The Centers for Disease Control (CDC) calculates the annual estimated cost of HIV using calculations that are based on the number of new diagnoses and then multiplied by the lifetime treatment costs. The total lifetime treatment costs of HIV (based on new diagnosis in 2009) is estimated to be $16 billion ($16,000,000,000).

The states with the highest financial HIV burden are Florida with 5,775 new Diagnoses and a lifetime costs of $2,120,000,000, California with 4,886 new diagnosis and lifetime costs of $1,794,000,000, New York with 4,649 new diagnosis and lifetime costs of $1,707,000,000, and Texas with 4,291 new diagnosis and lifetime costs of $1,575, 000,000.

The current lifetime treatment cost for one HIV infection is estimated to be $379,668. Prevention logic assumes that there will be a ‘lifetime’ savings of $379,668 for every infection averted. Based on this logic, it makes good financial sense to spend large amounts of money on HIV prevention programs that are proven to prevent new infections.

The CDC has announced grants of $339 million to state and local health departments for HIV prevention activities in 2012. The way the money is being granted has changed a great deal, with money being sent to states based on the number of people living with HIV. Previously, funding was allocated to states based on the number of people living with AIDS. This changes has created a great deal of shift and realignment in almost every health department in the nation.

Most of the federal funding will help to support prevention efforts such as HIV testing, condom distribution, and other activities to help people with HIV reduce their risk of transmitting HIV.

An additional 20 million dollars will be awarded in March, through competitive grants, to help fund innovative HIV-prevention demonstration projects.

The financial costs of prevention, care, and treatment of HIV/AIDS is staggering, but the toll taken on the emotional and physical lives of HIV-Positive individuals cannot be calculated or compared to the financial costs.

Think HIV/AIDS is not your concern, well think again! HIV/AIDS is everyone’s concern. Regardless of our HIV status, we all pay for HIV/AIDS in one way or another.

Stephan

Two of the most popular blog posts in the last year (“Would you tell?” and “HIV status in profile, what’s yours?“) involve disclosing your HIV status. Many of the 300 comments were passionate about whether or not you can (or should) trust someone’s negative HIV status on A4A.

Obviously, everyone has the opinion to disclose one’s HIV status and STD test results or not and it is an individual choice, each option (to tell or not to tell) has a justifiable argument. But the bottom line is that no matter what someone puts in their profile you have no choice but to take them at their word. Well, maybe this can change.

Would you take the time to verify someone’s HIV and STD test results if you could? Would you make your test results publicly available? Well, let me introduce you to Qpid.me!

Qpid.me independently confirms your HIV/STD status (and viral load if you are HIV+) with your doctor and/or clinic, then lets you share your status in ways that you choose. Quoting them: “Our goal is simple: to help you make better decisions about who and how you have sex.”

How does it work?

* You get tested wherever you want (or have already been tested within the last year)

* You sign-up at Qpid.me (they then fax your clinic/doctor to confirm your results)

* You share your results however you want (what about putting a link to them on your A4A profile?)

What do they confirm?

* HIV status and 3 curable STDS: chlamydia, gonorrhea, & syphilis

* If you’re HIV positive, your viral load is confirmed

* Herpes and HPV are not part of the results confirmed

Qpid.me is a currently a FREE service, their simple desire is to “help spread the love, nothing else”.

What do you think, would you post your STD/HIV test results?

Would you be willing to bareback with someone if they posted their HIV/STD test results?

How often would someone need to be tested for you to really trust their test results?

Would have someone’s test results available on their profile be something you would like to see?

Stephan

While conducting research and gathering information on Health Disparities and Correctional Health, I came across information that I believe is important for everyone to know.

Most alarming are the differences in incarceration by race. Blacks are incarcerated at a rate more than 6 times higher than white non-Hispanic males and 2.6 times higher than Hispanic males.

The majority of all inmates have been imprisoned as a result of the “war on drugs” and the “tough on crime” criminal justice policies. These policies have resulted in the U.S. having the highest incarceration rate in the world and have impacted us all, but the greatest long-term impact has been felt on the black community. In the United States in 2009, over 7.2 million people were under some form of correctional supervision including Probation, Prison, Jail and Parole. Additionally, there are estimated to be more than 16 million felons and ex-felons in the United States which represents 7.5% of the entire adult population, 22.3% of the black adult population, and an astounding 33.4% of the black adult male population.

These numbers are staggering and they matter to us all. Depending on their state of residence, these individuals may lose parental rights, the right to vote, the right to serve on juries, and the right to hold public office. In many states, their criminal history is public record and is readily searchable for anyone who wants to know.

There are lifelong consequences to the health of individuals and communities, that go far beyond the results that are related to the potential political consequences of incarceration, outcomes that are worthy of discussion.

What does it mean to the mental health and the social norms of a community and its individuals when a significant portion of the men in the community are arrested and imprisoned? What happens to long-term relationships such as husband and wife, father and son when the man of the house is incarcerated or re- incarcerated? Consider, that more than 7% of African American children currently have an incarcerated parent, with a far greater number who have parents that are ex-prisoners, ex-felons, and felons currently serving sentences outside of prison.

