percentage change was 1.5 percent, the great majority of which involved the 13 to 24 year age group.

Among racial/ethnic groups, the annual increase in the number of diagnoses among MSM was highest among Asian/Pacific Islanders at 12.1 percent, followed by a 3.6 percent rate among American Indians/Alaska Natives; however, these two groups accounted for fewer than 1 percent of all diagnoses made during the study period. The annual increase was 1.9 percent among both African Americans and Hispanics, and 0.7 percent among Caucasians.

In MSM younger than age 25, AFrican Americans bore the greatest burden with 7,658 new diagnoses (annual rate of change of 15 percent), followed by 3,221 new cases among Caucasians (9 percent annual increase) and 2,422 new cases among Hispanics (8 percent).

June 27 is National HIV Testing Day. To address the disproportionately high rate of HIV infection among blacks, the CDC has increased the number of testing sites in 23 geographic areas with the large nuber of HIV cases. A list of testing sites is available at www.hivtest.org.

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Report: Global Increase in HIV among MSM
THURSDAY, June 26, 2008 (GayHealth)

HIV/AIDS infection rates are growing among intravenous drug users, porstitutes and gay men around the globe, according to a new report from the International Federation of Red Cross and Red Crescent Societies.

The Geneva-based humanitarian agency noted that "HIV is a long-term and complex disaster on many levels... For marginalized groups across the world -- injecting drug users, sex workers, and men who have sex with men -- rates are on the increase."

The report also said that those groups live on the frings of society in many countries and often face "stigma, criminalization and little, if any, access to prevention and treatment services."

The 248-page report concluded that government services are overwhelmed by the need for support and treatment, stigma still prevents access for many and communities are devastated by its effects.

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NPR Program Examines Comic Book That Aims to Increase HIV/AIDS Awareness, Educations
WEDNESDAY, June 18, 2008 (The Body)

NPR's "News & Notes" on Monday included a discussion with comic book illustrator Robert Walker, who has written a comic book, titled "O+ Men," that aims to increase HIV/AIDS awareness. HIV-positive characters in the book take an experimental antidote that unexpectedly gives them superpowers, according to NPR.

Walker said he chose to focus on HIV/AIDS because he believes there "should be more of a push" for awareness about the disease following the increasing number of new cases, especially among young people. He added that he "felt it very important to use [his] talents to try to advocate AIDS awareness." The book details how people contract HIV and incorporates "real-life situations" faced by people living with HIV/AIDS, Walker said. The book also addresses HIV prevention.

Walker collaborated with HIV/AIDS specialist Howard Grossens to ensure the information in the book is accurate. In addition, the book includes two pages of HIV/AIDS resources, including telephone hotlines and facilities that provide HIV tests or support groups. Walker said the book is suited for teenagers and could be incorporated into sex education classes and other HIV/AIDS education programs (Chideya, "News & Notes," NPR, 6/16).

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Could Sexually Transmissible Infections Be Contributing to the Increase in HIV Infections Among Men Who Have Sex With Men in Australia?
WEDNESDAY, June 18, 2008 (The Body)

In [a] current study, researchers undertook to review data on sexually transmissible infections (STI) in men who have sex with men (MSM) in Australia to determine the possible contribution of STI to diverging trends in HIV notification in different states. They reviewed data from numerous sources, including routine national surveillance data, laboratory surveillance data, self-reported information on STI testing among MSM, and ad hoc reports of STI prevalence.

Between 1997 and 2006, increasing rates of gonorrhea and infectious syphilis notifications in urban men were noted, together with increasing rates of chlamydia notifications in men ages 30 to 49. By state, little differences in thes trends were found. Due to differences in the population groups sampled, the authors were unable to gain further information on trends among MSM from these studies. An increase in anal STI testing was found between 2003 and 2006; this may have increased the number of diagnoses of chlamydia and gonorrhea for MSM during this period.

"Over the past 10 years, there has been a substantial increase in diagnoses of gonorrhea and infectious syphilis, and probably chlamydia, in [MSM] in Australia," the authors concluded. "However, it is unlikely that changes in the pattern of STI transmission are responsible for the recent divergence in HIV rates between Australian states because there is little evidence that trends in STI also differ by state."

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Study: Brain similarities in women, gay men
TUESDAY, June 17, 2008 (GayHealth)

According to a new study, brain scans of gay men and straight women reveal that they share some common characteristics in the area of the brain responsible for emotion, mood and anxiety.

The scans also showed the same symmetry among lesbians and straight men, according to researchers from Sweden's Karolinska Institute.

Brain scans of 90 volunteers showed that the brains of heterosexual men and homosexual women were slightly asymmetric with the right hemisphere slightly larger than the left. The brains of gay men and heterosexual women were not.

The study was recently published in the Proceedings of the National Academy of Sciences.

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Palm Beach County, Fla., Commissioners Approve Plan to Reduce HIV/AIDS Services by $600,000 in 2009
FRIDAY, June 6, 2008 (The Body)

The Palm Beach county, Fla., commissioners have approved a plan to reduce funding for food and medical case management services for people living with HIV/AIDS by $600,000 in 2009, Larry Reed of the Palm Beach County HIV CARE Council announced on Tuesday, the Palm Beach Post reports. According to the Post, the decision is in response to the continued decrease in Ryan White Program funding.

The county is receiving $7.7 million in Ryan White money this year, which is $68,000 more than in 2007. However, it remains short of what the county received five years ago, before funding was reduced by 13%. According to county officials, there were 7,130 HIV cases reported in the county in 2006 -- the most recent year for which data are available.

The HIV CARE Council -- which assesses the needs of people living with HIV/AIDS in the county and recommends to county officials how to allocate the funding -- recommended that the money for all services be reduced by 9%. However, the county decided to take the largest reduction from medical case management, which will leave 500 people without services, according to Leed. County Community Services Director Ed Rich said the county is following federal guidelines to spend most of the funds on direct medical services. "We just don't have the money for all the services, so we try to follow the mandates as closely as possible," Rich said (Barton, Palm Beach Post, 6/3).

