We have three ambitious goals: to reduce new HIV infections in San Francisco by 50% by 2015, to ensure that all San Franciscans know their HIV status, and to make sure everyone living with HIV or AIDS has access to proper 
care… This year we are doubling the number of HIV tests we provide and we’re expanding our work in the African-American community through medical-case management and peer-advocacy services.
We just opened a new satellite office in the Castro for the Stonewall Project, a foundation program that helps guys with alcohol and other drug issues and connects the dots between drugs and HIV risk. We are collaborating closely with a number of community partners to provide free HIV services and care at locations across San Francisco.
We have more work to do as we move closer to ending HIV in the city where it first reached epidemic levels. We will try new prevention programs—and expand existing ones—as we go about reducing new infections by 50% by 2015. It’s a tall order, but if any city is poised to make it happen, it’s San Francisco.”
—San Francisco AIDS Foundation CEO Neil Giuliano, on his organization’s mission as it merges with STOP AIDS, to GayCities.com.
WillBFair
Finally, an hiv ceo doing something serious. I am so tired of the hiv community focusing only on care, with nothing to say about prevention. Actually, they haven’t just said nothing about prevention, but have spent thirty years making excuses for the gay community. Enough!
It’s long past time for the community to put its collective foot down on this issue. We know more than enough to stop the spread of hiv. The question is, will we be tough enough and supportive enough with each other to make a difference.
Haightmale
Neil Giuliano is fairly new, and is touching the right notes (especially considering he’s an Arizona Republican politician).
Cutting the infection rate by 50% is a noble goal, and I support the effort, even if it’s impossible to attain. In the 30 years since the first reported case of HIV, the treatment protocols have changed drastically and are more manageable for most people, and the life expectancy of individuals with the virus has been increased dramatically.
Someone dies of AIDS or AIDS related illnesses every 20 minutes in the United States today.
There is still a tremendous social stigma in the gay community, and outside of our community. The fact that many states prohibit kids from learning everything there is to know about exposure to the virus, because they believe it “promotes homosexuality” is outrageous and absurd.
I agree that our community should put our foot down and come together to make a difference – but that could mean putting marriage equality on the back burner, while we focus on education, and passing strong anti-bullying laws in all 50 states, employment and public accommodation/housing protections in every state, affordable access to mental health and addiction treatment centers, and a repeal of all discriminatory laws that forbid mentioning LGBT or any variant of those consonants, in the context of HIV and sex education.
I’m game. http://www.jiveinthe415.com/
Roy
WillBFair
@Haightmale: For thirty years, I’ve listened to excuses for why we can’t stop hiv in the community.
Now, without evidence, you’re saying that we’d have to give up the rest of our agenda. This one goal would cancel out everything else we want.
That’s a new one on me, and very ingenious. Even the self hating crowd in the eighties, who spit profanity at anyone who raised the issue, never went this far. You must have stones the size of Gibraltar.
How about a tactic that wouldn’t cost a dime? Ever hear of peer group pressure?
Haightmale
I have spent a considerable amount of time thinking about this. Because of the largely ineffective national leadership we’ve had over the years, we’ve squandered time, money, and energy with little to show for it.
In 29 states, it’s still legal to fire an employee because they’re lesbian, gay, or bisexual. In 35 states it’s legal to fire someone solely for being transgender.
Think about that for a minute. In more than half of the states – discrimination against the LGBT community is allowed by law!
If you pass marriage equality in a state, but it’s legal to fire someone from their job because of that marriage, or you can evict someone for being LGBT or marrying a same sex partner – what’s the point of marriage equality?
That’s why I said we should make a coordinated effort on the state and federal level to get employment protections in place, before we go whole hog for marriage equality. Without a coordinated national effort and lack of leadership – that’s where we stand.
So you can tear my ideas down, and call this short outline an excuse. You say you’ve been listening to excuses for 30 years, and you suggest peer pressure as an effective tool to combat unsafe sex among adults in the 50 states that comprise our union?
I’d love to see even anecdotal evidence that your suggestion might be effective.
