|
|
||||||||||||
|
|
New
York: HIV positive men at risk over meningitis outbreak A deadly cluster of bacterial meningitis has erupted among HIV positive gay men in New York City. It’s left one person dead in the last month and another in a critical condition – according to the Associated Press. The city’s health department on Thursday issued an alert for “gay men and men who have sex with men.” The outbreak includes a dozen cases in the last two years, but it seems to have accelerated with four cases in the last four weeks. Of the 12 total cases, four died. All four of the men – between the ages of 31 and 42 – who contracted the disease are HIV positive, which the department says puts them at a much greater risk than the general population. Investigators are trying to find out how the outbreak has managed to spread. People the men were in close contact with have been treated with antibiotics. Bacterial meningitis can cause swelling of the membranes covering the brain and spinal cord. The disease is rare, but people with HIV-weakened immune systems are more susceptible to infection. Consistent
and correct condom use reduces risk of bacterial STIs by 60% Consistent and correct condom use provides a high level of protection against bacterial sexually transmitted infections (STIs), US investigators report in Sexually Transmitted Infections. Individuals who always used condoms correctly were almost 60% less likely to be diagnosed with an infection. Consistent condom use on its own did not reduce the risk of bacterial STIs. “Efforts to promote condom use should be augmented with efforts to promote their correct use,” write the authors. “Condom use errors and problems are a global issue. Incomplete use of condoms is a problem requiring targeted education. Rectifying issues such as poor fit and feel of condoms and using oil-based lubricants may substantially reduce slippage and breakage.” Condoms are a cornerstone of HIV prevention and sexual health campaigns. A number of well-designed studies have shown their protective effect against male-to-female transmission of herpes, chlamydia, gonorrhoea, syphilis and human papillomavirus (HPV). However, whether condoms provide protection against the acquisition of STIs remains controversial. Research looking at this question has had number of important limitations. The most important of these is a failure to adjust for incorrect use of condoms (not using condoms from the start to the finish of penetrative sex) or condom 'accidents' such as slippage and breakage. “Failure to control for condom breakage and slippage may produce the analytical equivalent of condom non-use,” observe the investigators. “A prospective study of clinic attendees found 13% incidence of chlamydia and gonorrhoea among people reporting consistent condom use but also reporting at least one problem with incorrect use. In contrast, among those reporting consistency and lack of problems…no incident infections were found.” Previous research has also relied on study participants accurately remembering whether they used condoms and if they encountered problems. Investigators in the US therefore designed a prospective study involving attendees at five sexual health clinics. Participants received daily prompts to electronically recall incidents of penile-vaginal sex and use of condoms. The investigators wanted to see if consistent condom use was protective against three common bacterial STIs: chlamydia, gonorrhoea and trichomonas. They also wished to determine the protective effect associated with consistent and correct use of condoms. A total of 929 people were recruited to the study. A urine sample was taken at the start of the study to screen for STIs and further samples were submitted for testing after three and six months of follow-up. Most of the study participants were women (55%) and African American (65%). Their mean age was 29 years and the mean number of reported lifetime sexual partners was 30. For the full article, click here. Regular
HIV testing becoming the norm among gay men in Scotland The number of gay men testing for HIV in Scotland increased significantly between 2000 and 2010, a study published in HIV Medicine shows. The percentage of men reporting a test in the previous year increased from 27 to 57%. There was also an increase in the proportion of men who perceived testing as beneficial and as a community norm. However, significant barriers to testing still remained. These included: fear of a positive result; reservations about opening times and waiting periods at testing clinics; and a concern that testing HIV positive would lead to rejection by potential sexual partners who believed themselves to be HIV negative. Nevertheless, the investigators believe their results point towards the “normalization of HIV testing”. Testing is a cornerstone of efforts to control the HIV epidemic. Prompt diagnosis of the infection has considerable individual health benefits, enabling people to access treatment and care. Late diagnosis of HIV is an important factor underlying much of the remaining HIV-related mortality seen in the UK. Early detection of HIV also has public health benefits. There are compelling epidemiological data showing that the majority of onward transmissions in the United Kingdom originate in undiagnosed individuals. Gay men are one of the groups most affected by HIV in the UK. Guidelines recommend an annual HIV test for sexually active gay men and more frequent testing is advocated for those at highest risk of the infection. In an effort to increase the uptake of testing, screening for HIV at genitourinary clinics is now offered on an opt-out basis. There have been major improvements in HIV treatment and care over the past decade. Antiretroviral therapy is generally safe, tolerable and taken once daily. A number of studies have shown that, with the right treatment and care, the life expectancy of many HIV-positive people is now near normal. In addition, there is now a consensus that people taking HIV therapy that suppresses their viral load to undetectable levels are highly unlikely to transmit the virus to their sexual partners. Investigators in Scotland wanted to see if efforts to promote testing, together with these major improvements in HIV treatment, had had an impact on testing rates and attitudes towards testing among gay men. They therefore compared the results of cross-sectional research enquiring about these issues; the studies were conducted in 2000 and again in 2010. Participants were recruited at commercial gay venues across Scotland. To be eligible for inclusion in the study, participants were required to be resident in Scotland. The total number of men included in the 2000 sample was 686; the 2010 sample comprised 696 men. For the full article, click here. Australia
votes against legalising equal marriage Lawmakers in the Australian Parliament have overwhelmingly rejected a bill that would have introduced equal marriage rights for same-sex couples. The House of Representatives voted 98-42 against the legislation last night. It was the first of four bills introduced to the parliament that aimed to lift the country’s ban on same-sex marriage. A separate bill was also being debated in the Senate on Wednesday. The defeat was expected, on Tuesday, Finance Minister Penny Wong was seeking to down play expectations. “It will mean that it is very difficult for this bill to pass,” Senator Wong told ABC radio. Although Senator Wong’s own boss, Prime Minister Julia Gillard has staunchly opposed supporting equal marriage, Ms Wong is blaming opposition leader Tony Abbott for the defeat. Mr Abbott has refused to allow his MPs a conscience vote on the issue. Despite the defeat, Australia’s gay rights movement have vowed to continue their fight for marriage equality. The Brisbane Times reports Alex Greenwich from Australian Marriage Equality as saying: “Now the federal parliament has effectively brushed the wishes of a majority of Australians aside, the states and territories will take the lead, making me confident we will see same-sex marriages performed somewhere in Australia by the end of the year”. In New South Wales, a cross-party group of MPs is drafting a bill on the issue after Liberal Premier Barry O’Farrell and state opposition leader John Robertson granted a conscience vote to coalition and Labor members. Seattle
lawyers issue complaint against anti-marriage equality groups A Seattle law firm has filed a complaint against two anti-marriage equality groups for not declaring the source of their funding. The firm, Davis Wright Tremaine, made the complaint that Preserve Marriage Washington and the National Organization of Marriage had violated state law by not disclosing the source of their money and how they spend in their campaigns to repeal the Pacific Northwest state’s marriage equality law. According to Jerry Cornfield in the Heraldnet, the complaint, which is 188 pages in length, claims the National Organization of Marriage need to register as an out-of-state political committee and say where the money is coming from that’s enabling them to oppose Referendum 74 on the November ballot. Mr Cornfield wrote that the complaint also alleges the group is violating campaign spending rules by not listing expenses for the services of several people, including high-priced strategist Frank Schubert. The complaint also alleges that Preserve Marriage Washington has ignored state law by not declaring expenditures for key campaign staff, including manager Joseph Backholm, who also is executive director of the Family Policy Institute of Washington. Mr Cornfield said he had contacted Mr Backholm for a reaction. The complaint concludes: “Washington State has one of the strongest histories of openness and transparency in politics of any state in the country. I urge the PDC to hold Preserve Marriage Washington accountable for flouting that tradition and failing to be honest with the citizenry.” Washington United for
Marriage, a state group who are pro-marriage equality, denied involvement
with the complaint. “At a minimum, it would certainly serve all voters if the Public Disclosure Commission makes sure everyone is playing by the rules, including NOM and Preserve Marriage Washington.” This is not the first time NOM have come under scrutiny – they were investigated for fraud in 2009. Marriage
equality on the cards for Taiwan Two women were married in a Buddhist ceremony in Taiwan last weekend, in the first known ceremony of its kind to be held in the country. While no Asian countries have actually fully legalised marriage equality, Taiwan – along with Vietnam and Nepal – is one of the few that have taken a forward-thinking stance on the issue, with legislation pending for nearly a decade. If the bill is passed, Taiwan will become the first Asian country to legalise marriage equality. The two women in question, Huang Mei-yu and Yu Ya-ting, were joined together in a ceremony conducted by a female Buddhist master and activist, Shih Chao-hui. The couple have been together for seven years. A Buddhist nun, who attended the ceremony, told the Jakarta Globe: “I think this is their human right. They can choose freely to get married and we should respect them. “It makes no difference if couples are heterosexual or homosexual, as long as they are in love and they are happy.” LGBT rights and marriage equality are not new to Taiwan. In August 2011, 80 lesbian couples were “married” in a mass ceremony in downtown Taipei. Though this was technically illegal, no action was taken against the event. Asia’s biggest gay pride parade has also been held in Taiwan since 2003. CNN reported that in 2006, when he was mayor of Taipei, the now Taiwanese President Ma Ying-Jeou said “gay rights are part of human rights.” However, since he took office in 2008, he has failed to address the subject; but several commentators have pointed out that legalising marriage equality is an issue that’s unlikely to be high on the list of government priorities at the moment. During a visit to the country back in May, former governor of Florida, Jeb Bush, said that equal marriage was “a distraction” in the current presidential campaign, and it was the economy that was most important. Elsewhere in Indo-China, the possibility of equal marriage being legalised in Vietnam is growing strong; according to USA Today, the country’s justice ministry said it was going to consider the inclusion of same-sex marriage when marriage laws get rewritten in 2013. Thousands
join campaign to oppose American Scouts’ anti-LGB policy A campaign has begun on Change.org to urge California’s Golden Empire Council to reinstate 22-year-old Eagle Scout Tim Griffin and to reject the Boy Scouts of America’s policy barring LGBT Scouts and leaders. More than 60,000 people have joined the campaign so far. Mr Griffin, who was the longest-serving employee at Camp Winton, says that he was fired from the scout camp because of his sexuality. The campaign was begun by Alex Hayes, Camp Winton’s program director. Mr Hayes, along with nine other employees of the camp, resigned in protest following Mr Griffin’s dismissal. He said: “For the past eight summers, Tim was loved not only by his fellow camp staffers, but all of the Boy Scouts who participated in programs he ran at the camp. “More than 60,000 people have joined me, and the nine other employees who resigned, in taking a stand for Tim. We want the Golden Empire Council to know that the Boy Scouts of America’s discriminatory policy has no place in our Scouting community.” The Golden Empire Council said in a statement that Mr Griffin’s firing was “due to an issue with performance, violation of expected camp behavior and camp standards.” My Hayes added: “The Golden Empire Council claims he was fired because he violated the camp’s dress code, but as his direct supervisor at Camp Winton, I know this isn’t true. He was fired because of his sexual orientation. “If the Golden Empire Council truly stands by its statement, and Tim wasn’t fired because he’s gay, then the council should have no problem rejecting the Boy Scouts of America’s discriminatory ban on gay Scouts and leaders.” President Obama, who is honorary president of the Boy Scouts of America, has publicly opposed the body’s anti-gay policy. Mr Griffin, along with Alex Hayes and other former employees of Camp Winton, will deliver the petition in person at the Golden Empire Council’s office in Sacramento, California, tomorrow. Increased
rates of unprotected sex among undiagnosed gay men wipe out benefits of
diagnosis and HIV treatment The ongoing HIV epidemic among gay men in the Netherlands is due to increased rates of unprotected sex, investigators report in the online edition of AIDS. Higher rates of risky sex, especially among undiagnosed individuals and men who are not taking anti-HIV drugs, are offsetting the benefits provided by testing and antiretroviral treatment. “The resurgent epidemic in the Netherlands as a whole can be satisfactorily…explained by increased risk behaviour, predominantly in undiagnosed individuals,” write the authors. Gay men continue to be a main focus of the HIV epidemic. Diagnoses have increased in recent years, and there is some evidence that HIV incidence in gay men is also on the rise. Possible causes of the ongoing and possibly resurgent HIV epidemic in gay men include high rates of unprotected sex involving individuals who are unaware of their infection and those who are not taking treatment and the high rates of other sexually transmitted infections that are present in gay men. An international team of investigators wanted to get a clearer understanding of the causes. They therefore developed a mathematical model that was based on annual data for HIV and AIDS diagnoses in the Netherlands between 1980 and 2009. Incorporated into the model were assumptions about the efficacy of HIV therapy, and the infectiousness of individuals during the acute and chronic phases of HIV infection, as well as the impact of suppressive antiretroviral therapy on the risk of transmission. Using this model, the investigators calculated transmission and diagnoses rates. These were also estimated using information obtained from the Amsterdam Cohort Study. This was established in 1984 and the investigators focused on data concerning the proportion of HIV-negative men reporting unprotected anal sex in the previous six months with another man. There was agreement between the two models. Both showed that risk behaviour fell by approximately a half between the mid-1980s and the mid-1990s. This limited the spread of HIV among gay men. However, incidence then increased. This was primarily driven by increased rates of unprotected anal sex involving undiagnosed men. “The increase in risk behaviour among untreated individuals is offsetting benefits in terms of reduced incidence offered by enhanced testing and treatment, which reduce transmission,” comment the investigators. Thanks to the health benefits of antiretroviral therapy, there was no evidence that the resurgent epidemic was associated with increased mortality rates. “However the long-term healthcare costs and infection-associated morbidity will likely be substantial,” warn the authors. They conclude, “reductions in incidence could be obtained by increasing rates of diagnoses, by reducing time to initiate antiretroviral therapy, and by encouraging individuals to practice safe sex.” Could
North Africa and the Middle East be a new hotspot for HIV in gay men? HIV experts are concerned that the largely Islamic countries of the middle east and north Africa may be set to follow east and south-east Asia in seeing sharp rises in HIV infections in gay men and men who have sex with men. Studies presented at the 19th International AIDS Conference in Washington recently found relatively low HIV prevalence, but low rates of condom use in men who have sex with men (MSM). One study from Marrakech and Agadir in Morocco found that a high proportion of men ‘never’ used condoms in anal sex with men, and in the case of Marrakech, not in vaginal sex with women either. Meanwhile, a pioneering outreach project in the more conservative environment of Cairo, Egypt, found low rates of condom use and high rates of drug injection. A third, qualitative study from Beirut in Lebanon also found low rates of condom use and found that men who were uncomfortable with their sexuality had considerably lower rates of condom use and of testing for HIV but more sex partners. The Maghreb culture has prohibitions against homosexuality (as it does against adultery and sex work), and yet also has a history of relative tolerance of same-sex activity. It may have been protected against HIV in the past due to low background prevalence, universal male circumcision, and conservative sexual customs. However it also means that researching into men who have sex with men is fraught with difficulty. These studies therefore all featured highly selected groups of MSM, unlike the Thai study also reported at Washington. The Morocco study recruited men by ‘respondent-driven sampling’ whereby volunteers recruited other MSM contacts; the Beirut study also did this but in addition adjusted recruitment in order to ensure a balance between over- and under-25s. The Egyptian study was of men attending novel (for the area) HIV centres for high-risk populations and were recruited ‘deniably’. In other words, while they could be referred overtly by other MSM, they could also be referred by other groups of men who knew of the centre and who were defined in one way or another as being at high risk of HIV, such as drug injectors or taxi drivers, but disclosures of sexuality did not have to happen until participants were assured of confidentiality. High HIV risk levels in MSM in Agadir and Marrakech, Morocco The Moroccan study was prompted by a finding that, while HIV prevalence in the general Moroccan population is less than one per cent, 38% of all HIV cases were reported from Agadir and Marrakech. The three previous studies ever done in MSM has found HIV prevalence in MSM ranging from 2.4% to 4.4%. The current study used respondent-driven sampling to recruit 669 MSM, 323 from Agadir and 346 from Marrakech. To be included, men had to report having had anal sex with another man at least once in the last six months and to be over 18. HIV prevalence in this group overall was 4.2%, but in Agadir was 5.6%. For the full article, click here. Most
young Thai MSM define as heterosexual, even if they mainly have sex with
men A large, randomised sample of 21-year-old Thai men, presented at the 19th International AIDS Conference in Washington recently, has found that by far the largest risk factor for HIV infection is gay identity. Contrary to the oft-quoted saying “it’s not who you are, but what you do,” actual male/male sexual behaviour, while still an important risk factor, was not as strongly associated with being HIV positive as gay identity. The survey was conducted among over 35,000 army conscripts from all parts of Thailand. All 21-year old Thai men enter a lottery at the age of 21 for conscription into the Thai army and of these half a million young men, 60,00 to 100,000, in any year, are conscripted, twice a year in May and October.. This survey thus constituted a truly randomised, cross-sectional survey of the 21-year-old men who were inducted into the Thai army in May 2011. It was conducted no more than two weeks after induction and therefore serving in the army had no influence on the results. Men from all provinces in Thailand were included and from both urban and rural areas. The survey found that 7% of respondents had had sex with another man (MSM) but that only 1.1% only had sex with men. In all MSM, 83% identified as heterosexual, i.e. desiring women only. Even in exclusive MSM, only 21% said they desired men exclusively and 31% both men and women, meaning that nearly half (48%) of men who’d in fact only ever had male partners said they actually preferred women. Only 0.5% of all respondents had HIV, and only 2.6% of the MSM. However HIV prevalence increased to 9.4% in men who exclusively had sex with men, and to 16% in men who said they preferred sex with men, i.e. who identified as gay or transgender. Gay identity was in fact quite uncommon, at 180 individuals out of 35,359, or 0.5% of respondents. Having sex with both men and women was associated with a 4.5-fold higher risk of having HIV, and solely having sex with men with a 35-fold raised risk; but defining oneself as wanting sex with men and women was associated with a 26-fold raised risk, and as wanting sex only with men with an over sixtyfold raised risk. One of the explanations for desire being a greater risk factor than behaviour was that sex role was highly predictive of HIV infection: compared with exclusive ‘tops’, versatile gay men were 6.8 times more likely to have HIV and exclusive ‘bottoms’ 8.6 times more likely. If non-gay-identified MSM are more likely to be insertive, this would explain why activity was less predictive of HIV than identity. Another might be that the culturally-accepted way of being an MSM in Thailand, at least outside urban centres with gay scenes, has tended to be to become a Katoey (ladyboy/transgender). 'Out' Kaoteys would tend to be exempted from military service, until 2011 because they had a 'mental disorder', now changed to 'gender identity disorder'. So this survey would tend to under-represent certain self-identified MSM. Other traditional HIV risk factors were more common than MSM sex. While only 3.2% of all respondents had ever injected drugs, 33% had had sex with a female sex worker, 10% had been in prison and no less than 52% had ever used non-injectable methamphetamine which, as Yaa Baa (‘mad pills’), is the most common recreational drug in the country. For the full article, click here. Black
gay men in the UK almost twice as likely to have HIV as white men, meta-analysis
shows A new analysis of existing studies on the sexual health of black gay men in the UK has found that despite having similar sexual risk behaviours to white gay men, they have almost twice the chance of being HIV-positive. The findings are published in a special issue of The Lancet on men who have sex with men, published last week to coincide with the 19th International AIDS Conference (AIDS 2012). While reviewing studies on HIV infection and risk factors that affect black men who have sex with men in the United States, Greg Millet and colleagues also examined similar studies from the United Kingdom and Canada. They wished to see if the inequalities experienced by black MSM in the US were unique to that setting. A total of 13 UK reports were identified, nine of which were based on the semi-annual Gay Men’s Sex Survey. Putting all of these results together, the researchers found that black men had almost twice the odds of having HIV as white gay men – odds ratio 1.86 (95% confidence interval 1.58 – 2.18). They were also more than twice as likely to have a sexually transmitted infection – odds ratio 2.66 (95% confidence interval 1.53 – 4.64). But their individual risk behaviours were the same as for white gay men, with no statistically significant differences seen in terms of unprotected anal intercourse, unprotected sex with men of a different HIV status, number of partners, drug use and protective behaviours. Black men were more likely to have tested for HIV (odds ratio 1.75) but less likely to be on antiretroviral therapy if diagnosed with HIV (odds ratio 0.78). The authors say that this finding is surprising, given the UK’s open access health service, but note that immigration status can act as a barrier to accessing healthcare. A recent study based on the UKCHIC cohort has also found that black and minority ethnic gay men are 17% less likely to start antiretroviral therapy than white gay men, but that after starting treatment there are no differences in treatment outcomes. The new meta-analysis also showed that, compared to other black people living in the UK, black gay and bisexual men have a nine-fold greater risk of HIV infection (odds ratio 9.3, 95% confidence interval 7.1 – 12.1). Compared to the general population in the UK, black MSM have more than one hundred times the risk of having HIV (odds ratio 111.4). The authors note that these findings resemble in many ways those of the United States – despite similar risk behaviour to their white peers, black gay and bisexual men have a markedly higher number of infections. For the full article, click here. Truvada
Approved to Reduce the Risk of Sexually Transmitted HIV in People Who
Are Not Infected With the Virus On July 16, 2012, the Food and Drug Administration approved Truvada (a fixed dose combination of emtricitabine/tenofovir disoproxil fumarate) to reduce the risk of HIV infection in uninfected individuals who are at high risk of HIV infection and who may engage in sexual activity with HIV-infected partners.Truvada is to be used for pre-exposure prophylaxis (PrEP) in combination with safer sex practices to prevent sexually-acquired HIV infection in adults at high risk. Truvada is the first drug approved for this indication. Truvada for PrEP is meant to be used as part of a comprehensive HIV prevention plan that includes risk reduction counseling consistent and correct condom use, regular HIV testing, and screening for and treatment of other sexually-transmitted infections. Truvada is not a substitute for safer sex practices FDA previously approved Truvada (August, 2004) to be used in combination with other antiretroviral agents for the treatment of HIV-infected adults and children 12 years or older. As part of PrEP, HIV-uninfected
individuals who are at high risk will need to take Truvada daily to lower
their chances of becoming infected with HIV should they be exposed to
the virus. Again, PrEP indication means Truvada is approved for use as
part of a comprehensive HIV prevention strategy that includes other prevention
methods, such as safe sex practices, risk reduction counseling, and regular
HIV testing. Truvada for PrEP is being approved with a Risk Evaluation and Mitigation Strategy (REMS). The central component of this REMS is a prescriber training and education program to assist prescribers in counseling and managing individuals who are taking or considering Truvada for PrEP. The training and education program will not restrict distribution of Truvada but will provide information about the important elements of a comprehensive HIV prevention strategy, the importance of adhering to the recommended daily dosing regimen, the serious risks of taking Truvada for PrEP if already infected with the virus or becoming infected with HIV while taking Truvada for the PrEP indication. “The REMS for Truvada for the PrEP indication is aimed at educating health care professionals and uninfected individuals to help ensure its safe use for this indication without placing an unnecessary burden on health care professionals and patients who use Truvada for treating HIV infection. Truvada’s safety and efficacy for PrEP were demonstrated in two large, randomized, double-blind, placebo-controlled clinical trials. The iPrEx trial evaluated Truvada in 2,499 HIV-negative men or transgender women who have sex with men and with evidence of high risk behavior for HIV infection, such as inconsistent or no condom use during sex with a partner of positive or unknown HIV status, a high number of sex partners, and exchange of sex for commodities. Results showed Truvada was effective in reducing the risk of HIV infection by 42 percent compared with placebo in this population. Efficacy was strongly correlated with drug adherence in this trial. For the full article, click here. Pink
Dot in Singapore Highlights Gay-Rights Debate
SINGAPORE–A record turnout for the weekend’s Pink Dot gathering promoting gay and lesbian rights in Singapore offers the latest evidence that social attitudes toward gay residents are easing in the city state, even though the government still criminalizes homosexuality. In addition to attracting a record crowd of 15,000 people to Hong Lim Park – the only venue in the city-state where demonstrations are allowed – the fourth annual Pink Dot gathering also drew heavier local media coverage than in past years and more high-profile corporate sponsors, including Barclays bank, which was a sponsor for the first time this year. Pink Dot – which is billed as a gathering to celebrate “freedom to love” irrespective of gender, rather than an overt political protest – has been growing in size and prominence in recent years. Attendance has swelled six-fold since the its inaugural installment in 2009, according to organizers, and it also boasts corporate sponsors such as Google Inc., which signed on last year as the first multi-national to sponsor the event. “There has definitely been increased visibility” for the lesbian, gay, bisexual and transgender community in Singapore, said Leow Yangfa, a social worker. “In the early days, coverage was very limited but now [the local press] cannot avoid covering an event with 15,000 people,” he added. Mr. Leow, who is gay, has edited an anthology of “coming-out” stories. He notes that while initial Pink Dot gatherings were generally attended by the “same faces” – local activists who are well-known in the lesbian and gay community – he now sees people from more varied backgrounds, including many straight Singaporeans and their children, at the yearly gathering. “It is an indication that as a community, we are finally empowered, and that what we are doing is getting noticed,” he said. For the full article, click here. Supreme
