Friday, August 20, 2010

A response to my report from Mayor Fenty of Washington DC

Dear Mr. Maloney:
Mayor Fenty thanks you for your letter of August 10, 2010 and concern about online social networking sites for gay and bisexual men.  The Mayor was heartened to hear courageous personal story and that your health is strong.  Your experience is a powerful inspiration.  Mayor Fenty directed the Department of Health HIV/AIDS, Hepatitis, STD and TB Administration to respond.
The Department of Health shares your concern about the impact of the HIV/AIDS epidemic on the community of gay and bisexual men.  In the District of Columbia, we estimate between 14% and 20% of all gay and bisexual men are living with HIV/AIDS.  However, the number may be higher.  From a recent study on gay and bisexual men, we found 40% were diagnosed HIV positive through study who were previously unaware of their diagnosis.  We are also seeing that even with the history of HIV/AIDS in the gay and bisexual community, there remain high risk factors as one-third did not know their partner’s HIV status and 40% did not use condoms at last sex.  The study had significant findings of discordant relationships between younger men with a lower rate of HIV and older men with a substantially higher rate of HIV.  In these age discordant relationships, there was even less condom use.  With the findings of this study, the Department of Health has established a new policy to recommend that all gay and bisexual men in the District get tested twice a year for HIV.  There will be a new advertising campaign to launch in the fall promoting this twice a year HIV testing recommendation.
The Department of Health invited experts and community stakeholders to work with us in the development of a strategic plan to address HIV and gay and bisexual men.  We expect to release the plan in the next month.  Many of the concerns you raised were also raised by our community work group.
The Internet as you mentioned has become a significant meeting place for men, especially to engage in sexual activity.  In our study “MSM in DC: A Life Long Commitment to Stay HIV Free”, we found that 35% of men in the study had used the Internet to find a sex partner.  We believe this number is likely higher as there were some limitations in the study methodology.  It is interesting to note that men who had partners through the Internet were more likely to use a condom (74%) than men overall (56%).
The Department of Health has an approach to work with these sexual social networking sites.  We have established a relationship with Manhunt and Adam4Adam in our efforts to reduce the transmission of syphilis among gay men.  Syphilis has grown significantly in the District and has nearly exclusively impacted gay men.  The Department is one of a handful of jurisdictions that has pioneered Internet Partner Notification on syphilis.  We required the cooperation of Manhunt and Adam4Adam to establish a profile to contact partners of newly diagnosed individuals who only had a Manhunt or Adam4Adam profile address.  The Department also works with several of our community partners who do outreach on these sites, particularly to young men who may be susceptible to encounters with older men.
This year, the Department will be launching a new campaign to promote condom use and we expect to place public service advertising on those sites with links for gay and bisexual men to obtain free condoms through our DC Condom Program.  We are also considering similar advertising on HIV testing. 
We concurred with your recommendation on making HIV testing in bathhouses.  We developed a public-private partnership with the Crew Club, DC’s bathhouse, Whitman Walker Clinic, and the Department of Health supported by Gilead Sciences to conduct HIV and syphilis testing at the club.  We started the project in July and it has been a success to date.  Many of the persons who got tested said that they would not have gotten tested, even a gay-friendly public health provider, and did so because we were available at the club.
This year, we will be starting a new project to promote condom use among gay and bisexual men social networks.  This is an exciting opportunity to bring condom education and HIV/STD information directly to men where they are. 
We recognize your concerns that vulnerable people could be drawn unsafely into the social network facilitated by Internet sites.  It is our aim at the DC Department of Health to do all we can to make information and direct interventions to reduce transmission.  We support innovative efforts such as our social networking program and community-based projects such as the DC Center’s HIV Working Group Toolkit program to distribute condoms in clubs, bars and restaurants.  DC provides free condoms and lube to the project.  We are making HIV and STDs visible in the District to send a clear message that the health of our residents is our top priority.
Please contact me with any questions and concerns you may have.  Thank you again for your commitment to helping the health of gay and bisexual men.
Partnerships, Capacity Building & Community Outreach Bureau Chief
HIV/AIDS, Hepatitis, STD & TB Administration
D.C. Department of Health
64 New York Ave., NE, Washington, DC 20002

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