Tag Archive: gay health

Why would you want to know if you are immune to HIV?

Why would you want to know if you are immune or partially immune to HIV?

Most gay men will know someone who has lots of unsafe sex but they are still negative it is likely because they are immune to HIV.   There are also lots of people who have been HIV positive for along time but are relatively healthy, these people are likely partially immune.

IF both your parents have the gene (CCR5) to make one immune to HIV then you will be immune.  IF one of your parents has the gene (CCR5) then you  will be partially immune to HIV.

 

IF YOU ARE HIV NEGATIVE – you may want to know you are immune because:

You can find out if you are immune to HIV or partially immune to HIV but getting a simple swab of your mouth.  The results will tell you if you are unlikely to become HIV + (partially immune), or if you will almost certainly will not become HIV+.  This knowledge may help you to have less anxiety about sex or some people may decide to have risker sex.

If one is partially immune then you will be a slow progresser, then the HIV virus will not have the same effect on you as someone who is not partially immune.

 

The immunity comes from not having receptors that allow the virus to enter the body.  One who is partially immune has fewer receptors so becoming infected is lessened and if one does get infected the disease will progress more slowly.

 

IF YOU ARE HIV POSITIVE – you may want to know you are immune because:

You will know if you are a slow progresser.   You may want to take less HIV medication to keep your viral load suppressed.  You may have peace of mind that you are not so likely to get sick from HIV.

A company called delta-32 will sell you the test to find out if you are immune to HIV.   Their website gives a lot of interesting information on HIV immunity.

Their website is:     http://www.delta-32.com/

Where to get tested for immunity to HIV/Who is immune to HIV?

http://www.delta-32.com/  This website will now give  you the test for HIV immunity.

The map below show where people are most likely to be immune to HIV.

Picture

The delta 32 mutation is more prevalent in some racial backgrounds than in others. Population studies of the Caucasian population of western European ancestry revealed that approximately 1% of people were homozygous (2 copies) for the delta 32 mutation and up to 20% of people were heterozygous (1 copy). Within the United States, Canada and Australia, the frequency is 8% to 10% within the Caucasian background individuals, but less than 1% in the Afro-American populations. There is also a very low frequency of the mutation among the population in eastern Asia but much higher towards western Asia.

Why no one speaks for Gay Men’s Health concerns

 

 

IT may be time to explore the systematic causes for the reasons that gay men’s health is being generally ignored by governments.  Before our health needs will be addressed appropriately we need a strong lobbing or advisory group who is not government funded and it free to take a strong stand on important issues.

An example of poor government action on gay men’s health is PEP.  PEP will effectively halt HIV infection in persons who have had a risk the previous day (or two).  PEP has been made available by many governments around the world.  Even in what some may think of as a slow and backward country like South Africa has made PEP available for years.  But, not in BC.  Why are we so slow?  Why have gay men become infected by HIV for years when they did not need to be?  I believe that it is because we have not had a strong independent voice to harass the government and force change.   HIM over a year and a half ago wrote a paper on the benefits of PEP and quietly lobbied the government.  An influential gay physician wrote a strongly worded letter to the government body responsible for PEP, pushing for PEP.  Yet still we have only a local trial of the use of PEP that begins this month.  If you do not live in Vancouver you are out of luck.

A local gay agency has had some of its funding withheld because this Conservative government did not approve of their actions.  We cannot count on our non-profit agencies to take strong stands against government.  If they do embarrass governments then we risk them losing funding, and us losing these effective agencies in our community.

In the early 80s the agency which preceded Positive Living (PWA) was loud and unrelenting in forcing proper care and treatment for persons with HIV.  Guys were literally fighting for their lives, and it is because of this that they were able to force governments to address the needs of those with HIV.  We now have no group who can forcefully stand up to the government to demand proper policies and services for gay men.

When profit is part of the equation then policy advancement slows dramatically.  It took almost 20 years of research to “prove” that cigarettes cause cancer.  Everyone admitted that there was a link of cigarettes and cancer but no real proof of the cause for over 20 years.   In our case we have a study that was done that saw that people who used water based lube for anal sex were three times more likely to get HIV or STIs.  Upon exploring this relationship more it was found that likely most water based lube damages anal lining.  Now we are two years after the original research but no authority will advise you to consider not using water based lube, until it is further understood.  Though there may not be “proof” of water base lube causing HIV and STI transmission you should know there is an apparent link and you can choose lube according.  Who is advocating for us?