Court Health Care Decision: Individual Mandate Survives WASHINGTON -- The individual health insurance mandate is constitutional, the Supreme Court ruled Thursday, upholding the central provision of President Barack Obama's signature Affordable Care Act. The controlling opinion, written by Chief Justice John Roberts, upheld the mandate as a tax, although concluded it was not valid as an exercise of Congress' commerce clause power. Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan joined in the outcome. The decision in National Federation of Independent Business v. Sebelius comes as something of a surprise after the generally hostile reception the law received during the six hours of oral arguments held over three days in March. But by siding with the court's four Democratic appointees, Chief Justice Roberts avoided the delegitimizing taint of politics that surrounds a party-line vote while passing Obamacare's fate back to the elected branches. GOP candidates and incumbents will surely spend the rest of the 2012 campaign season running against the Supreme Court and for repeal of the law. Five justices concluded that the mandate, which requires virtually all Americans to obtain minimum health insurance coverage or pay a penalty, falls within Congress' power under the Constitution to "lay and collect taxes." "The individual mandate cannot be upheld as an exercise of Congress's power under the Commerce Clause," Roberts wrote. "That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it. In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Congress's power to tax." Ginsburg, writing separately for the four liberals, said they would have upheld the mandate under the commerce clause too. "Unlike the market for almost any other product or service, the market for medical care is one in which all individuals inevitably participate," she wrote. "Virtually every person residing in the United States, sooner or later, will visit a doctor or other health care professional." Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito joined in a dissent. Together, Roberts' controlling opinion, Ginsburg's concurrence, the four-justice dissent and Thomas' own dissent add up to 187 pages. For the full article, click here. The
road to PrEP: trials, regulation and roll-out Within the next three years, up to 33,000 people may take part in 22 different studies worldwide to demonstrate the feasibility, or otherwise, of pre-exposure prophylaxis (PrEP) to prevent HIV, the IAPAC evidence summit, Controlling the HIV epidemic with antiretrovirals, was told on 12 June.Some of these studies are underway but others are still in the design stage or in need of funding. Dr Jim Rooney of Gilead Sciences, the manufacturer of tenofovir (Viread) and Truvada (tenofovir and FTC), the products being tested in the vast majority of these studies, told the meeting that up to 13,000 men who have sex with men (MSM) could end up being involved in 14 different studies and up to 19,500 heterosexual men and women in eight studies. These studies were particularly crucial in establishing whether PrEP might be less, or more, effective in open-label settings than in randomised placebo-controlled trials. Some of these are ongoing or open-label extensions of studies such as Partners PrEP in 4758 sero-different couples in Kenya and Uganda, or iPrEx OLE (Open Label Extension) in 1500 MSM in six countries. Others are just beginning, such as the IPERGAY study of intermittent PrEP in gay men in France. While it is planned that this could eventually include 1900 men, researcher Bruno Spire told the IAPAC meeting that 300 participants had to be enrolled by February 2013 if the next phase of the study was to be funded, and that recruitment had been rather slow so far, partly because of "ideological obstacles" to there being a placebo arm. Similarly, Dr Sheena McCormack of the UK's Medical Research Council told the meeting that, while the planned UK PROUD study of immediate versus delayed PrEP could eventually include 5000 MSM, only a pilot project in 300 MSM has so far been proposed, with a tentative start date (if the protocol is agreed) in October 2012. In the US, nine studies in 4255 MSM are planned; these include specific studies amongst African-Americans and adolescents. In the latter case, a study amongst 18- to 22-year-olds is ongoing, with a possible extension to 15- to 17-year-olds. Similarly in South Africa, a small study called CHAMPS will recruit 100 male and female teenagers aged 14 to 18. Also in South Africa, a second – or rather third – study of a vaginal microbicide, FACTS, will recruit 2200 women aged 18 to 30 and possibly another 400 aged 30 to 40. The study will aim to confirm the efficacy demonstrated in the CAPRISA 004 study, after the failure of the tenofovir-gel arm of the VOICE study to do that. A smaller study will look at safety and acceptability in 15- to 17-year-olds. Jim Rooney also looked at the regulatory environment. The US Food and Drug Administration voted for approval of tenofovir/FTC (Truvada) as PrEP in May this year but confirmation, expected in September, is subject to a Risk Evaluation and Mitigation Strategy (REMS) document. In Europe, Rooney said, Gilead had been in talks with the European Medicines Agency (EMA) but specific plans for authorisation had not been finalised and at present the EMA has issued a draft of a so-called ‘reflection paper’ on the general requirements for licensing HIV drugs for prevention: comments and feedback are welcome until 30 June. For the full article, click here. Is
treatment as prevention ready to roll out, or do we need to know more? Major randomised studies of the impact of antiretroviral treatment expansion on new infections are getting underway, and should provide important evidence to guide further implementation, researchers reported at the International Association of Physicians in AIDS Care summit, Controlling the HIV Epidemic with Antiretrovirals, in London this week. However some delegates attending the meeting, composed of physicians, community advocates, donors and programme managers, argued that expansion of antiretroviral treatment in order to achieve an impact on new infections should not be held back by the need to conduct further research. Prof. Julio Montaner of the University of British Columbia, a long-time advocate of the use of antiretrovirals for prevention purposes, argued passionately that the available evidence obliged donors, programme managers and physicians to move swiftly to make treatment more widely available. “People have been talking about [another] 1996 moment. Please remember what 1996 was like. We had early results from two clinical trials, we didn’t have clinical endpoints, viral load hadn’t been validated, [but] we put it all together and flew by the seat of our pants. Morbidity and mortality declined by 90% within a year. My concern is, we have the evidence today – what are we going to do to expand treatment to everyone who is eligible?” However, when questioned about perceptions of treatment as prevention in their own countries, 51% of delegates said that medical providers were unsure and wanted to see more data before implementing it, and 43% of delegates at the meeting questioned through an electronic polling system said that they thought more research was needed before implementation. Prof. Montaner told the meeting, “100% coverage of everyone who is eligible is non-negotiable”, but debate over who should be eligible persists despite evidence of the impact of antiretroviral drugs on transmission from the HPTN 052 study. “HPTN 052 showed impact at an individual level, but we don’t know the population effectiveness of treatment as prevention,” said Dr Sarah Fidler, of Imperial College, London, an investigator on a planned study of treatment as prevention. The HPTN 052 study showed that when treatment was commenced at a CD4 count above 550 by the HIV-positive partner in a serodiscordant relationship, transmission to partners was reduced by 96%. Dr Fidler noted that ecological studies in specific locations, such as San Francisco and the Canadian province of British Columbia have shown a correlation between expanded treatment coverage and a decline in new HIV diagnoses at a population level. Research in Kwazulu-Natal province, South Africa, also shows an association between the expansion of antiretroviral coverage and a decline in the hazard of HIV acquisition between 2004 and 2011. However, each of these pieces of evidence is drawn from a setting where treatment was being provided under prevailing guidelines, without aggressive efforts to enrol everyone eligible onto treatment. The majority of infections are passed from undiagnosed individuals, unaware of their HIV status, and it is likely that the majority of infections occur before individuals are eligible for antiretroviral treatment under current guidelines. Proposals for wider treatment, at CD4 cell counts above 350, coupled with efforts to achieve near-universal knowledge of HIV status through community HIV testing campaigns, have never been evaluated in a real-world setting. For the full article, click here. French
blood donation ban for gay men to be lifted ‘in coming months’ The ban on the donation of blood by men who have sex with men in France is due to be lifted ‘in the coming months’. Minister of Health and Social Affairs Marisol Touraine announced the move as she gave blood on World Blood Donation Day yesterday. She told Reuters: “The criterion [for donation] cannot be the nature of sexual relations or sexual orientation. “The only criterion is that of risk, and on that point we will ensure that men who have sex with men are able to give blood because that is not, in itself, a risk factor.” She added that the move would be made “in the coming months”. Reuters in France reported that Ms Touraine’s predecessors had vowed to open blood donation to men who have sex with men, previously barred due to the higher prevalence of HIV among the group, but had not acted to do so. Ms Touraine denied that sexual orientation itself was a risk factor, saying: “Simply, there is no population at risk because of their sexual orientation.” Following the election of Francois Hollande as president of France, Prime Minister Jean-Marc Ayrault recently announced that equal marriage and adoption laws for the country’s gay community would be implemented “quickly”. The lifetime blood donation ban on men who had ever had sex with a man was lifted for England, Wales and Scotland in November last year. The Department of Health implemented a one-year deferral period instead, so that men who have had gay sex in the last 12 months may still not donate blood. Leon
Panetta Wants To Honor Contributions Of Gay Troops Defense Secretary Leon Panetta wants to honor the contributions of gay troops by marking June as Gay Pride Month. The AP is reporting that the Pentagon is preparing to hold its first ever Gay Pride celebration later this month. “Don't Ask, Don't Tell,” the policy which banned gay and bisexual troops from serving openly ended nine months ago. Nearly 14,000 service members were drummed out of the military for violating the policy. “Now that we've repealed 'Don't Ask, Don't Tell,' he feels it's important to find a way this month to recognize the service and professionalism of gay and lesbian troops,” Navy Capt. John Kirby, a spokesman, told the AP. Officials have said repeal of the 18-year-old law has gone smoothly. “I don't think it's just moving along smoothy, I think it's accelerating faster than we even thought the military would as far as progress goes,” said Air Force 1st Lt. Josh Seefried, a finance officer and co-director of OutServe, a professional association for gay troops. If
people who need HIV drugs aren’t getting them now, why should the
prevention benefit of treatment be the reason that the drugs become available? The issue of ‘treatment as prevention’ raises a number of ethical issues, Richard Ashcroft, professor of bioethics at Queen Mary University of London told the IAPAC Controlling the HIV Pandemic with Antiretrovirals Evidence Summit in London this week. He reminded the audience that it is rare for a doctor to give a patient a medicine that will primarily benefit a third party. He went on to highlight situations in which, at present, antiretroviral treatment is not universally available to all people who need it for their own health. In such circumstances, why should treatment’s prevention benefit be “the clincher” that convinces funders and policy makers to make the drugs more widely available? At the same meeting, Kevin Fisher of AVAC noted that the ethical concerns tended to differ in different parts of the world. In settings where there is already good access to HIV treatment, the concerns are often related to individuals experiencing external pressure or compulsion to take treatment. In resource-limited settings, the concerns focused more on the cost of and access to treatment. Stefano Vella of the Istituto Superiore di Sanità in Italy said that in resource-limited settings, working towards universal access to antiretrovirals was the way to take treatment as prevention forward. “Prevention is a consequence of treating those in need,” he said. But there’s also the question of the quality of the antiretroviral regimens that are commonly used in poorer countries. “We cannot curb the epidemic with sub-optimal therapies,” he said, pointing to drugs such as d4T which are cheaper but have significant side-effects as well as to people kept on failing first-line regimens. In a number of richer countries, the concerns centre more often on the treatment choices that an individual makes, and how the balance is struck between the benefits to individual health and those to public health. This issue is likely to remain unsettled as long as there is no consensus or clear evidence on whether there is a benefit or harm to the individual in starting HIV treatment with a CD4 cell count above 350. Secondary data from the HPTN 052 trial that will be presented at July’s conference in Washington may shed light on this. But the START trial, which was designed to definitively answer the question, is still recruiting participants and will not provide results for another four years. Gus Cairns of NAM reminded the audience that patient choice is an issue in any treatment decision, with doctors always needing to take it into account alongside their professional duty to care for the patient. Even if the CD4 cell count is 10 cells/mm3 and the doctor very strongly recommends treatment, the patient can still make the choice to refuse treatment. Robert Carroll of the Association of Nurses in AIDS Care pointed out that if there is a massive expansion in the number of people taking treatment, there will need to be a corresponding rise in the number of healthcare workers. Will these new workers be sufficiently trained and have the skills to support patient autonomy, avoid coercion and understand the impact of stigma? These are likely to be particular concerns as treatment approaches become ever more simplified and standardised. Equally, Ceri Evans, a sexual health adviser at London’s Chelsea & Westminster Hospital, commented on the skills and staff time needed when supporting individuals who are considering personal decisions about treatment as prevention. For example, when individuals in a serodiscordant couple are considering stopping using condoms, there may be power imbalances within the couple that need to be addressed. For the full article, click here. World
Health Organization sets out route map for scale-up of treatment as prevention The number of people eligible for antiretroviral treatment will grow by around six million as a result of recent World Health Organization recommendations on the use of antiretroviral drugs to prevent HIV transmission, Dr Gottfried Hirnschall, head of the WHO’s HIV department told the IAPAC Controlling the HIV Pandemic with Antiretrovirals:Treatment as Prevention and Pre-Exposure Prophylaxis Evidence Summit in London. The new recommendations almost double the number of people judged to be in need of antiretroviral therapy – calculated at 7.4 million people with CD4 counts below 350 and therefore in need of treatment at the end of 2010. In 2010, antiretroviral coverage reached 47% of those eligible, he said. His remarks coincided with the release by WHO of a Programmatic Update on Antiretroviral Treatment for Prevention of HIV and TB, which sets out the organisation’s plans to galvanise greater use of antiretroviral treatment in order to limit new infections. The summit, organised by the International Association of Physicians in AIDS Care, is designed to review recent advances in the use of antiretroviral drugs as a means of preventing HIV transmission, and to discuss the practical implications of the new data for treatment and prevention programmes. Speaking on the first day of the two-day summit, Dr Hirnschall pointed out that, for every person placed on treatment, 2.5 people are still becoming infected every year, amounting to approximately 2.7 million infections a year in 2010. Scale-up of a combination of effective prevention interventions remains urgent, and antiretroviral treatment must play a central role in the prevention of new infections, he said, following last year’s release of the results of the HPTN 052 study, which showed that early antiretroviral therapy for the HIV-positive partner reduced the risk of HIV transmission by 96% in serodiscordant partnerships. Similarly, evidence from the South African province of KwaZulu-Natal demonstrates that, at the population level, antiretroviral therapy is already having an impact on one of the most severe epidemics in sub-Saharan Africa. Every 1% increase in antiretroviral coverage among adults in rural communities between 2004 and 2011 was associated with a 1.7% reduction in the risk of HIV acquisition, suggesting the potential for large reductions in HIV incidence if greater progress towards universal access to antiretroviral treatment can be achieved. However, Dr Hirnschall noted that current coverage in low- and middle-income countries – 47% in 2010 – “is not giving us the prevention gain we want to see”. WHO issued guidance on HIV counselling and testing for serodiscordant couples in April 2012. It recommended antiretroviral therapy for all HIV-positive people in a serodiscordant partnership, irrespective of CD4 cell count. Thirteen countries already make recommendations for serodiscordant couples on the use of antiretrovirals for prevention of HIV transmission, including the United Kingdom, the United States, Canada, Italy, Nigeria, Zambia, Thailand and France. The Chinese Center for Disease Control and Prevention has begun providing ART for the HIV-positive partner in serodiscordant couples, regardless of CD4 count, and plans to reach an estimated 30,000 couples as part of a national strategy for the use of antiretroviral therapy for prevention. For the full article, click here. Washington
Gay Marriage Ban Referendum 74 Qualifies For Ballot Officials in Washington state on Tuesday announced that a referendum on a gay marriage law has qualified for the ballot. The secretary of state's office announced that backers of Referendum 74 had submitted sufficient valid signatures to qualify the question, the AP reported. Preserve Marriage Washington turned in 247,331 voter signatures last week, more than twice the number needed. Officials checked a random 3 percent sample of signatures for validity. The marriage law, which
was approve by lawmakers at the urging of Governor Chris Gregoire, was
set to take effect on Thursday but it was put on hold when the group turned
in the signatures last Wednesday. Groups are preparing to battle on the issue in 4 states this fall, including Minnesota and Maryland. Voters in Maine will be asked to approve equal marriage rights for gay and lesbian couples. Various polls have found gay marriage supporters slightly ahead in all four battleground states. Support – in particular among African-American voters and Democrats – has increased since President Barack Obama announced his support for such unions last month. A recent poll in Washington found that 54 percent of voters believe it should be legal for gay couples to get married. Debate
surrounds intersex inclusion in the DSM V The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is the American Psychological Association (APA) guidebook used by psychiatrists all around the world. It is currently undergoing revisions for a fifth edition, which has sparked controversy in many areas. Among these is its inclusion, for the first time, of intersex people. Many transgender people have welcomed the DSM’s shift from referring to them as having ‘gender identity disorder’ to using the term ‘gender dysphoria’. This removes the stigma associated with the concept of disorder but means that, because they can still be said to have a recognised condition, they can still access treatment. The way gender dysphoria is defined, however, rests on a binary understanding of biological sex, so it is an awkward fit for intersex people. Crucially, gender dysphoria places the emphasis on the person who wants to change, not on the world around them. The International Intersex Organisation (OII) have challenged this, noting the many intersex people are assigned a sex at birth on a best-guess basis and may be subject to surgery to reinforce that assignment. If they are unhappy with their bodies, this is often because doctors have made mistakes and misinterpreted their gender. Labelling them gender dysphoric protects the idea that doctors can never be wrong. It means that children whose behaviour is at odds with their assigned sex are seen as poorly adapted. Such children may be subjected to psychiatric treatment aimed at reinforcing approved gender behaviour, even though such treatment is increasingly seen as inappropriate, and potentially damaging, when applied to trans children. “When a child is born with an atypical sex anatomy, often called a disorder of sex development (DSD) or intersex condition, doctors must sometimes make an educated guess about what gender assignment makes the most sense. If the child later decides that the guess was wrong, is that a sign that something is wrong with the child?” asks Anne Tamar-Mattis, executive director of Advocates for Informed Choice (AIC). This version of the DSM has been subjected to heavy criticism for what is seen as the unnecessary medicalisation of natural behaviour. The British Psychological Society has expressed concern about the inclusion of intersex on this basis, arguing that many of the problems intersex people face have clear social causes. The APA argue that inclusion will make it easier for intersex people to access care through the WPATH guidelines designed to help trans people. These are, however, poorly designed to fit the needs of intersex people and are likely to need extensive revisions to be able to do so effectively. For the full article, click here. Health
educators should work with the inner contradictions that 'barebackers'
express When asked by researchers to talk about their practice of having ‘bareback’ sex (unprotected anal intercourse), HIV-negative gay and bisexual men express a contradiction between their concern to remain uninfected and their simultaneous awareness that their behaviour may expose them to infection, according to a study published in the July issue of Qualitative Health Research. The research suggests that, rather than giving factual information about risks, health promoters should create spaces in which men who bareback can talk about their behaviour and its justification, in order to explore inner contradictions and reframe their behaviour. This isn’t the first study to show that many HIV-negative gay men who bareback remain concerned about the prospect of acquiring HIV and want to avoid infection. However, previous studies have given little attention to how men understand and deal with this tension. Researchers at Columbia University therefore recruited men who self-identified as a ‘barebacker’ or someone who ‘practices barebacking’ to take part in a two-hour, face-to-face, in-depth interview about their sexual behaviour. Men were recruited from dating web sites associated with bareback sex in New York. Interviews were conducted in 2005 and 2006. Although HIV-positive men were also interviewed, this analysis covers the 89 HIV-negative men who took part. Their average age was 32, four-fifths were employed and they were broadly representative of the ethnic diversity of New York City. Findings Timothy Frasca and colleagues say that they “observed contradictions in some men’s narratives between their wishes to avoid HIV infection and their simultaneous acknowledgment of the risks involved in their barebacking practices”. The researchers identified a number of ways in which their respondents dealt with these contradictions during the interviews. Some men said that, on occasion, intense sexual sensations could overwhelm their calculations about risk: “Something happens. You know, you get to a point, it’s as if being sexually turned on – you know, they talk about how your judgment is impaired when you’re on drugs. I don’t need drugs. All I need is to be with a hot guy, and a good deal of my judgment gets put on hold.” Men who said that they were powerless in the face of sexual desire did not try to explain such incidents away as not really being risky. Instead they admitted that they were unable to carry out their prior intentions. However, the authors note that, like a number of others, this respondent used the present tense to describe this scenario. His language suggests a recurrent or habitual situation, rather than a specific and unusual incident. Other men described sexual practices – such as withdrawing before ejaculation or not barebacking on a first meeting – which they thought could reduce the risk of infection. But at the same time, they often expressed doubt about the reliability of what they were doing. “I know that precum has HIV in it too. So you really don’t protect somebody by pulling out. But it’s kind of a pretence toward that.” “You know, if you do an enema, then that kind of washes everything around, so, um, [a doctor] said that’s not, not always, you know, a sure way to make sure that even if someone does come inside you, to get that out, so, you know [inaudible] risk is still high.” Given interviewees’ lack of confidence in strategies such as these, the researchers suggest that the beliefs about sexual risk did not determine the limits of the men’s behaviour, but helped to reassure the men about the behaviour they were engaging in anyway. For the full article, click here. Federal
Appeals Court: Gay Marriage Ban DOMA Unconstitutional A federal appeals court in Massachusetts on Thursday upheld a ruling declaring the Defense of Marriage Act (DOMA) unconstitutional. The 1st U.S. Circuit Court of Appeals in Boston said the Clinton-era law which bans federal agencies from recognizing the legal marriages of gay and lesbian couples is discriminatory, the AP reported. The three-judge panel unanimously upheld a lower court's ruling which found the law unconstitutional. The House Bipartisan Legal Advisory Group (BLAG) last year appealed two cases in which U.S. District Judge Joseph Tauro declared that DOMA violates the constitutional rights of married gay couples. House Speaker John Boehner instructed BLAG to defend the law in court after President Barack Obama said the Department of Justice (DOJ) would no longer do so. Boehner approved a budget of up to $1.5 million and hired prominent lawyer Paul Clement to represent the House. BLAG lawyers argued that Congress had a rational basis for approving the law, including preserving a uniform definition of marriage. Mary Bonauto, a lawyer with the legal group Gay & Lesbian Advocate & Defenders (GLAD), argued that DOMA discriminates against gay couples by preventing them from accessing federal spousal benefits. “DOMA's precise point was to create an across the board exclusion of same-sex couples in the U.S. Code. The promise of equal protection is that likes are to be treated alike – but DOMA treats married same-sex couples differently from all other married persons, making gay people and our marriages unequal to all others,” she said. “Under the current Supreme Court authority, Congress' denial of federal benefits to same-sex couples lawfully married in Massachusetts has not been adequately supported by any permissible federal interest,” said Judge Michael Boudin, writing for the court. Significant
worsening of sexual health in England in 2011: gay men and young heterosexual
adults had high rates of STIs There has been a significant worsening in the sexual health of gay and other men who have sex with men in England, new surveillance data released by the Health Protection Agency shows. Infections also remained high among heterosexual young people, aged between 15 and 24. Overall, there was a 2% increase in the number of reported sexually transmitted infections in 2011 compared to 2010. But cases of gonorrhoea and syphilis were up by 25 and 10% respectively. Although the increase in diagnoses is partly attributed to improved testing and surveillance, doctors believe that high rates of unprotected sex are leading to the continued transmission of sexually transmitted infections. Investigators from the HPA are especially concerned about the 25% increase in gonorrhoea diagnoses. The infection is becoming increasingly difficult to treat due to the emergence of strains which are resistant to antibiotics. Analysis of longer-term trends showed that rates of syphilis, genital herpes and genital warts have all increased significantly since 2002. This year’s increase follows a modest fall in the number of infections diagnosed in 2010. As in previous years, gay and other men who have sex with men had high rates of sexually transmitted infections. Three-quarters of syphilis cases in 2011 were in this group, as were 50% of gonorrhoea diagnoses. The number of gonorrhoea cases in gay and bisexual men increased by 61% compared to 2010, chlamydia by 48%, genital herpes by a third, syphilis by over a quarter and genital warts by 23%. A substantial proportion of gonorrhoea cases in this population involved extragenital sites. Some 16% of infections were in the throat, with 20% located in the rectum. The authors believe that these figures are likely to represent an underestimate. Several factors appear to have contributed to the upsurge of diagnoses in gay men. The large increase in gonorrhoea is partly attributed to improved testing and surveillance. Highly sensitive nucleic acid amplification tests (NAATs) are now used to diagnose infections. Reporting of sexual orientation has also improved. However, investigators are convinced that the increase is at least partly due to ongoing high rates of unprotected sex. The researchers highlight the continuing LGV epidemic continues in older HIV-positive gay and bisexual men and recent outbreaks of Shigella. Younger heterosexual people also had high rates of infections. Overall, two-thirds of chlamydia diagnoses involving heterosexuals involved patients aged between 15 and 24. This age group also accounted for 57% of gonorrhoea and 56% of genital wart diagnoses. The only apparent good news in the report was a 2% fall in cases of chlamydia. However, the investigators believe that was simply due to a decline in the number of young people being screened. Inner London had the highest overall rates of sexually transmitted infections. Investigators believe this is due to the concentration of at-risk populations in this area. For the full article, click here. Gay