There are many health outcomes as a result of incarnation. For example, the correctional commission estimates that over 20% of all individuals in the United States infected with HIV and close to 40% of individuals infected with hepatitis C pass through correctional institutions in a given year. Out breaks of tuberculosis have been traced to correctional facilities (with the rates of tuberculosis in Rikers Island reported to be higher than the rates in many third world countries).

There is much more that can be said on the topic, but there are two conclusions that one significant study has made that are worth quoting and concluding this post: Incarceration has significant long-term effects on physical health, and incarceration plays a role in perpetuating racial inequalities in health.

I am attending the Annual Meeting for the National Coalition of STD Directors (NCSD) in San Diego. NCSD is the only national organization that provides to support to STD Directors from departments of health from around the nation. This meeting provides an opportunity for NCSD members and colleagues to focus awareness in the areas of Public Health and the Impacts of Health Care Reform, Social Determinants of Health, Third Party Billing, STD Prevention among Special Populations, The National AIDS Strategy, as well as many other important topics within the field of STD prevention. I work with NCSD as Senior Advisor, Men Who Have Sex with Men, Sexual Health and Technology

I was privileged to present today in a session called, “Why are High-Risk Sexual Behaviors, STDs and HIV Infections Increasing among Men Who Have Sex with Men?” My presentation was titled, “Are Infection Rates Increasing in MSM as a Result of Changes in The Sexual Behavior of Men?” I believe that anal sex is a behavior that more men and women are engaging in, and that there is more same-sex behaviors between married men and other heterosexually identified men than ever before, and Internet is facilitating the increase of same-sex sexual behaviors.  

If you are interested in the presentation it is available through this link.  

Please feel free leave your thoughts and comments!

Stephan

There has been a lot of talk about people who are overweight paying more for seats on airplanes and health insurance in an effort to cover expenses that can increase as a result of an individual being overweight or obese. The argument has been that those who cost more, should pay.

According to the Centers for Disease Control, the medial care costs of obesity in the United States is about 147 billion, yes, billion with a ‘B’.

Rather than directly tax the overweight for being larger, Denmark has taken steps to prevent the increase in weight before it is a problem and to help reduce the weight of the country by implementing a “Fat Tax”.

The first steps toward fat prevention using legal and economic pressure in Denmark were taken in 2004, when the Danish government made it illegal for foods to contain more than 2% trans-fat. This was followed up in 2010 with a tax on all sugary junk food.

The new fat tax, implemented Friday, affects all foods, including milk, cheese and butter. This means customers will be paying about $3 more per kilogram of saturated fats in a product.

There has been talk in the US about increased fees for insurance based on weight, higher costs for flights and other measures that could help off-set increased costs based on health risks and weight. There has even been some action taken in this direction. For example in 2008 the state of Alabama increased insurance rates for over 37,000 state employees determined to be unfit.

What are your thoughts?

Is it better to try to prevent a population from becoming overweight as Denmark is doing, or to increase costs based on weight, or do simply nothing?

Should those who cost more pay more?

As everyone hopefully knows, gay men are affected by several health concerns at disproportionate rates when compared to the general population, especially in regards to sexually transmitted infections and HIV.

According to the Centers for Disease Control (CDC) there are approximately 19 million new STD infections each year, which cost the U.S. healthcare system $16.4 billion annually and cost individuals even more in terms of acute and long-term health consequences. STDs are not to be taken lightly as undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences.

I have worked with public health for over 11 years, and I can tell you first hand that progress is being made, but there is a long way to go towards a level of health for men who have sex with men that is acceptable.

As a technology geek and an gay men’s health activist, there are two areas that are my primary areas of concern: Internet Outreach and Internet-Based Partner Services. There are a couple of blog posts on the topics; Would You Tell, which discusses partner services in general and Disease Intervention Specialists, which discusses the process and people that contact persons that may have been exposed to an infection, including HIV. You can find more information about the work on my website InternetInterventions.org.

One of the biggest challenges I face is educating public health in such a way as to help them understand the sexual freedom we, as men who have sex with men, enjoy and helping them understand the technologies, like Adam4Adam, that we use.

The second challenge that I find to be almost as difficult is in educating gay men on exactly what public health is trying to do online and why.

The history between public health and men who have sex with men is long and there have been painful experiences on both ends. Public health has been abused by gay men, and gay men have been abused by public health. The sad understory is that our health suffers as a result of these difficult experiences that it is difficult for us to move away from these experiences.

From the gay men’s health side of the street, I hear stories about the “sex police” and the government “invading our bedrooms” and I can understand that perspective. From the public health side I hear staff say “we are just trying to stop the spread of STDs and HIV” and “I can tell his partners for him anonymously so they can get help if they need it, I am protecting his privacy”. 

I also understand the perspective that talks about “the government” having sexual health information. On the surface it sounds scary, but in practice, they have the information already by law, (many infectious diseases must be reported) so why not work with them to get your partners checked?