Another example of poor government policy came to light when I was writing about condoms provided to our community.  I was told that the Ministry of Health formulates it policy for the entire province.  They would not tell me what criteria was used to select “proper” condoms, or who was on the committee that is charged with this task.  If 10% of the population is gay, then 5% of the provincial population are gay men yet they account for over 50% of the HIV!  It seems only sensible that the most useable and effective condoms be made available to gay men.  No changes will come about until the government is forced to take action.

I am calling for the Provincial government to formulate a committee of gay men who are not part of the government or government agencies who are not afraid to ask difficult questions and push for effective public policies for our community.  Current policy that is formulated seems to come from persons who read about gay men and their sexual behaviour, but I wonder if any of them making policy affecting gay men really understands the complex dynamics that are part of our sexual community.  It seems only reasonable to ask “the experts” – in this case the experts are not those who read about gay men’s sex but those who know and understand the complexity of gay sex.

 

This is my last regular column in Xtra, but you can follow some of my thoughts on my blog – bcoleman.ca where you can find writing that did not make it into print and other random thoughts.

Women have to make gay helath policy – where are the gay men?

 

 

Gay sexual health policy driven too much by women

 

For years I have been at meetings where discussion of sexual health messaging, policy and procedures is taking place.  Too often these meetings are dominated by women. Few men and often I am one of the only or few gay guys there.  Of course many meetings happen that I am not part of but it seems like most of these meetings are dominated by women.

 

I was told by a gay guy that he attended a half day meeting about spending the $50 million dollars for BC HIV “prevention” (this is another story for next time, 50 million for what?), he said the presenters never mentioned the words gay, MSM, homosexual.  But there was discussion on mother to child transmission,  which has happens much less than one time a year.  I must add that the women try hard to understand gay men’s issues.  Not long ago I was at a meeting (the only gay guy in the room), it was about gay men’s sexual health issues.  There was discussion about a new term “pig sex”, and this was being explained to all assembled.  It feels strange to be sitting with a bunch of straight females talking about gay guys having “pig sex” (as a new phenomenon). Where are the gay men in these discussions?  If gay men are not part of the discussions then who will try to understand our needs, someone has to.  It is not easy for someone outside the community to fully understand, it is hard work for these people, they need our help.

 

An example of this kind of ineffective practice is a situation where men would be telling women about what being pregnant is like.  They can talk about it and have an understanding of the concept of pregnancy but they can never know pregnancy the way a women can.  The women often involved in gay health research, know their limitations, want to understand and want to help gay guys live a healthy life.  I have always felt welcomed and my comments as a gay guy are always greatly appreciated, but ultimately most policy and procedural decisions about treating gay guys are made not by gay guys but by straight women and straight men.

 

HIV education needs to acknowledge as a basic truth that sex for gay men isn’t just a collection of physical practices to be modified.  It’s how we relate,  how we connect, and yes, love.  Understanding that is where HIV education needs to start.  I modified this quote from:

http://www.dailykos.com/story/2010/9/3/896919/-WGLB-presentsYou-Cant-Handle-the-Truth%21:-Gay-Men-and-HIV-Education  It is an interesting article that examines some of these issues in more depth.

 

Gay guys are the largest group of new infections of HIV, by far!  Gay guys are the largest group of group of new syphilis cases by far.  If gay guys are such a large group of the sexual health clients then where are they in being included in part of the solution.   It seems like HIM (Health Initiative for Men), and PWA are well placed to have or develop their expertise in sexual health of gay men, and should be a permanent consultant to all discussions about policies and procedures relating to gay men.  I do not think they are asked for their input and understandings very often.  Gay men should be a main part of all training of sexual health nurses, because they are the main part of the positive syphilis

A year of writing for Xtra Newspaper and what that was like

 

 

It has been a year since my first column came out.  It is time to talk what has and has not changed  in that year.

Know the risks of HIV transmission got lots of attention, and some professionals in the field of HIV did not like it.  I only quoted Spectrum Health’s website for the data, but people who did not like what I said about risks attacked me but not the 10 doctors at Spectrum who specialize in the field. Interesting I think.

PEP (Post Exposure Prophylaxes) seemed to stir some interest.  Although BC is generally advanced in addressing HIV issues, we are backward in addressing PEP.    Guys can be kept from getting HIV by going to the Hospital emergency room and getting PEP.  But BC is slow to act, now that is about to change.  In the next few weeks PEP will be available to guys who feel they were exposed to HIV. The wheels move slowly and every day more guys are needless infected by HIV, but finally PEP will be available soon!