and bisexual men who inject drugs more likely to have HIV than other men
who inject drugs HIV prevalence is four times higher in gay and bisexual men who inject drugs, compared to heterosexual, male, injecting drug users, UK investigators report in Sexually Transmitted Infections. The study also showed that prevalence of infection with the hepatitis C virus was significantly higher among gay and bisexual male injecting drug users (IDUs). The investigators believe that the higher HIV prevalence seen in gay and bisexual IDUs was due to sexual transmission of the virus. However, the higher rate of hepatitis C is largely attributed to sharing injecting equipment. The study showed that gay and bisexual men were significantly more likely to report unsafe injecting practices than heterosexual men. Studies conducted in the US and Brazil have previously shown higher prevalence of HIV and hepatitis C in gay and bisexual men who inject drugs compared to heterosexual male IDUs. Investigators wished to see if this was also the case in the UK. They therefore analysed data from national surveys of injecting drug users conducted between 1998 and 2007 in England, Wales and Northern Ireland. To be included in the current analysis, people had to be aged between 15 and 60 years and to have both had sex and injected drugs in the previous twelve months. Prevalence of HIV and hepatitis C in the participants was determined using anonymous oral antibody tests. Participants also completed a brief questionnaire covering demographic information and sexual and drug use risk behaviours. A total of 8671 male injecting drug users were included in the study. Overall, prevalence of HIV was 1%; 33% of participants were infected with hepatitis C. Just over half the participants (53%) reported ever having had an HIV test. A large proportion of people with HIV (39%) were unaware they were infected with the virus. The prevalence of both infections was significantly higher in London compared to other regions. Sex with another man in the preceding twelve months was reported by 4% of men. This proportion was unchanged over the ten years of the study. Most of the men who reported sex with men also reported sex with women (79%). Prevalence of HIV infection was significantly higher in gay and bisexual men than heterosexual men (3.2 vs 0.79%; p < 0.001). Gay and bisexual men also had a higher prevalence of hepatitis C virus infection (43 vs 32%; p < 0.001). The prevalence of co-infection was slightly higher in gay and bisexual men, but not significantly so (0.63 vs 0.48%). Higher-risk sex was reported by three-quarters of gay and bisexual injecting drug users compared to 40% of heterosexual IDUs. Sharing of injecting equipment was also more common among gay and bisexual men than heterosexual men (38 vs 27%; p < 0.001). Gay and bisexual men and heterosexual men were of a comparable age (approximately 29 years) and had been injecting drugs for a similar length of time (seven years). For the full article, click here. Antiretroviral
therapy may be stabilising HIV epidemic in Danish gay men The use of antiretroviral treatment appears to have stabilised the HIV epidemic in Danish gay men, even though rates of risky sex have increased, research published in the online edition of the Journal of Acquired Immune Deficiency Syndromes suggests. “While unsafe sex among MSM [men who have sex with men] has increased substantially and the number of HIV-positive MSM living in Denmark has enlarged, the incidence of HIV diagnoses in this population has remained stable for more than a decade,” write the authors. “Our findings indicate that this paradox is due to effective antiretroviral therapy and not increased awareness of safe sex.” The investigators believe that the HIV epidemic in Danish gay men is being sustained by undiagnosed people and diagnosed people who are not yet on antiretroviral therapy. There is growing interest in the use of HIV treatment as prevention. Studies conducted in heterosexual people show that the risk of sexual transmission of the virus is negligible if a patient is on HIV treatment and has an undetectable viral load. Data showing the impact of antiretroviral therapy on the HIV epidemic in gay and other MSM are largely lacking. However, investigators in Denmark hypothesised that antiretroviral therapy was indeed preventing new infections in gay men. They examined three data sources to see if this was indeed the case. These sources provided information on: HIV prevalence and the number of new diagnoses; the sexual risk behaviour of gay men; and the incidence of syphilis. Between 1995 and 2009, there was a median of 93 new HIV diagnoses in gay men per year. There was evidence of a modest decline in new diagnoses in the late 1990s, followed by a vague increase until 2005, when the number of new diagnoses stabilised. Other surveillance data showed that the number of undiagnosed infections in the country remained largely unchanged at approximately 500 people. During the period of the study, there was a 75% increase in the number of HIV-positive gay men who were alive and living in Denmark from 1035 in 1995 to 1813 in 2010. Over the same period, the number of HIV-positive gay men with a viral load above 400 copies/ml fell from 1035 to 262. For the full article, click here. Nevada
Gov. Brian Sandoval Seeks Dismissal Of Gay Marriage Ban Challenge The administration of Nevada Governor Brian Sandoval has asked a federal court to dismiss a challenge to Nevada's constitutional amendment banning gay marriage in the state. Responding to a lawsuit filed in April by legal group Lambda Legal on behalf of eight gay couples challenging the constitutionality of Nevada's 2002 voter-approved amendment, Sandoval said the states, not the federal government, get to decide on marriage. “[T]he central question involved – the definition of marriage – is peculiarly and traditionally the right of states to define,” Wayne Howle, solicitor general in the state attorney general's office, stated in a written response. The suit's lead plaintiffs, Beverly Sevcik, 73, and Mary Baranovich, 76, of Carson City, have been together nearly 41 years, raised 3 children and have 4 grandchildren. “We've seen each other through thick and thin, in sickness and in health,” Sevcik said in a statement. “After four decades of sharing a life together, all we want is to show our love for each other as other couples do, through marriage.” Lambda Legal staff attorney Tara Borelli said Nevada's 2009 domestic partnership law conflicts with the argument that gay couples do not qualify for marriage. “Nevada's prohibition on marriage for same-sex couples serves no legitimate state interest, a fact the state even acknowledged by creating a parallel, but less respected, legal status of registered domestic partners,” Borelli said. “The ban on marriage equality brands these loving couples and their children as second-class citizens, and encourages private bias and discrimination.” The case, Sevcik v. Sandoval, represents a strategic legal shift for the legal group which in 2009 warned the American Foundation for Equal Rights (AFER) against pursuing litigation in federal court, saying a loss in the U.S. Supreme Court would set back the marriage equality movement. AFER, which has won two rounds in its legal battle to have California's gay marriage ban, Proposition 8, declared unconstitutional, is now supporting Lambda Legal in its case with a $25,000 contribution to the plaintiffs' legal fund. Clandestine
Gay Rights Rally in Tehran
So it was an act of special significance when a small group of young people gathered in a hilly park overlooking Tehran to show, for a few brief but public moments, their support for Iranian gay rights. It was far from the biggest LGBT rights rally on May 17, the International Day Against Homophobia commemorating the World Health Organization's 1990 decision to remove homosexuality from its catalog of mental diseases, but it carried its own significance. Though the gathering appears to have been small and brief, the young activists photographed the subversive displays, posting the photos to public social media site Joopea, which has a number of Farsi pages. The photos are reproduced above, showing the rainbow flag waving over Tehran, activists holding a sign reading "no to homophobia" on the metro, and rainbow-colored balloons floating through the skyline. For the full story, click here. International
Day Against Homophobia and Transphobia marked globally Governments, organisations and individuals around the world have been marking this year’s International Day Against Homophobia and Transphobia today. IDAHO falls on 17 May each year on the anniversary of the World Health Organisation’s decision decategorise homosexuality as a mental disorder. The organisation points out that 1.5 billion people globally still live under regimes which criminalise gay relationships. Rainbow balloons are being released today in Russia, Estonia, Ukraine, Germany and Iran, IDAHO organisers said. Last year, events taking a stand against homophobia were held in seventy countries. This year, IDAHO coordinators say activists in 95 countries around the world have planned some form of event. Equalities Minister Lynne Featherstone said: “Today is an opportunity to celebrate how much progress has been made in changing attitudes towards LGB&T people. “In the UK, we are continuing to remove barriers and tackle prejudice – by toughening hate crime laws, campaigning to eradicate homophobia and transphobia in sport, supporting action against bullying in schools, and through our current consultation on how to implement equal civil marriage. “However, today it is also important to reflect on the challenges we still face, at home and abroad. We are continuing to drive change across government through our LGB&T action plan as well as pushing for more action from partners overseas.” Location-sensitive networking app Grindr said it was sending a message to its global user database asking them to add the word IDAHO to their profile. Jessica Stern, Acting Executive Director of the International Gay and Lesbian Human Rights Commission said it was marking three key advances in South America. For the full article, click here. US
regulators set to approve HIV home-testing kit HIV home testing is soon likely to become legal in the United States, following a unanimous vote in support of the OraQuick In-Home HIV Test by a panel of experts advising the Food and Drug Administration (FDA). The test that may be made available over-the-counter is designed to be used at home, without medical supervision. A sample is taken by swabbing an absorbent pad around the outer gums, adjacent to the teeth; the results are given in twenty minutes. The 17 members of the Blood Products Advisory Committee (BPAC) voted unanimously that the benefits of the test outweigh its potential risks for consumers. While the test is not as accurate as professionally-administered tests, the panel felt it could provide an important way to make HIV testing available to more people. The FDA is not bound to follow the recommendations of its advisory committees, but usually does so. This would be the first complete home-based screening test for any infectious disease available for purchase from US pharmacies and internet retailers. The panel heard overwhelmingly supportive public testimony from more than two dozen witnesses including HIV activists, black community representatives and public health experts. Home testing While this would be the first legal home-testing kit in the US, home sampling for HIV antibody testing is already legal there. When using a home-sampling kit, the individual takes an oral fluid or blood sample in their own home and mails it to a laboratory, which will make the results available online or by phone. With home-testing kits (as with a pregnancy test), the individual takes a sample and interprets their results on their own. Until now, only home-sampling tests have been legally available in the US and UK. The OraSure company has adapted its OraQuick Advance test for use by individuals who do not have medical training. Whereas the professional version can test either oral fluid or a fingerprick blood sample, the OraQuick In-Home HIV Test is only for testing oral fluid. However a recent meta-analysis found that the professional-administered OraQuick test had slightly poorer performance when testing oral fluid samples than when testing blood samples. In particular, the test’s sensitivity was slightly lower than ideal. The home test kits come with detailed instructions and links to free telephone support. Whereas the professional kits are sold for less than $20, the home version is likely to be more expensive, but no more than $60. For the full article, click here. US
advisory panel recommends Truvada drug be marketed for HIV prevention An FDA panel in the US has approved the administration of the drug Truvada to at-risk but uninfected people in an effort to prevent the spread of HIV, though experts warn condoms must remain the ‘bedrock’ of such efforts. The technique for which the drug would be marketed, known as Pre-Exposure Prophylaxis or PrEP, uses antiretroviral drugs to decrease the likelihood of HIV infection in people who come into contact with the virus. The FDA’s Antiviral Drugs Advisory Committee voted 19 to 3 in favour of allowing doctors to prescribe Truvada for this purpose to men who have sex with multiple male partners. The committee also voted for it to be prescribed to the partners of HIV-positive people and other groups after a day of public comment and debate. The Food and Drug Administration usually adopts the decisions made by its panels of experts. Truvada, a mixture of tenofovir and emtricitabine, can currently be administered to people living with HIV and used for prevention, but if the FDA adopts the recommendation, it could be marketed as a preventative measure. The use of the drug in prevention efforts has prompted debate over whether at-risk people would consistently take a daily pill and if it could produce a drug-resistant strain of HIV. The Washington Post said the senior vice president of the Gilead drugs company, which manufactures Truvada, told the committee it should be added to the “existing toolbox” of prevention efforts. The AIDS Healthcare Foundation opposed the drug’s approval for prevention purposes. Joey Terrill, the Foundation’s Domestic Advocacy Manager told the committee gay men he spoke with believed the drug would mean they would no longer need to wear condoms. Mitchell Warren, executive director of the Aids Vaccine Advocacy Coalition said the panel’s recommendation “brings us closer to a watershed for global HIV prevention efforts”. He added: “PrEP, while not a panacea, will be an essential additional part to the world’s success in ending AIDS. For the millions of men and women who remain at risk for HIV worldwide, each new HIV prevention option offers additional hope that we will achieve the end of the epidemic.” Sir Nick Partridge, Chief Executive of Terrence Higgins Trust, said: “We have to take every new opportunity to improve the effectiveness of HIV prevention and slow the spread of this epidemic. “There is no single method of prevention that can on its own stop the transmission of HIV. Adding Truvada to our existing range of prevention programmes, including safer sex campaigns, using condoms and regular testing for HIV is an exciting prospect. “But we need to know if people at highest risk of infection are prepared to take a pill every day and whether there would be an increase in risk-taking behaviour which could outweigh the prevention effectiveness of Truvada.” He added: “Whatever happens, condoms will continue to be the bedrock of HIV prevention as the easiest, cheapest and most effective way to stop HIV. If you’re worried that you’ve been at risk, get tested and look after your health.” A clinical trial called PROUD, Pre-exposure Option for Preventing HIV in the UK, will begin to examine the efficacy of such a daily pill regimen in the UK this autumn. The trial is a collaboration between the Medical Research Council and the Health Protection Agency. HISTORIC:
Obama Announces Support for Marriage Equality President Barack Obama has officially evolved. Amid rampant Beltway speculation and growing calls for an unequivocal position on marriage from LGBT groups and the national media, President Obama said in a Wednesday interview with ABC News’ Robin Roberts, "It is important for me to go ahead and affirm that I think same-sex couples should be able to get married." The president's decision, he explained, stemmed from his own experience with gay staff in committed relationships as well as the continued discrimination against gay service members, who can now serve openly in the military following repeal of “don’t ask, don’t tell” but are denied the same basic equal rights as their heterosexual counterparts. “I’ve stood on the side of broader equality I hesitated on gay marriage in part because I thought civil unions would be sufficient,” the president said. “But I have to tell you that over the course of several years, as I have talked to friends and family and neighbors when I think about members of my own staff who are in incredibly committed monogamous relationships, same-sex relationships, who are raising kids together, when I think about those soldiers or airmen or marines or sailors who are out there fighting on my behalf and yet feel constrained, even now that 'don't ask, don't tell' is gone, because they are not able to commit themselves in a marriage, at a certain point I’ve just concluded that for me personally it is important for me to go ahead and affirm that I think same-sex couples should be able to get married,” Obama said. Obama's conclusion in favor of marriage equality also reflected a generational shift that cuts across party lines, he explained. "When I go to college campuses, sometimes I talk with college Republicans who think that I have terrible policies on the economy or on foreign policy but are very clear that when it comes to same-sex equality, or sexual orientation, that they believe in equality," the president said. "They’re much more comfortable with it." The groundbreaking comments mark the first time that a sitting president has publicly voiced support for same-sex marriage, and come just three days after Vice President Joe Biden said in an interview with NBC that he supports such rights for gay and lesbian couples. “I am absolutely comfortable with the fact that men marrying men, women marrying women, and heterosexual men and women marrying another are entitled to the same exact rights, all the civil rights, all the civil liberties,” Biden said. Biden’s comments and the intense media speculation they unleashed perhaps left little room for Obama’s continued evolution on the matter, precipitating Wednesday’s interview with ABC that described by some as “hastily arranged.” Though Wednesday's presidential interview may have no immediate impact on the actual state landscape of marriage rights, the presidential imprint on the freedom to marry is perhaps incalculable in its historic significance, and adds symbolic weight to the administration's 2011 decision to cease legal defense of the Defense of Marriage Act, the antigay 1996 law that denies federal recognition of same-sex marriages and bars couples from a multitude of rights and responsibilities as a result. “It was time, and I’m glad he did it," Congressman Barney Frank said Wednesday of the president. “I almost forgot that he hadn’t formally said it. The big breakthrough was when he said that he wasn’t going to defend DOMA." Several national polls show a clear trend for marriage equality support — a recent Gallup poll showed 50% of Americans favor same-sex marriage, for instance, with previous polls as high as 53% in support. But it’s unclear how the president’s position will affect his reelection bid, particularly in critical swing states, including North Carolina, which passed the antigay Amendment One by an overwhelming margin Tuesday. In a statement released shortly after the president’s remarks were aired, Human Rights Campaign president Joe Solmonese said, “Today, President Obama made history by boldly stating that gay and lesbian Americans should be fully and equally part of the fabric of American society and that our families deserve nothing less than the equal respect and recognition that comes through marriage. His presidency has shown that our nation can move beyond its shameful history of discrimination and injustice. In him, millions of young Americans have seen that their futures will not be limited by what makes them different.” Chad Griffin, who will take Solmonese’s place at the LGBT organization next month, said that Obama’s marriage equality endorsement “will be celebrated by generations to come.” But on the campaign trail earlier today, presumptive GOP presidential candidate Mitt Romney drew sharp divisions between his position and that of the president, telling a local Fox News affiliate in an interview, “I do not favor marriage between people of the same gender, and I do not favor civil unions if they are identical to marriage other than by name. My view is the domestic partnership benefits, hospital visitation rights, and the like are appropriate, but that the others are not.” Following the president's remarks, Romney weighed in further at an Oklahoma Republican Party event with Gov. Mary Fallin, reiterating his anti-marriage equality position. "I know other people have differing views — this is a very tender and sensitive topic, as are many social issues. But I have the same view that I’ve had since, well, since running for office," Romney said. The topic wasn't so tender at the annual Conservative Political Action Conference in February, where Romney quipped that his "severely conservative" record as governor of Massachuetts prevented the state "from becoming the Las Vegas of gay marriage.” As an onslaught of press releases from public officials flew throughout the course of the afternoon, Republican National Committee chairman Reince Priebus also drew contrasts between the GOP and Obama on Wednesday afternoon, asserting that the White House announcement was nothing more than cynical politics. "While President Obama has played politics on this issue, the Republican Party and our presumptive nominee Mitt Romney have been clear. We support maintaining marriage between one man and one woman and would oppose any attempts to change that." On Monday, Education secretary Arne Duncan joined Biden in publicly supporting marriage equality. Another cabinet official, HUD secretary Shaun Donovan, voiced his personal support for same-sex marriage last fall, while other cabinet members have avoided comment on the subject. Minutes before the ABC interview was to begin, Sen. Joseph Lieberman, when asked by MSNBC’s Andrea Mitchell about the president’s position, said, “If he’s going to endorse [marriage equality], I respect him for having the guts to say what he believes.” Obama’s confusing position on the issue, where he has opposed state initiatives to ban gay marriage yet evaded stating his own beliefs for some time, had drawn increasing fire from both sides of the aisle. Some Republicans have slammed the president for what they see as a cynical equivocation on the issue and sought to equate his position with that of Mitt Romney. That framing is patently false, Obama supporters charged back, given Romney supports a federal marriage amendment barring equality and would uphold DOMA. Obama first explained his position to AmericaBlog’s Joe Sudbay in October 2010. Two months later he said in a White House news conference on the subject, “My feelings about this are constantly evolving. I struggle with this. I have friends, I have people who work for me who are in powerful, strong, long-lasting gay or lesbian unions. And they are extraordinary people. And this is something that means a lot to them and they care deeply about.” Previously, the president said that he was in favor of civil unions, but not marriage, though in a 1996 questionnaire while running for state Senate in Illinois, Obama said he would favor legalization of same-sex marriages. President Obama visits Los Angeles on a campaign swing Thursday, one that will include a mega-fund-raiser hosted by George Clooney that will be attended by national marriage equality supporters including director Rob Reiner, a board member of the American Foundation for Equal Rights, which organized the federal lawsuit against California’s Proposition 8. Gay
partners' HIV transmission study due to start, despite practical barriers A large study looking at HIV infections in gay men who are within long-term relationships with HIV-positive partners is about to start in Australia, the International Microbicides Conference in Sydney heard today. This Opposites Attract study will look at the risk of HIV acquisition by the HIV-negative parter within different-status relationships and hopes to make an estimate of the comparative risks of HIV transmission from HIV-positive partners who are, and are not, on antiretroviral therapy (ART). Initially starting in Sydney, Melbourne, Brisbane and Adelaide, it is planned that the study will expand to other Australian cities and to Thailand. Calculations of study size and expected loss to follow-up are being informed by findings from a large study of HIV risk in gay male relationships, the HIM study (Bavinton). Background The need for a study of HIV transmission risk and the influence of viral suppression in gay men has existed ever since the Swiss Statement in 2008. This said that within certain parameters people with an undetectable viral load could not sexually transmit HIV, but the authors later emphasised that evidence for this was only strong in studies of vaginal sex. The need for further evidence became stronger when the HPTN 052 study found that treating the HIV-positive partner in heterosexual different-status relationships reduced their chance of transmitting HIV by 96%. Since then both the British HIV Association and the US Department for Health and Human Services have recommended ART for prevention purposes in some patients, but both emphasise that the assumption that this will work for gay men is an extrapolation of the data for heterosexuals, and another study recently found that up to a quarter of gay men with no detectable HIV in their blood may have detectable levels in semen. A study looking at whether treatment works as prevention is thus badly needed in gay men. While a randomised controlled study of immediate versus delayed treatment like HPTN 052 will be difficult to do in the future, given changes in the criteria of ART initiation, an observational study of risk within different-status relationships could be done. The challenge, however, will be that gay male relationships are less likely to be monogamous, and HIV more likely to be transmitted during casual sex, than in heterosexuals. A study was therefore undertaken of different-status and same-status gay male relationships to assess whether a transmission study would be feasible. The HIM Study findings The Health in Men (HIM) study is a cohort of 1427 initially HIV-negative gay men recruited in 2001 to 2004 to look at risk factors for HIV, which has provided useful data on risk behaviours in other studies. In this study, an analysis was done of data originally collected in 2007. HIM subjects completed annual interviews and were asked whether they were in a primary relationship, how long it had lasted, whether their partner had HIV and, if so, whether the subject knew their viral load. Characteristics of different-status and same-status relationships were collected. Two-thirds of HIM subjects reported being in a primary relationship of which 8.4% (79 individuals) reported that their partner had HIV. This is roughly the same as the proportion of gay men estimated to have HIV in New South Wales (see Prestage). Another 21% of the subjects, however, reported that they did not know their partner's HIV status. Within the 79 different-status partnerships, two-thirds of HIV-negative men knew their partner's HIV viral load, and 58% said it was undetectable. In terms of contrast between different-status and same-status relationships, some factors were similar, such as age of the HIM subject and their partner, the length of the relationship (roughly 50% had lasted longer than two years) and whether sex was permitted with people outside the relationship. The rate of relationship breakup was similar too: each year, 29% of different-status relationships and 26% of same-status relationships broke up. Different-status relationships were less likely to break up if they had been going for more than two years, if the HIM subject was over 44, and if the relationship involved 'serospositioning' (i.e. the HIV-negative partner was only ever 'top' if they had sex without a condom). Other things were different, though. HIM subjects in different-status relationships were more likely than other subjects to report having sex outside the relationship, having unprotected sex with casual partners, and having tested for HIV in the last three months, and were 2.5 times more likely to report that they were in an open relationship. Conversely, they were less likely to report having unprotected sex within the relationship, to have 'negotiated safety' agreements about no condomless sex outside the relationship, and to be the receptive partner. There were eight new HIV infections in the 79 men in different-status relationships during the average 3.9 years of follow-up. HIV incidence among men in different-status relationships was 2.2% a year and 0.7% in same-status relationships (hazard ratio: 3.12). HIV acquisition was three times more likely if the HIM subject had been 'bottom' with their partner in unprotected sex, and over 15 times more likely if their partner had ejaculated inside them. HIV transmission was six times more likely to occur within the first year of a relationship than after that point and was 4.7 times more likely if the HIM subject was under 35 than if they were over 44. Conclusions Presenter Benjamin Bavinton said that these findings posed challenges for the designers of the forthcoming Opposites Attract study. Firstly, the high break-up rate meant that recruitment had to be ongoing throughout the relationship in order to replace attrition due to break-ups. Secondly, high rates of sex outside the primary relationship meant that phylogenetic testing of all HIV infections was essential to establish which were transmissions from the primary partner (results would not be released to participants). Thirdly, Australian criminal law meant that sexual risk behaviour data could only be collected from HIV-negative participants. Fourthly, because infection was so much more common in the first year of relationships, men in new, tentative and not necessarily committed relationships would have to be recruited. And finally, most of the blood tests would have to be done with the initially HIV-negative partner, including when the relationship might have just broken up or just after they had received the news that they had acquired HIV: retention in these circumstances might be a big problem. Nonetheless, recruitment is about to start: for would-be subjects and professionals interested in the study, there is more information at www.oppositesattract.net.au. References Bavinton B et al. Exploring gay men’s serodiscordant relationships: Implications for future ‘treatment as prevention’ studies in gay men. International Microbicides Conference, Sydney, 2012. See here for programme. Prestage G et al. Homosexual men in Australia: population, distribution and HIV prevalence. Sexual Health 5(2):97–102, 2008. Hepatitis