Quite frankly that’s naive and ignorant at best, and would further alienate the marginalized members of our community that we need to be embracing, not pressuring, or scaring, into the sexual practices that you deem to be acceptable sexual behavior. There is a large percentage of people who become infected due to issues surrounding self-esteem and mental health issues, and an even larger population with a dual diagnosis related to mental health and addictions. Peer pressure? I don’t think so.
You don’t have to look very far online to see personal ads and sex ads that have inflammatory and insensitive statements related to race, body images, sero-status, addictions, political affiliations, etc etc etc. And you want to reinforce that with your peer pressure? Good luck with that – let me know how you do.
Self-loathing is a part of our coming out process, and the judgmental bullshit you see within our community doesn’t make us stronger and more cohesive, it reinforces those feelings of inadequacy and isolates a lot of people.
If you’re looking for a project because you have a lot of time on your hands – go to the CDC website and look at infection rates by year – pre-millenium and post-millenium. Then find out when Manhunt and sites like that started asking people to publicly state their sero-status (which is a violation of HIPAA and the ADA and more laws).
Those websites and how someone completes their profile is what the majority of people rely on in assessing a potential sex partner’s status. When cruising became an online phenomenon our community stopped talking to each other about HIV, and many other issues as well. If we want to get back to basics, and truly do something to combat the spread of HIV, we would demand that sero-status be private as current federal law requires.
I feel better now that I’ve ranted. I wrote over 1000 words to respond to your whinge. I’m posting half of it here, and I’ll finish it later and post all of my thoughts on my blog most likely tomorrow.
http://www.jiveinthe415.com/
Jase
@Haightmale: Manhunt asking people to voluntarily post their status is not a violation of HIPAA…(I’m the privacy attorney for a 10,000 employee health system…all I do is HIPAA)
Haightmale
Hi Jase – pray tell. What about the ADA? And why is it legal for the information to be displayed? I received wrong info and I appreciate your letting me know.
Roy
jiveinthe415.com
Riker
@Haightmale: Partially because it is voluntary, and partly because profiles aren’t linked to an identifiable person. If the websites used real names instead of a pseudonym, and posted the results of an HIV test they conducted, HIPAA would be relevant. Even if a person DOES choose to list their status, there’s no guarantee they aren’t lying.
What they do is no more illegal than my posting my status on Facebook.
WillBFair
@Haightmale: Of course I don’t have evidence that peer group pressure would work, because there has been none in thirty years. But it is a necessary first step.
And of course I realize that interlized homophobia is a huge part of the problem. I saw that in the eighties when they were spitting hatred at anyone who addressed hiv. So part of peer group pressure needs to be mutual support. We need to honest about our self hatred in order to overcome it.
But for twenty years we’ve known enough to stop queer hiv. And there are plenty of strategies we should use: testing, sero division, monogamy, safe sex f–k buddies, safe sex always, testing, open communication, the shouting down of barebackers, the setting of all these standards among us (as mature communities do), and NO MORE EXCUSES.
I’m sorry about my snarky tone towards you. But thirty years is a long time to listen to the avoidance tactic. And I’m frustrated. But for me, people who make excuses for gay hiv are the most self hating of us all.
WillBFair
@Haightmale: By the way, I used to live on Oak and Central, right down from Buena Vista Park.
Terry Michael
Of course, anyone reading this could do a little reading and learn that the single pathogen (“HIV”) theory of acquired immune deficiency syndrome is the biggest fraud–and most harmful–in medical history. But that would take some intellectual curiosity, wouldn’t it? You can begin by going to http://www.terrymichael.net and invoking my special report on HIV-AIDS, which will link you to fact checked journalism on the subject. Have a great World afrAIDS Day December 1!
WillBFair
@Terry Michael: Psycho white trash rube fest. F–ck y–. Go back to your low heartless hick culture. And leave my sweet gay people alone.
Haightmale
@WillBFair: I got worked up after I read your snarky comments! And in the very long response that I initially composed, I called you a snarky rhymes with rich, and I put my own snarky bitchy reply to the side and edited it later to reflect the kinder gentler me. Thanks for acknowledging your tone.