What happened with the condoms?  Well I was told by the media person at BCCDC that a committee decides on which condoms will be bought,  I was told that I would not be told who is on that committee and I would not be told what goes into making a decision.  But now there are new condoms provided for the public.  I manufacture of these condoms claims that they exceed the US and International standards for condoms.  The only criticism I have seen about the new condoms it that they may be a bit small.  Now the HIM clinic at 1033 Davie gives out larger condoms and non-latex condoms.

Where is the wart vaccine?   I am told that the BC Cancer XXX will be recommending that the wart vaccine become available for males.  I talked to a doctor in the field and he said that if he were again out on the sex market he would get the vaccine because it has few side effects and help a person immune system cope with the wart virus.  A very nice nurse took the time to review my article and point out places in my article that were unclear and could have presented the issue more accurately.

Loneliness feeling disconnected.  Well this one seemed to get the most positive reaction for people.  It seems though that most people could identify with the problem.  But most people in the helping business seemed to miss my point that though there are many activities for gay guys to participate in, there are reasons they don’t.   People are less likely to attend group discussion than a course where because of shyness (or whatever).   I called for courses to help guys address their isolation but people seemed to respond with the same programs that are out there.

I expected a lot of reaction to HIV immunity but it seemed like interesting information at people took in to use as they might.

How often should you get tested?   Well BCCDC is working on a policy about how often gay guys should get tested.  I think that risk based testing as well as routine testing is the best answer.  IF you have a risk then get tested, if you tend to be a bottom who has lots of sex then your routine might be every 2-3 months, if you tend to be a top than every 3-4 months get tested.  We will see what BCCDC has to say eventually.

Now for some personal reflections about this column.  Not everyone likes what I say here.   I was surprised how intensely some people will react to me voicing my opinion.   I think I am a bit naive about this, but I did not expect some of the reactions I got.   Someone lobbied Xtra to have me fired, I felt bullied by someone.  Some professionals started talking about me being mentally ill in an apparent attempt to discredit me.  One person hit me, though it was not an assault it was harder than necessary just to make a point.  And there were many guys who will come up to me and tell me how much they enjoy what I write about.  I hope it is useful and gets discussion going about important topics for our health. My goal is to create a healthier and happier community for us all.

Gay guys and warts and vaccines

Gay men and warts

OPEN WIDE / Why aren’t gay and bisexual men getting free HPV vaccines?

Bill Coleman / Vancouver / Thursday, December 16, 2010

 

Warts.  Warts.  Warts.  Almost all of us have had them (or have them now).

Warts make wonderful dinner conversation, which  can lead to all sorts of interesting discussions about homophobia, anti-gay government policy, fucking, penises, asses, hope, and even cancer and death. Who knew those little pesky spots can have so much effect on gay men?

When I was young, in the middle of the last century, my parents were not so educated and did not know anything about warts. In those days we were told to rub a penny on the wart, bury the penny for six weeks, dig it up, then rub the wart again and it would magically disappear. Now we know that a wart comes from a virus.

Yes, another virus for gay guys to worry about. But this virus has an effective vaccine.

The wart virus is called human papillomavirus, or HPV for short. Gay guys can and do get anal cancer from the HPV (wart) virus, but the BC government will not pay for gay guys to get the vaccine, even though they pay for every school-age female to get it.  (Anti-gay government policy? Homophobia?)

Warts are the most common sexually transmitted disease. So if you’ve got warts, you’ve probably been sharing them with your boyfriend. But if almost all of us gay guys have this wart virus, does it really matter?

HPV is the most common cause of cervical cancer. Granted, most gay guys do not have cervixes, but they do have asses. A penis may enter an ass and bring the HPV virus along with it. (See: now we’re on to fucking. And no, you do not have to have a wart on your dick to have the virus.)

If your dick does transmit the wart virus, in five to 10 years there can be big problems. The HPV virus can cause anal cancer.

Dr Joel Palefsky, an infectious disease expert from the University of San Francisco, says, “almost all HIV-positive gay men have HPV in their anus.”

The Vancouver sample of the ManCount survey of gay men shows 79 percent of HIV-positive guys and 62 percent of HIV-negative guys have anal wart virus.

The survey also found that 64 percent of HIV-positive guys and 34 percent of HIV-negative guys have abnormal cells in their anuses, which can lead to anal cancer.

HIV-positive gay men are 10 times more likely to get anal cancer than women are to get cervical cancer.