C infections now twice as likely in HIV+ gay men as in injecting drug
users, Swiss study finds The annual incidence of hepatitis C infection in gay men with HIV is now nearly twice that seen in HIV-positive injecting drug users, according to a Swiss study. Hepatitis C infections started increasing substantially from 2005 onwards, the study finds, and there is an accelerating trend, with a particularly large increase in infections in the last year. The Swiss HIV Cohort Study (SHCS) of the largest and most complete cohorts of HIV patients in the world; it includes the majority of HIV-positive people in Switzerland. Annual tests for hepatitis C became routine in 1998. This survey looked at 6534 patients who were hepatitis C negative at the point they entered the SHCS and who have had at least one other hepatitis C test since then. In terms of the original route-of-exposure group they belonged to when diagnosed with HIV, 3333 patients (51%) were gay men, 3078 (47%) were heterosexual and 123 (2%) were injecting drug users. For the sake of clarity, patients who were both gay and IDU were excluded from the study, as were heterosexuals who started infecting drugs after HIV diagnosis. Since 1998 there were 167 new cases of hepatitis C infection of which 101 (60%) were in gay men. But half of the cases in gay men happened since 2009; in the last three years 51 out of 65 new cases of hepatitis C (78%) were in gay men. Incidence rates have changed dramatically since 1998. In that year the annual incidence of hepatitis C in HIV-positive injecting drug users was 13.9% and it fell to 2.2% a year in 2001. In contrast annual hep C incidence in gay men was just 0.2% a year in 1998 and is now 4.1%, an 18-fold increase. There has also been a less dramatic increase in non-injecting heterosexuals: hepatitis C incidence was under 0.1% a year in 1998 and is now about 0.8%. In multivariate analysis, three risk factors stood out in gay men, each roughly doubling the risk of hepatitis C infection: inconsistent condom use, a past history of syphilis, and being already infected with hepatitis B. “These observations underscore the need for improved HCV surveillance and prevention among HIV-infected men who have sex with men,” comment the researchers. Reference Wandeler G et al. Hepatitis C incidence in the Swiss HIV Cohort Study: a changing epidemic. Nineteenth Conference on Retroviruses and Opportunistic Infections, Seattle. Abstract 743. 2012. Catholic
bishops bless gay marriage rollback The two bishops of the Catholic Archdiocese of Seattle, in a letter to the faithful, say they will deploy parishes to collect signatures for Referendum 74, a measure for the November ballot designed to roll back same-sex marriage in Washington. While asking that signatures not be collected on Easter Sunday, the bishops described the issue as “critically important” and said information on the signature drive is being sent to pastors throughout the Western Washington diocese. The letter is signed by Archbishop J. Peter Sartain and Auxiliary Bishop Eusebio Elizondo. Sartain testified against marriage equality at a Washington State Senate hearing earlier this year. In their letter, the bishops specifically deny that refusing marriage to same-sex couples equates to discrimination — an argument made by Gov. Christine Gregoire, a Catholic, in arguing for marriage equality. “Treating different things differently is not unjust discrimination,” the bishops claim. “Marriage can only be between a man and a woman because of its unique ends, purpose and place in society. The word ‘marriage’ isn’t simply a label that can be attached to different types of relationships. “Instead ‘marriage’ reflects a deep reality — the reality of the unique, fruitful, lifelong union that is only possible between a man and a woman. There is nothing else like it, and it can’t be defined or made into something that it isn’t.” State Sen. Ed Murray, D-Seattle, a Catholic and long-partnered gay man who sponsored the same-sex marriage bill, described the bishops’ deployment of parishes to gather signatures as “fairly reprehensible.” “To use church resources, in advancing a measure that promotes discrimination, is incredibly disappointing,” Murray said. “As a gay person, and a Catholic, I can understand their refusal to perform (gay) marriages. Using the church in promoting a referendum . . . is very disappointing.” The bishops noted that, under the state’s domestic partnership law (which the Catholic Church lobbied against), same sex couples “already enjoy the rights and privileges of married couples.” Anne Levison, a former judge and co-owner of the Seattle Storm, and leader in the marriage equality campaign, responded that the bishops’ letter is a case of clerical error. “OF all institutions, the Church should understand why domestic partnerships can’t replace marriage,” said Levinson. “Marriage is so much more than a collection of legal rights. The essence of marriage remains the same whether the two people are straight or gay or lesbians: Two people affirming their love and commitment to each other.” Many
men with undetectable HIV in blood still have low levels in their semen,
studies find A study of 101 gay men at the Fenway Health HIV clinic in Boston, USA (Politch) has found that a quarter of men with undetectable viral loads in their blood nonetheless had detectable HIV in their semen. Although seminal viral load in these men was low (median 200 copies/ml), the researchers suggest that this is still enough to be one of the explanations for ongoing transmission in gay men despite a high proportion being on antiretroviral therapy. There was a very strong association with detectable HIV in semen and having a current sexually transmitted infection (STI). Six of the eight men whose HIV was undetectable in blood but detectable in semen (so-called virally discordant) had a urethral STI. After adjusting for other factors the researchers concluded that men who had an STI and/or urethritis were 29 times more likely to have viral discordancy. A quarter of ‘undetectable’ gay men have HIV in semen... In the Boston study, participants were on average 43 years old and three-quarters were white. They had all been on antiretroviral therapy (ART) for more than three months and 80% for over a year. Nearly three-quarters were judged as being at high risk of acquiring an STI because they had had unprotected sex in the last three months. Nine of the men were diagnosed with an STI (gonorrhoea, syphilis, chlamydia or non-gonococcal urethritis) and 24 had leukocytospermia or white cells from the immune system in the sperm, indicative of urethral inflammation. Eighteen of the 101 men had a detectable viral load in their blood; their median blood plasma viral load was 560 copies/ml and ranged from 80 to 640,000 copies/ml. Nine of these 18 men also had detectable HIV in their semen (50%). Of the 83 men without detectable HIV in their blood, 21 (25%) had detectable HIV in their semen. The median seminal viral load in these men was 200 copies/ml and ranges from 80 to 2560 copies/ml. As well as having an STI, in multivariate analysis, two other factors remained strongly associated with having detectable HIV in semen in men without it in blood. High levels of the inflammatory cytokine TNF-a were associated with a 14-fold greater risk of a discordant seminal viral load, and having had unprotected insertive anal sex (being ‘top’), which was associated with a more than sevenfold greater risk. There were therefore in this study low but detectable levels of HIV in the semen of a quarter of men who would register as being virologically suppressed on a viral load blood test. To what extent might this be contributing to ongoing HIV transmission in gay men? This is unknown, but the researchers point out that although a viral load below 1000 had rarely been associated with transmission in heterosexual studies, some infections have occurred and animal models suggest that HIV is five times more transmissible via anal than vaginal sex – so a median viral load of 200 would imply a low but definite risk of transmission. A 2008 study from San Francisco (Butler) found that the median seminal viral load in men transmitting HIV to partners was just 4300 copies/ml and the lowest was 110 copies/ml, while a 2009 study from Brighton in the UK (Fisher) that linked HIV infections in gay men genetically found that two out of 41 transmissions of HIV (5%) were from men with an apparently undetectable viral load. However, studies of the link between viral load and transmission suffer from it being difficult to pin down transmitters in a cohort of gay men with multiple partners and where viral load may be measured months after the transmission (in the Butler study, the average gap between transmission and viral load test was 103 days). One interesting aspect of this study was the higher risk of seminal viral load associated with unprotective insertive sex. The researchers suggest that urethritis in these HIV-positive gay men could be caused by infections with fecal bacteria acquired during sex or even that the virus detected could be passively carried virus from other HIV-positive gay men. Either way, this would tend to increase the infectiousness of HIV-positive men if they have insertive sex with negative men. For the full article, click here. Australia:
Poor mental health among LGBT people Almost 80 per cent of LGBT Australians have suffered from intense anxiety in the past year alone, according to a new survey released today. More than 4000 people, between ages 16 and 89, who self-identified as gay, lesbian, bisexual or transgender were surveyed in a study organised by La Trobe University and Gay and Lesbian Health Victoria. Almost half of the respondents said they hid their sexuality or gender identity in a range of situations, fearing violence and discrimination. In addition, while three in four participants had a regular GP, less than 70 per cent were open about it with their practitioners. Liam Leonard, a research fellow at La Trobe said this study clearly showed that LGBT Australians suffered poorer mental health than the population at large. “The most common health conditions among participants were depression and anxiety/nervous disorders,” he added. The full study and its results — supported by a national depression initiative ‘beyondblue,’ the university and the government of Victoria — will be unveiled tomorrow by the state’s Mental Health Minister Mary Wooldridge, and beyondblue’s chairman, Jeff Kennett. New
US treatment guidelines recommend antiretroviral treatment for all people
with HIV Newly updated US antiretroviral treatment guidelines are recommending antiretroviral treatment for all people with HIV infection, with particular emphasis on treatment for: people with CD4 cell counts below 500; anyone at risk of transmitting HIV to partners; pregnant women; and people with hepatitis B co-infection or HIV-related kidney disease. The new recommendations strengthen previous US recommendations on when to start treatment, which recommended initiating treatment at CD4 cell counts between 350 and 500 cells/mm3. The 2009 guidelines panel was, however, divided as to the strength of this recommendation: based on available evidence, 55% of the panel considered it a 'strong' recommendation and 45% 'moderate'. The new Department of Health and Human Services (DHHS) guidelines state that “antiretroviral therapy is recommended for all HIV-infected individuals”. In support of this recommendation, the new guidelines cite a range of evidence showing associations between viral replication and increased risk of illness and death in people with HIV, but do not discuss the absolute reduction in risk that might be associated with earlier treatment, nor the number of people who would need to receive treatment in order to prevent one new death or event in a year. In contrast, recently issued draft British HIV Association treatment guidelines continue to recommend treatment when the CD4 cell count falls below 350 cells, although treatment may be started earlier in people with hepatitis B or by people concerned about the risk of transmitting HIV to partners. British guidelines also recommend earlier treatment where a number of other conditions are present. The new US guidelines draw attention to data from two large cohort studies which show that any degree of uncontrolled viral replication above 500 copies/ml, and the duration of uncontrolled viral replication, are each associated with a higher risk of death. The guidelines also note an association between HIV infection, immunosuppression and an increased risk of cardiovascular disease and of malignancies. They highlight the fact that older patients consistently have poorer CD4 cell responses after starting treatment, and suggest that starting treatment earlier may result in better CD4 cell responses to treatment. In common with new recommendations in the British HIV Association guidelines, the US guidelines also discuss the new evidence from the HPTN 052 study showing that HIV treatment greatly reduces the risk of HIV transmission. This information should be discussed with all patients, the US guidelines recommend, and antiretroviral therapy should be offered to all patients at risk of transmitting HIV to their partners. Note: This article has been amended since it was first published on March 29 after a discrepancy between between the .pdf version of the March 2012 guidelines and the HTML version of the March 2012 guidelines posted to aidsinfo.nih.gov was drawn to our attention. The erroneous information, suggesting that expert opinion was evenly divided regarding antirtetroviral treatment initiation in people with CD4 counts above 500 in the March 2012 guidelines, has been corrected here and on aidsinfo.nih.gov. Serosorting
does help prevent HIV – up to a point An meta-analysis of HIV-negative gay men’s sexual behaviour and HIV incidence rate in four HIV prevention studies, presented aerlier this month at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) has found that attempting to ‘serosort’ by restricting unprotected sex to partners known to be HIV-negative does have efficacy as an HIV prevention strategy when compared with having none at all. Serosorting is, however, considerably less effective in reducing the chances of having HIV compared to other strategies such as monogamy, only having insertive sex, or ‘seropositioning’ (only taking the bottom role with partners known not to have HIV and being top with partners of positive or unknown status). ‘Seroadaptive’ behaviours include any method of attempting to reduce the risk of HIV acquisition or transmission by altering one’s sexual behaviour according to the HIV status of partners. The term ‘serosorting’ has been used in various different ways. Most commonly it means restricting unprotected anal sex to partners known to have the same HIV status as yourself. When unprotected sex between HIV-negative men is confined to a primary relationship, with condoms use in all other encounters, this has been called ‘negotiated safety’. While some studies have found serosorting in HIV-negative men to be effective, others have not. Attempted serosorting by HIV-negative people has an inherent drawback that serosorting by HIV-positive people lacks: people can only be certain of their status up to the first time they risk exposure to HIV after their last negative HIV test. Research indicates that a large minority of people in high-risk communities who assume they are HIV-negative in fact have HIV, and that a large proportion of men who ‘know’ their partner’s HIV status have in fact tried to guess it. For the full article, click here. Poll:
65 percent of British agree gays should have equal right to marry The latest in a line of polls gauging public opinion on the proposed right of gay couples to marry in Britain has found two thirds of the public support it. Over the weekend, the Populus poll asked a thousand voters in Scotland, England and Wales what they thought of such a move, proposals for which have been formally unveiled as part of a public consultation by the government for England and Wales today. The majority of those asked in the phone poll agreed with the statement: “Gay couples should have an equal right to get married, not just to have civil partnerships.” 65 percent agreed, 27 percent disagreed and 8 percent said they did not know. Support for the move was highest among women and those aged 18 to 34. The proportion for agreeement Scotland was 66 percent. 59 percent told Populus they agreed gay couples should have equal rights to adoption and while while three quarters thought gay couples should have “exactly the same rights” as straight couples, only 58 percent thought children should be taught in schools about gay relationships’ equal status. A questionable poll commissioned by Catholics Voices and conducted by ComRes was released last week. It appeared to show that 70 per cent of the public are opposed to same sex couples getting married. A full PinkNews analysis of the subject is here. Polls by ICM and YouGov released at the weekend found 45 percent and 43 percent support for equal marriage respectively. In the ICM poll, 36 percent opposed the move and the YouGov poll, 32 percent opted for civil partnerships and 15 percent thought gays should have no legal recognition. The coalition group Scotland for Marriage, a sister organisation to the Coalition for Marriage in England and Wales, will be running a series of adverts in the Scottish press today on their latest poll. In that poll, conducted by the Opinion Research Business, 53 percent agreed with the statement: “Since gay and lesbian couples already have the same rights as married couples available to them under civil partnership, they should not be allowed to redefine marriage for everyone else.” The question was described as “biased and misleading” by equal marriage advocates the Equality Network and was equally derided when the Coalition for Marriage used it in a ComRes poll to show support for their position earlier this year. UK:
THT’s myHIV site to let users find and recommend best HIV services The UK’s first service for people living with HIV that allows them to recommend healthcare providers to others and find recommended services themselves has been launched. The initiative by HIV and sexual health charity Terrence Higgins Trust and healthcare recommendation site iWantGreatCare will enable people living with HIV to find and recommend healthcare services that are sensitive to their needs. A 2008 study found that one in five people with HIV had experienced discrimination in the last year from GPs or other healthcare professionals. Terrence Higgins Trust’s partnership with iWantGreatCare creates the UK’s first patient-generated resource for people with HIV to share healthcare recommendations. It allows people coming through the charity’s interactive members’ website myHIV to submit confidential ratings and reviews recommending healthcare professionals, as well as the overall facilities. These detailed recommendations will then help others with HIV find the best local healthcare providers that have been directly endorsed by someone living with the condition. By registering on the myHIV website, people with HIV can also privately store health and treatment information, access online counselling and advice, and gain 24-hour community support. Among the questions users are asked are whether they trusted the doctor, whether he or she listened and whether they would recommend them. Garry Brough, Membership Officer for Terrence Higgins Trust, said: “Due to continuing high levels of stigma around HIV, people with the condition are often concerned about confidentiality and potential discrimination, even in healthcare settings. “Our collaboration with iWantGreatCare will finally allow people with HIV to find and recommend local services which are sensitive to their their needs, and signpost healthcare professionals who are already providing high-quality support to people with HIV.” Dr. Neil Bacon, founder and CEO of iWantGreatCare, said: “Finding a great doctor can make a huge difference to the lives of HIV patients. This partnership is a powerful way for people with HIV to directly benefit from others’ experiences and to find the very best care they can – whether that be finding a GP or a dentist. “The detailed information being submitted is highlighting excellent care, whist helping patients avoid services that have provided a poor experience to their peers. The partnership with the Terence Higgins Trust heralds a new way of sharing uniquely valuable information and harnessing the wisdom of patients to improve quality standards as well as openness in healthcare.” For more information, visit www.myhiv.org.uk. Superinfection:
second HIV infections happen as often as first ones Two studies of people with HIV in Rakai, Uganda and Mombasa, Kenya presented at the 19th Conference on Retroviruses and Opportunistic Infections show that the rate at which they acquired second, subsequent strains of HIV was about the same as the HIV incidence rate in the general population. This is called superinfection. It needs to be distinguished from dual infection, where a person acquires two different strains of HIV at the same time (this is quite common) and viral divergence, which is when a person acquires one strain of HIV but it diversifies into different strains during chronic infection because of ‘copying mistakes’ during replication, which happens in all untreated chronic infections. Superinfection is of particular interest to vaccine studies because it shows that HIV infection does not confer any general immune protection to infection with other HIV viruses, though some studies have shown that some people develop a degree of immunity to their partner’s specific virus. There has been little consensus on how often superinfection happens and, if it does, whether it has any consequences for the health of people living with HIV. The first cases of superinfection were detected because in individual cases something clinical did happen, usually a jump in viral load or drug failure because the second virus was a drug-resistant strain, and for a while such cases were used as a warning to HIV-positive people not to stop using condoms with HIV-positive partners. Until recently, however, we have not had the genetic equipment to show how common superinfection is, and therefore how common adverse consequences are. Superinfections in Rakai Andrew Redd of the National Institute of Allergies and Infectious Diseases collaborated with the researchers conducting the well-studied Rakai Cohort in Uganda to perform so-called ultra-deep sequencing, next-generation genetic tests on blood samples collected at different times from people with HIV. They were looking for evidence that the HIV in some people’s blood tended to cluster into two or more different strains that were dissimilar to each other and that only one strain had initially been there. Only if both of these requirements were satisfied could the person be considered to have had a superinfection. The tests picked up differences in the p24 core and the gp41 envelope proteins of HIV and could detect a virus that formed as little as 1% of the total viruses circulating in a person’s blood if they came from totally different viral subtypes, or 7% if they came from the same subtype but were genetically distinct. They tested blood samples from two different periods: ones taken at diagnosis between 1997 and 2002, and then one taken at least two years later, before people started antiretroviral therapy. These samples were taken between two and eleven years later. For the full article, click here. Will
treatment as prevention make a difference to the UK epidemic? Health promoters
respond Whereas in previous years, delegates at the CHAPS conference of gay men’s health promoters have demonstrated a certain scepticism with respect to ‘treatment as prevention’, the topic took centre stage in Bristol this week. At a panel discussion on the impact the approach will have in the UK, Cary James of the Terrence Higgins Trust and other speakers argued that treatment as prevention will be part of a combination prevention approach that will still promote condom use, other forms of safer sex and regular testing. Moreover treatment as prevention will amplify the benefits of the other interventions. However earlier in the day, Ford Hickson from Sigma Research had noted that while there are multiple ways in which individuals can reduce their risk of being involved in HIV transmission there has long been a tendency for people to strongly advocate the universal use of one method, to the exclusion of all others. While homophobes would like gay men to simply avoid having anal sex and various groups urge men to have fewer sexual partners, a great number of people see condoms as the sole answer. More recently, treatment as prevention and other biomedical interventions have sometimes been presented as magic bullets. Matthew Hodson of GMFA noted difficulties with condoms, including failure rates and the fact that many men find that they reduce intimacy, spontaneity and sensation. “Any alternative to condom use which doesn’t have those drawbacks and which has a similar or better impact on reducing the risk of transmission has got to be welcomed,” he said. But he warned of difficulties in communicating new HIV prevention messages. “Condoms have never been the sole HIV prevention activity but have become synonymous with ‘safer sex’,” he said. “Community attachment to the ‘use a condom every time’ message is immense and any agency which suggests alternatives or publicly questions whether condoms remain the best method for HIV prevention is going to face a truckload of criticism and accusations of betrayal. “A lot of the adjustments we have made to our HIV prevention messages over the years have been ignored, condemned, misrepresented or gone unnoticed,” he continued. “Any change in the message that we put out will take a long time to filter through to people who aren’t already engaged with information about HIV.” Cary James commented: “I’m not quite sure whether ‘treatment as prevention’ is the message or whether it’s just an added benefit that reinforces the work that we are already doing.” The social researcher Peter Keogh noted the distance that needs to be travelled between the compelling evidence of effectiveness and the routine use of treatment as prevention in the UK. Research on how it can be implemented in clinical settings is needed, he suggested, and clinicians may need resources to help them be most effective when engaging with their patients about their social and sexual lives. Cary James noted that treatment as prevention is bringing clinicians and community prevention groups together, and amplifies the role that sexual health clinics can play in HIV prevention. Matthew Hodson argued that communication around treatment as prevention will be more effective if those involved can come to a consensus on the core messages about the benefits of treatment, its impact on infectiousness and the role that condoms will continue to play. For the full article, click here. PrEP
needs more study before being provided, UK physicians conclude A position statement by the British HIV Association (BHIVA) and the British Association for Sexual Health and HIV (BASHH) has concluded that as yet the data on the efficacy of pre-exposure prophylaxis (PrEP) is not compelling enough for it to be offered to patients on demand, and that it should only be prescribed in the context of a clinical research study until more data on its efficacy is gathered. The BHIVA/BASHH position contrasts with that of the US Centers for Disease Control, which issued guidance for doctors prescribing PrEP to patients last year. The two UK organisations, which represent HIV and STI healthcare workers respectively, conducted a consultation on PrEP last year which included in-person and telephone conferences with a variety of UK treatment and prevention stakeholders in the UK (including NAM), and the creation of an ongoing PrEP Working eGroup. The finalised position statement notes that in 2010 there was the highest-ever number of new HIV infections in gay men in the UK (over 3000, 81% acquired here) and adds that this “continued increase in infections...underscores the urgent need to...rethink our overall strategy for HIV prevention at a time when the NHS is undergoing change.” It also however notes that the data on the efficacy of PrEP has so far been widely disparate (see Aidsmap reports on the iPrEx, PartnersPrEP, TDF2, FemPrEP and VOICE trials), in contrast to convincing evidence both for the efficacy of condoms when used consistently and correctly and of treatment as prevention. It also notes that these are many unanswered questions in the case of PrEP: will it be affordable and cost-effective? Will it increase the likelihood of drug resistance? Are there long-term toxicity concerns for HIV-negative people taking it? And will it induce people to abandon condom use? It also notes there has never been a systematic evaluation of behaviour-change programmes in the UK, also in contrast to the US. It concludes that “it is imperative to gather [more] evidence for the value of PrEP in the UK” and that therefore “We recommend that ad hoc prescribing is avoided, and that PrEP is only prescribed in the context of a clinical research study”. Until then, “regular HIV testing, the diagnosis and treatment of other STIs, and intensive health promotion activities...should be implemented in preference to PrEP.” Reference McCormack S, Fidler S, Fisher M. The British HIV Association/British Association for Sexual Health and HIV position statement on pre-exposure prophylaxis in the UK. International Journal of STDs and AIDS 23:1-4. DOI: 10.1258/ijsa.2100.051211. 2012. Gay-Marriage
