Bay Windows - National News, November 30, 2000
Peter Cassels, Bay Windows staff

In an interview Nov. 28, Larry Kessler, executive director of the AIDS Action Committee of Massachusetts (AAC), said he is disturbed by the perception that ôbeing infected is not a big deal. Here weÆve made incredible progress on the human rights front and so on, but thereÆs this new trend that seems to be evolving that, æWell, you know, itÆs no big deal if I get infected. IÆll just take the meds.Æö

Warning that ôitÆs still a big deal, and still not a day at the beachö Kessler said, ôPeople shouldnÆt get cavalier and say, æIÆm going to abandon my safe sex practices.Æ ItÆs not like getting the clap. This is very serious and itÆs far from over in the gay community. What drives me nuts is the attitude that itÆs not our problem any more.ö

He noted that even though the percentage of new infections that are among gays has declined to 50 percent, the actual numbers are higher than they were in the early days of the epidemic.

Kessler attributed part of the blas attitude in Massachusetts to the fact that the anti-viral medications are widely available to people with low paying jobs or no insurance. ôIn some states, like Georgia, they have lotteries and the number of slots for coverage is fairly low,ö he pointed out. ôSome states have incredible co-payments. They cannot avoid the $10,000 in annual costs. It gets to the point where they have to decide whether to pay rent or buy the drugs.ö

He also warned that ôunless we do better with the drugs as a whole, thereÆs always that possibility that weÆre going to peak out on their effectiveness. Some patients have already experienced that. Others have never got a chance to peak because of side effects or other infections.ö

Because of the role men play in the diseaseÆs spread and prevention, UNAIDS, the Joint United Nations Programme on HIV/AIDS, has selected ôAIDS: All Men ù Make a Difference!ö as the World AIDS Day 2000 theme.

UNAIDS cited five reasons for focusing on men this year: they represent the majority of people living with HIV/AIDS; their behavior often puts their sexual partners at risk; unprotected sex endangers their male and female sex partners; they need to give greater consideration to AIDS as it affects their families, and men often do not give adequate attention to their own health.

The organization pointed out that one reason why men represent the majority of the infected population is that they are more likely to use alcohol, inject illegal drugs and use other substances that lead to unsafe sex. They also have, on average, more sex partners than women, so they are likely to infect more people over a lifetime.

One problem cited by UNAIDS is that many men who have sex with women also have sex with other men and often deny their bisexuality or homosexuality for fear of being stigmatized. Such men, the organization contends, ignore HIV prevention warnings.

Men should be encouraged, UNAIDS advises, to take better care of their familiesÆ and their own health. Studies show that men are less likely to seek health care than women and more likely to engage in behaviors such as substance abuse and unsafe sex that put others at risk.

When Kessler first heard about the theme several months ago, he found it odd. ôI thought all people make a difference. But the more I thought about it, the more it made sense, because men are the primary infectors on several fronts. ItÆs great to put the responsibility back on men, if you can create a campaign around it.ö

He reported that the AAC is working with a womenÆs organization in Botswana to help stem the tide of new infections there. To be funded by Bristol Myers-Squibb, the pharmaceutical giant, the project would train HIV-infected women on how to educate those not yet infected on precautions to take and how they can support one another in a hostile environment.

ôIn many ways itÆs 1981 or 1982 for Botswana,ö Kessler said, comparing it to the early stages of the American epidemic. Laws foster a reluctance to report new infections because people with HIV cannot work, so they are fired from their jobs. Even AIDS service providers do not hire HIV-positive people. ôThey are basically making the situation worse by making them unemployable. Unless they write some laws that protect people it will never end. [Botswana is] the most progressive African country. ItÆs even worse in other countries, where [HIV-infected people] get stoned to death.ö

The Bristol Myers-Squibb funding will be used to help train women and help the organization set up its accounting procedures. The AAC will only receive money for technical assistance.

Pat Daoust, a nurse and former director of AAC client services, is coordinating the project. ôPat has been to Botswana several times,ö Kessler reported. ôShe is a very wise, sensible person who is committed to health care and human rights. She has developed a trust with the women.ö

The AAC hopes to replicate some of its programs, but will be very cautious, Kessler said. ôWe donÆt want to be seen as colonialists or having all the answers .We hope to learn as much as we can give in return.ö He said a number of other AIDS organizations are looking at similar models.

First observed Dec. 1, 1988, after an international summit of health ministers called for a new spirit of social tolerance and a great exchange of information, World AIDS Day has as its goal strengthening global efforts to address the epidemic. In the U.S., the observance is coordinated by the U.S. Committee for the World Health Organization and the Pan American Health Organization.

In 1999, the world recorded 2.8 million deaths, the highest since the epidemic began. In the U.S., 46,000 new infections were reported last year, 82 including two new HIV cases every hour among people under the age of 25. Men account for 82 percent of all AIDS cases to date in the U.S. AIDS is the fifth leading cause of death for Americans 25 to 44 years old.

Sex between men still accounts for many new infections ù 34 percent. Injection drug use accounts for 22 percent and heterosexual contact, primarily through sex with injection users, represents 15 percent.

New HIV cases among gay and bisexual men of color rose to 52 percent in 1998, the last year with reported data, from 31 percent in 1989. Authorities fear a rise in HIV infections among teenagers because they engage in behaviors that put them at risk. About 50 percent of high school students have had sexual intercourse and more than 16 percent have had four or more sex partners by graduation. The Centers for Disease Control reports that about a quarter of high school students used alcohol or drugs during their last sexual intercourse.

ôHIV has reached catastrophic proportions in some areas of the globe and is about to explode in others,ö President Bill Clinton wrote in his World AIDS Day 2000 message. ôWe do not live in isolation from our global neighbors, and it is imperative that the United States join together with all nations to mobilize a greatly expanded world response to stem the rising tide of this disease.ö

Clinton asserted that this yearÆs theme ôcalls on all men around the world to embrace a new leadership role not only in prevention, but also in the care of their children and other loved ones à ö t
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