Saturday, August 14, 2010

My Letter to President Obama

My Letter to President Obama

And to all 50 Governors and 100 US Senators, also sent to Kevin Fenton who is the Director at the CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, and to Dr. Howard Koh who is in charge of the President’s initiative. I also sent this letter to the National Institutes of Health office of AIDS research (OAR).

RE: HIV/AIDS Initiative announced on July 14th , 2010

“Uncovering a MSM (men who have sex with men) social networking epidemic, and public health crisis facing the MSM community, my personal story, and my ideas about engaging these websites, expanding access to testing, education, and awareness as related to the your HIV/AIDS initiative.”

Dear President Obama,

I know that you are a busy man, but I hope you can find 10 minutes in your day to read this letter, possibly if it’s a nice day – in the Rose Garden? Though, this subject matter may be better read in the privacy of the Oval Office. Please feel free to share this letter with Kathleen Sibelius and other members of your team involved in this initiative.

In response to the your recent HIV/AIDS initiative I am writing with regard to a Public Health Crisis devastating the MSM community and I write to offer suggestions on how to curtail this crisis. I want to bring to your attention a MSM social networking epidemic that is causing detrimental health consequences in communities all across America.

I listened to you and as you made a commitment to reducing HIV/AIDScases by 25 percent over the next 5 years. In doing so I think it is essential that more resources are to be appropriated to fighting the spread amongst the MSM community. The negative social and behavioral health trends within this community are contributing to the growing number of newly infected HIV cases amongst gay and bisexual men. I want to share with you some brief statistics from the CDC.

A snapshot of statistics from the CDC

· MSM (men who have sex with men) account for nearly half of the more than one million people living with HIV in the U.S. (48%, or an estimated 532,000 total persons).

· MSM account for more than half of all new HIV infections in the U.S. each year (53%, or an estimated 28,700 infections).

· While CDC estimates that MSM account for just 4 percent of the U.S. male population aged 13 and older, the rate of new HIV diagnoses among MSM in the U.S. is more than 44 times that of other men.

· MSM is the only risk group in the U.S. in which new HIV infections are increasing. While new infections have declined among both heterosexuals and injection drug users, the annual number of new HIV infections among MSM has been steadily increasing since the early 1990s.

The social networking epidemic that I referred to above is websites such as manhunt.net, adam4adam.com, bareback.com, barebackrt.com, men4now.com, and craigslist.com. These sites are the most popular amongst the MSM community with manhunt.net and adam4adam.com being the most frequented. These sites allow users to interact in real time via instant message, e-mail, and webcams. Users are able to describe their level/interest in drug use, and check boxes of behaviors attributed to unsafe sex practices. These sites allow users to disclose their HIV status, which most people disclose unknowingly or intentionally lie about. None of these sites do age verification. Unfortunately, when the COPA legislation was struck down by the Supreme Court is was a big win for the adult porn industry. Though, responsible sites should be doing age verification, especially sites such as those mentioned above and throughout the internet porn industry.

Out magazine did an article on Jonathan Crutchley and Larry Basile (the owners of manhunt) and reported that the company that runs Manhunt -- Online Buddies, Inc., based in Cambridge, MA brings in at least $2.4 million per month -- almost $30 million a year -- not counting ad revenues. The money comes mostly from subscription fees paid by the site's huge subscriber base. In the United States, Manhunt now has nearly 1 million members, and the site receives more than 400,000 unique visitors per month. As reported in an OUT Magazine article; in 1993, 2.3% of gay men found their first male sexual partner online. In 2003 the number was 61.2%. (These figures come from the United Kingdom, and there’s been no parallel study in the United States, but sociologists believe the findings here would be similar. The implications of that trend are enormous,” says Jeffrey Klausner of the San Francisco Department of Public Health. “It means that gay men who were once socialized in brick-and-mortar establishments, surrounded by other people, are now being socialized online.” Gay men still go out as well, but our nightlife habits are very different than they were 12 years ago. Jeffrey Parsons, professor of psychology at New York’s Hunter College, says his unpublished research confirms the common sense that “when guys go to bars, they’re going to be with their friends, not to meet new people.” You may reference the full article at http://out.com/detail.asp?id=24005.