Support in New Jersey Reaches High After Christie’s Bill Veto New Jersey (STONJ1) voters’ support for same- sex marriage reached a record high in the days after Republican Governor Chris Christie vetoed legislation to legalize the unions, a Quinnipiac University (78104MF) poll shows. Registered voters favor gay marriage 57 percent to 37 percent, according to the survey released today. They also approve, 67 percent to 28 percent, Christie’s proposal to put the matter on the November ballot, a plan rejected by Senate President Steve Sweeney and Assembly Speaker Sheila Oliver, leaders in the Democratic-controlled Legislature. “What’s left, for now anyway, is a political issue,” Maurice Carroll, director of the Quinnipiac University Polling Institute in Hamden, Connecticut, said in a statement. Seven U.S. states permit gay and lesbian partners the right to wed. In Maryland, Governor Martin O’Malley is set to sign a bill as soon as today that would make his state the eighth, alongside Washington, New York, Massachusetts, Connecticut, Iowa, New Hampshire and Vermont, plus the District of Columbia. The New Hampshire legislature is considering a repeal of that state’s two-year-old law. New Jersey lawmakers approved legalizing marriage for same- sex couples Feb. 16. Christie issued a conditional veto the next day. Referendum Option Christie, 49, who’s midway in his first term, has said he believes marriage should be limited to one man and one woman. When he suggested that voters decide the issue and said he would abide by the results, Sweeney rejected the option, saying civil- rights matters shouldn’t be left to popular opinion. Voters around the U.S. have rejected gay marriage in all 31 referendums involving the question. Pollsters surveyed 1,396 registered voters by telephone from Feb. 21-27. The results have a margin of error of plus or minus 2.6 percentage points. The findings showed the highest support for gay marriage in New Jersey among the six Quinnipiac polls on the issue since November 2006. The latest previous poll, in January, found 52 percent in support and 42 percent opposed. For the full article, click here. Gay
online encyclopaedia debuts WikiQueer, a gay, bi and trans online encyclopaedia has launched publicly this week. The wiki site began collating content after its soft-launch last year and has now gone live. Unlike Wikipedia, WikiQueer says it will allow dynamic content from existing online LGBT and wiki projects, content geared towards activism around issues, and in-depth information on the LGBT communities which may not presently meet Wikipedia’s notability standards. WikiQueer founder and lead administrator, Gregory Varnum said: “I felt drawn to the concept of presenting LGBT information via wikis for years. “Helping with dozens of pages and projects on Wikipedia and assisting with the development of specialized LGBT wiki projects fulfilled some of that. However, I consistently came back to the need for a truly comprehensive wiki by and for the LGBT communities, free of any community politics.” WikiQueer is backed by The Aequalitas Project, a nonprofit organization “serving as an incubator for new progressive programs”. Founder of POZ Magazine and inaugural member of WikiQueer’s global advisory board Sean Strub said: “WikiQueer enables a wealth of information about the LGBT community to be shared. “It’s a far cry from the time–not so many years ago–when looking up “homosexual” in the card catalog at a high school library was so often the first step to finding ourselves and each other. I’m looking forward to the creative ways the growing WikiQueer community will develop and utilize the information we share and collectively own.” Maryland
Gov. Martin O'Malley To Sign Gay Marriage Bill Thursday Maryland Governor Martin O'Malley will sign a gay marriage bill into law on Thursday, making Maryland the eighth state to legalize such unions. The Maryland House of Delegates joined the Senate in approving the bill earlier this month. O'Malley introduced the measure earlier this year and testified in its favor during committee hearings on the issue. “It is not right or just that the children of gay couples should have lesser protections than the children of other families in our state,” O'Malley told one panel. “Nor would it be right to force religious institutions to conduct marriages that conflict with their own religious beliefs and teachings.” The governor is scheduled to sign the legislation during a 5PM ceremony Thursday. Opponents of the measure on Wednesday announced that the State Board of Elections had approved their petition language, The Washington Post reported. The campaign to put the law up for a popular vote will be organized by the Maryland Marriage Alliance, which is supported by the National Organization for Marriage (NOM). Nearly 56,000 valid signatures, one-third of which would need to be submitted by May 31, with the remainder by June 30, are need to put the measure on the fall ballot. Iowa
Poll: Majority opposes ban on same-sex marriage A majority of Iowans oppose passage of a state constitutional amendment banning same-sex marriage, a new Des Moines Register Iowa Poll shows. The poll found that 38 percent favor a legislative initiative to pass a constitutional amendment, while 56 percent are against. Six percent aren’t sure. The findings show little movement on the issue from February 2011, when 40 percent of those surveyed supported passing an amendment, while 54 percent were opposed. Ben Tuttle, 26, of Ames, an airport worker who refuels airplanes, said his reasoning for opposing the amendment is simple: “Equality for all.” Lou O’Brien, 50, of Ankeny, a payroll supervisor and a self-described swing voter, embraces a contrasting view. “I believe in the original family unit,” she said. “That is the way I was brought up.” Age makes a difference, although support for a constitutional ban fails to reach a majority in any age group. Thirty-four percent of Iowans under 35 support a ban. Among Iowans 55 and older, the figure rises to 43 percent. Political affiliation makes a difference, too. Sixty-four percent of Republicans favor a ban, but just 35 percent of independents and 15 percent of Democrats. GOP candidates frequently say they believe marriage should be restricted to one man and one woman. Many Democrats see marriage for gays and lesbians as a civil rights matter. The poll, which surveyed 800 adults Feb. 12-15, has a margin of error of plus or minus 3.5 percentage points. For the full article, click here. Supreme
Court won’t hear NOM disclosure case The U.S. Supreme Court announced on Monday it won’t hear a case brought by the anti-gay National Organization for Marriage challenging a Maine law requiring the organization to reveal its donors. The high court posted a notice on its website indicating it wouldn’t hear the case, known as National Organization for Marriage v. McKee, without providing comment. The decision means NOM no longer has any avenue of appeal in the case. NOM, among the most high-profile organizations opposing same-sex marriage, asked the Supreme Court to take the case after the U.S. First Circuit Court of Appeals upheld the constitutionality of the Maine disclosure laws. In 2009, NOM contributed a total of $1.8 million to Stand for Marriage Maine and was one of the top fundraisers for the political action committee, which funded efforts for a Maine referendum that nullified the same-sex marriage law in the state. According to Maine law, any organization that makes expenditures of more than $5,000 to influence a ballot question must register and file reports with the Maine Commission on Governmental Ethics & Election Practices. The anti-gay group contested this law on the basis that NOM shouldn’t be defined as a political action committee and because the statutory scheme of the law was unconstitutionally vague, but the First Circuit denied these arguments. The high court decision on Monday not to take up the case means the appellate court ruling will stand. NOM didn’t respond to the Washington Blade’s request to comment on the Supreme Court decision or a sense of timing for when they would disclose their donors. LGBT advocates praised the decision by the Supreme Court and said it’ll keep NOM more transparent in its efforts to stop the advancement of same-sex marriage. Fred Sainz, the Human Rights Campaign’s vice president of communications, said the Supreme Court’s decision means the court has “once again allowed state disclosure laws to stand.” “Even conservative judges have rejected NOM’s pleas for secrecy and misguided attempts to thumb its nose at donor disclosure laws,” Sainz said. “At some point, this fringe anti-LGBT group has to realize that it can’t just pick and choose which laws it follows and which laws it ignores.” Fred Karger, who’s running as an openly gay candidate for the Republican nomination for president, helped bring NOM’s practices to the attention of the Maine Ethics Commission in 2009. He said he’s “thrilled” with the Supreme Court decision. For the full article, click here. PrEP
Could Be "Game Changer" In Fight Against HIV, Says Report From
the Fenway Institute Analysis examines biomedical prevention technology to be reviewed by U.S. Food and Drug Administration by June 15, 2012 Pre-exposure chemoprophylaxis (PrEP) —taking antiretroviral medications to prevent HIV transmission—could be a “game changer” for HIV prevention, according to an analysis released by The Fenway Institute today. PrEP has demonstrated partial efficacy with men who have sex with men (MSM) and heterosexuals in several recent studies. Recent modeling of PrEP implementation coupled with scaled up treatment predicts that PrEP could significantly reduce HIV incidence and prevalence. If PrEP is accompanied by sustained care, behavioral interventions, and safety monitoring, PrEP need not lead to increased sexual risk behavior or drug resistance. “PrEP has the potential to dramatically reduce HIV incidence among gay men, heterosexual women and men, and other populations,” said Sean Cahill, Director of Health Policy Research at The Fenway Institute and author of the report. “We look forward to action by the U.S. Food and Drug Administration and the World Health Organization this year to make PrEP available to those most vulnerable to HIV. PrEP could prove an invaluable new tool in the fight against HIV.” The Fenway review of PrEP implementation issues, titled Pre-exposure prophyalxis for HIV prevention: Moving toward implementation, summarizes the state of PrEP and microbicides research as of January 2012, looks at willingness to use PrEP among various populations, addresses concerns about PrEP that could present obstacles to implementation, offers strategies for effective implementation, and examines policy issues related to cost and how to make PrEP accessible to those most vulnerable to HIV. Based on a review of published research and interviews with policy makers, funders and other stakeholders, it examines regulatory developments and planning underway both within the U.S. and globally. Some have raised concerns about PrEP related to potential side effects, risk compensation (the idea that people will stop using condoms if PrEP becomes available), and drug resistance. However, reviews of five major clinical trials involving about 6,000 participants by the Forum for Collaborative HIV Research shows no greater risk of side effects, no risk compensation, and no clinically significant development of drug resistance in participants. Guidance from the U.S. Public Health Service and the World Health Organization is expected in 2012. The U.S. Food and Drug Administration announced February 13, 2012 that it would review Gilead Science’s application to use FTC-TDF (brand name Truvada) for PrEP by June 15, 2012. Demonstration projects to develop real world best practices for implementing PrEP are underway or set to launch soon in the U.S. and in sub-Saharan Africa. While the cost of PrEP in the U.S. would be substantial, private insurers and state Medicaid departments are open to covering PrEP, and low-cost generic medications could enable access in low-income countries. The prioritization of highly vulnerable populations could increase the cost-effectiveness of PrEP. Providing PrEP is also much less expensive than treating someone for HIV over the course of a lifetime. “Fenway was a U.S. site for the global iPrEx PrEP study with gay and bisexual men, and is testing a vaginal microbicides ring with dapivirine and maraviroc,” said Kenneth Mayer, MD, Medical Research Director and Co-Chair of The Fenway Institute. “We are very optimistic about the potential for PrEP and microbicides to revolutionize HIV prevention and allow us to dramatically reduce new infections here and around the world.” The Fenway Institute’s analysis found that the most effective prevention interventions will be those that combine behavioral interventions, structural interventions, and emerging biomedical technologies, such as PrEP and microbicides. The analysis concludes with recommendations for implementation of PrEP, including the following:
A PDF of the brief is available online at fenwayhealth.org/prepimplementation. Poll
finds Irish support for gay marriage at 73%
The poll, by Red C, showed nearly three quarters of those asked said they would agree with the statement: “Same sex marriage should be allowed in the Constitution”. The results were presented to Ireland’s Oireachtas yesterday in a report prepared for the Department of Public Expenditure and Reform on the last Constitutional referendum. Kieran Rose, Chair of Ireland’s Gay and Lesbian Equality Network said: “The poll confirms the openness of Irish people and their support for further critically important progress to achieving equality for lesbian and gay people. “GLEN’s goal, and that of lesbian and gay people, is access to civil marriage which is the only option that will achieve equality of status with opposite-sex couples and which would underpin a wider equality for lesbian and gay people.” said Rose “The proposed Constitutional Convention provides the opportunity to build on the progress of Civil Partnership and provide constitutional protection for our relationships. It also offers a very important opportunity to protect all families equally, including lesbian and gay headed families. 1005 people were polled ahead of a Constitutional Convention which will consider giving couples equal marriage rights. Moninne Griffith, Marriage Equality’s Director said: “The results of today’s Red C poll are vitally important. “It shows that not only are Irish people in favour of marriage equality, but they are also in favour of its inclusion in our Constitution. That is a huge step forward in our work to achieve equality for same-sex couples and families all over Ireland.” “We will be engaging fully with the Constitutional Convention and we look forward to engaging in debate with the members of the Convention, and other stakeholders, as to how marriage equality can be introduced as quickly as possible. “With 73% of the population in favour of allowing marriage equality in the Constitution, the Irish people are clearly ready for marriage equality.” Marriage Equality said the level of support for lifting the ban on gay marriages had grown from 56% in 2008. Gay
Marriage Debate Moves To Maryland Senate The Maryland Senate on Thursday will begin debate on Governor Martin O'Malley's plan to make Maryland the eighth
state to legalize gay marriage. Senate President Thomas Mike Miller Jr. told Reuters. Miller, who opposes gay marriage, has previously said the believes the bill will clear the chamber. The move comes less than a week after the measure narrowly cleared a long-standing hurdle in the House of Delegates and days after the Senate Judiciary Proceedings Committee sent it to the full Senate. The Senate approved
a similar bill last year before it was shelved in the House due to lack
of support. Only one Senate Republican, Senator Allan Kittleman of Howard, voted in favor of the measure last year. An amendment likely to be considered would expand the bill's religious exemptions to include private businesses and individuals. Opponents of the measure have vowed to put the issue before voters in the fall. Judge
Finds DOMA Unconstitutional Federal judge Jeffrey White, who was appointed during George W. Bush's presidency, has ruled the Defense of Marriage Act unconstitutional. According to Think Progress, White, a judge in the U.S. District Court for Northern California, ruled in favor of Karen Golinski, an attorney and employee of the U.S. Court of Appeals for the Ninth Circuit, saying that her rights had been violated under the equal protection clause of the U.S. Constitution when she was denied spousal benefits that heterosexual employees receive. In 2009, Chief Judge Alex Kozinski had ruled in Golinski's favor, saying that not providing those benefits violated the Ninth Circuit's employment policies prohibiting discrimination based on sexual orientation, according to our earlier reports, but the U.S. Office of Personnel Management immediately announced that it would not comply with Kozinski's ruling, arguing that DOMA excluded same-sex couples and it lacked the legal authority to extend those spousal benefits to Golinski, even though she and her wife were legally wed. Today's ruling is a victory for Lambda Legal, which represented Golinski, and other opponents of DOMA. According to Ginny LaRoe of The Recorder, who live-tweeted the trial today, White, yet another GOP appointee to vote in favor of gay rights — Judge Vaughn Walker, of Proposition 8 fame, was as well — said that DOMA should now be "subjected to heightened scrutiny. But it also fails even rational basis review." It is also, as Think Progress notes, "a serious setback" for Republican leaders in Congress, who have taken over the defense of DOMA in lawsuits after Obama administration officials announced they would no longer make a case for it. The full court opinion is available at Think Progress. Australian
gay men cautious about PrEP; most in need are the most interested Only just over one in four Australian gay men in a recent scientific survey described themselves as ‘willing’ to use pre-exposure prophylaxis (PrEP) against HIV. The others were either neutral about PrEP or unwilling to use it. Those who were willing to use PrEP were significantly more likely to have had unprotected anal sex with casual partners in the previous six months; to have had more than ten partners during that time; to have ever taken post-exposure prophylaxis; and to perceive themselves as likely to become HIV positive in the future. The paper also found that nearly half of the sample used condoms inconsistently with casual partners and less than 30% used them consistently with regular partner. This is consistent with other recent Australian surveys. It also found that although three-quarters of the group were confident in discussing condoms only 10% described using condoms as ‘a positive experience’ with the majority neutral or negative about condoms. The study The study was conducted by researchers from the University of New South Wales with researchers also involved from Goldsmith’s College in London and Utrecht in the Netherlands. It was part of the PrEPARE Project, a larger study of attitudes to PrEP in Australian gay men and Men who have Sex with Men (MSM). Participants were given a definition of PrEP thus: “PrEP is when HIV-negative people take anti-HIV drugs before sex to try to reduce the chance of infection. Although there have been some promising trial results, PrEP is still being tested and is currently not available in Australia.” Importantly, it did not give participants specific information about the trial results. It then asked nine questions about PrEP (two on concerns and seven on attitudes, examples being “I would be willing to take PrEP to prevent HIV” and “I am worried about the side effects of PrEP drugs”) and asked participants to score their answer on a five-point scale. The composite score from the seven questions on attitudes were then used to indicate willingness/neutrality/unwillingness to use PrEP, which was the study’s primary outcome measure. It also measured attitudes towards condoms (nine questions, examples being “condoms are uncomfortable” and “condoms make sex more exciting”), about ease of discussing condoms with partners, about attitudes to medicines and about participants’ perception of the likelihood of becoming HIV positive in the future. For the full article, click here. Canada
expected to fill gay marriage ‘gap’ today Canada is expected to announce changes to its Civil Marriage Act today which will stem fears about the validity of gay marriages between couples who could wed in Canada but not their home countries. Controversy was sparked last month after a federal lawyer responded to an unnamed lesbian couple’s divorce application appearing to say that since they could not have a wedding in their home countries, Canadian law did not technically recognise their marriage. Attorney General and Minister of Justice Rob Nicholson stepped in to allay fears, saying the government would make any necessary changes to the legislation. He said: “The confusion and pain resulting from this gap is completely unfair to those who are affected. I want to make it clear that, in the government’s view, those marriages are valid.” Up to 5,000 marriages were thrown into doubt by the document regarding the marriage between a British and an American woman. They were seemingly unable to divorce because Canadian law required one half of a couple to live in the country for a year before a divorce could be granted. It was not immediately clear how serious the issue identified by the lawyer was. Advocacy groups said: “No court has accepted this view and there is no reason to believe that either Canada’s courts or its Parliament would agree with this position, which no one has asserted before during the eight years that same-sex couples have had the freedom to marry in Canada.” Later dubbed a “legislative gap” by Nicholson, it has been attributed to patchy drafting when Canada became one of the first countries in the world to enshrine equal marriage rights. It affects foreign nationals whose home countries will not allow them to marry a member of their own sex. The Ottawa Globe and Mail which originally ran the story quotes family lawyer Grant Gold, who said that when the laws were being enacted in 2005: “The euphoria of the moment might have taken over.” Does
Maryland Have the Votes for Marriage? Following a decisive Thursday vote for marriage equality in New Jersey, lawmakers in Maryland are grappling for last-minute support from undecided delegates to pass their own marriage bill. The Maryland House of Delegates needs 71 votes to pass a bill supported by Gov. Martin O’Malley that would legalize civil marriage in the state. Whether the chamber has the requisite votes has been a matter of high speculation, however. Pro-marriage equality lawmakers delayed consideration of the legislation Thursday. The Washington Post reports that debate on the bill is expected to resume Friday afternoon, with the delegates back in session at 12:30 p.m. Eastern Time (read the report here). A source in Annapolis said Friday that the "votes were close" and could not confirm whether enough support currently exists. Yesterday, bill supporters agreed to an amendment that would push the effective date of the legislation to January of next year. Opposition groups have already begun collecting signatures for a potential November referendum: Only 53,650 signatures are needed to put the issue on the ballot. Nearly a year ago, the House voted to shelve a marriage bill by recommitting the legislation back to the Judiciary Committee — this after it became clear that marriage equality supporters simply did had not have enough votes. Anti-marriage equality groups including the National Organization for Marriage are pushing hard for a similar outcome today. “As I write, Delegates are debating Governor O'Malley's proposal to radically redefine marriage in the state,” NOM president Brian Brown wrote on the group’s blog. “The vote is expected to happen later today, so we need you to call right now. Our team working the halls of the Capitol is telling us that the vote is neck-and-neck, and could go either way.” For the full article, click here. New
Jersey Assembly Approves Gay Marriage The New Jersey Assembly on Thursday approved a bill that would make New Jersey the eighth state to legalize gay marriage. Members voted 42 to 33 on the measure after a roughly 3-hour debate. The debate was opened by the bill's sponsor, Assemblyman Reed Gusciora, who rejected Governor Chris Christie's call to put the issue up for a popular vote, saying “it's just the wrong thing to do.” “This is all about whether you will allow two people to love one another in the privacy of their own home,” Gusciora, who is openly gay, told colleagues. Assembly Speaker Sheila Oliver also urged colleagues to vote in favor of the bill. “This is clearly a constitutional issue of equal access under the law,” she said. A motion to send the bill back to committee failed but received a loud round of applause from opponents sitting in the gallery. The vote comes just days after the Senate approved the measure by a wider margin than expected. Supporters cheered as the final tally was displayed on the chamber's large LED screen. But the cheering from supporters is expected to end soon, because neither chamber has sufficient support to override Christie's promised “swift” veto. During a Tuesday news conference, Christie called the Legislature's actions an “act of theater on their part because they know it's not going to happen.” However, Christie is not expected to have the last word. Democratic leaders have nearly two years to override the governor's veto. Based on this week's votes, supporters remain 3 votes shy of that goal in the Senate and 12 votes in the Assembly. New Jersey currently recognizes gay and lesbian couples with civil unions, which Christie has said he supports. Lawmakers enacted civil unions in 2006 after the state's Supreme Court unanimously agreed that it is unconstitutional to deny gay and lesbian couples the rights granted to married heterosexual couples and ordered the Legislature to remedy the situation. Marriage supporters, who say civil unions are flawed and that separate is never equal, have returned to court to argue their case. “If @GovChristie thinks marriage veto will put the issue to rest, he hasn't met our clients,” legal group Lambda Legal tweeted on Thursday. “We aren't going away.” Half
of all new HIV transmissions in US may originate in undiagnosed individuals Almost half of all new HIV transmissions in the US originate in individuals who are unaware that they are HIV-positive, a modelling study published in the online edition of AIDS estimates. Only 20% of HIV infections in the US are undiagnosed, but the investigators calculated that they were the source of 49% of all new onward transmissions. “Decreasing the number of persons unaware of their infection must remain a priority goal of HIV prevention efforts,” comment the authors. With appropriate treatment and care the prognosis of many HIV-positive patients is now normal. Virologically suppressive antiretroviral therapy also has wider public health benefits, reducing the risk of HIV transmission by 96%. Late diagnosis is the principal factor underlying much of the HIV-related mortality that continues to be seen in resource-rich countries. Several studies have also suggested that a disproportion amount of new HIV transmissions have their source in undiagnosed individuals. Testing is therefore a cornerstone of efforts to control HIV. Opt-out HIV testing is now recommended in the US for adolescents and adults aged between 13 and 64 years as part of their routine health care. Screening at least annually is recommended for patients with higher risk of the infection. Previous research has suggested that HIV transmission rates in the US are 3.5 times higher for undiagnosed individuals compared to patients whose infection has been diagnosed. Investigators updated the information used to arrive at this estimate, taking into account revised estimates of the proportion of undiagnosed infections and the impact of virologically suppressive HIV therapy on infectiousness. The model was based on HIV prevalence rates in 2008 and HIV incidence between 2006 and 2009. The proportion of HIV-positive individuals unaware of their infection was 20%, and 39% of patients had a viral load below 400 copies/ml. Other variables included in the model were estimates of the frequency of unprotected sex with HIV-negative partners. The model also took account of the proportion of patients who were successfully linked to HIV care and retained in care. An estimated 49% of all new transmissions were from individuals who were unaware of their infection status. If the proportion of diagnosed patients with a viral load below 400 copies/ml increased to 60%, this increased the burden of new transmissions attributed to undiagnosed individuals to almost 60%. “Increasing the percentage with viral suppression substantially reduced the percentage of transmissions form persons aware of their infection,” comment the authors. “The impact could be even further strengthened with implementation of revised recommendations for antiretroviral treatment for patients with CD4 cell count below 500 cells/mm3, or even higher.” The transmission rate for patients aware of their infection status varied between 1.8 and 2.7 per 100 persons. It was between three and seven times higher for undiagnosed individuals (9.2 to 12.6 per 100 persons). In a scenario when 39% of HIV-positive patients had a viral load below 400 copies/ml, then each increase of 100 in the number of diagnosed infections was estimated to avert eight new transmissions. However, simply reducing the number of undiagnosed infections is not enough in itself to control the HIV epidemic. The authors stress that patients then have to be promptly connected with a specialist clinic, retained in care and achieve virological suppression. “While current estimates of the percentage of persons diagnosed with HIV who are linked to care are relatively high (69% to 82%), the percentage of persons retained in care is much lower (45% to 59%) and estimates of the percentage with viral suppression range from 24% to 39% for those who are aware of their infection.” The authors conclude: “Additional efforts are needed to educe the number of people unaware of their infection…reduce transmission rates, and improve linkage and retention in care and viral suppression. Reference Hall HI et al. HIV transmissions from persons with HIV who are aware and unaware of their infection, United States. AIDS 26, online edition. DOI: 10.1097/QAD013e328351f73f, 2012 (click here for the free abstract). EXCLUSIVE:
Nancy Pelosi Supports 2012 Democratic Party Platform Including Marriage
Equality House Minority Leader Nancy Pelosi (D-Calif.) supports the 2012 Democratic Party platform including, for the first time, language in full support of marriage equality, her spokesman told Metro Weekly on Tuesday evening, Feb. 14. The former House speaker's support for the move comes in response to Freedom to Marry's announcement on Feb. 13 that it was launching a campaign to ask the Democrats, as the group put it, to "Say I Do" to including such a marriage equality plank in the party's platform. The platform, a detailed statement of the party's positions that will be finalized at the Democratic National Convention this September, has never included language in support of the right of same-sex couples to marry. And the leader of the party, President Obama, opposed marriage equality in the 2008 campaign. He said in December 2010 that his position on marriage equality was "evolving" but that he still "struggle[s]" with it. His press secretary, Jay Carney, said this past week of Obama's position, "You know his position, where it stands now, on the issue of same-sex marriage, so I really don't have much to add on that." Freedom to Marry's proposed platform plank would aggressively support marriage equality. The Human Rights Campaign, National Gay and Lesbian Task Force and National Stonewall Democrats all support the inclusion of a marriage equality plank, with leaders of NGLTF and Stonewall Democrats endorsing the specific Freedom to Marry language. The proposed plank states: "We support the full inclusion of all families in the life of our nation, with equal respect, responsibilities, and protections under the law, including the freedom to marry. Government has no business putting barriers in the path of people seeking to care for their family members, particularly in challenging economic times. We support the Respect for Marriage Act and the overturning of the federal so-called Defense of Marriage Act, and oppose discriminatory constitutional amendments and other attempts to deny the freedom to marry to loving and committed same-sex couples." Pelosi spokesman Drew Hammill tells Metro Weekly, "Leader Pelosi supports this language." For the full article, click here. Social
network aims to connect rural gays A new social network has been launched to help geographically isolated gay and trans people socialise with other members of the LGBT community. The Country Slicker has been designed to counter a ‘lonely farmer’ perception of rural life in the UK. Founder David Middleton says: “Although people in the LGBT community can find themselves isolated in both a physical and social sense there’s really a lot going on in the countryside for people to take advantage of. “We’d like to help change the notion of city-living being the only choice for an active social life.” The network has an open blog area, a forum and regional events pages where members can post details of activities. The site also features a monthly newsletter to which members will be able to contribute and promote specialist skills or rural businesses for free. Middleton adds: “The image of the ‘lonely farmer’ is something that many people see when they think of rural life-styles, but there are thousands of gay people who have chosen to live in the country from a variety of backgrounds who may wish to connect with others or who may have a lot to offer the LGBT community. “The Country Slicker provides a platform for members to organise events and activities as a means of making new friends.” Membership is currently free but the founders say it may charge a monthly subscription in future. Washington
Gay Marriage Foes Launch Repeal Campaign An effort to repeal a gay marriage law in Washington state was launched by opponents on Monday, just hours after Governor Chris Gregoire signed the bill into law. Gay and
lesbian couples will be allowed to marry in the state starting on June
7 provided opponents do not gather sufficient signatures to put it up
for a vote. In that case, marriage equality would be put on hold pending
the outcome of a November election. “Preserving marriage as the union of one man and one woman is worth fighting for,” said NOM President Brian Brown. “Marriage is the cornerstone of society that not only unites a couple to each other, but ensures that any children born of their union will have the best opportunity to be raised by their own mother and father. We're committed to giving Washington voters the right to decide the definition of marriage in their state, just as voters in 31 other states have been able to do.” In a statement posted at its website, the Family Policy Institute of Washington said: “We ARE going to exercise our right to referendum and reject this law.” In her remarks before signing the legislation, Gregoire touched on the upcoming fight to keep the law in place. “If asked those questions with their heads and their hearts, I believe the people of the state of Washington will say, 'Yes, marriage equality is right for our state and our time is now. The time is today,'” she said. Voters in 2009 rejected an effort to repeal a domestic partnership law which gave gay couples all the protections of marriage. Ugandan
gay rights workshop ‘raided’ Amnesty International has called on Uganda to end its “outrageous harassment” of activists after a cabinet minister reportedly raided a workshop being held by gay and trans rights advocates. Uganda’s Minister for Ethics and Integrity, Simon Lokodo, was accompanied by police to the hotel where the event was being held, the organisation said. Announcing that the workshop was illegal, rights activists were expelled from the hotel and threatened with force. Salil Shetty, Amnesty International’s Secretary General said: “This is an outrageous attempt to prevent lawful and peaceful activities of human rights defenders in Uganda. Amnesty International also said the minister had attempted to order the arrest of Kasha Jacqueline Nabagasera, a prominent gay and trans rights activist and winner of the 2011 Martin Ennals Award for Human Rights Defenders who had been present. The reasons for the attempted arrest were not immediately clear. Last year, her rights group’s Kampala offices were burgled and documents listing member names stolen. For the full article, click here. Majority
In New Jersey Support Gay Marriage A majority of New Jersey voters say gay marriage should be legalized. According to a Rutgers-Eagleton poll of 914 registered voters released Tuesday, 54 percent of respondents support gay marriage, and 35 percent oppose it. However, a majority also say the issue should be put up for a vote. Fifty-three percent of respondents said they support Governor Chris Christie's call for voters to decide the issue at the ballot box. Supporters of marriage equality have rejected the idea, arguing that civil rights should never be put up for a vote. “It may be that given several polls showing majority support among voters, supporters of same-sex marriage think it would win in November,” pollster David Redlawsk, a political science professor at Rutgers University, said in a statement. “But in the face of a likely intensive campaign from opponents, this could be wishful thinking.” The survey was released a day after the New Jersey Senate voted in favor of legalizing gay marriage by a wider margin than expected, and two days before an expected vote in the Assembly. Christie has said he would veto the bill if it reached his desk. SWAZILAND:
Reaching out to gays for the first time MBABANE - If caught, any Swazi engaged in a same-sex relationship will be arrested and jailed. But public health officials are using Valentine's Day to urge gays to trust promises of confidentiality and test for HIV. "February is known as the month of love, when couples express their love for each other through gifts, especially on Valentine's Day. The purpose of our new campaign, called 'The Love Test', is to encourage couples to undergo HIV testing," said Simon Zwane, Deputy Director of Health. He acknowledged that in Swazi society gay sex is taboo but said the health ministry was actively extending its reach to include gay couples in HIV counselling and testing. "Couples need to be consistently aware of their HIV status. This will result in them making joint decisions on risk reduction in their relationships," said Zwane. Swaziland's HIV prevalence has remained the world's highest for years, with about a quarter of all adults living with HIV. Several NGOs, including the Alliance of Mayors’ Initiative on Coordinated Action against AIDS at the Local Level (AMICAALL) and the family planning company, PSI International, are partners in the nationwide campaign, the first health initiative in the small impoverished country to acknowledge the existence of gays and welcome them to make use of HIV testing and counselling services. "Just admitting that there are gays in Swaziland is a big step for a government ministry," said Alicia Dlamini, a HIV testing counsellor in Manzini, the country’s industrial hub. Three months ago the Minister of Justice and Constitutional Affairs, Magwagwa Gamedze, a traditional chief appointed by King Mswati, dismissed a recommendation by a United Nations working group on human rights that Swaziland enact a law to protect gay members of society. Gamedze said so few, if any, gays live in Swaziland that the bother of drafting such a law was not worth the effort. "It was difficult for government to formulate a policy on homosexuals or enact a law to recognize them because they actually formed a minority if ever they existed. Their numbers do not permit us to start processing a policy," the justice minister said. For the full article, click here. Washington's
Chris Gregoire To Sign Gay Marriage Bill; New Jersey To Vote Gay marriage will be on the minds of lawmakers in Washington state and New Jersey on Monday. Washington Governor Chris Gregoire will sign a gay marriage bill approved by lawmakers into law at 11:30AM, making Washington the seventh state to legalize such unions. The Democrat-controlled House approved the measure with a 55-43 vote last Wednesday, a day after a federal court declared California's gay marriage ban, Proposition 8, in violation of the United States Constitution, and one week after the Washington Senate passed the measure with a wider margin than expected. Gregoire for the first time endorsed marriage equality at a press conference introducing the bill last month. Citing her Catholic faith, Gregoire said she struggled with the issue. The law will go into effect on June 7 provided opponents do not gather sufficient signatures to put it up for a vote. In that case, marriage equality would be put on hold pending the outcome of a November election. Recent polls have found that a narrow majority of Washington voters do not favor repeal. Since 2007, Washington has recognized gay couples with domestic partnerships. A 2009 effort to repeal those protections was rejected by voters. New Jersey
lawmakers will vote on similar legislation this week. The Senate will
debate the issue on Monday and the Assembly on Thursday. “It is absolutely going to pass on Monday, and I expect it to pass the Assembly on Thursday, and it's going to go to the governor's desk, Sweeney said during an appearance on WNYC's the Brian Lehrer Show. Sweeney, who recently called his 2010 vote against marriage equality “wrong,” also conceded that he does not have the 27 votes in the Senate to override an expected veto from Republican Governor Chris Christie. Christie has said he supports the state's civil unions law. “If the governor vetoes the bill, we're gonna fight to override the governor,” Sweeney said. “I have two years to do it almost, so that gives us plenty of time to work on people.” VA:
Adoption agencies 'conscience clause' passes Senate The state Senate on Thursday approved the "conscience clause" bill that allows state-funded private adoption agencies to deny placement services to children and prospective parents who don't share their beliefs. The bill effectively would allow faith-based organizations, such as Catholic Charities, to legally deny the placement of gay children and the adoption of children by gay parents. Senate Bill 349, sponsored by Sen. Jeff McWaters, R-Virginia Beach, codifies recently adopted state regulations governing the adoption and foster-care placement of children by state-funded agencies. It passed the chamber on a 22-18 vote, with two Democrats — Sens. Charles J. Colgan, D-Prince William, and Phillip P. Puckett, D-Russell siding with all 20 Republicans in the evenly divided chamber. Federal law prohibits discrimination by race, national origin and religion. Virginia law allows adoption to married couples and single adults — gay or straight — but does not extend to gay couples. McWaters said the bill doesn't change who can and who cannot adopt children in Virginia. Instead, he said, it preserves the rights of faith-based organizations to carry out their services without violating the tenets of their religious beliefs. But critics say the current regulations allow faith-based adoption agencies — which account for more than half of the 80 placement agencies that receive state funding — to discriminate against gay children or a prospective gay parent if their lifestyle conflicts with the religious beliefs of the organization. Further, they argued that the legislation would sanction an even broader and arbitrary discrimination, because it potentially allows any private placement agency licensed by the state to make up its own changing set of discriminatory rules in administration of services. On Wednesday, 18 Democratic amendments to the bill were voted down. On Thursday, many of the same sponsors of the amendments spoke out against the measure on the floor, arguing that no placement agency has the right to impose its beliefs on others if it is using state dollars. Sen. Adam P. Ebbin, D-Alexandria, Virginia's first openly gay legislator, gave a personal speech on the floor, citing the experiences of several gay friends and the children they have adopted. The bill, he said, "doesn't uphold moral principles. It's morally wrong." For the full article, click here. Washington's
Chris Gregoire To Sign Gay Marriage Bill Monday
Gregoire will sign the bill into law at 11:30AM, making Washington the seventh state to legalize gay marriage. The Democrat-controlled House approved the measure with a 55-43 vote on Wednesday, a day after a federal court declared California's gay marriage ban, Proposition 8, in violation of the United States Constitution, and one week after the Washington Senate passed the measure with a wider margin than expected. Gregoire for the first time endorsed marriage equality at a press conference introducing the bill last month. In an interview with gay glossy The Advocate, the governor said she struggled with her Catholic faith on the issue. “I
think it's fundamentally wrong to discriminate. At the same time, I have
accepted my religion can have religious freedom to do what it chooses
to do, but that cannot allow a state to engage in discrimination, so that's
been my evolution,” she said. If opponents gather sufficient signatures to put the law up for a vote, its June start would be put on hold pending the outcome of a November election. Marriage
Equality Bill introduced in Illinois Illinois state representatives have filed a much-anticipated marriage equality bill in the Illinois General Assembly, local LGBT groups announced Feb. 8. Reps. Greg Harris, Deb Mell and Kelly Cassidy have introduced the Religious Freedom and Marriage Fairness Act, which would allow same-sex couples to marry in Illinois. "We commend these leaders for taking yet another step towards full equality for lesbian and gay families in Illinois, and we are grateful to them for their leadership. This is just the beginning: the road to marriage equality is sure to be long, but it is one that we must travel together," said LGBT organization Equality Illinois in a statement. But Equality Illinois CEO Bernard Cherkasov warns that fight will be far from easy. "I really do think we will have marriage equality within the near future," Cherkasov said, but added, "I don't think it's going to pass tomorrow." Anthony Martinez, executive director of The Civil Rights Agenda ( TCRA ) , expressed similar sentiments. "Marriage has always been one of the principal goals for our organization and we are pleased to finally be able to move forward towards achieving that goal," Martinez said in a statement. Martinez said the timing is exciting, with the news coming just a day after California's anti-marriage equality amendment Proposition 8 being ruled unconstitutional. Still, Martinez told Windy City Times, the Illinois bill would not likely pass this time around. "People need to understand that this is not a slam dunk," he said. "We have work to do." Harris has introduced similar bills in years past, all of which failed. This year, may be no different, said activists. But Cherkasov added that marriage bills have often been introduced alongside civil union legislation, giving lawmakers the option to choose between the two. Civil unions were less controversial and easier to pass, he said. But the advent of civil unions has shown that "separate but equal" has failed, said Cherkasov. "What we know now about civil unions is that they haven't worked to provide full equality," he said. People in same-sex civil unions have reported many circumstances in which they were denied recognition this year in Illinois. The Illinois Department of Revenue originally announced that civil union spouses could not file taxes jointly because Illinois filings are required to match federal filings. Due to the Defense of Marriage Act, same-sex couples cannot file jointly at the federal level. The Department of Revenue later reversed that decision after pressure from LGBT advocates. A group of lawmakers that also included Ann Williams, Sara Feigenholtz and Senator Heather Steans began talks in January over the latest marriage legislation. For the full article, click here. HOUSE
VOTES YES; MARRIAGE READY IN WASHINGTON Following the Senate, the Washington House voted 55-43 today to approve marriage equality and send the bill to the governor, who has said she will sign it. A spokeswoman for Gov. Christine Gregoire said Wednesday afternoon that she expects to sign the bill early next week, making Washington the seventh state plus the District of Columbia to legalize same-sex marriage. A round of amendments from Republicans looking to stop the bill all failed. One of the failed amendments had tried to require a referendum before same-sex marriage could be approved. Sen. Ed Murray, the gay man who has led much of the push for same-sex marriage in the state, said he and others are already gearing up for an expected referendum in November spurred by a petition drive. He told TVW that first a "decline to sign" drive would try to keep a repeal measure off the ballot. Republican representative Jay Rodne delivered an impassioned condemnation of the marriage equality bill, reminding the House that "what we do today can be undone by a future legislature" or at the ballot box. Rodne called the bill "progressive reengineering" and "an exercise of power that contravenes human nature." He claimed it harms children and families. "Children who are going to be brought into this world in the context of a same-sex marriage will have their relationship with one of their biological parents forever severed by force of law," he lamented. Democratic representative Jamie Pedersen, who is gay, is in a domestic partnership, which Washington approved under a law known as "everything but marriage." He said his four children deserve to know "their daddy and their papa have made that kind of a lifelong commitment to each other." "Marriage is the word that society uses to describe a committed lifelong relationship," said Pedersen. Democratic representative Laurie Jinkins said the bill will strengthen families, especially hers. She said her partner of 23 years and their son helped motivate her yes vote. "All we do here — education, health care, jobs — we do all of those things for one simple beautiful reason," she said. "It's for our families." WA:
Legislature poised to approve gay marriage OLYMPIA, Wash. — The Legislature is set to approve a measure that would legalize gay marriage in Washington state. The House is expected to begin debate on the bill at 1 p.m. Wednesday. The measure passed the Senate last week on a 28-21 vote, and it is expected to easily pass in the House. Once passed by the Legislature, Gov. Chris Gregoire is likely to sign the bill into law next week. Because there is no emergency clause on the bill, the law wouldn't take effect for 90 days. Opponents have already promised a referendum battle at the ballot, so it's likely it could be put on hold pending the outcome of a November election. If opponents are unable to gather enough signatures to qualify for the ballot, couples could marry starting in June. Increased
risk of anal cancer for all groups with HIV Gay men are not the only group of HIV-positive patients who have an increased risk of anal cancer, according to North American research published in the online edition of Clinical Infectious Diseases. The researchers found that incidence of the cancer was also significantly higher in non-gay HIV-positive men as well as HIV-positive women when compared to individuals in the general population. “We confirmed that HIV-infected MSM [men who have sex with men] experienced the greatest risk of anal cancer,” write the authors. “We also found that both HIV-infected other men and women had substantially higher rates than HIV-uninfected men and women, and that HIV-infected other men and women had similar rates.” They believe that their findings may have implications for anal cancer screening strategies. Thanks to improvements in HIV treatment and care the prognosis of many HIV-positive patients is now near normal. However, HIV-positive patients appear more likely to develop certain malignancies, including anal cancer, compared to their HIV-negative peers. Understanding the incidence of anal cancer in the different populations affected by HIV can help develop strategies to prevent the cancer. Therefore investigators from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) analysed findings from 13 US and Canadian studies. Their aims was to determine incidence of anal cancer in HIV-positive patients, who were divided into three categories – MSM, other men and women. Rates of anal cancer in these HIV-positive patients were compared to those observed in HIV-negative men and women. Analyses were also conducted to see if there were temporal trends in anal cancer incidence, and if any specific risk factors for the malignancy in HIV-positive patients could be identified. A total of 34,000 HIV-positive patients (55% MSM, 19% other men, 26% women) and 110,000 HIV-negative controls (90% men) were included in the study. Data gathered between 1996 (the year effective HIV therapy first became available) and 2007 were examined by the investigators. Incidence of anal cancer in MSM was 131 per 100,000 patient years. Among HIV-positive other men incidence of the malignancy was 46 per 100,000 years, and incidence in HIV-positive women was 30 per 100,000 person years. Incidence was therefore significantly higher in HIV-positive MSM compared to other men (p < 0.01). However, incidence rates for HIV-positive other men and women did not differ significantly. Over the same period, the incidence of anal cancer in HIV-negative men was just 2 per 100,000 person years. There were no cases of the malignancy in HIV-negative women. For the full article, click here. California
gay-marriage ruling may affect Washington SAN FRANCISCO — A federal appeals court Tuesday struck down Proposition 8, finding California's ban on same-sex marriage is unconstitutional because it deprives gay and lesbian couples of the equal right to wed. In a decision that pushes the gay-marriage issue a step closer to the Supreme Court and could have ramifications in Washington state, the 9th U.S. Circuit Court of Appeals upheld former U.S. District Judge Vaughn Walker, who invalidated Proposition 8 in 2010 after conducting an unprecedented trial. "Proposition 8 serves no purpose, and has no effect, other than to lessen the status and human dignity of gays and lesbians in California, and to officially reclassify their relationships and families as inferior to those of opposite-sex couples," wrote Judge Stephen Reinhardt, who was joined by Judge Michael Daly Hawkins. Judge N. Randy Smith dissented, saying there were "legitimate governmental interests" in restricting the definition of marriage to a union between a man and woman. Proposition 8 backers now can ask the 9th Circuit to rehear the case with an 11-judge panel or proceed directly to the Supreme Court. Smith's dissent could be a strong indicator there will be some support within the court to take a second look at the case. The appeals court also rejected the argument that Walker's ruling should be scrapped because he did not disclose he was in a long-term same-sex relationship while he was handling the case. Smith joined in that part of the ruling. As a result of the continued legal wrangling, same-sex marriages are not expected to resume in California soon, with further appeals likely to stretch at least into next year. For the full article, click here. Washington
is likely the next state to allow gay marriage Washington state may soon allow same-sex couples to wed — potentially the seventh state to take such a step in a growing nationwide debate. Washington's state Senate passed the bill 28-21 Wednesday. This week, the bill goes to the House, where it is likely to pass, said Sen. Ed Murray, a Democrat and the bill's sponsor. Gov. Chris Gregoire, a Democrat, has said she will sign the bill if it makes it to her desk. The other states that allow same-sex couples to wed are Massachusetts, Connecticut, Iowa, Vermont, New Hampshire and New York. The District of Columbia also allows the practice. "As state after state approves marriage equality for gay and lesbian couples, it encourages more states," said Murray, who is openly gay and has led changes in Washington's gay rights and domestic partnership laws. Washington's bill may be challenged by opponents, who are expected to make a push to have the question of same-sex marriage put on the ballot in November, Murray said. Pastor Joe Fuiten, one of the leaders of a campaign for a referendum that would overturn the bill, said he and others oppose the measure because it would change the definition of marriage and affect what children are taught in schools. "Marriage is important and when somebody wants to change what marriage historically is, that has consequences," said Fuiten, who heads the Cedar Park Assembly of God church in Bothell, Wash. "It has consequences to families and children going forward." Fuiten said the opponents' camp in Washington is made up of about 40 organizations and is growing. Legislatures in New Jersey and Maryland are expected to debate same-sex marriage bills this year, said Jack Tweedie, who tracks same-sex marriage at the National Conference of State Legislatures. In California, the issue is in the courts. Opponents of same-sex marriage in Minnesota and North Carolina have pushed to get referendums on constitutional amendments this year that would define marriage as between a man and a woman, Tweedie said. Supporters of same-sex marriage in Maine have gathered enough signatures to put the question on the ballot in November, said Marc Solomon, national campaign director for Freedom to Marry. "We have to win states," Solomon said. "Eventually, I think we will get to the place where either Congress or the courts will finish the job." National
Black HIV/AIDS Awareness Day
UPDATE