Back to the point of this post, part of my hope in having the health portion of this blog is to provide a way for YOU to educate public health through your comments on the posts, and to educate gay men about what it is that public health is really up to through the posts.

Also, I think it is important for both public health and gay men to acknowledge Adam4Adam and their willingness to support gay men’s health, and do so in such an respectful way, they have never sought to turn their health work into a money making venture and they not only allow the work, they support it!

As the result of many years of advocacy, I have had agreements, funded by the Centers for Disease Control (CDC) with two significant national organizations, the National Alliance of State and Territorial AIDS Directors (NASTAD), and the National Coalition of STD Directors (NCSD).

As part of my work with NASTAD we held a conference on “Reaching Gay Men Using the Internet” and produced a full report you are welcome to read. There are a series of videos that have been produced and are available on YouTube. This conference was a unique effort focused on the sexual health of gay men and technology.

There have been many efforts since this gathering. Most recently NCSD hosted a cultural competency webinar that attracted more than 144 individuals from across the nation. This session is the first of its kind and part three of a three part series on Internet-Based Partner Services and using technology for sexual health.

This webinar on cultural competency can be viewed here, it is a great opportunity for you to get an insider’s view of these on-going efforts to use technology to reach men who have sex with men.

As always, your comments on these materials and the topic are welcome!

D.C. Attorney General Irvin Nathan has accused Miracle Hands, an HIV/AIDS service provider in Washington, DC that is owned by Cornell Jones, of spending nearly $300,000 in federal tax dollars to open a strip club.

According to the Washington Examiner, Cornell Jones “is a self-described former D.C. drug kingpin with convictions for narcotics distribution on his record.”

The lawsuit claims that the agency requested the funds to renovate a warehouse for use as a resident job training center for HIV-Positive individuals.

Funding for the renovation of the Queens Chapel Road warehouse was released in 2005, continued in 2006 and in April of 2007 Miracle Hands received an additional $139,000 to complete the renovations. The warehouse at 2127 Queens Chapel Road NE, opened as the Stadium Club in early 2010.

We have all heard it, “He is not bi, he is gay and afraid to come out”. Well, it is time for those that believe this to think again! Contrary to a 2005 study, a new study titled: “Sexual arousal patters of bisexual men revisited” which was accepted for publication June, 2011, states that true bisexuality does seem to exists.

This study included 35 bisexual men, 31 homosexual men, and 34 heterosexual men, from greater Chicago recruited from “Internet personal advertisement lists from those respective populations”.

Sexual identity (homosexual, heterosexual, bisexual) was stated by each participant and levels of sexual attraction to women versus men was rated on the Kinsey scale.

Participants were shown 3 minute videos and then stated if they were aroused (subjective arousal). They were also checked for genital arousal using an indium/gallium strain gauge that measured changes in penile circumference (simply stated they checked to see if participants started to get a chubby).

The study found that on average, the bisexual men in the study had ‘distinctly bisexual’ patters of both genital and subjective arousal.

So, the next time you think or say “come out” to someone that claims to be Bi, think again, because it appears, they are out and not only are they out, but they have twice the chance for a date this weekend!

Stephan

Masturbation is very common, even with those in relationships. Several reports have claimed that over 95% of men masturbate.

We know most are ‘doing it’, but what are the possible health side effects of masturbating?

First, you could reduce your risk of prostate cancer through regular masturbation. A study of over 1000 men who had developed prostate cancer and 1,250 men who had not, found those who had ejaculated the most between the ages of 20 and 50 were the least likely to develop the cancer. Why? It appears that ejaculating may prevent carcinogens from accumulating in the prostate gland. For those that suffer from urinary incontinence, masturbation may help you to “hold your water” by strengthening the pubococcygeus muscles. If masturbation is not enough to help, then there are exercises known as the “Kegel workouts” that can also help strengthen this muscle. In addition to helping with urinary incontinence these exercises can help create a stronger erection, help with premature ejaculation and can even “allow some men to achieve a form of orgasm without allowing ejaculation, and thereby perhaps reach multiple “climaxes” during sexual activity.”

Masturbation can also lead to better sex and sexual relationships. Masturbation is a great form of intrapersonal communication, and may positively affect your ability to relate to a sex partner.

Masturbation is a method by which you can get to know what you enjoy and do not enjoy, potentially enhancing sex with a partner.

Masturbation may lower your blood pressure. A small study has shown that full intercourse resulted in the lowest average blood pressure in stressful situations with masturbation also leading to lower blood pressure compared to those with no recent sexual activity. And some professionals even consider masturbation to be a cardiovascular workout. (hummm, I wonder if I can get Weight Watcher activity points for jerking off?) It is important to remember, as with all things, moderation is key. Too much of a good thing, even masturbation, can be a problem.

Compulsive masturbation can be a sign of other emotional problems and can have some undesirable outcomes. But for the most part, masturbation is regarded as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable, and safe. It is a good way to experience sexual pleasure, possibly improve your health, and can be done throughout your life.

Stephan