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Decline in Teen Sex Levels Off, Survey Shows
THURSDAY, June 5, 2008 (The Body)

New CDC survey data show that be every measure, a decade-long decline in sexual activity among high school students leveled off between 2001 and 2007, and that the rise in condom use by teens plateaued in 2003.

Moreover, the survey found evidence that teen sexual activity may have begun creeping up and condom use might be edging downward, although these trends are not yet confirmed by statisticians.

"The bottom line is: In all these areas, we don't seem to be making the progress we were making before," said HOwell Wechsler, acting director of the Division of Adolescent and School Health at CDC, which conducted the survey. "It's very troubling."

The new report did not examine the reasons for the trends, but experts say they could include rising complacency about HIV/AIDS, changing attitudes about sex and pregnancy, shifts in ethnic diversity, and the fact that some teens cannot be persuaded to wait. Others blame movies, books, advertising and cultural messages that glamorize sex.

The data came from CDC's biennial Youth Risk Behavior Survey, which polled 14,103 students representing 157 high schools nationwide. The survey found a slight increase between 2005 and 2007 in the proportion who reported they had ever had sex, had begun having sex before age 13, had engaged in sex within the last three months, and had sex with at least four partners.

The new figures renewed the heated debate about abstinence-focused sex education programs.

The rising trend of teenagers having sex reversed around 1991 because of AIDS and other factors. The 2005 CDC survey showed the first signs that thes positive trends might be reversing.

"What's really important here is we're really running out of steam," Wechsler said. "Ther's no reason for panic, but there is reason for concern."

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Rapid Assessment of Drug-Related HIV Risk Among Men Who Have Sex With Men in Three South African Cities
THURSDAY, June 5, 2008 (The Body)

The researchers designed the current study to assess the association between drug use and risk sexual behavior among men who have sex with men (MSM) in locations known to have high prevalence rates of drug use and sexual risk behavior in three South African cities: Cape Town, Durban and Pretoria.

To recruit drug-using MSM, street intercepts and purposive snowball sampling were employed. The rapid assessment included observation, mapping, key informatn interviews and interviews of MSM focus groups. HIV testing was performed on drug-using key informants.

"The use of drugs like crack cocaine, cannabis and methamphetamine to specifically facilitate sexual encounters was evident," the authors noted. Even though HIV risk knowledge was high, drugs led to inconsistent condom use and other high-risk sexual activities. Among MSM who were drug injectors, many reported sharing needles and reusing injection equipment. One-third of the MSM who agreed to be tested were HIV-positive.

The men's views about drug and HIV treatment and preventive services and their efficacy were mixed. The results highlighted various barriers to accessing services, including stigma associated with homosexuality and the availability of drugs in treatment facilities.

In conclusion, the authors offered several recommendationis, including: addressing the gap between HIV-risk knowledge and practice; extending [voluntary counseling and testing] services for MSM; increasing the visibility of drug abuse services within communities; addressing concerns about drug availability in treatment centers as well as re-integration issues and the need for after-care services; reducing stigma in drug and HIV services for MSM; and "strengthening the link between drug treatment services and HIV prevention by integrating HIV/drug-related risks into HIV prevention efforts and HIV risks into drug use prevention efforts."

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Architect of "don't ask" calls for second look
THURSDAY, June 5, 2008 (The Advocate)

Former U>S. Sen. Sam Nunn, one of the primary lawmakers involved in the 1993 passage of "don't ask, don't tell," prohibiting gay men and lesbians from serving openly in the military, has called on the government to review the law.

"I think [when] 15 years go by on any personnel policy, it's appropriate to take another look at it -- see how it's working, ask the hard questions, hear from the military. Start with a Pentagon study," Nunn said Tuesday after an Atlanta seminar on national security, The Atlanta Journal Constitution reported.

Nunn, a Democrat from Georgia, would not state explicitly whether he supports ending the policy.

"I'm not advocating anything, except I'm saying the policy was the right policy for the right time, and times change. It's appropriate to take another look," Nunn said to reporters.

Though some LGBT activists and strategists see Nunn's statements as significant, many also say he did not go far enough.

"If you look at what he said, he didn't really say anything," said Aubrey Sarvis, executive director of the Servicemembers Legal Defense Network, which lobbies for repeal of the "don't ask" policy. "He never called for congress to change the federal statute. He didn't say he favored repealing 'don't ask, don't tell.' Not many people have an opportunity to right a wrong 15 years later. I find it, all in all, to be very disappointing."

Sarvis told The Advocate that Nunn's move may be an indication that he's positioning himself for a high-level post in a Barack Obama administration.

"You can't avoid the speculation that it's an attempt to become now aligned with Sen. Obama's position on 'don't ask, don't tell.' If former Sen. Nunn has any ambition of entertaining the possibility of being in an Obama administration, he knows he has to move away from his former position." Sen. Obama has clearly stated his support for repealing the policy.

"Don't ask, don't tell" is widely seen by gays as infringing on their right to free expression.

As reported in the Journal Constitution, Nunn added, "People don't understand that that was the beginning point. We basically made it possible for people to serve honorably in the military without lying on the application."

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Seattle Public Health HIV/AID Program launches multi-media testing campaign
WEDNESDAY, June 4, 2008

The HIV/AIDS Program at Public Health - Seattle & King County has launched a multi-media campaign designed to increase the frequency of HIV testing among men who have sex with men (MSM) at high risk for HIV infection. Local data suggest that while most MSM have tested at least once in their lifetime, high-risk MSM are not testing at the recommended frequency. The "Little Prick" campaign encourages MSM who have had unprotected sex with a partner of unknown or discordant HIV status during the prior year to get tested every three months.

The campaign will reach MSM through gay-oriented Internet sites, gay-oriented print media, billboards, sidewalk chalk drawings outside key bars and bathhouses, and coasters, posters, and mirror clings to be distributed to local bars and bathhouses.

To access the campaign website, follow the link below.

www.homohealth.org/littleprick.htm

If you have any questions about the campaign or would like to campaign materials to distribute, please contact the HIV/AIDS Program at 206 296-4649.