Prop. 8: Gay-marriage ban unconstitutional, court rules A federal appeals court Tuesday struck down California's ban on same-sex marriage, clearing the way for the U.S. Supreme Court to rule on gay marriage as early as next year. The 2-1 decision by a panel of the U.S. 9th Circuit Court of Appeals found that Proposition 8, the 2008 ballot measure that limited marriage to one man and one woman, violated the U.S. Constitution. The architects of Prop. 8 have vowed to appeal. The ruling was narrow and likely to be limited to California. “Proposition 8 served no purpose, and had no effect, other than to lessen the status and human dignity of gays and lesbians in California,” the court said. The ruling upheld a decision by retired Chief U.S. District Judge Vaughn R. Walker, who struck down the ballot measure in 2010 after holding an unprecedented trial on the nature of sexual orientation and the history of marriage. In a separate decision, the appeals court refused to invalidate Walker’s ruling on the grounds that he should have disclosed he was in a long term same-sex relationship. Walker, a Republican appointee who is openly gay, said after his ruling that he had been in a relationship with another man for 10 years. He has never said whether he and partner wished to marry. ProtectMarriage, the backers of Proposition 8, can appeal Tuesday's decision to a larger panel of the 9th Circuit or go directly to the U.S. Supreme Court. The high court is expected to be divided on the issue, and many legal scholars believe Justice Anthony Kennedy will be the deciding vote. Gays and lesbians were entitled to marry in California for six months after the California Supreme Court struck down a state ban in May 2008. The state high court later upheld Proposition 8 as a valid amendment of the California Constitution. While the Proposition 8 case was still pending in state court, two same-sex couples sued in federal court to challenge the ban on federal constitutional grounds. DECISION DAY: Court to Decide If Prop. 8 Constitutional Nearly three years after Kristin Perry, Sandra Stier, Paul Katami, and Jeff Zarrillo sued California state officials after they were denied marriage licenses, a three-judge panel with the Ninth Circuit Court of Appeals will rule Tuesday on whether Proposition 8 violated the U.S. Constitution by stripping gay Californians of the right to marry. A decision is expected to be released by 10 a.m. pacific time. Regardless of whether the panel upholds or reverses now-retired U.S. district judge Vaughn Walker’s decision striking down the 2008 ballot measure, the ruling is almost certain to trigger an appeal to the U.S. Supreme Court. The court announced Monday that it would be filing its opinion on the constitutionality of Prop. 8, as well as several ancillary rulings, including whether Walker’s decision should be vacated because he is gay and in a long-term relationship — an open secret during the trial, though one that was not raised publicly until the San Francisco Chronicle published an article on the matter two years ago today. Attorneys representing Yes on 8, the coalition that backed Prop. 8, argued in court filings last spring that Walker had a personal stake in the outcome of the case and should have recused himself. U.S. district judge James Ware, who has handled matters involving the case, Perry v. Brown, since Judge Walker retired last year, summarily dismissed those arguments. Should they lose, the Prop. 8 proponents are expected to seek an injunction against the Ninth Circuit’s ruling as they continue their appeals, further delaying the right to marry for the two plaintiff couples in the case, as well as thousands of other gay couples in California. The ninth circuit panel will also rule on whether Prop. 8 supporters have legal standing to defend the ballot measure in court when state officials decided not to do so. However, given that the court announced it has decided on the merits of the case, legal observers note that the panel has also likely decided that Prop. 8 supporters indeed are entitled to defend the initiative and that their attempt to vacate Walker’s decision has fallen flat, as expected. The American Foundation for Equal Rights, which organized and financed the Prop. 8 legal challenge, will be holding two press conferences — one in Los Angeles, followed by another in San Francisco — directly following release of the court’s opinion. Last week, the ninth circuit panel ruled that recordings of the Prop. 8 trial cannot be made public. However, because current court rules mandate that documents filed under seal become public 10 years after a case is closed, the recordings could be released August 4, 2020 — a decade after Walker’s landmark decision. US
CDC recommends HPV vaccine for young men Young men and adolescent boys between the ages of 11 and 21 should be vaccinated against human papillomavirus, the cause of genital warts, anal and cervical cancer, the Advisory Committee on Immunization Practices has recommended, in a new Adult Immunization Schedule published in Annals of Internal Medicine. The committee also recommends that all gay and bisexual men and HIV-positive men aged 26 and under should be vaccinated. US guidelines already recommend that young women and girls aged 11 to 26 should receive the vaccination. In the United Kingdom HPV vaccination is offered to girls aged 12 to 13 through a National Health Service vaccination programme, although girls in the 14-17 age group can also be vaccinated. At present the only HPV vaccine licensed for use in males is Gardasil, manufactured by Merck, which protects against four cancer-causing types of HPV (types 6, 11, 16 and 18). Gardasil is licensed for use in boys aged 9 – 15 years in the United Kingdom. Vaccination has been shown to reduce the subsequent risk of genital warts, precancerous cervical changes and cervical cancer in women. In young men the vaccine has been shown to reduce the risk of HPV infection. In an accompanying editorial Dr Sandra Fryhofer of Emory University, Atlanta, notes that although clinical data are not available, the rationale that vaccination also protects against oropharyngeal cancers caused by HPV is “certainly plausible”. A recent review of the impact of HPV vaccination in Melbourne, Australia, found that the risk of young men and women under 21 being diagnosed with genital warts fell by approximately 60% between 2007/8 and 2010/11 among patients attending the Melbourne Sexual Health Centre. This followed the implementation of a vaccination programme in girls and women aged 26 and under from 2007 onwards. The number of sexual partners did not affect the reduction in risk. In contrast new diagnoses of genital warts did not fall significantly in heterosexual women and men aged 30 and over, nor in men who have sex with men, indicating that these groups are not benefiting from the effect of the current vaccination policy. Washington
Teen Takes Own Life After Antigay Bullying Friends and family gathered to mourn a 14-year-old student from Cashmere, Wash. who committed suicide last week after he was bullied for being gay. His death is at least the fourth suicide reported this year among LGBT youth. The Wenatchee World reports that Rafael Morelos hanged himself in late January after enduring repeated bullying, including a fake Facebook page reportedly set up to taunt him online. His mother, Malinda Merelos, said she had known her son was gay for a few years, but didn’t know he was being bullied. “He pretended everything was OK,” she said. “Sometimes he acted strong, but inside, he was dying, little by little.” Rob Cline, principal at Cashmere Middle School, where Morelos was enrolled, said school officials had taken “appropriate action” earlier in the year when Morelos was bullied, but declined to say what action the district took to combat antigay attacks. “Student discipline is not something I am at liberty to share,” Cline said. The investigation is currently closed, but local police officials have said it would be reopened if the school or family presents evidence of bullying. Gay
Marriage Bill Clears Washington House Panel A bill which would make Washington the seventh state to legalize gay marriage cleared a House panel on Monday. The House Judiciary Committee approved the measure with a 7 to 5 vote after hearing an hour's worth of testimony from supporters and opponents. One lawmaker abstained from voting. The panel voted against 5 amendments before sending the measure to the full House. One amendment would have expanded the bill's religious protections to include private businesses and individuals. Another would have put the measure up for a public vote. Testifying before the committee was 13-year-old Allison who said she opposed the legislation because children would be denied either a mother or a father. “I'm concerned that this bill does not protect the religious beliefs of business owners who may not want to support the same-sex marriage. I believe that every child deserves the love of a mother and a father. Each of these parents have a unique role to play in the life of a child,” she testified. “In order to walk properly you must wear one left shoe and one right shoe. Wearing two left shoes or two right shoes it becomes hard to walk. It is the same in a family.” The House could vote on the bill as early as Wednesday, a week after the Senate gave its approval. Governor Chris Gregoire has urged lawmakers to approve the legislation. Men
who have sex with men may now be the highest-risk group for HIV in Africa,
IAVI study suggests
The study, which compared the Kenyan populations with a largely heterosexual group from South Africa, also found lower-than-expected HIV incidence amongst female sex workers and their clients. The researchers also found that recruiting MSM into the study was easier than expected, but note that there was a particularly high dropout rate in MSM. They comment that while MSM “need urgent risk reduction interventions, and may be a suitable cohort for future HIV prevention studies,” because African MSM face considerably legal and social hurdles in coming forward, “careful consideration of the counselling and clinical needs, follow-up schedule and social support is vital to ensure continuing research participation.” The study The aim of the study was to collect data on HIV and STI incidence and risk factors in three populations in Kilifi, a district north of Mombasa, and the Kangemi district of Nairobi, both in Kenya, and from Gugulethu township in Cape Town in South Africa, the better to target HIV vaccine trials. The researchers recruited 716 people in Mombasa, 653 in Nairobi and 465 in Cape Town, The researchers primarily used participants to recruit their peers in South Africa, where background HIV prevalence at 28% is ten times higher than in Kenya, but in Kenya recruited attendees at HIV testing centres, via outreach work in bars and brothels, and via ‘snowball’ sampling (asking members of a particular group to recruit others from the same group). The original idea had been to collect data on high-risk heterosexuals including sex workers but, as the researchers comment, “it quickly became apparent that MSM were willing to come forward and participate in HIV prevention research”. Somewhat different monitoring and follow-up criteria were used in the three centres. In Cape Town participants were monitored monthly and followed up for one year while in the two Kenyan cohorts participants were monitored quarterly for two to four years. In Mombasa participants were examined for STIs at every visit but in Nairobi and Cape Town only examined if they had symptoms. As a result annual STI incidence was much higher in Mombasa (23%) than in the other two centres (3.7% and 4.4%). The average ago of participants was mid-20s (slightly older in Nairobi); nearly 70% were women in Cape Town, 50% in Nairobi and 36% in Mombasa. Participants in Capt Town were almost entirely heterosexual men and women and were not sex workers. In Mombasa 56% of men (36% of the study population) was an MSM; 63% of men said they had sold sex (mainly to other men) and 54% had bought it. Three-quarters of female participants said they were female sex workers while one in 20 women said they had bought sex. In Nairobi nearly all women defined as a sex worker and 85% of the men had bought sex; 22.5% of the men had had sex with other men and 33% defined as a male sex worker. For the full article, click here. Amazon
Joins Starbucks, Google, Microsoft In Supporting Gay Marriage Internet retailer Amazon on Wednesday became the latest high-profile Washington-based company to endorse an effort to legalize gay marriage in the state, the Seattle Times reported. “Amazon is joining other Pacific Northwest companies, including Microsoft, Starbucks and Nike, in support of Washington state's marriage equality bills,” Amazon said in a statement. “The spirit of these bills is consistent with our longstanding employment practices.” Amazon's support arrived just hours before the Washington Senate approved the bill by a wider margin than expected. More than 100 companies have endorsed the effort, including Concur, Group Health Cooperative, Nike, RealNetworks and Vulcan. Starbucks said in a statement that it was “proud to join other leading Northwest employers in support of Washington state legislation recognizing marriage equality for same-sex couples.” “This important legislation is aligned with Starbucks' business practices and upholds our belief in the equal treatment of partners,” the company said. Microsoft added that not allowing gay marriage could leave Washington companies at a competitive disadvantage: “Washington's employers are at a disadvantage if we cannot offer a similar, equitable and inclusive environment to our talented employees, our top recruits and their families.” WA:
Historic Senate vote clears way for gay marriage in state OLYMPIA — In the end, it wasn't even close. After more than a decade of laying the ground work and fretting that the votes would be just out of reach, state Sen. Ed Murray watched Wednesday night as the Senate easily passed legislation that would legalize gay marriage. The vote was 28-21. "For a lot of people in my age group, this is a stunning event," said Murray, the prime sponsor of the bill. "It's something we did not believe would happen in our lifetime." While it wasn't final passage, the Senate always has been viewed as the biggest hurdle for same-sex marriage legislation, as it was for gay-rights bills in previous years. The measure now heads to the House, where supporters say they have more than enough votes. It's expected to pass as early as next week. The governor strongly supports the bill as well. Washington would become the seventh state to legalize gay marriage, depending on the outcome of a threatened referendum challenge by gay-marriage opponents. Little sign of nervousness was apparent in the hours leading up to the Senate floor action. Murray, a Seattle Democrat, and his longtime partner, Michael Shiosaki, actually held a celebratory news conference before the Senate went into session. Gay-marriage supporters packed the Senate galleries, and they burst into applause when the vote tally was announced. "It's exciting to be here and see the civil-rights movement move forward," said Kevin Moser, 31, a Seattle man who was there with his partner, Bret Tiderman. "It means that one day our parents will be really excited to go to a wedding," Tiderman said. Jane Sterland, 56, of Centralia, was one of the few gay-marriage opponents on hand to witness the vote. "I'm a Christian, and this is not pleasing to God," she said. "I feel very grieved that the bill is even in question." In addition to the 26 lawmakers who previously had announced support for the Senate measure, two more Republicans, Sens. Andy Hill of Redmond and Joe Fain of Auburn, voted for it as well. Republicans Steve Litzow of Mercer Island and Cheryl Pflug of Maple Valley had pledged support earlier. Overall, 24 Democrats and four Republicans voted for the bill. For the full article, click here. On
the Verge: Washington Senate Votes Today on Marriage The Washington state senate is expected to pass a marriage equality bill Wednesday — legislation that Gov. Chris Gregoire has promised to sign into law. The senate will likely vote on the bill late Wednesday afternoon or early evening. Though the vote margin in the senate chamber is extremely narrow, the bill is expected to pass in the house by a wide margin. If passed, Washington would become the seventh state plus the District of Columbia to extend equal marriage rights for same-sex couples. But marriage equality opponents including the National Organization for Marriage have vowed to take the issue to a voter referendum and to fund primary challenges to Republican lawmakers who voted in favor of gay marriage. On Tuesday, Washington state senator Ed Murray, an openly gay lawmaker and lead sponsor of the bill, told The Advocate he remains confident that the 25 pledged votes needed to pass the legislation remain solid. Gay
marriage equality in Scotland ‘by the end of 2013' Scotland is likely to have full marriage equality by the end of 2013 at the latest, Tim Hopkins, Director of the Equality Network told PinkNews.co.uk at a reception in the Scottish Parliament yesterday evening. 400 people attended the reception after all opposition party leaders signed up to the Equal Marriage Pledge. The Scottish government, led by the Scottish National Party, concluded public consultation on equal marriage on 9 December. It was the government’s largest ever public consultation, with over 50,000 responses. It will now analyse the feedback and publish their response in spring along with a draft bill, which will be open for expert consultation and voting by mid-2013, expected to pass as law by the end of 2013. “This is the last piece of devolved legislation in Scotland that needs to be changed to introduce full equality for LGBT people in the law,” declared Hopkins. This is in contrast to England and Wales, where the consultation process will only start in March this year. Westminster “might move ahead at the same time scale as in Scotland, but if it doesn’t, the fact that it goes here will help campaigners in the rest of the UK” speculated Hopkins. Speaking with PinkNews.co.uk, out bisexual MSP Patrick Harvie, leader of the Green party stated: “This is a real opportunity to shift the argument not just here but in the rest of the UK. If we are to move on this quickly Westminster will be prompted to move on this issue faster”. Opinion polls suggest a majority of Scots support equal marriage, including the Scottish Social Attitudes Survey 2010 which indicated 61% support versus 19% opposition. This included a majority of respondents following all the major faiths and political parties in Scotland. For the full article, click here. Gay
Marriage Opponents, Supporters Testify In Maryland Opponents and supporters of a gay marriage bill on Tuesday packed a Maryland Senate committee hearing on Tuesday. The Judicial Proceedings Committee hearing held this year's first public debate on the measure which seeks to make Maryland the seventh state to legalize gay marriage. The committee's first speaker was Governor Martin O'Malley, who introduced the bill last week. O'Malley argued that his bill was necessary to ensure the children of gay couples are protected. “We all want the same thing for our children – the opportunity to live in loving, caring, committed and stable homes protected equally under the law,” O'Malley testified. “It's not right and it is not just that the children of gay couples should have lesser protections than the children of other families in our state.” Baltimore Mayor Stephanie Rawlings Blake told the panel that the measure was about civil rights: “All couples, regardless of sexual orientation, deserve the same legal protection and rights under the law. The measure is expected to face few obstacles clearing the committee or the full Senate, which approved a similar bill last year. However, the bill lost in the House of Delegates – a loss which supporters hope not to repeat this year. One opponent of the measure testified that its religious exemptions were flawed because they did not extend to private businesses and individuals. Another objected to marriage equality because science has yet to determine whether sexual orientation is an immutable characteristic and used recent comments by actress Cynthia Nixon to back up her claim. A vote on the measure is expected within the next two weeks. Gay
Marriage Bill Clears Washington House Panel; Senate Vote Wednesday A bill
which would make Washington the seventh state to legalize gay marriage
cleared a House panel on Monday, the AP reported Members rejected three amendments offered by Republicans, including one that would have expanded the bill's religious exemptions to include private businesses and individuals. Lacey All, chair of Washington United for Marriage, thanked the committee for its work. “As the bill continues to progress in both chambers in Olympia, it is clear that momentum is on our side,” All said in a statement. “The stories of love, honor, commitment and family that our legislators are hearing from their constituents continue to be the single most important factor that sets us apart from those who oppose this bill.” The vote came as the Senate is expected to vote on its companion bill later this week. Senator Ed Murray, the chief sponsor of the bill in the Senate, said he expects the measure to reach the Senator floor on Wednesday. Supporters of marriage equality have said they have sufficient support to clear both chambers and Democratic Governor Chris Gregorie has said she will sign the bill. However,
opponents have vowed to challenge the law with a referendum. Half
of Maryland residents back legalizing same-sex marriage
Overall, the Post poll found that 50 percent of Marylanders support allowing gay and lesbian couples to marry while 44 percent are opposed. That is the highest recorded level of support in Maryland in a Post poll, about the same for the rest of the country — as measured by another recent Post survey — despite Maryland’s reputation as one of the nation’s most liberal states. The new poll found a sharp divide among Maryland Democrats based on race. Among whites, 71 percent support same-sex marriage, while 24 percent do not. Among blacks, 41 percent are supportive, while 53 percent are opposed. Maryland has the largest concentration of African Americans of any state outside of the Deep South. The poll findings highlight the challenge ahead for Gov. Martin O’Malley (D) as he tries to pass legislation this year in the heavily Democratic General Assembly, where there is a rift within his own party over gay nuptials that mirrors public sentiment. Debate in the General Assembly is intensifying on a bill that would make Maryland the seventh state, in addition to the District, to legalize same-sex marriage. On Monday night, a group of ministers and lawmakers have planned a large rally outside the State House to make clear they still oppose legislation that narrowly passed the Senate last year but fell a few votes short in the House of Delegates. In advance of a Senate hearing on the bill, gay-rights supporters are planning a news conference on Tuesday morning with clergy members to show the measure has religious support in the 90-day legislative session. For the full article, click here. UK:
LGBT history month to launch this week Peter Tatchell will join a panel of figures from gay and transgender life on Wednesday night at one of the first events in 2012's LGBT history month. The national event, which is in its eighth year, has as its theme the issue of homophobia in sport. A full list of events across the UK can be found at the LGBT History Month website. Suran Dickson, CEO of the anti-bullying charity Diversity Role Models, will be hosting Queer Question Time with a panel of 5 local, national, and international LGBT icons at the first event in Southwark. Queer Question Time will cover the special topic of homophobia in sport as well as the Olympics and the Cultural Olympiad and the broader issues facing the LGBT community. The panellists will include sports broadcaster Bob Ballard, the FSA’s Head of Corporate Responsibility Claire Harvey, founder of the Marlin swimming group Dave Merchant and Kelly Simmons, Head of National Game for the FA. Sue Sanders, the Co-Chair of LGBT History Month UK and Schools Out and Councillor Abdul Mohamed, Cabinet Member for Equalities and Community Engagement will be opening the evening at 7pm followed by a performance from the Pink Singers, an LGBT community choir based in London. The launch will take place at Glaziers Hall by the river Thames on Wednesday 1 February 2012. Doors 6 – 9.30pm,
Music from the Pink Singers 7pm, Debate 7.30pm Chris
Gregoire, Washington State Governor, Discusses Gay Marriage, Chris Christie,
And More Governor Chris Gregoire of Washington wishes she'd supported marriage equality for gays and lesbians years ago -- and she hopes President Obama evolves in his thinking soon. But she respects the president’s “personal journey” and asked people to “give him the time” to see it through. Having introduced a marriage equality bill several weeks ago that now reportedly has the votes in the state legislature to pass, Gregoire, in an interview on my radio program on Sirius XM OutQ, also criticized Governor Christie of New Jersey for urging marriage equality be voted on at the ballot without a vote of the elected representatives. The governor also spoke of the heartfelt and emotional response she’s received from the public to her decision, including from a gay teen who was contemplating suicide. Regarding her own journey Gregoire said: “I wished I could have come to the point that I am today six years ago, seven years ago, five years ago. But it took me a journey and for that, I’m sorry that it took me as long as it did. But it’s genuine. It’s not about politics. It’s very heartfelt. it’s about my [Catholic] faith and I have struggled with it.” She’s enormously moved by the response she’s received. “Probably the most moving -- I’ve received thousands of emails and letters and telephone calls,” she said. “And the one that just hit my heart was a sixteen year old who said, ‘I’ve thought about suicide, and now that you’ve come out as strong as you have, I feel good about myself. And one day I will not go on bended-knee and ask someone to join me in a domestic partnership -- I’ll ask them to marry me.’ That’s the exact thing that moved me to where I am and that’s only right for our children in this state and for their parents.” Of President Obama still “evolving” on marriage, as he has put it, disappointing many LGBT supporters who want him to come out fully for equality, Gregoire asked for patience: “I think, I hope, the president will evolve in his thinking and his personal journey but I have to respect the journey he’s on. He has done, in my opinion, a great job as commander-in-chief, with respect to our military, as a voice for anti-discrimination for gay, lesbian, bisexual and transgender people of this nation. I would ask our friends, as a big an ask as it is, give him the time to see the journey through. I believe he will get to where I found myself, [New York] Governor Cuomo found himself. But people need to give him the opportunity to get there.” Gregoire responded to Gov. Christie’s controversial suggestion that marriage equality go to the ballot in New Jersey without a vote by the representatives by discussing the politics in her own state, where ballot initiatives are commonplace and easy for citizens to launch. “If someone out there in the community believes it should go to a ballot there’s a mechanism by which they can do that readily in our state, and do it all the time, and I respect that and believe the people of the State of Washington will stand up," she said. "But meanwhile, today, in my state I am urging every one of my senators and representatives to stand up, take the vote, do the right thing. Bear the responsibility, do not just send it to the ballot.” For the full interview, click here. NJ:
Black Leaders Blast Christie for Referendum Proposal Prominent African-American elected officials including Newark Mayor Cory Booker slammed the suggestion from New Jersey Governor Chris Christie to put same-sex marriage to a public vote, while the governor, legislative leaders and advocates appeared to be girding for a protracted confrontation on Wednesday. The Star-Ledger reports that Booker, a Democrat who has refused to perform marriages at Newark city hall until all couples have the right, stood in “unprecedented public divergence” with the Republican governor on Wednesday when he warned that minority rights should not be subjected to a majority vote. "I shudder to think what would have happened if the civil rights gains, heroically established by courageous lawmakers in the 1960s, were instead conveniently left up to popular votes in our 50 states," said the mayor in a statement. During a news conference reported by the Associated press, he echoed senate sponsors of the bill who opposed the referendum idea the previous day. “Dear God, we should not be putting civil rights issues to a popular vote, to be subject to the sentiments, the passions of the day,” said Booker. “No minority should have their rights subject to the passions and the sentiments of the majority. This is the fundamental bedrock of what our nation stands for.” Christie called for the Democratic-controlled legislature to put the issue to a public vote on Tuesday at a town hall in Bridgewater while a senate judiciary committee hearing on the marriage equality bill was underway in Trenton. The panel advanced the bill in an 8-4 party line vote, but Christie also reiterated his promise to veto the measure, which threw into doubt the prospect of garnering enough Republican support for an override. Speaker Sheila Oliver, the first African-American woman to lead the New Jersey assembly, expressed offense at additional comments from Christie on Tuesday that civil rights advocates in the South during the 1950s and ‘60s “would have been happy to have a referendum on civil rights rather than fighting and dying in the streets.” “Governor, people were fighting and dying in the streets of the South because the majority refused to grant minorities equal rights by any method,” she said, according to the AP. “It took legislative action to bring justice to all Americans, just as legislative action is the right way to bring marriage equality to all New Jerseyans.” A spokesman for Speaker Oliver told The Advocate that the assembly is expected to take up the bill soon. For the full article, click here. Washington
Archbishop Peter Sartain Testifies Against Gay Marriage Bill
According to the Catholic News Agency, Sartain testified against the bill during a Senate committee hearing held on Tuesday. Supporters of making Washington the seventh state to legalize gay marriage – and the first on the West Coast, not counting California which briefly legalized the union in 2008 – say they have the votes to approve the measure. Opponents have vowed to put the issue before voters. Sartain
said that because “only the union of a man and a woman can generate
new life” that no “other human relationship is its equivalent.” “Marriage makes a contribution to the common good of society unlike any other relationship, through the procreation, rearing and education of children,” he said. “I urge you to uphold the definition of marriage as the union of one man and one woman.” MN:
St. Paul City Council opposes marriage amendment
Six of the seven City Council members sponsored the resolution so it passed easily. Only Council Member Don Bostrom didn't sign on to the proposal. Bostrom was absent and didn't vote on the resolution. "It's not my issue," he said in explaining why he wasn't a sponsor. The five-paragraph resolution notes that St. Paul "has long recognized the importance of equality for all citizens and has been a leader in supporting human rights, including the adoption in 1990 of an ordinance making it illegal to discriminate based on sexual orientation." The city also adopted a domestic partnership registry in 2009. With the passage of the resolution, the council joined the coalition Minnesotans United for All Families. The group is opposing the amendment. The Nov. 6 ballot question will read: "Shall the Minnesota Constitution be amended to provide that only a union of one man and one woman shall be valid or recognized as a marriage in Minnesota?" If approved, the amendment would add a new section to the constitution reading, "Only a union of one man and one woman shall be valid or recognized as marriage in Minnesota." N.J.
