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Do not know they have HIV!

hivchicagomainA first-of-its-kind study looking at HIV infection rates found that half of gay men in Chicago who have HIV did not know they were infected, and two-thirds of infected black men were unaware. In addition, infection rates for black men were more than twice the rates for whites and Hispanics. The results of the Chicago Department of Public Health survey are sobering, officials say, but not unexpected. "It's a terrible thing, but it is not surprising," says Jim Pickett, director of advocacy for the AIDS Foundation of Chicago. The statistics prove what some organizations, including the city, have been seeing for several years: That gay black men are among the fastest growing groups to test HIV-positive. The Chicago study found that more than 17 percent of gay men in Chicago have HIV; 39 percent did not get tested in the last year because they were worried about the result. Almost 600 gay men from across the city were tested for HIV/AIDS and interviewed about their lifestyles, including questions about drug use and number of partners. Ninety-one of the subjects tested positive for the virus. Thirty percent of gay black men in Chicago tested positive, the study showed, while Hispanics and white men had rates of 12 percent and 11.3 percent, respectively. A quarter of blacks aged 18-24 tested positive. More than 37 percent of blacks aged 25-34 - the highest of any age group - tested positive. The numbers are similar to national figures.
"What we think we're seeing here is the shifting sands of two epidemics," says Nik Prachand, an epidemiologist with the city of Chicago's STI/HIV/AIDS division. "What we're seeing right now is a new surge in (HIV cases) with black (gay men)."
Prachand says anecdotal data has backed up the information the city collected between August and December last year. He said it is important to understand that the prevalence of HIV in black men can be tied to the elevated rates in the black community.
"It's not that black (gay men) are exhibiting higher risk behaviors in either sex or drug use," he says, pointing to data showing them to engage in less risky behavior than whites or Hispanics. "It's sort of a network effect. When your overall community prevalence is higher, you're going to see elevated rates within subgroups."
Pickett says the study points to a need for an overhaul of how gay men approach health.
"When you focus on one specific thing, it doesn't reflect all the issues," including mental and physical health, depression and substance abuse, he says. More than 40 percent of those surveyed admitted illicit drug use, and whites were more likely to do drugs than any segment.
"We need to incorporate HIV into a broader or more holistic framework (covering) gay men's health needs from top to toe," Pickett says.
That's the city's take, too, says Prachand.
"I think it's important that our prevention points towards healing the whole community. It's an issue of being more holistic about HIV," he says.
But, with HIV's high profile in the community, Pickett and others say more testing is needed. Currently, the CDC recommends that gay men be tested once a year. Ariq Cabbler, co-chair of the Chicago Black Gay Men's Caucus, says two tests a year should be the norm; Pickett recommends three. Cabbler is worried that a new breed of promiscuous young men are not listening to the traditional HIV/AIDS messaging. The study's statistics show that men who tested negative in earlier tests are now testing positive, an indication, Cabbler says, that they are engaging in risky activity during a 90-day period of time when HIV essentially incubates in the body.
"We need to know who makes up these social networks," which include men who meet other men over the Internet or through phone networks, he says. "You're kind of playing Russian roulette."
As part of its response to the report, the health department is proposing expanded testing and condom distribution, more community-level interventions, and outreach programs, including through the Chicago Black Gay Men's Caucus. Pickett said the city has done a good job in making gay men's health a priority.
"I am happy to say that Chicago is a leader in this country in working with the community and working with gay men. I can only imagine what the numbers could be if CDPH hadn't been doing good work."
He said the AIDS Foundation and other groups are stepping up awareness efforts this month. June is Gay Pride Month.
"The moral of the story is we want to catch people early in their infection," Pickett says. "We don't want people to test positive; we want them to test negative. And we want to provide them with the right kind of counseling and the right tools to maintain that negative."
The city is formally releasing the study's results June 9 at a 1 p.m. meeting at the DePaul Center. Health officials will lead a community discussion to see how the city's response can be improved. Story From Alex Parker ChiTownDailyNews
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HIV and Swine Flu Alert