Sharon Bogan, Educator Consultant
HIV/AIDS Program
Public Health - Seattle & King County
400 Yesler Wy., 3rd Floor
Seattle, WA 98104
206 205-4038
sharon.bogan@kingcounty.gov

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Official: Calif. marriages to begin June 14
TUESDAY, May 27, 2008 (PlanetOut)

Same-sex couples in some Californina counties will be able to marry as soon as June 14, the president of California's county clerks association said.

Stephen Weir, who heads the California Association of Clerks and Election Officials, said Monday he was told by the Office of Vital Records that clerks would be authorized to hand out marriage licenses as soon as that date, which is a Saturday and exactly 30 days after the California Supreme Court ruled that sam-sex marriage should be legal.

The court's decisions typically take effect after 30 days, barring further legal action.

"They are shooting for the 14th," said Weir, adding that the state planned to give California's 58 counties advice this week for implementing the historic change so local officials can start planning.

Suanne Buggy, a spokeswoman for the California Department of Public Health, which oversees the vital records office, would not confirm Monday that state officials have settled the matter of when counties can or must start extending marriage licenses to same-sex couples.

"We will be getting guidance out to the counties soon," Buggy said.

According to Weir, it would be up to each county clerk to decide whether to open their offices to gay and lesbian couples that Saturday or to wait until the following Monday.

Some clerks have said they would try to accomodate couples at the earliest possible date, depending on their staffing and anticipated demand, he said.

If the court's decision does take effect June 14, couples could, in theory, plan to obtain their licenses and take their vows at 12:01 a.m. that day, he said.

As it happens, Weir's office in Martinez already holds open hours on the second Saturday of each month, so serving couples who want to get hitched as soon as possible won't be a problem, he said. He and his partner of 18 years hope to be the first ones to tie the knot.

"Just because we ahve been so close to it, and so far, I would really like to be the first," Weir said.

An effort, however, is under way to stay the Supreme Court's decision until voters can decide the issue with an initiative planned for the November ballot. The measure would overrule the justice's decision and amend the state constitution to ban same-sex marriage.

Justices ahve until the ruling's effective date to weigh the request, but could give themselves longer to consider it, attorneys have said. Another complicating factor is that the Supreme Court also directed a midlevel appeals court that upheld the state's one man-one woman marriage laws a year ago to issue a new order legalizing same-sex marriage, and it's not clear when the appeals court would comply.

Massachusetts it the only other state to legalize same-sex marriage, something it did in 2004. More than 9,500 same-sex couples in that state have wed.

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Russia ends gay blood-donor ban
FRIDAY, May 23, 2008 (The Advocate)

Russia has repealed its six-year ban on gay blood donors after a tumultuous battle between gay activist groups and the Russian Minister of Health and Social Development.

Tatyana Golikova, the minister of the department, signed the decree April 16, but members of the media were not informed until Thursday night, according to U.K. Gay News.

Activists have been campaigning against the ban since April 2006, when they sent a letter to the ministry of health and social development asking for a repeal of the ban because it was unconstitutional. In September 2007, activists attempted to picket the ministry's office in Moscow, but the Prefecture of the Central Administrative Area of Moscow banned the demonstration for security reasons, U.K. Gay News reported.

In 1993, consensual gay sew was legalized and in 1999, Russia's authority on psychology decided to declassify homosexuality as a mental illness.

"Russian legislation finally got rid of the last direct discriminatory provision against homosexual people," Russian LGBT activist Nikolai Alekseev told reporters in Brazil.

"Now we are going to ask for positive actions of the authorities in order to directly ban discrimination on the basis of sexual orientation in Russia law as well as criminal prosecution for hate speeches and aggressive homophobia," Alekseev said.

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Advocates Call for Creation of National Strategy to Fight HIV/AIDS in U.S.
WEDNESDAY, May 21, 2008 (The Body)

Advocates at a congressional briefing on Tuesday called for a comprehensive strategy to address HIV/AIDS in the U.S., CQ HealthBeat reports. According to the advocates, the plan should focus on boosting coordination between stakeholders, targeting high-risk populations -- such as blacks, Hispanics and men who have sex with men -- and reducting HIV/AIDS-related stigma. Some of the advocates suggested that the plan follow the framework of the President's Emergency Plan for AIDS Relief.

Terrell Halaska, a consultant who has served as a health and education adviser for Congress and the Bush administration, attributed much of PEPFAR's success to its multipronged approach. Halaska added that an effective domestic strategy would require guidleines for anitretroviral treatment, HIV testing and prevention, as well as "connecting the dots" among existing programs. Halaska also said that such a plan would need bipartisan support and the ability to engage partners in the business, edcuation and philanthropy sectors.

Halaska said that U.S. HIV/AIDS efforts overseas have been more effective than domestic programs, adding that domestic efforts are a "Byzantine maze of programs." Halaska said, "We have to take the same approach here that we did overseas."

Marjorie Hill, CEO of the Gay Men's Health Crisis, said an effective domestic strategy would require significant efforts among lawmakers. "A national AIDS strategy will require presidential leadership," she said, nothing that Democratic presidential candidates Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) ave pledged to develop plans if elected. Advocates also have sought a smiliar commitment from presumptive Republican presidential nominee Sen. John McCain (Ariz.), according to Hill. Congress also "clearly has a crucial role" in allocating domestic HIV/AIDS funding and holding the next administration accountable, Hill added.

In addition, Kathie Hiers, CEO of AIDS Alabama, voiced disappointment in a shortage of CDC funding for HIV/AIDS prevention and surveillance programs. She said that the Alabama Department of Public Health receives $2 million in CDC funding annually and that $500,000 of the money goes to HIV/AIDS programs. Hiers said she and her colleagues sometimes joke about applying for PEPFAR funding because HIV/AIDS cases in Alabama "rival those in Africa." She noted that 70% of HIV cases occur among blacks, even though the group accounts for 23% of the state's population (Cooley, CQ HealthBeat, 5/20)

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One in four gay adults without health insurance
MONDAY, May 19, 2008 (GayHealth)

Lack of health insurance is a national epidemic affecting millions of Americans, and it's a leading topic in the presidential campaign in 2008. But it's an even greater crisis for gays and lesbians, according to a new survey.

The stunning report reveals that nearly one in four gay and lesbian adults lack health insurance and are nearly twice as likely as their heterosexual counterparts to have no health insurance coverage.