In a paper published in 2006 by a Vancouver group, gay men were found to be 35 to 70 times more likely to get anal cancer than the general population (Lampinen 2006).

HIV-negative gay men have a rate of anal cancer at 35 per 100,000. Women get cervical cancer from the wart virus at a rate of 8 per 100,000. Is the health of gay men not important to this government? Or are we expendable?

So here it is: there is a vaccine for warts. It is effective. Why not just take the vaccine?

Well, there are two complications. The vaccine works best if you get it before you have the virus in your ass. The BC government will pay for any female under age 26 to be vaccinated against HPV, but they will not do the same for gay guys — even though the vaccine is approved for use in males aged 9 to 26 in Canada. Gay men in the UK have been receiving the HPV vaccine for some time now.

All young gay and bisexual guys in BC should be getting this vaccine, too.  But our not-so-gay-friendly healthcare system won’t pay for it.

How many young gay and bisexual guys even think about warts, let alone have $450 lying around to pay for their own vaccines?

I wonder if our health minister thinks you deserve to get cancer and die if you let some guy put his dick in your ass.

Why is no one standing up and demanding proper healthcare for gay men?  It is time to speak out to demand proper treatment from our medical health system. We will not be heard by being quiet, by being nice. It is time to act!

Lobby the health minister, talk to your doctor, and ask your doctor if you need to be examined for HPV virus in your anus

 

Show us the real HIV transmission risks

Show us the real transmission risks

OPEN WIDE / Stop dumbing down HIV for gay men

Bill Coleman / Vancouver / Thursday, February 10, 2011

 

Gay men need to know the truth about HIV transmission.

I asked staff at a local AIDS agency why they don’t tell people the whole story about the risks of HIV transmission. The reply was something like, “Well, we thought about it but decided not to.”

I tried to get another local organization to provide this information on its website, but they declined.

What is going on here? Do people think we can’t handle the truth? How can we make informed decisions when we aren’t given the information we need to calculate the level of risk we’re each comfortable taking?

Can you answer this question accurately: how likely is it that an HIV-negative guy will get HIV if he is fucked in the ass by an HIV-positive guy not wearing a condom? Most people do not know the answer and will guess wrong. The risk is not as high as you might think.

When I used to lecture groups about HIV, I would ask this question. Many people thought there was a 100 or 90 percent chance that the negative guy would get infected. Some ventured to suggest a 50-50 chance of infection.

The truth is the risk is far lower! If you’re getting fucked in the ass by a positive guy, the chance of transmission is one time in 200, according to the US Centers for Disease Control.

The only local place I know of that will tell us these facts is on the Spectrum Health website. It is not easy to find but it is there (www.spectrum-health.net/index.php?option=com&mdashcontent&view=category&layout=blog&id=83&Itemid=200).

Here is the breakdown of sexual transmission risks for gay men, according to the US Centers for Disease Control:

•    being fucked by an HIV-positive     guy who cums inside you:     1 in 200

•    fucking an HIV-positive guy:     1 in 1,500

•    sucking an HIV-positive guy:     1 in 10,000

•    getting sucked by an HIV-positive         guy: 1 in 20,000

I’m not suggesting we all go out and take risks. I’m just saying we’re all entitled to make our own decisions about how many risks, if any, we want to take.

If you like to fuck and get fucked but do not like condoms much, then you can see it is seven times more risky to get fucked than to fuck without condoms.  Make your own choice about how much risk you are comfortable taking and how important the sex is for you.

I also think there would be less stigma for poz guys if we all knew the real risks of HIV transmission. Maybe then negative guys would find poz guys less scary. Living with constant fear of getting HIV can become a huge burden. Knowing the facts can help all of us to feel more in control and can help in making informed decisions around our sexual activities.

Other factors can affect the odds of getting HIV. High viral loads and sexually transmitted infections make transmission more likely, for example. Whereas an undetectable viral load makes it less likely. (Needless to say, avoiding getting cum in your ass makes transmission even less likely.)

Newly infected guys can have a high viral load for two months or more and be up to 20 times more likely to infect someone. I have concluded that it may be safer to have sex with a poz guy with an undetectable viral load than with someone who mistakenly thinks they are negative but really has a high viral load, which is what happens three to six months after infection.

A final rule of thumb to prevent HIV transmission: don’t get cum in your eyes. Getting blood in your eyes in a hospital setting is considered high risk.

Open Wide appears in every other issue of  Xtra