I like debating issues, and listening to other people’s point of view, especially when it can be respectful and constructive. I’m a blogger and I write about a lot of this stuff. I read some of the published studies, and books and articles to try to understand the total picture.
Peer pressure has been studied countless times, and generally speaking the data reflects that when a group tries to impose their morality, or teach a behavior that involves stress and pressure, whether it’s a negative or positive reward, that it’s ineffective. Right now there are studies being done of adolescent and middle school kids, and the effect of peer pressure in small controlled environments, because some academics feel that it can be an effective tool to combat behavioral problems and bullying in Middle Schools.
The LGBT community, particularly those who are considered elderly today, lived in fear that someone could barge into their bedrooms and homes, and some experienced that humiliation. They fought hard in courts, and in the media, and it wasn’t until Lawrence v. Texas in 2003 when they found that it was reasonable to expect privacy, and no interference by your government in your sex life. By finding that anything less violated one’s due process, they were able to rule on the legal merits without having to examine and rule on “behavior.”
When I see you say “shout down the barebackers,” and safe sex always stuff I cringe, and think big brother, and being judged that’s big brother and Hitler/Mussolini-ish. I’m curious about what you mean exactly. And check out my blog when you get a chance. It’s not fancy like queerty, but I write every word and it’s my point of view. check it out!
Ciao!
Roy
http://www.jiveinthe415.com/
B
No. 2 · Haightmale wrote, “Neil Giuliano is fairly new, and is touching the right notes (especially considering he’s an Arizona Republican politician). Cutting the infection rate by 50% is a noble goal, and I support the effort, even if it’s impossible to attain.”
Then in No. 3 · WillBFair wrote, “@Haightmale: For thirty years, I’ve listened to excuses for why we can’t stop hiv in the community.”
Well, there are good excuses – things we didn’t know 30 years ago that we now do (which suggests BTW a goal of a 50% reduction may be achievable). I’ll refer interested readers to http://www.google.com/url?sa=t&rct=j&q=%22haltinug%20viruses%20in%20scale-free%20networks%22&source=web&cd=1&ved=0CCcQFjAA&url=http%3A%2F%2Fwww.barabasilab.com%2Fpubs%2FCCNR-ALB_Publications%2F200205-21_PhysRevE-HaltingViruses%2F200205-21_PhysRevE-HaltingViruses.pdf&ei=Lsy1TtTbG6HXiQK5-7SCAQ&usg=AFQjCNE9tBkk9H3FqJVpgCsvd4uBEU5bGQ for technical details. Before 2001, it was thought that if you can reduce the transmission rate per person below a threshold, a virus would naturally die out from the population. When those models were applied to computer viruses, however, they didn’t work – the virus should have died out but didn’t. Understanding why that happened led to some insights that apply to the AIDS epidemic as well.
Social networks (including ones of sexual contacts) tend to be “scale-free” (a technical term) and a property of these networks is that there are “hubs” which have a very high number of connections. Sexually, think of “Don Juan” discovering sex clubs like “Blow Buddies”, a name that leaves little to the imagination. It turns out that there is a big payoff for concentrating your efforts on the hubs, and if you ignore the hubs, you will likely fail. People are finally getting clued in – saw some posters offering free passes at these locations if you took an HIV test.
If you ignore such places or act like people who frequent them deserve whatever they catch, the consequence is that you will not make any progress in eliminating new infections.
Finally, since some people won’t like hearing this and will probably try to “shoot the messenger”, I’ll simply state in advance that the only thing I’d accept as a valid counter-argument is showing that there was a mistake in some peer-reviewed publications (physics and computer-science journals, in this case).
B
[Seem to be having trouble posting this so I’ve deleted a link in case that is the problem]
No. 2 · Haightmale wrote, “Neil Giuliano is fairly new, and is touching the right notes (especially considering he’s an Arizona Republican politician). Cutting the infection rate by 50% is a noble goal, and I support the effort, even if it’s impossible to attain.”
Then in No. 3 · WillBFair wrote, “@Haightmale: For thirty years, I’ve listened to excuses for why we can’t stop hiv in the community.”