The online survey, conducted by Harris Interactive, reports that 22 percent of gay and lesbian survey respondents reported having no health insurance, compared to only 12 percent of heterosexual adults in the survey.

The survey was taken between April 7 and 15, 2008 in conjunction with Witeck-Combs Communications.

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Calif. justices rule for same-sex marriage
THURSDAY, May 15, 2008 (PlanetOut)

In a monumental victory for the gay rights movement, the Califronia Supreme Court overturned a voter-approved ban on gay marriage Thursday in a ruling that would allow same-sex couples in the nation's most populous state to tie the knot.

Domestic partnerships are not a good enough substitute for marriage, the justices ruled 4-3 in striking down the ban.

Outside the courthouse, gay marriage supporters cried and cheered as the news spread.

Jeanie Rizzo, one of the plaintiffs, called Pali Cooper, her partner of 19 years, and asked, "Pali, will you marry me?"

"This is a very historic day. This is just such freedom for us," Rizzo said. "This is a message that says all of us are entitled to human dignity."

In the Castro, historically a center of the gay community in San Francisco, Tim Oviatt started crying while watching the news on TV.

"I've been waiting for this all my life," he said. "This is a life-affirming moment."

[In] the city of San Francisco, two dozen gay and lebian couples and gay rights groups sued in March 2004 after the court had halted San Francisco's monthlong same-sex wedding march that took place when Mayor Gavin Newsom opened the doors of City Hall to same-sex marriages.

"Today the California Supreme Court took a giant leap to ensure that everybody -- not just in the state of California, but throughout the country -- will have equal treatment under the law," said City Attorney Dennis Herrera, who argued the case for San Francisco.

The challenge for gay rights advocates, however, is not over.

A coalition of religious and social conservative groups is attempting to put a measure on the November ballot that would enshrine laws banning gay marriage in the state constitution.

The Secretary of State is expected to rule by the end of June whether the sponsors gathered enough signatures to qualify the marriage amendment, similar to ones enacted in 26 other states.

If voters pass the measure in November, it would trump the court's decision.

California already offers same-sex couples who register as domestic partners the same legal rights and responsibilities as married spouses, including the right to divorce and to sue for child support.

But, "Our state new recognizes that an individual's capacity to establish a loving and long-term committed relationship with another person and responsibly to care for and raise children does not depend upon the individual's sexual orientation," Chief Justice Ron George wrote for the court's majority, which included Justices Joyce Kennard, Kathryn Werdegar and Carlos Moreno.

In a dissenting opinion, Justice Marvin Baxter agreed with many arguments of the majority but said the court overstepped its authority. Changes to marriage laws should be decided by the voters, Baxter wrote. Justices Ming Chin and Carol Corrigan also dissented.

The conservative Alliance Defense Fund says it plans to ask the justices for a stay of their decision until after the fall election, said Glen Lavey, senior counsel for the group.

Gov. Arnold Schwarzenegger, who has twice vetoed legislation that would have granted marriage rights to same-sex couples, said in a news release that he respected the court's decision and "will not support an amendment to the constitution that would overturn this state Supreme Court ruling."

The last time California voters were asked to express their views on gay marriage at the ballot box was in 2000, the year after the Legislature enacted the first of a series of laws awarding spousal rights to domestic partners.

Proposition 22, which strengthened the state's 1978 one-man, one-woman marriage law with the words "Only marriage between a man and a woman is valid or recognized in California," passed with 61 percent of the vote.

The Supreme Court struck down both statutes with its sweeping opinion Thursday.

Lawyers for the gay couples had asked the court to overturn the laws as an unconstitutional civil rights violation that domestic partnerships cannot repair. A trial court judge in San Francisco agreed with gay rights advocates and voided the state's marriage laws in 2005. A midlevel appeals court overturned his decision in October 2006. (Lisa Leff, AP; AP writers Terence Chea, Jason Dearen, Juliana Barbassa and Evelyn Nieves contributed to this report.)

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HRC rates hospitals for equality
TUESDAY, May 13, 2008 (PlanetOut)

Just over half of 88 hospitals got top marks under a new rating system created by two national gay rights organizations which hope the standards will result in more compassionate treatment of gay and lesbian patients.

Policies addressed in the ratings include patient nondiscrimination, visitation and decision-making rights for partners, diversity training for staff and nondiscriminatory employment practices.

The hospitals participated voluntarily, and the groups behind the report said there will be no effort to rate hospitals that don't want to respond. Instead, they hope many hospitals will strive for high ratings as the survey recurs annually.

Called the Healthcare Equality Index, the ratings were designed by the Human Rights Campaign and the Gay and Lesbian Medical Association.

The index is modeled after HRC's Corporate Equality Index, which rates corporations on policies for gay and lesbian workers. It has tracked a surge in the number of Fortune 500 companies offering benefits to same-sex partners.

Some responses to the new survey came from hospital networks. Kaiser Permanente, answering on behalf of 31 hospitals in California and Hawaii, said all met the survey's 10 criteria. They were among 45 hospitals in all with top marks.

University Hospitals of Cleveland, representing 10 Ohio hospitals, said they full met only two criteria - domestic partner benefits for employees and a patient nondiscrimination policy that includes sexual orientation.

The HRC and the medical association said their goal is to highlight hospitals with high rankings and induce others to abandon inequitable practices.

"Too many times, a gay man has been unable to comfort his partner, a transgender person has been ridiculed instead of treated or a lesbian mom has been barred from seeing her child at the hospital," the groups said.

In one example cited by the HRC, attorney Kenneth Johnson described his struggle to verify his relationship with his partner, James Massey, in 1006 when Massey was rushed unconscious to Howard University Hospital in Washington, D.C.

Johnson said he had to travel back to his home in Virginia to fetch legal documents before the hospital allowed him to join in medical decision-making for Massey, who had suffered a cerebral hemorrhage and died the next day. The two men had registered as domestic partners in California and had an adopted son.

The healthcare index includes recommendations for hospitals, starting with the forms filled out by patients. It recommends that "transgender" be an option for gender and that relationship status include the term "partnered" as well as "single," "married," "divorced" and "widowed."