hivswinefluThose with HIV may experience more severe illness, complications. The Center for Disease Control (CDC)  has issued "interim guidance" for clinicians treating patients with swine flu who are also HIV-positive. The full publication is available here. The document notes that people with compromised immune systems, including people with HIV, are more at risk for seasonal flu, and thus are more likely to be at risk for H1N1, or swine-origin, flu as well.
There are insufficient data available at this point to determine who is at higher risk for complications of swine-origin influenza A (H1N1) virus infection. However, adults and adolescents with HIV infection, especially persons with low CD4 cell counts, are known to be at higher risk for viral and bacterial lower respiratory tract infections and for recurrent pneumonias.
Evidence that influenza can be more severe for HIV-infected adults and adolescents comes from studies among HIV-infected persons who had seasonal influenza; these data are limited. However, several studies have reported higher hospitalization rates, prolonged illness and increased mortality, especially among persons with AIDS. Thus, immune compromised persons, including HIV-infected adults and adolescents and especially persons with low CD4 cell counts or AIDS can experience more severe complications of seasonal influenza and it is possible that HIV-infected adults and adolescents are also at higher risk for swine-origin influenza complications.
People with HIV who contract swine flu should be treated with antiviral medications zanamivir or oseltamivir, the two drugs to which the virus is not resistant. "No adverse effects" have been reported in people with HIV who have received the two flu medications and "there are no known absolute contraindications" for people receiving the drugs when they are also taking antiretroviral drugs to treat HIV, according to the CDC. People with HIV should take the same precautions as the general population to avoid contracting swine flu:
The risk for swine-origin influenza A (H1N1) might be reduced by taking steps to limit possible exposures to persons with respiratory infections. These actions include frequent handwashing, covering coughs, and having ill persons stay home, except to seek medical care, and minimize contact with others in the household who may be ill with swine-origin influenza virus.
Additional measures that can limit transmission of a new influenza strain include voluntary home quarantine of members of households with confirmed or probable swine influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded settings. If used correctly, facemasks and respirators may help reduce the risk of getting influenza, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene.
A respirator that fits snugly on the face can filter out small particles that can be inhaled around the edges of a facemask, but compared with a facemask it is harder to breathe through a respirator for long periods of time.
In addition, people with HIV should be vigilant about their health by making sure they adhere to their HIV treatments, the agency said.
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11 Bars Get Death Threats

Eleven gay bars in Seattle were sent letters Tuesday threatening ricin attacks — in what some are describing as a hate crime The following story is being reported by the Seattle Times

 (click image below to enlarge)
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The anonymous letters say, "I have in my possession approximately 67 grams of ricin with which I will indiscriminately target at least five of your clients. ... I expect them to die painfully while in hospital." A 12th letter was sent to the alternative weekly The Stranger, according to its Web site.

That letter says the paper should be

 "prepared to announce the deaths of approximately 55 individuals."

 The letter lists the bars as: The Elite, Neighbours, The Wildrose Bar, The Cuff, Purr, The Seattle Eagle, R Place, Re-bar, C.C.Attle's, Madison Pub and The Crescent. The letter implies the attacks will take place one Saturday this month.

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In a statement, the Seattle Police Department said it takes the threat seriously. It has seized the letters and is processing them and is coordinating efforts with the FBI and other federal agencies. The U.S. Centers for Disease Control and Prevention says ricin is a poison found naturally in castor beans that can be deadly if purified and then ingested or inhaled.

Dan Giroux, a bartender at The Elite, said he read the contents of the letter through the envelope with a flashlight after being warned not to open it and found the experience "a little horrifying." "I expect to feel safe at work. Being here is like being at your house. But this doesn't make you feel safe," he said.

Elite manager Kay Hansen said the bar has been informing customers of the threat and warning them to make sure they don't leave their drinks unattended: "On the one hand you don't want to overreact, but on the other hand, you want to make sure your staff and clients are safe."

Stranger editorial director Dan Savage said he didn't take the threat too seriously: "I get a death threat a day with Savage Love," he said, referring to a sex column he writes.

Savage said the letters didn't contain any religious references, making him wonder whether the author was an embittered gay person. He said that if the threat were designed to ruin business for gay bars, it may backfire. Staffers from The Stranger made a point of visiting gay bars Tuesday night to show their support, he said, and others may be inspired to do the same.

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