Washington Blade - May 3, 2002
Lou Chibbaro Jr.

Clinic officials said the data were obtained from questionnaires completed by men who visited Whitman-Walker's Gay Men's Health & Wellness Clinic in 2000 and 2001 for routine tests for sexually transmitted diseases, including HIV.

The officials said the study was funded by the U.S. Centers for Disease Control and Prevention and its finding that more gay and bisexual men were engaging in unsafe sex practices was consistent with similar studies in several other cities, including San Francisco and New York.

The D.C. data also show that the rate of HIV infection among the men participating in the survey dropped slightly, from 3.8 percent in 2000 to 3.5 percent in 2001.

In addition, the rate of gonorrhea infection among the D.C. area men in the sample, who have sex with other men, remained steady, rising slightly from 6.46 percent in 2000 to 6.5 percent in 2001. The data show that the rate of new syphilis cases remained the same -- 1.3 percent for both years.

Despite the dip in the rate of new HIV infections and the statistically insignificant increase in STD rates, Whitman-Walker Executive Director Cornelius Baker called the findings an "alarming trend." He said the large number of men engaging in unsafe sex could result in a jump in new HIV infections in the next few years.

Baker also pointed to another finding, that the majority of those who tested positive for HIV in a sub-sample of the 2001 data were African American. The survey showed that while African Americans made up 29 percent of the men tested at the clinic for STDs and HIV in a six-month period in 2001, African Americans comprised 40 percent of the men during this period who tested HIV positive.

Dr. Gary DeSimone, director of Whitman Walker clinic where the study took place, said the 2000 data were based on a sample of 1,654 men who reported having sex with men. He said the 2001 data were based on a sample of 2,200 men, who are referred to in studies as "MSMs" (men who have sex with men).

The percentage of men who reported not using a condom when engaging in insertive anal intercourse with a male partner rose slightly from 23.8 percent in 2000 to 25 percent in 2001. Very few men reported using condoms during oral sex. The number who acknowledged performing oral sex on a partner who wasn't wearing a condom dropped from 85 percent in 2000 to 81.5 percent in 2001.

The data pertaining to condom use were based on a response to a survey question asking about condom use during the survey participants' last sexual encounter, DeSimone said.

A skewed sample?

DeSimone said he delivered a presentation on the data to a National Sexually Transmitted Disease Conference in San Diego in March. The CDC sponsored the conference. The CDC also funded the study in which Whitman-Walker gathered its data for this presentation, DeSimone said.

"All of this is raw data," DeSimone said. He said the sample of men who seek out STD testing at Whitman-Walker could skew the findings toward men who may not be representative of all gay and bisexual men.

"This data is being used to say, 'This is what people are doing out there,'" he said. "It's not saying there is an actual increase from year to year."

But DeSimone said the study results were troubling because they show, for example, that out of 122 men in the study who were diagnosed with a sexually transmitted disease, 84 tested negative for HIV and reported they had known about their HIV negative status.

"It's clear that many people are engaging in high risk sexual activity regardless of their known HIV status," DeSimone said. "That means that HIV-negative men are putting themselves at increased risk for HIV infection, while HIV-positive men are putting themselves at risk of infection with another STD, such as syphilis, which can actually speed up the progression of their HIV disease.

"Every man needs to know that they need to protect themselves or they may be putting their very lives in jeopardy," he said.

DeSimone acknowledged that a press release issued by Whitman-Walker announcing the findings of the data may have been misleading by reporting that the number of new syphilis cases among the gay and bisexual men in the clinic sample "nearly doubled between 2000 and 2001." Whitman-Walker spokesperson Michael Cover said he based that assertion on the data, which show the number of new syphilis cases rose from 18 in 2000 to 33 in 2001.

DeSimone, however, noted that the number of men participating in the survey rose from 1,654 in 2000 to 2,200 in 2001. He said the increase in sample size would be expected to result in an increase in the number of syphilis cases, even though the percentage of new syphilis cases remained identical for the two years -- 1.3 percent. Nevertheless, he said the increase in cases from 18 to 33 is "still troublesome," even though the rate of new cases stayed the same.

"I always believe in erring on the cautious side," said Wayne Turner of the local AIDS advocacy group Act Up D.C. "But this study doesn't show any significant increase in anything."

Turner said he is disappointed that Whitman-Walker is not being more aggressive in distributing condoms and water-based lubricant -- which experts say can insure the safest possible protection against HIV and STD transmission -- to D.C. gay bars and other places where gay men meet.

Clinic officials have said a limited budget prevents them from sending workers more than a few times a month to individual gay bars with condoms and safe-sex information packets.

"They keep spending money on all these studies, but they don't want to spend more money on putting condoms in the bars and clubs," Turner said.

News Reporter Lou Chibbaro Jr. can be reached at lchibbaro@washblade.com.
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