The gay rights groups said the ratings are intended to create a best-practices standard that would counteract the patchwork nature of state laws and hospital policies affecting gays and lesbians.

For example, 20 states prohibit employment discrimination based on sexual orientation, and 12 also ban discrimination based on gender identity; hospitals in other states theoretically can refuse to hire people because they are gay or lesbian.

Ten states extend legal recognition of some sort of same-sex partnerships, and hospitals there already offer those couples equal visitation and decision-making rights. In other states, hospital practices on those matters vary widely.

Among the hospitals completing the survey was VAnderbilt University Medical Center in Nashville, Tenn., where there is no state recognition of same-sex partnerships.

Joel Lee, the hospital's associate vice chancellor for communications, said the facility nonetheless has a policy respecting same-sex partners' rights. It honors the wishes of patients who can express themselves and encourages staff to "sort it out the humane way" in cases where one partner is incapacitated, Lee said.

Joe Solmonese, president of the Human Rights Campaign, said he was pleased by the response to the survey, even though hundreds of hospitals did not rely to an invitation to participate.

"It's the beginning of a dialogue," he said. "We're not calling out the bad guys -- we're trying to show them the way." (David Crary, AP)

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CDC Needs Increased Funding for HIV Prevention Efforts, Advocates Say
TUESDAY, May 13, 2008 (TheBody)

CDC needs a $600 million increase in funding for effective HIV/AIDS prevention and surveillance programs, advocates said Monday at a briefing hosted by the AIDS Institute to assess the agency's efforts to fight HIV/AIDS in the U.S., CQ HealthBeat reports. The $600 million increase would nearly double CDC's current HIV/AIDS pervention budget, CQ HealthBeat reports.

According to Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, CDC's HIV prevention and surveillance programs account for 3% of all federal HIV/AIDS funding. NASTAD members spend about 50% of the agency's $692 million domestic HIV prevention funding, according to CQ HealthBeat. Scofield said that HIV cases decreased by nearly 75% as CDC's budget increased between the late 1980s and early 1990s but that new cases remained stagnant when the funding increases were halted.

According to CQ HealthBeat, CDC publishes 49 targeted "interventions" aimed at reducing the risk of HIV among specific groups, and state and localities apply for money to institute the interventions. Four of the 49 interventions target men who have sex with men of all races, even though this group accounted for 71% of new HIV cases among men in 2005. Forty-three percent of the interventions target women, who accoutned for 26% of new cases in 2006, CQ HealthBeat reports.

Currently there are no established interventions for black and Hispanic MSM, female prison inmates, crystal methamphetamine users, commercial sex workers, veterans, people older than 50 and homeless people. Carl Schmid, director of federal affairs for the AIDS Institute, said that a lack of funding has undermined CDC's efforts to establish more interventions.

Some advocates at the forum "roundly criticized" the Bush administration and Congress for neglecting to fund needle-exchange programs and prison-based programs, as well as for diverting money to programs such as abstinence-only education, CQ HealthBeat reports. The panel also criticized how funds are distributed through the Ryan White Program. Scofield noted that recent modifications in the law have forced CDC to shift $30 million in HIV funding to mother-to-child HIV transmission efforts, which already recieve money from other grant programs.

"We're holding the epidemic at bay, " Majorie Hill, CEO of the Gay Men's Health Crisis, said, adding, "The only way we're going to make a real dent is allocating realistic resources." Officials from NIH's National Institute of Allergy and Infectious Diseases, which oversees HIV/AIDS funding, were not available for comment (Walker, CQ HealthBeat, 5/12).

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National Asian and Pacific Islander HIV/AIDS Awareness
Day is May 19
MONDAY, May 12, 2008 (GayHealth.com)

National Asian and Pacific Islander HIV/AIDS Awareness Day is on May 19, with its goal being to raise awareness and mobilize preventive and therapeutic services to protect this multifaceted community from the scourge of HIV/AIDS.

The National Instituted of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, joins with Asians and Pacific Islanders in mourning the members of this community who have died from AIDS and in supporting those who care for those living with HIV.

The latest statistics indicate that the incidence of AIDS is on the rise among Asians and Pacific Islanders. The estimated number of AIDS cases in this population grew from 3,574 in 2002 to 4,526 in 2006, and Asians and Pacific Islanders were the only U.S. ethnic or racial group for which the annual reported AIDS deaths rose during that period.

Moreover, between 2001 and 2004, the estimated annual percentage change in the number of HIV/AIDS cases in this population - 8.1 percent for men and 14.3 percent for women - was higher than in any other U.S. ethnic or racial group.

Follow these links for more information about National Asian and Pacific Islander HIV/AIDS Awareness Day or National Institute of Health's HIV/AIDS prevention.

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Pa. House Stymies marriage-ban amendment
THURSDAY, May 8, 2008 (The Advocate)

The Democrat-controlled Pennsylvania House of Representatives has thwarted an effort to amend the state constitution to ban same-sex marriage.

State Sen. Michael Brubaker, the main sponsor of the Senate version of the bil, asked the Republican-majority Senate to table the bill indefinitely, the Pittsburgh Post-Gazette reported Wednesday.

Brubaker said he is not abandoning the bill, but is not sure when he will push for it again.

The proposed constitutional amendment passed the Senate appropriations and judiciary committees, but its next stop would be the House State Government Committee, chaired by Democrat Babette Josephs. In 2005, Josephs strongly opposed another proposed constitutional ban on same-sex marriage. At a rally Monday, Josephs called Brubaker's bill "discriminatory, disgraceful, morally wrong and unnecessary," according to the Post-Gazette.

Brubaker defended his bill by saying it would enforce long-held tradition of heterosexual marriage.

"I have a healthy respect for the homosexual community," the paper quoted him as saying. "I have a healthy respect for heterosexuals. I have a deep respect for the institution of marriage. I am standing for marriage. I am not standing against any individual sector of our society."

To amend the constitution, the same bill must be approved in two different legislative sessions and then by a statewide referendum.

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Australia: New Immune Treatment May Control AIDS Virus
FRIDAY, May 2, 2008 Maggie Fox (Reuters.com)

Building upon successful outcomes with monkeys, scientists are already planning human trials of a new approach to fighting HIV infection.