Marriage Bill Advances, Christie Wants Referendum
Democratic lawmakers introduced the bill two weeks ago with the expectation that it would pass both houses, in contrast with 2010, when the measure died after a 20-14 vote in the senate. Senate President Stephen Sweeney, who abstained from voting two years ago, has since changed his position and become a sponsor of the legislation. He told The Advocate he planned to discuss the legislation with Christie, who could choose to veto the bill or let it become law without his signature, after it passed the senate and general assembly. However, Christie appeared to foreclose prospects for dialogue when, at the same time as the committee hearing, he announced during a town hall that he planned to veto the bill. The governor said he wanted lawmakers to put the issue before voters in a referendum. A Quinnipiac poll last week showed that a majority (52%) of New Jersey voters support marriage equality for the first time. "I think this is not an issue that should rest solely in my hands, or the hands of the Senate President or the Speaker or the other 118 members of the Legislature," said the governor, according to the Star-Ledger. "Let's let the people of New Jersey decide what is right for the state." The remarks represented a departure from Christie’s more open tone of recent weeks. As recently as Monday, a Christie spokesman told The Advocate that the governor planned to allow the legislative process to unfold, and then review it in accordance with a 45-day review period, "just as he would any other piece of legislation.” Senate President Sweeney responded with a resounding no when a speaker informed the hearing participants of the governor's announcement. His reply appeared to escalate the mounting confrontation between Democratic lawmakers and the Republican governor. "Civil rights is not to be placed on the ballot," said Sweeney after a speaker interrupted to share the governor's announcement. "It’s to be voted on by the people in this house." Senator Ray Lezniak, a bill sponsor, directly addressed Christie in comments before voting to advance the bill. For the full article, click here. Washington
Witness Says Gay Marriage Would Pollute Social Environment Christopher Plante of the National Organization for Marriage (NOM) on Monday testified that he objects to a proposed gay marriage bill in Washington state because it would pollute the social environment for future generations, ThinkProgress.org reported. “Today, you can go to the supermarket and buy seventh generation cleaning products because it is politically correct to be worried about the ecology we're leaving the seventh generation. What is the social environment we're going to leave the seventh generation,” Plante told lawmakers on the House Judiciary Committee reviewing the measure. (Related: NOM pledges to work against Washington state Republicans who support gay marriage.) Senator
Mary Margaret Haugen announced
she would vote in favor of the bill before the panel began its public
hearing, giving supporters sufficient support to make Washington the seventh
state to legalize gay marriage. “Hitler
tried to change and redefine what life was and it was a great failure,”
he testified. “I can't believe at the age of 58, I'd even be here
discussing something like this. It's totally an abomination and disgusting.” “So you're telling me that you know better than God,” Hutcherson said. “You're telling me that God is not right by limiting marriage to just a man and a woman. You're doing the same thing. You're just saying God is too narrow minded, but you're just as narrow minded, because you just want to give it to two men or two women.” First
Washington, Now New Jersey Braces for Marriage Showdown New Jersey Senate president Stephen Sweeney admits that he made a “mistake." That's how he describes his behavior two years ago, when he abstained from voting on the marriage equality bill and contributed to the 20-14 defeat of the measure. The Democrat blames his move on politics, where he supported the substance of the bill but bowed to the political winds of his conservative South Jersey district. “I’m a big boy, I made a mistake,” said Sweeney in an interview with The Advocate. While confirming reports that he is considering a run for U.S. Senate in 2014, he insisted his recent sponsorship of a same-sex marriage bill stems from a motivation to remedy an injustice, not career aspirations. “I am going to correct the mistake, and I am going to do what’s right for the people that were wronged," he said. "That’s all this is about.” If successful this session, Sweeney and other leaders of the Democratic-controlled state legislature could close a bumpy chapter for the state's nine million residents. The saga began when the Supreme Court of New Jersey issued a decision in 2006 that prompted the legislature to pass a civil unions bill later that year. A state commission concluded the civil unions law created a “second-class status” in 2008, but a lame-duck legislative drive for marriage equality failed in 2010 despite a promise from outgoing Gov. Jon Corzine to sign the bill. Gov. Chris Christie, the Republican who succeeded him, does not support marriage equality, a factor that distinguishes him from the Democratic governors of New York, Washington and Maryland, all Catholics like Christie, who have pushed for the legislation. As of Monday, Washington appeared to be on the verge of becoming the seventh state plus the District of Columbia with marriage equality, after the last of the required votes emerged in the senate. Sweeney said that last time, he agreed to be one of the 21 votes that would pass the bill, but in a “political calculation,” he refused to provide a yes vote for any bill that failed. When Gov.-elect Christie prevailed on five Republican senators to retract their support, it became apparent the legislation could not pass, and so Sweeney abstained, the equivalent of a no vote. Fast forward two years, and Sweeney believes his chamber has enough votes to pass the bill “easily" next month. The Senate Judiciary Committee will hold a hearing and vote on the bill Tuesday, and he expects a successful floor vote on the bill on February 13. The vote would mark the first time a marriage equality bill passes either chamber of the New Jersey legislature. “It’s going to pass,” said Sweeney. “That’s how confident I am. It will pass the senate on the 13th.” Sweeney also expressed optimism about prospects in the general assembly led by Speaker Sheila Oliver, but passing the bill represents only part of the battle. Legislators need to gather the two-thirds majority required to override a potential veto, should Christie exercise that option after the bill reaches his desk. “We’re getting there,” Sweeney said of the ongoing effort in his chamber. “This is an enormous lift.” Democrats control the senate 23-16, with one open seat, and Sweeney said it could be possible to get support from as many as 22 members of his conference. He said that Republican interest in the bill is “moving,” although he declined to name prospective GOP votes except Sen. Jennifer Beck, who has already announced her support. “I don’t want any more headaches for them than they’re going to get,” he said. To continue reading this article, click here. WA:
Legislature has enough votes to legalize gay marriage OLYMPIA (AP) -- Washington's Legislature now has enough votes to legalize gay marriage. Democratic Sen. Mary Margaret Haugen says she will support the measure, becoming the 25th vote needed to pass the bill out of the Senate. The House already has enough support, and Gov. Chris Gregoire has endorsed the plan. Washington would become the seventh state to legalize same-sex marriages, following New York, Connecticut, Iowa, Massachusetts, New Hampshire and Vermont. Washington state has had a domestic partnership law since 2007, and a "everything but marriage" law since 2009. Haugen's announcement came has hundreds of people filled the capitol to advocate for and against gay marriage. State senators began considering the bill during a morning committee hearing. Opponents and supporters of gay marriage packed a Senate committee hearing Monday for the first public hearing of the most high-profile issue before the Washington state Legislature this session. Dozens of people crammed into a small Senate committee hearing room, which was quickly filled to capacity as people lined up outside the room two hours in advance of the 10 a.m. start. The Senate set up three overflow areas for the public, including the public gallery on the Senate floor. Opponents of gay marriage wore buttons that said "Marriage. One Man. One Woman." Others wore stickers that read "Washington United for Marriage," a group that announced in November that it was forming a coalition to support same-sex marriage legislation. Democratic Sen. Ed Murray, a gay lawmaker from Seattle who has led the push for gay civil rights and domestic partnerships, testified before the Government Operations, Tribal Relations & Elections Committee with his longtime partner, Michael Shiosaki. "I have waited 17 years to ask this body to consider marriage equality for gay and lesbian families," said Murray, who is sponsoring the Senate bill. "I realize the issue of marriage for our families is emotional and divisive. It touches what each of us holds most dear, our families." Opponents argued that the measure goes against traditional marriage and the Bible. "You are saying as a committee and a Legislature that you know better than God," said Ken Hutcherson, pastor of Antioch Bible Church. The National Organization for Marriage issued a statement Monday morning pledging a referendum campaign to fight any gay marriage law at the ballot. Last week, the group announced that it would spend $250,000 to help fund primary challenges to any Republican who crosses party lines to vote for same-sex marriage in Washington state. So far, two Republicans in the Senate, and two in the House have said they would vote in support of gay marriage. Gay marriage has won the backing of several prominent Pacific Northwest businesses, including Microsoft Corp. and NIKE, Inc., and last week a conservative Democrat who once opposed same-sex marriage said he will now vote for it. The state House is widely expected to have enough support to pass gay marriage, and Gov. Chris Gregoire publicly endorsed the proposal earlier this month. The state Senate is now just one vote shy of having the 25 votes needed to approve the bill, with a half-dozen lawmakers remaining uncommitted. In October, a University of Washington poll found that an increasing number of people in the state support same-sex marriage. About 43 percent of respondents said they support gay marriage, up from 30 percent in the same poll five years earlier. Another 22 percent said they support giving identical rights to gay couples but just not calling it marriage. To continue reading this article, click here. Maryland,
Washington, New Jersey Begin To Debate Gay Marriage
In Maryland, Governor Martin O'Malley is expected to introduce his proposed legislation for this year's General Assembly, which should include the gay marriage bill he pledged to back last spring. Senate
President Thomas V. Mike Miller, who does not support the measure, has
said the Senate will take up the issue before the House. Analysts this year say they expect a quick OK in the Senate but capturing the 141-member House remains in doubt for supporters. Committees in Washington and New Jersey will begin holding public hearings on gay marriage bills which were filed earlier this month. Democratic leaders in Trenton are looking for veto-proof majorities in the House and Senate to blunt an expected veto from Republican Governor Chris Christie. However, Christie has yet to say what he would do if lawmakers approve the marriage equality bill. A bill filed in Washington has the backing of Democratic Governor Chris Gregoire. Strong support in the House leaves little doubt the bill will clear the chamber. However, the measure remains 1 vote short in the Senate, where 2 Republican senators have voiced their support. Five senators remain undecided. Md.
same-sex legislation to be examined in two committees, House speaker says In a sign of the tough road ahead for same-sex marriage legislation in Maryland, House Speaker Michael E. Busch said Monday that he would assign this year’s bill to two committees instead of one, a procedural change that could increase the measure’s chances of passage. Busch (D-Anne Arundel) said the decision would allow more delegates to closely examine the controversial measure, which died unexpectedly on the House floor last year after narrowly passing the Senate. But critics said the move suggests the votes are not there this year to advance the bill from the Judiciary Committee, the House panel that approved it last year, to the full chamber. At times in the past, when bills have been “jointly referred” to two committees, House leaders have used a majority vote from just one panel as justification to send legislation to the floor. House rules are largely silent on such situations but grant the speaker considerable leeway on committee assignments. “This issue is way too important to be playing games with,” House Minority Leader Anthony J. O’Donnell (R-Calvert), an opponent of same-sex marriage, said upon learning of Busch’s decision. “I guess it shows a great lack of confidence in the Judiciary Committee. I think that committee is capable of doing the job.” Busch, who supports the bill, said it makes sense to have the Health and Government Operations Committee examine it as well, given that panel’s history of weighing civil rights measures. Aides have acknowledged that support for the same-sex marriage bill appears stronger on that panel. For the full article, click here. Effort
To Repeal Gay Marriage In Washington Already Underway Passed in 1996 when no state or district had legalized marriage equality, DOMA prohibits recognition of legal same-sex marriages for federal purposes. The Respect for Marriage Act would amend federal code to read that an “individual shall be considered married if that individual's marriage is valid in the State where the marriage was entered into or, in the case of a marriage entered into outside any State, if the marriage is valid in the place where entered into and the marriage could have been entered into in a State.” (Text of the bill is here.) Video of the meeting will be available at the Senate Judiciary Committee website here. The Advocate will have an updated report on the meeting later today. Lifetime
blood donation ban for gay men lifted today Regulations banning the donation of blood by men who have ever had gay sex will be lifted from today. The Department of Health announced the changes in September, implementing a one-year deferral period instead, so that men who have had gay sex in the last 12 months may still not donate blood. The change comes into force in England, Wales and Scotland this week. Northern Ireland has not yet decided whether it will relax the rules, prompting an accusation of homophobia against its health minister. The Advisory Committee on the Safety of Blood, Tissues and Organs (Sabto) carried out a review and found it could no longer support the permanent exclusion of men who have had sex with men. Dr Lorna Williamson, NHS Blood and Transplant’s medical and research director, said: “Our priority as a blood service is to provide a safe and sufficient supply of blood for patients. This change gives us an opportunity to broaden our donor acceptance on the basis of the latest scientific evidence. “The Sabto review concluded that the safety of the blood supply would not be affected by the change and we would like to reassure patients receiving transfusions that the blood supply is as safe as it reasonably can be and amongst the safest in the world. There has been no documented transmission of a blood-borne virus in the UK since 2005, with no HIV transmission since 2002.” Gay rights campaigners said gay men would still be treated unfairly under the new rules implemented today, as heterosexuals engaged in higher risk sexual activity are not subject to the same restrictions. The one-year deferral was chosen in part because of Hepatitis B, which disproportionately affects gay and bisexual men. While there is a four-week window between transmission and detection of HIV, Hepatitis B can take up to a year to be cleared by the body. HIV charities generally welcomed the announcement, although they called for further reviews if the rates of HIV and Hepatitis B in gay men fall. National AIDS Trust, Terrence Higgins Trust and GMFA said in a joint statement at the time of the announcement: “Whilst we are pleased to welcome this rule change for gay men, we will continue to encourage SaBTO to regularly review their restrictions on blood donation related to sexual behaviour (including other groups in addition to gay men). Particularly as the epidemics around blood-borne viruses evolve and scientific evidence changes and advances.” The European Commission said that any ban on the basis of sexual orientation breaks EU laws. But in response to a recent written question, John Dalli, the European Commissioner for Health and Consumer Policy, said that sexual behaviour should not be confused with sexual orientation. Gay rights charity Stonewall said the change was a “step in the right direction” but called for donors to be screened purely on the basis of behaviour, rather than sexual orientation. Chief executive Ben Summerskill said: “Safety must remain paramount. However at a time of national shortages in blood, everyone who can give blood at no risk to recipients should be able to donate. “To retain a blanket ban on any man who has had sex with another man in the last year, even if he has only had oral sex, remains disproportionate on the basis of available evidence.” He added: “Stonewall will continue to push for a donation system based on the real risks a potential donor poses. People wanting to donate blood should be asked similar questions – irrespective of their sexual orientation – that accurately assess their level of risk of infection. Sadly, the proposed new system will still fail to do this.” Zambia
and Zimbabwe appear to reject gay rights “pressure” on aid
Government minister Given Lubinda said the Zambia would only enact laws supported by its citizens and in line with their culture. He said: “David Cameron must be reminded of what we agreed when we met in Paris for the Paris Declaration. When we met in Ghana, we came up with the Accra Agenda for Action and both those declarations are that no country will use its aid to influence the policies of an aid receiving country.” Speaking to Zambia’s Hot FM Radio, he continued: “It is wrong for Mr Cameron to try and use aid as a way of influencing policies and laws of Zambia. Zambia will not be pressured to formulate laws or policies by any foreign government.” Meanwhile in Zimbabwe, one political party leader said chances for gay rights protection were “zero”, despite Prime Minister Morgan Tsvangirai’s assertion that gay rights are “human rights” last month. Welshman Ncube is the leader of MDC-M, who make up around 5 percent of Zimbabwe’s House of Assembly, but said the view was widely held. Ncube was meeting with church leaders in Bulawayo last week when he said the views of the people were clear and they did not support gay rights in the constitution, The Zimbabwean reports. He said: “If you look at the constitution data today, the people said no to protecting gay rights and I think chances are zero”. “If we listen to the views of people who attended COPAC [constitutional select committee] meetings, it is clear that they said no to gay rights.” However, Mr Cameron’s announcement about how the status of gay rights could affect a country’s aid does not reflect a change of essential policy, as LGBT rights have historically fallen under the head of human rights and have always been expected to be recognised by aid-receiving countries. Instead, the stricter implementation of the Department for International Development’s existing guidelines would see a reduction in General Budget Support, the aid that is sent directly to overseas governments, in favour of alternative funding mechanisms if those governments are not seen to recognise all human rights. A UK Government spokesperson said: “The UK Government is at the forefront of work to promote human rights around the world, and regularly criticises Governments which violate those rights. “This includes working to end religious intolerance, and persecution and discrimination against individuals on the basis of their sexuality. “Our new approach, set out in detail in July this year, means we only provide aid directly to governments when we are satisfied that they share our commitments to reduce poverty; respect human rights; improve public financial management; fight corruption; and promote good governance and transparency.” The government intends to reduce the amount given in General Budget Support to foreign governments from 16% of bilateral foreign aid in 2009/10 to 9% in 2014/15. Ugandan and Ghanaian governments have already signalled that they will not legislate to protect gays. Nancy
Pelosi Files Brief In Support Of Challenge To DOMA Democratic leader Nancy Pelosi on Thursday filed an amicus brief in support of plaintiffs challenging the constitutionality of the Defense of Marriage Act (DOMA), the law that bars federal agencies and the military from recognizing the legal marriages of gay and lesbian couples. The filing is supported by 132 House Democrats, including Representatives Steny Hoyer, James Clyburn, Jerrold Nadler, John Conyers, Barney Frank, Tammy Baldwin, Jared Polis and David Cicilline. The brief argues that Congress acted hastily in approving DOMA. “When Congress enacted DOMA in 1996, gay and lesbian couples could not marry anywhere in the world. Bowers v. Hardwick was still good law, inviting discrimination as a means of expressing moral disapproval of lesbians and gay men. In this atmosphere, many were reluctant to speak openly about themselves or their families,” the lawmakers' brief reads. “DOMA's proponents capitalized on this, portraying the possibility of same-sex couples joining in marriage as a concerted attack by 'homosexual extremists' on heterosexual marriage and exhorting Congress to act quickly to preempt this possibility.” The brief was filed in two cases being heard in the First Circuit Court of Appeals. The filing makes it clear that the House is divided on the issue. House Speaker John Boehner, a Republican from Ohio, has authorized up to $1.5 million to defend the law in court. Anal
HPV infection more likely to persist in gay men compared to heterosexual
men An international team of investigators have found a possible explanation for the higher rates of anal cancer observed in men who have sex with men (MSM) compared to men who have sex with women (MSW). In the December 1st edition of the Journal of Infectious Diseases, researchers from the HIM study report that anal human papilloma virus (HPV) infections were significantly more likely to persist in MSM than MSW. “Compared with MSM, we consistently observed a lower prevalence, incidence, and persistence of anal HPV among MSW,” comment the investigators. Cigarette smoking was independently associated with the persistence of the infection in MSM. Anal cancer can be caused by persistent infection with certain strains of HPV. Overall rates of anal cancer in men are low (approximately 1 per 100,000, but are significantly higher in men who have sex with men (36 per 100,000 before the HIV epidemic).
|
||||||||||||
| This site contains HIV prevention messages that may not be appropriate for all audiences. If you are not seeking such information, or may be offended by such materials, please exit this website. |