In early August, the Centers for Disease Control and Prevention (CDC) released revised figures on the number of new U.S. HIV infections each year. The updated statistics revealed an increase of more than 16,000 cases over the agency’s previous estimate of 40,000 new infections annually — even though rates declined for injection drug users and heterosexuals.
The stunning news was met with a flurry of media coverage.
LGBT activists and AIDS service organizations (ASOs) immediately took notice of the fact that the CDC said the burden of new HIV infections is “greatest among gay and bisexual men of all races.” Of the total 56,300 new HIV infections each year, a full 53 percent of them occur in gay/bisexual men and men who have sex with men (MSM).
Youth advocacy groups also received a wake-up call. According to the report, people age 29 and under represented 34 percent of new HIV infections, the highest of any age group. The LGBT-focused National Youth Advocacy Coalition said the numbers indicate that “existing public education efforts surrounding HIV prevention must be updated to be more relevant and effective at reaching youth.”
In 2005, Metrolina AIDS Project (MAP) was one of three ASOs chosen to operate a CDC pilot program testing the waters for a “gay opinion leader” prevention program. With $1 million in hand, ASOs in Charlotte, Raleigh and Greensboro targeted well-liked and influential young men in gay nightclubs. They provided them with training and education on HIV and risk reduction. The men were then charged with encouraging their peers to take HIV tests, use condoms and play safe.
MAP later created their own proposal for a similar project and D-UP! was born. Begun in 2006, the four-year program seeks to “recruit and train influential African-American men and men of color ages 13-24 and take them through a risk reduction program,” D-UP! Program Coordinator Darren Johnson told Q-Notes.
After they’ve completed the program, participants become “popular opinion leaders” and use their status as influential men in young communities of color to encourage safe-sex practices, HIV testing and risk reduction to their peers. Johnson said many of their program participants are affiliated with the “ballroom” scene — a sub-culture within the larger LGBT community.
Some, like Dan Savage, a syndicated gay columnist who writes about sex, have criticized the CDC pilot program for their use of gift cards, which were given to the “gay opinion leaders” after completing their training.
Savage called the program “completely retarded” and questioned results from CDC surveys collected from 300 men, which claimed a 32 percent reduction in unprotected anal intercourse and a 40 percent reduction in the average number of sexual partners, according to an AP report.
Photo Credits: Metrolina AIDS Project
“Who conducted the interviews? Who wrote up the results? If it was the same folks handing out the gift cards I wouldn’t put much stock in those reported reductions in rates of unsafe sex and reductions numbers of sexual partners,” Savage wrote in an Aug. 11 post at TheStranger.com’s SLOG blog. “It’s possible that the 300 men enrolled in the program were telling the gift-card-givers what they wanted to hear in order to keep the gift cards coming. Or, if the gift-card-givers had a stake in the success of the program, it’s possible the gift-card-givers were inclined to read good results into inconclusive data.”
Johnson told Q-Notes that MAP also gives gift cards to men who complete their risk reduction training sessions “as a way to compensate them for their time and energy,” but he stressed that he believes the program is working.
“I think programs like D-UP! are effective,” he said. “It is important for people to know as much as they can about how the virus is affecting our community. We are encouraging people to have conversations about HIV and risk reduction tools and techniques.”
When people come into the trainings, Johnson said, many of them have no idea how to protect themselves against HIV. AIDS activists have long believed that education and frank discussion of the issues will dramatically improve HIV-infection rates.
Johnson added that HIV testing is a major portion of MAP’s and D-UP!’s programming and they provide free HIV testing at the gay nightclubs they visit in and around Charlotte. He also said that approximately 100 young men had been trained as popular opinion leaders in 2008 alone.
Greg Varnum, the acting executive director of the National Youth Advocacy Coalition, told Q-Notes that his organization “doesn’t think the gift card program is that bad of an idea.”
“The gift cards are a way of engaging young people and bringing them to the table,” he said. “Social marketing campaigns are successful and they do work. Offering incentives for youth leaders to participate in them is not unusual and is a pretty common practice.”
Only 25 years old himself, Varnum relates to a youth culture that never experienced the horrors of the first wave of the HIV/AIDS epidemic.
“We have dialogue with younger people who’ve never experienced the original AIDS epidemic,” he said, “but we also have a modern AIDS epidemic we are experiencing in a different way.”
And like the risqué D-UP! “Prevention is Sexy” media campaigns, Varnum doesn’t see a problem in using sex to sell prevention of a health crisis that is inextricably intertwined with sex.
“We can talk to any marketing expert today and they will tell you that sex sells,” Varnum said. “We may not like it but unfortunately we don’t get to create the environment we work in. If we want to attract the interest of young people, we have to keep in mind that we’re competing with multi-million dollar organizations who are using sex.”
Akil Campbell, the executive director and founder of Raleigh’s Men United for HIV/AIDS Awareness (MUFHA) also believes, like Varnum, that a more holistic approach needs to be taken when addressing education and prevention.
“The key to reaching these at-risk persons is determining where they are, their habits outside of sexual activities, and when they would be more likely to receive health information,” Campbell told Q-Notes. That means taking outreach and prevention measures to schools, colleges, nightclubs, the internet and even retail stores.
Campbell’s organization also believes incentives work to engage people who’d otherwise likely not care and completely miss any messages for how to keep themselves safe.
Varnum also thinks abstinence-only sex education needs to go. “Our stand is that abstinence-only sex education does not work,” he said. “We believe it is harmful in regard to safe-sex practices and stopping the HIV/AIDS epidemic.”
If education and prevention programs are going to be successful, Varnum explained, they’ll need to be developed by the same young people they’re meant to serve. “Programming not developed by young people, for young people doesn’t work.”