In findings reported Friday online, researchers described the potential treatment known as OPAL, for Overlapping Peptide-pulsed Autologous Cells. The process involves mixing a patient's own blood cells with tiny bits of protein from HIV. The approach would be categorized as an immunotherapy technique or a therapeutic vaccine, said Stephen Kent of the University of Melbourne and colleagues.

The researchers worked with macaque monkeys infected with the related simian immunodeficiency virus (SIV). The team took peptides from the virus and placed them in laboratory dishes with both whole blood and isolated immune system cells. This helped train the cells to recognize the virus and mount a more effective defense against it.

"Virus-specific CD4 cells are typically very weak in HIV-infected humans or SIV-infected macaques; dramatic enhancement of these cells were induced by OPAL immunotherapy and this may underlie its efficacy," the team wrote.

The researchers noted that the best results were attained when the treatment was introduced soon after infection. "Although it may be challenging to identify humans within three weeks of infection, this is when HIV-1 subjects typically present with acute infection," they wrote.

"Levels of virus in vaccinated monkeys were 10-fold lower than in controls, and this was durable for over one year after the initial vaccinations," the team wrote. "The immunotherapy resulted in fewer deaths from AIDS. We conclude this is a promising immunotherapy technique. Trials in HIV-infected humans of OPAL therapy are planned."

The full report, "Control of Viremia and Prevention of AIDS Following Immunotherapy of SIV-Infected Macaques with Peptide-Pulsed Blood," was published in Public Library of Science Pathogens (2008;4(5):e1000055).

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Suppression of Human Protein Reduces HIV's Ability to Enter T Cells, Replicate, Study Finds
WEDNESDAY, Apr. 30, 2008 (kaisernetwork.org)

Researchers have found that suppressing the human protein ITK in CD4+ T cells reduces HIV's ability to enter the cells and replicate, according to an NIH study published Monday in the Proceedings of the National Academy of Sciences, Reuters reports.

For the study, Pamela Schwartzberg of Boston University and colleagues used human cells in a laboratory to test two methods of inactivating ITK. One method stopped ITK from functioning. In the other method, the researchers used a drug to chemically interfere with the protein (Dunahm, Reuters, 4/28). "Suppression of the ITK protein caused many of the pathways that HIV uses to be less active, thereby inhibiting or slowing HIV replication," the researchers said (AFP/Google.com, 4/28). Schwartzberg added that the researchers did not "completely block (infection), but we certainly severely impaired it. It has minor effects at multiple stages of HIV life cycle, and together that all adds up to a more profound effect" (Reuters, 4/28).

The researchers said that they were concerned that ITK suppression "might kill or otherwise impair the normal functions of T cells." However, both suppression methods slowed HIV replication but did not interfere "significantly" with T cell survival, according to the study. In addition, the researchers said that mice with ITK deficiencies were able to fight other viral infections (AFP/Google.com, 4/28).

According to the PA/Google.com, ITK suppression could help address the emergence of drug-resistant strains of HIV because it targets a human protein rather than the virus (PA/Google.com, 4/28). Study researcher Andrew Henderson of Boston University added that treatments based on ITK suppression could complement existing antiretroviral drugs. Schwartzberg said that it likely would be several years before a drug that suppresses ITK could enter human clinical trials. She added that more lab experiments are needed to assess other ways of suppressing the protein.

NIH and the researchers have filed for a patent on suprressing ITK to treat HIV with the U.S. Patent and Trademark Office. The protein also is being examined as a possible target to treat asthma and other illnesses involving the immune system, Reuters reports (Reuters, 4/28).

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Masturbation may prevent prostate cancer
MONDAY, Apr. 21, 2008 (The Advocate)

Frequent masturbation may help me cut their risk of contracting prostate cancer, Australian researchers have found. It is believed that carcinogens may build up in the prostate if men do not ejaculate regularly, BBC News reported on Wednesday. The researchers surveyed more than 1,000 men who had developed prostate cancer, and 1,250 men who had not. They found that men who had ejaculated the most between the ages of 20 and 50 were the least likely to get cancer. Men who ejaculated more than five times each week were a third less likely to develop prostate cancer.

Sexual intercourse may hot have the same effect because of the higher risk of contracting a sexually transmitted disease, which could in turn raise the risk of cancer. "Had we been able to remove ejaculations associated with sexual intercourse, there should have been an even stronger protective effect of ejaculations," Graham Giles of the Cancer Council Victoria, who led the researchers, said in the article.

The prostate produces a fluid that his incorporated into ejaculation, which activates sperm and prevents them from sticking together. Studies on animals have shown that carcinogens like 3-methylchloranthrene can be harbored in the prostate. Frequent ejaculation encourages cancer-inducing fluids to "flush out."

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Virtual Prevention: Fighting HIV Online
TUESDAY, Apr. 15, 2008 (POZ)

by David Evans

Describing the state of HIV prevention at a large, international AIDS conference recently, Ronald Stall, PhD, of the University of Pittsburgh School of Public Health, said, "Is HIV prevention working amont gay men in the United States? I think to put it in the most polite terms, the best thing we can say is not as well as anyone would like."

A set of key statistics published by the Centers for Disease Control and Prevention (CDC) on their website in March of 2008 states it more plainly: The number of HIV-positive gay and bisexual men has increased steadily between 2001 and 2005.

The problem has been well documented in various metropolitan areas. Accordint to the New York City Departmnet of Health and Mental Hygiene, between 2001 and 2006, HIV diagnoses increased by 32 percent among gay and bisexual men aged 30 or younger in the city. And in a five-city CDC study conducted between June 2004 and April 2005, 40 percent of 462 gay and bisexual men tested for HIV were confirmed to be positive for the virus - 62 percent of them didn't even know they were infected, and a whopping 8 percent were likely infected within six months prior to testing.

So, what is causing the spike in new HIV diagnoses? Experts point to several possibilities from "cultural amnesia around the epidemic" to the age-old misperception of invincibility among youth to increased drug and alcohol use to a lack of sufficient fear of a disease that has been rendered "manageable" - and survivable - with treatment. Others point out that in some cities younger gay men aren't getting tested as often. And since researchers think that the majority of transmissions in the U.S. happen during the first weeks and months after infection, when people still think that they're HIV negative, less frequent testing means people remain unaware of their status and pass on HIV to others. All of these factors undoubtedly leave young people more susceptible to contracting HIV.