From my personal observations, after about 4-5 years of manhunts inception they did away with their unlimited free membership, created a free limited membership, and began charging users for premium services. Now, with even more capital their advertising campaign became racier, and there slogan “Get on Get Off” took the gay male community by storm. The brand took off, and before long scantly clothed manhunt representatives were scouring bars throughout the country’s largest gay markets giving away prizes and free memberships to join their site. Today they are heavily involved in sponsorship of gay public events; they sponsor pool and dance parties throughout the country, and there racy ad’s can found on public phone booths throughout New York City.


Many of the other sites as mentioned further above have followed in the footsteps of manhunt. Adam4adam.com allows users to post sex party events, often unprotected sex parties held at individual homes, and other public accommodations. They also allow users to post professional escort (prostitution) ads. Craigslist has a M4M section where users can post what they are looking for sexually in hopes to find other strangers with shared interests. The websites barebackrt.com and bareback.com (in their names alone) and throughout the site, promote unprotected sex.


These sites harbor safety for those who wish to partake in drug use, other illegal drug and sexual activity, and unsafe sex. The sites try to limit some language with particular references to drugs, but members get around these restrictions through various inferences in their user profiles, and through the un-monitored real time instant messaging and e mail functionality. Right now the homepage of manhunt pictures a guy scantly clothed, and advertises that currently 45,500 users are logged in and invites users to open a free account with the slogan “Cruise.Chat.Connect”.


These MSM social networking websites need to finally be uncovered, and these websites need to start being more responsible and being held accountable, with strict regulations and oversight. I do understand that a good portion of folks use these sites innocently, just as I had in the beginning, and I understand the first amendment right. I get that we all make our own choices, and that it falls on us should we suffer negative consequences as a result of our poor choices.


My story with manhunt began at the shy and vulnerable age of 22 when I was exploring my sexuality. I was lured in when I saw an ad in Boston introducing manhunt.net, and offering an unlimited free membership. Manhunt was a way for me to explore my sexuality by chatting with members from all over the country in an environment I felt comfortable in. I met my first partner off the site, and had made many good friends. As the years went on the talk and inference of drugs began seeping into these sites.


Today, we have got an MSM social networking epidemic on our hands where drug use (mainly crystal methamphetamine and GHB) have become synonymous with these sites, contributing to a rise in HIV infections in the young MSM population as referenced by the CDC statistics above.


In March 2010 I fell prey to manhunt.net after I learned that I was HIV positive, and in April my Doctor informed me that I had also contracted Hepatitis C (non IV drug user). Both transmitted from a user on manhunt.net who listed in his profile that he was negative. I take responsibility for my actions, but I wonder had I never been lured into manhunt.net at the age of 22, would I have contracted these illnesses??!?


Today I am concerned for that 22 year old out there seeing his first manhunt.net ad on a phone booth in New York City and logging in for the first time. I am concerned for him when he is introduced to crystal meth through another member on the site, and then becomes addicted. I’m concerned for his safety as a result of meeting a stranger. I am concerned for him 10 years later when he’s lost 10 years of his life to online chat rooms, drugs, sexual compulsivity, depression and anxiety; brought on by the psychological effects of Crystal Meth usage and GHB. It concerns me the most that this young guy will not even make it to the age of 32 and be killed by a culture that he was lured into by salacious advertising.


Fortunately, at the age of 32 I am here to tell my story. Five months ago the diagnoses crippled me emotionally and physically, and I entered a drug treatment facility to understand my addition to crystal meth and to come to terms with my diagnoses. Fortunately, both illnesses were caught very early. I went on medicine for the HIV right away and after 2 months my viral load was undetectable. I have a Doctor at Mt Sinai who is treating my Hepatitis and told me on my last visit that too is undetectable and I am headed for a cure. As research is indication early detection of both these illnesses is key!