Well, there are good excuses – things we didn’t know 30 years ago that we now do (which suggests BTW a goal of a 50% reduction may be achievable). I’ll refer interested readers to R. Pastor-Satorras and A. Vespignani, Epidemic spreading in scale-free networks, Physical Review Letters 86 (2001), 3200-3203. for technical details. Before 2001, it was thought that if you can reduce the transmission rate per person below a threshold, a virus would naturally die out from the population. When those models were applied to computer viruses, however, they didn’t work – the virus should have died out but didn’t. Understanding why that happened led to some insights that apply to the AIDS epidemic as well.
Social networks (including ones of sexual contacts) tend to be “scale-free” (a technical term) and a property of these networks is that there are “hubs” which have a very high number of connections. Sexually, think of “Don Juan” discovering sex clubs like “Blow Buddies”, a name that leaves little to the imagination. It turns out that there is a big payoff for concentrating your efforts on the hubs, and if you ignore the hubs, you will likely fail. People are finally getting clued in – saw some posters offering free passes at these locations if you took an HIV test.
If you ignore such places or act like people who frequent them deserve whatever they catch, the consequence is that you will not make any progress in eliminating new infections.
Finally, since some people won’t like hearing this and will probably try to “shoot the messenger”, I’ll simply state in advance that the only thing I’d accept as a valid counter-argument is showing that there was a mistake in some peer-reviewed publications (physics and computer-science journals, in this case).
Mitch
@WillBFair: This is so typical of the self-centered mentality that characterizes seronegative gay men on this site. The wait list for AIDS drugs recently soared past 10,000 souls while the CDC tested ways for those without the virus to use those same drugs to have bareback sex. As this is published, HIV websites across the nation are urging their positive readers to “sign on” to facilitate research which holds no promise of benefitting them. A passing glance through clinicaltrials.gov reveals that the volume of HIV vaccine research dwarfs cure research, despite increasing scientific consensus that the latter is more achievable. If it weren’t for the largesse of the german government and innovative private firms, we would still be living in a world where the word “cure” was tabboo. Every bathhouse, church and gay bar offers free condoms and testing wrapped with admonishments to use the rubbers, but support for people with HIV borders on nonexistant outside of a few cities on the coasts. Despite this, the first comment here was actually “I am so tired of the hiv community focusing only on care, with nothing to say about prevention.” How much more do you want the “HIV community” to focus on prevention? If it weren’t for the infectious nature of the virus, I’d think you wanted us to literally slit our wrists and bleed for you.
HIV services are unique in being expected to cater to the needs of those who don’t have HIV by constantly fighting the good fight of prevention. When was the last time that the Komen foundation was criticized for not doing enough in the name of prevention? How many lung cancer victims do you know that dedicate the remainder of their lives to teaching people about the evils of smoking? Why exactly should the “HIV community” focus on prevention which does nothing for those with HIV? Effective political entitites do not gain traction through altruism though, and services for those with the virus have withered while the message of prevention flourishes. A toxic stew of politics, political correctness and internalized serophobia have rendered most HIV service organizations all but worthless to most people with HIV, and the conversation we have on the topic is so distorted in favor of narcissists like yourself that we’re barely empowered to point this out. The fact of the matter is that everyone capable of wiping their ass knows the basics about preventing HIV, but HIV has and will continue to spread because of the nature of social diseases. Beating the dead horse of “prevention” has taken us as far as it can, and is now going nowhere fast.
We need HIV CEOs who prioritize care for people with HIV. We need a community that demands new and better treatments for people that actually have the disease, not those that don’t. We all need to understand that treatments IS prevention because people who are effectively treated are MUCH less infectious, and if we’re ever cured we won’t be infectious at all. We need to give people motivation to seek out treatment, which means hope of a better tomorrow-not a life telling high schoolers how to put cucumbers on condoms, testing gay men who suck every dick in the bathhouse or endless web pages filled with “DDF UB2”. We need a modicum of rational self interest injected into the equation. We need this not just for every single person infected with this virus, but to eventually make progress against the incidence of this disease and ultimately protect those who don’t have it.