But there's another factor - the Internet. While its impact on relationships, dating and sex is still new and largely uncharted, most will agree that it has drastically altered the way people, particularly those looking for sex, connect. The Internet makes meeting people more efficient. A single person can meet hundreds of people within a matter of minutes in cyberspace - to do the same thing in the real world takes a lot more time. Meeting online allows people to skip the stages of getting acquainted, cutting straight to a sexual encounter without the preamble that could provide the time and/or information that would perhaps lead to a more considered decision. It may not be coincidental that as the number of Internet-based dating and sex websites has increased, so has the numbers of new HIV infections.

Simon Rosser, PhD, a researcher from the University of Minnesota, who spoke after Stall at the 15th Conference on Retroviruses and Opportunistic Infections (CROI) this past February in Boston, believes that the rise of the Internet as a place to easily and efficiently find sex partners is intimately connected with the increased numbers of gay men who are becoming HIV positive. He likened the Internet's impact on sex (rendering it more casual) to the drastic change that occured in attitudes about air travel. While airplanes were once thought to be the realm of exotic thrill seekers, they are now commonly used by everyone from grandmas to babies. "If the Internet has a similar effect on sex, we have to ask is casual sex about to get a lot more common and even more casual?" he asked.

While it has yet to be proven that the Internet is a direct cause of increased HIV infections, the Web has undoubtedly created an arena that presents new challenges for those looking to do prevention outreach work. And some worry that the surge in online traffic will soon leave many more traditional venues for hooking up - like parks, baths and bars - empty. In an article in Xtra West, Terry Trussler, the research director of Vancouver's Community Based Research Centre, explained that the proportion of men who spend more than 50 percent of their free time with the gay community - where traditional prevention efforts are focused and where young men can learn about safer-sex norms - decreased from 62 to 42 percent, and said, "[For] many gay men who are 20 now, their first sexual encounter will have happened through connectiosn made through their computer."

Rosser, speaking at the conference, concurred, pointint out that while the gay community has grown considerably online, the traditional gay infrastructure is eroding, and since online hookups are so much more efficient than bars or bathhouse hookups, gay men are having more sx with more people than before. More sex means that occasional slipups or decisions to forgo condoms with a special guy are also more likely to occur.

Acknowleding the potential link between a rise in online connections and the spread of HIV, prevention experts are beginning to examine what can and should be done to prevent HIV online - perhaps even in those very setting that seem to contribute to behaviors that can lead to HIV. One challenge is that most of the groups in the U.S. responsible for doing HIV prevention work, and the government agencies that fund them, have al imited presence in cyberspace. Critics of current off-line prevention efforts point out that even if we could deliver new web-based prevention tools tomorrow, they will have limited efficacy unless we find ways to integrate them into the activities that gay and bisexual men already enjoy doing, such as participating in social-networking sites, shopping online and using the Internet to learn about non-health topics.

This shift in the way we meet and date online is leading several ingenious pioneers to try to capitalize on the Internet's potential to stretch the boundaries of traditional HIV prevention thinking. It's too early to tell whether they'll succeed in changing behavior and reducing new infections, or even whether they'll be able to convince their fellow prevention workers to join them on the Web. But recent statistics point to a critical need to find a mechanims that will reach those who are looking for love - and everything else - online. And such a mechanism should have enough sophistication, fun and sexiness to compete with other things that men are also doing online, such as checking e-mail, downloading music and updating their Facebook.com profile.

Disturbing Trends
Stall's conclusion that HIV prevention wasn't working well for gay and bisexual men was based on his careful scrutiny of all the available data he could find on HIV incidence, which estimates how many new infections occur each year. He and his colleagues found that by the most conservative estimate, 2.39 percent of gay and bisexual men in the U.S. were becoming infected annually between 1995 and 2005. Stall then calculated what would happen to a gropu of men who were 20 years old in 1995 and had a 2.39 percent HIV incidence rate. He found that by 2005, when the men had turned 30, nearly a quarter of them were likely to be infected with HIV, and that by 2015, when the men would turn 40, over 40 percent would be HIV positive.

If we consider this hypothetical group of twentysomethings, HIV wasn't the only thing that began to affect them in 1995. By then the most technologically advanced were regularly using the Internet for e-mail and to find information. By the end of the century, gay chat rooms were the rage, and more sophisticated websites devoted to personal ads for sex and dating were beginning to show up all over the Web.

Epidemiologists began to see the influence of the Internet around 2000, when rising syphilis rates among HIV-positive men were often traced back to online chat rooms and websites where people could meet and hook up. Early evidence also suggested that hIV transmission was being facilitated onlin. Rosser says researchers like him began to ask, "Is there something magical about the Internet? Is it attracting men of higher risk? What's going on?"

Professor Jonathan Elford, of City University London, in England, says the Internet has "opened up opportunities for conducting research, which didn't exist 10 years ago," and that "What we do find, is that men who are recruited through the Internet are more likely to report high levels of risk."

Rosser's own research suggest that HIV-negative men are not necessarily taking more risks with people they meet online than they would, say, with someone they met at a bar or bathhouse, but that because hooking up online is so much more efficient, they are havin gmore sex. "In the old days, let's say I might score five times a week; now I can score 50 times a week, and we don't think it's just increased it alittle bit, it's increased it a lot," he says.

While increased HIV risks and new diagnoses may cause some to automatically assume that HIV-positive men are knowling having sex with unconcerned and irresponsible HIV-negative men, experts say this is a rare phenomenon. In fact, the vast majority of people with HIV, once they've been diagnosed, cease having unprotected sex with partners who say they are HIV negative or don't konw their status. Rather, new HIV cases appeart o happen in clusters, among men who assume they are HIV negative, all of them in the early-infection stage with very high viral loads. Since young gay men are having sex more often with more people, but getting tested for HIV less often, taking higher risks or slipping up on safer-sex commitments turns into a numbers game that more and more men are losing.