Today I have renewed focus to finally put an end to this madness and promote myself to a greater cause. That cause is to help prevent another young male from being lured by salacious advertising, and roped into a life non representative of gay culture. My cause today is to be an advocate in my community in the fight against HIV/AIDS, Hepatitis and other STD’s. I have committed to furthering my education with a Masters Degree in Public Health, with my primary interests in Health Education and Awareness. I will be moving to Fort Lauderdale, FL from Upstate, NY and will be enrolled in classes in the fall in pursuit of these goals. I will also begin volunteer work in the fall in the LGBT community of Ft Lauderdale, FL.

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With grave concern over the social and behavioral health impacts this niche of a culture is having on the LGBT community; It’s time these businesses are put on notice, that no longer will they be able to continue the same practices which have been in place for many years. As you have read, these websites have become catalysts to unsafe sex practices, substance abuse, and criminal behaviors. These sites have become an embarrassment to the LGBT community and for too long these sites have been allowed to continue "business as usual", as the rates of HIV infection and other STD’s continue to rise amongst the MSM community.

Today, we are dealing with the biggest public health care crisis in the MSM community since AIDS was first diagnosed in the 80’s. We can no longer turn a blind eye on these sites. These sites must be put on notice that no longer will they be able to run “business as usual”. I ask for your help in taking the battle to these websites and to try to protect that shy and vulnerable young adult with so much potential from making a foolish mistake. Just call on me, as I am committed to helping however I can. Together we can meet if not beat your goal of reducing HIV infections by 25 percent.

I appreciate your service to our Country and your attention to this matter. I look forward to seeing the positive changes begin to happen.

Sincerely,

A concerned member of the LGBT community

My Ideas and Suggestions

Ideas on expanding testing

The first strategy of the President’s HIV/AIDS initiative is to expand testing. Below are ideas I’ve come up with.

1) We can partner with GLBT business and events (bars, clubs, circuit parties, bathhouses, pride events, and other GLBT events) to provide testing. In all my years I have never seen this kind of community outreach. All of the testing I have ever been witness to has been through Dr Offices, clinics, GLBT centers, and other medical care facilities. In these setting I would suggest offering the standard antibody test that can generally produce results in 3-7 days. I would suggest against the 20 minute rapid test so that issues surrounding privacy are not compromised and patrons can learn of their status in a setting of their choosing.

2) We can utilize a mobile medical service, such that are currently used in medical outreach programs throughout communities across the country. You see this often for free mammograms for women or blood donation. Why not utilize these same medical mobile vehicles for HIV and other STD testing. We can get deep into the most heavily infected areas this way. Can we pair up with the Red Cross to provide testing?

3) Let’s increase the use of the RNA PCR and DNA PCR testing methods. Though more expensive than the standard Elisa antibody test, these testing methods can pick up HIV antibodies in as little as 2-4 weeks post transmission. Compared to the standard antibody test (most commonly used) that can take from 6-12 weeks post transmission before antibodies are found. My HIV was diagnosed by a PCR test, and because of this early detection I was able to start meds before the virus had a chance to aggressively replicate. And research is finding early detection and treatment is showing promising results.

4) Let’s partner with a company in the private sector called Home Access Health Corporation (FDA Approved). They provide at home HIV and Hepatitis C tests. I used this company as a young adult, when I was too afraid to walk into a clinic, let alone let anyone know I was sleeping with men (it is a very confidential method). These packages arrive in a non-descript box, and comes with an easy to use lancet. A simple finger prick of blood is swabbed onto a test strip and sent back (in a non-descript box) to the company’s lab. The test results are just the same as if done anywhere else. Depending on the test they can provide results in as fast as one or seven days. Trained counselors are on hand when the client calls in for his results. I am sure these test kits can be purchased in bulk. We can create a system to provide these test kits free of charge. This is a project I would love to get a grant for!

5) Expand testing at inpatient and outpatient substance abuse centers. When I was out in Minnesota undergoing my substance abuse treatment a community health organization (called the Red Door Clinic) would come every Monday to provide free testing and education. It was a service they provided free of charge.

6) Buy the domain testfree.org and develop it to provide free HIV test kits, or to schedule a free and confidential in home test, or at a location nearest client. A feature could also be to type in your zip code, or address to find a free testing location nearby.

7) With the advent of mobile technology and specifically the worldwide use of the I-phone, why can’t an “app” be developed that pin points the nearest testing locations in regard to your geographical location. We can incorporate facts, education, awareness, and other information as it is related to HIV/AIDS within the application.

8) Create a face-book account and update periodically with testing events being held nationally and with education, awareness and other news as it relates to HIV/AIDS

9) Is it legal to provide incentives for getting an HIV test? Incentives such as a pair of free movie tickets, fast food incentives, Broadway tickets…etc. This can be done by teaming up with local businesses.

10) The government or the private sector could train, and employ thousands of Home Testing Technicians/Counselor’s to do in home testing and to provide counseling and offer resources In case of a positive result.

Education and Awareness

CDC Statistic

· More than half (54%) of all cases of HIV infection or AIDS among young people aged 13–24 during 2003–2006* were from male-to-male sexual contact. Thirty-four percent were from heterosexual contact. Young adults and teens, under the age of 25, continue to be at risk.

1) As the numbers from the CDC indicate above – I would suggest a more comprehensive approach to health care education in our schools. Children in as early as the 6th or 7th grade should have their first comprehensive lessons regarding HIV/AIDS and other STD’s. As the CDC indicates, children as young as 13 are becoming infected, and this is also when teen promiscuity begins. Health Education with lessons on HIV/AIDS should be continued until the 10th grade. In the sophomore and senior year’s elective courses for college credit could be offered to those who are interested in a career in health care/public health.

2) How about having high school student assemblies that are held at least two times per year regarding the issues surrounding HIV/AIDS and other STD’s. I remember a Woman that came to my school once to speak of her fight with AIDS, and her story was riveting. Nobody laughed or talked during that assembly. I am sure schools do have assemblies on specific health matters, but ensuring assemblies are held regarding HIV/AIDS with a set number of these assemblies per year or throughout middle school and high school would go a long way in de-stigmatizing these words and associated illnesses. By inviting young HIV positive/AIDS speakers in the 13-24 year age bracket into speak – the students may best be able to relate and realize that it can really happen to them.

3) This is a personal suggestion of mine, based on experience. It’s not a secret that there is a HUGE link between drug use, and sex. Particularly in the MSM community with Crystal Methamphetamine and GHB contributing to unsafe sex practices. I would advise early education in the 6th-7th grade regarding the negative health impacts these drugs can cause. What helped me with my addiction was when someone introduced me to CMA (Crystal Meth Anonymous). The rooms were extremely welcoming, supportive, and educational. In my 7 year occasional battle with this drug – I never knew such an organization existed. I never even heard of NA (Narcotics Anonymous). I feel had I known about these organizations earlier I may have been saved from my addiction and illnesses. These organizations are self supporting without the capital for funding ad campaigns, but maybe Government can fund an ad campaign which creates awareness to these organizations.

4) I see numerous ads in bars and clubs linking crystal meth with sex, which provide simple messages against this type of behavior. However, we can talk about education and awareness till we are blue in the face and someone is still going to do crystal meth and have sex. Telling people “this is not good for you” has not worked as it’s related to meth and sex. We need to combat this problem from a different angle. How do we do this? Through intervention methods. Team up with CMA, NA, and AA in coming up with an ad campaigns (mentioned above) and community outreach programs. Let’s intercept that 22 year old that picked up drugs for the first time and make him aware of these organizations he can seek help from.

5) Let’s team up with Dr Offices, Government Agencies, Faith Based Organizations, Psychologists, Psychiatrists, and other medical professionals and business’s. We can hold community forums to offer specific topics as they relate to HIV/AIDS and other STD’s. These lessons/discussion, question/answer sessions can be conducted at Dr. Offices, Churches, Town Halls, and other establishments – followed by the option for free HIV testing. An example: A Gastroenterologist office in Upstate NY holds weekly support groups and information sessions regarding Hepatitis C.

6) Parents need to be made aware of these underground websites, and set up software on computers at home that block these sites. A piece of software called NetNanny, is very effective at blocking all porn sites, including the underground niche sites that I mentioned in my main letter.