What's more, "The Internet has now taken over as the No. 1 venue for meeting sexual partners for men at high risk," says Rosser. He's reported data from the Minneapolis St. Paul area that showed 52 percent of single gay and bisexual men surveyed met sex partners online, compared with 47 percent who met partners at a bar or club, and just 11 percent who met partners at either a bathhouse or a sex club.

Rosser also feels that the Internet isn't just affecting HIV transmission among gay and bisexual men; it may also be affecting the physical brick-and-mortar gay community. He has reported that with the exceptions of gay Meccas like San Francisco and New York, "gay neighborhoods and gay infrastructure, for instance gay bars, all appear to be in decline."

Elford doesn't feel that the Internet is replacing physical venues in the gay community as much as addint to them. He sayus, "Most of the men who said they used the Internet also went to bars and clubs... That's what we found in London, and there's some evidence that the same is probably true in bigger U.S. cities."

We Need New Tools and New Messages
Though experts may disagree about the effect that the Internet has had on real-world gay environments, most agree that the majority of gay and bisexual men probably have spent at least some of their time cruising for sex partner sonline and that HIV prevention interventions should increasingly be focused there.

Researchers have been quick to move som aspects of their research online, such as surveys and behavioral surveillance, but few have moved beyond what currently constitutes the maojrity of online HIV prevention efforts, which are mostly limited to written HIV prevention information, prevention workers who cruise chat rooms or post ads on craigslist.com, proflies on Facebook and MySpace and e-mail notifications to the sex partners of people who've tested positive for a sexually transmitted infection (STI) like HIV or syphilis.

Joshua Tager, senior digital editor for Out and The Advocate magazines in New York City, says that he worries that even if prevention experts do manage to build new onlin tooles, they meay fail to work if they follow the model of existing off-line prevention efforts, which rarely adhere to the kinds of guidelines that gay businesses do if they want to be successful - namely that their products need to be sexy and enjoyable. Rosser, himself one of those prevention experts, agrees, saying, "One of the problems [with existing prevention programs] is that we made them more clinical and we had idiots like me develop more professional-type seminars and we sort of left the community out of it, and we actually left sex out of it." In short, the newer prevention tools are going to have to go far beyond a simple message of "use a condom every time" if they are going to match up with the kind of subtle risk assessment strategies that gay and bisexual men are already using. And they're going to have to be entertaingin and sexy to get their point across.

Stall and others point out that many HIV-positive men are already using a strategy called serosorting, whereby they choose to have sex only with other HIV-positive men or at least only have unprotected anal sex with these men, as a wayto keep from passing HIV on to HIV-negative men. This strategy ins't perfect, as the flurry of syphilis cases among HIV-positive men around the globe indicates, but it does mean that HIV-positive men are not putting their HIV-negative partners at risk. While serosorting may be great for HIV-positive men who wish to bareback, its effectiveness for HIV-negative men who'd also like to try condom-free sex is questionable.

"If someone in their ad says that they're HIV positive, and another person responds who says that they're HIV positive, chances are they really are HIV positive. But if two men say that they're HIV negative, that depends on when they've had their last test, and what they've done since their last test. It's much less reliable," explains Elford.

Another risk-reduction strategy that some gay and bisexual men are trying out is called strategic positioning, whereby HIV negative men have unprotected anal sex with partners who are HIV positive or whose HIV status is unknown, but only as the insertive partner. As Michael Ross, PhD, from the University of Texas School of Public Health in Houston, observes, however, "You know strategic is a work that George Bush uses all the time in reference to the war in Iraq, but just because we say something is strategic doesn't mean that it makes a lot of sense."

Yet another factor causing gay and bisexual men to weigh the pros and cons of condoms, is a Swiss proclaimation made earlier this year that stated that for straight monogamous couples, where one is HIV-negative and the other HIV-positive, HIV transmission was impossible provided that the HIV-positive partner was taking antiretroviral drugs, had an undetectable viral load for at least six months, and didn't have any other STIs.

New online prevention tools, therefore, need to be both technologically innovative and offer sophisticated and comprehensive sexual-risk-assessment strategies. But Tager feels they need to go even further. He says, "If you think about most HIV prevention workshops, they're always these stand-alone activities that someone has to make time and effort to attend. Rarely, if ever, are they incorporated into the kinds of activities that most gay men find enjoyable. I wish that people doing prevention would ask for the help of [experts in the field of gay website development] in devising new prevention efforts. I think we've got a lot to offer."

Fortunately, the handful of people conducting research about what will constitute the most effective online prevention tools have taken Tager's message to heart. A Ducth group led by Gerjo Kok, PhD, From the department of experimental psychology at Maastricht University in the Netherlands, in what Ross calls "pretty much the gold standard for interventions at this point in time," has built a virtual gay cruise ship to help men navigate and learn about sexual decision making. Men get to choose from one of four attractive animated male pursuers, guiding them through the cruise ship and helping them think through a number of sexual decision-making scenarios arising from encounters with other animated ship passengers.

Most men who participated in the gay-cruise prevention liked it. In their evaluations, 86 percent said it was enjoyable, 52 percent said it helped them to know more about their sex life, and 61 percent said they became more conscious about dating and sex.

You'd think, given this kind of response, that there'd already be an online gay-cruise prevention tool available worldwide. But the release of such a tool has been hled up because there's a problem. Though Kok and others proved that you can engage and retain large numbers of gay men to complete an online intervention, they also recognized that it is remarkably difficult to find those same men three or six months later to follow up and see if their behavior changed as a result of the intervention. Thus, as innovative as the gay-cruise prevention tool may be, the researchers were unable to effectively track whether or not it caused the men who experienced it to ultimately take fewer risks.

Rosser is leading another team at the vanguard of HIV prevention. It's developed an onlin interactive health and sexuality environment called SexPulse that is being rigorously evaluated. SexPulse is in its third of 12 months of follow-up; involving about 600 gay men, though early results are promising, the project is not yet ready for primetime as, like with the online cruise ship, its longer-term effectiveness is still unproven.

"What we're trying to do with SexPulse is come up with engaging, fun ways that guys can learn about their sexuality... I mean there's a real gay sensibility that is wonderful and relevant to the onlin experience [of SexPulse] t