7) An obvious suggestion is to have a booth set up at every health fair across the country, and every gay pride event. We can offer testing, hand out brochures, and speak one on one with folks regarding various medical concerns regarding HIV/AIDS and other STD’s

8) What about 30 second PSA commercials put on by local governments, or big business, such as pharmaceutical companies and other large medical services companies? Statistics are scary, and speak volumes. I am envisioning a commercial with young people of all ethnic backgrounds, speaking out, and saying, simply, I am HIV positive for about 15-20 seconds with some startling statistics spoken and/or shown on the TV for the next 10 seconds. These commercials can play throughout various broadcasting markets during television programming targeting the 13-24 year bracket most at risk. Other advertising mediums targeting this age bracket can also be utilized.

9) We know that many celebrities do a lot of charitable work and donate tons of money when it comes to fighting HIV/AIDS. Let’s get more on board – younger celebrities in that 13-24 year old bracket, celebrities that kids idolize and will listen to their messages.

10) As we know, shopping malls are very popular to the young adults. I would like to see partnerships between community health organizations and shopping malls to provide on-site testing, health education, and awareness. Along these lines we can possibly work with Fast Food chains to spread the message. For instance maybe McDonalds, Burger King, Taco Bell, or KFC - will for a month out of every year, place on their bags, or throughout their various packaging statistics regarding HIV/AIDS, education, and contact information to organizations that can help.

11) We need increased awareness of PEP (Post Exposure Prophylaxis). While living in NYC I saw many clinics advertising this as a service. If you feel you had an at risk exposure within 72 hours you can begin taking HIV drugs to inhibit the virus from forming in your system.

Engaging websites and other MSM business’s

1) Restrict manhunt.net advertising in public places (ie. Public Phone booths in NYC). Look into their advertising campaigns and the advertising campaigns of other sites for violations in advertising and fine these companies when appropriate.

2) With regard to the oil spill the President placed a moratorium on deep water drilling, until they were able to access the risk of such drilling and how best to prevent this from happening again. Why not place a moratorium on these sites and put them through a thorough review. Like I said in main letter, these sites have been able to go on, “business as usual” for too long.

3) Put a special tax on these websites and bathhouses and other business’s in the porn industry, with the money going directly to help fund the President’s HIV/AIDS initiative.

4) I am familiar with the 2009 Supreme Court Ruling striking down COPA, but we can still encourage/implore these sites to use age verification technology.

5) Shut down the sites barebackrt.com and bareback.com that, because their names alone promote unsafe sex practices. Would we allow a site called terrorist.com with anti American propaganda to exist? This is a war in Public Health and irresponsible sites promoting the spread of diseases should be shut down!

6) Make a strong case to these sites that they should not be allowing talk of or even inference of drug use. Currently, as I referenced in my main letter, users of these sites are allowed to talk about their level/interest in drugs and even make inferences in their user profiles that go unnoticed by the website administrators.

7) Require that these sites have in place monitoring of messages being sent back and forth between users, people available 24/7 to intercept messages regarding talk of drugs, sale of drugs, and inferences of such, and immediate cancellation of accounts when such violations of the site are broken.

8) Currently these sites do have links to safe sex resources and other health education/awareness links, but they are often buried in the site and hard to find. I would encourage these sites to make these links and messages more visible. Or at each log in – they must read the disclaimer in large print – not fine print.

9) Do not allow ads to be posted by users offering escort services, “masseur” services, or other “professional services” as adam4adam.com currently allows.

10) Create jobs for undercover internet specialists. These specialists would monitor websites 24/7 for illegal, unethical, and other suspicious behavior, and report findings to the office of the President’s Internet Czar.

11) Restrict the hours of Gay Bathhouse operations. Currently Gay Male bathhouses throughout the country are a 24/7 operation. The gay social networking epidemic and bathhouses are breeding grounds for crystal meth usage and sex.

I hope that you have found some of these ideas useful. Please feel free to reach out to me for further information or ideas. I am willing to help. Again I appreciate your time and service to our Country.




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