Finding the IRMA Advocate Within - at Oxford!

“Hey, this is something I can do!”

by Jerome Galea, IRMA Steering Committee Member

I’d like to share with the IRMA readership a recent experience I had that I hope inspires others to do the same: give a public presentation on Rectal Microbicides (RM) describing what they are and why we need them.  As Jim Pickett will attest I was pretty nervous about the proposition but with lots of support from IRMA as well as friends who sat through my “dress rehearsal” the day before, I learned that I actually know lots about the topic and can make a decent show of it…which means probably most people reading this could, as well.

A bit of background – I’m studying in London and through some colleagues was asked if I’d be willing to present at a seminar series on evidence based interventions at the Department of Social Policy and Social work at Oxford (!) University.  The invitation happened months ago and I said “sure” without thinking much about it.  But as the day grew nearer and I saw all of the other speakers in the lineup (all PhDs and lots of professors, neither of which I am) I started to panic.

I tried to get out of it but the convener encouraged me to do it saying basically that “a degree doesn’t guarantee you know what you’re speaking on; if you know it, you know it!”

So, the first person I called was Jim Pickett – I knew he’d be able to point me in the right direction and provide support and even materials that I could adapt to my audience.  In this case it was a group of masters and PhD students from varied backgrounds but all interested in learning more about RM.

When I talked to Jim, we discussed what IRMA materials I could use but also how I could personalize the presentation with my particular interests (e.g., RM in Latin America).  In this way I had a solid foundation of time-tested materials to work from to which I could merge in my personal style and interests to come up with something that was unique.

When I started the presentation (which is available on the IRMA website, “No Butts About It – Rectal Microbicides and HIV Prevention” -  blatantly plagiarizing  Jim’s presentations) the first thing I asked of the 50 or so attendees was how many had heard of microbicides and to my surprise about three-quarters had.  Working from that base was great since people already had an idea that such a product was under development, but admittedly most had heard only of vaginal microbicides.

Working from the IRMA materials, I first presented an overview of HIV/AIDS in the world; talked about the “tool box” of prevention interventions and where microbicides fit in; showed how microbicides work and discussed current studies underway; talked about anal sex as a human behavior and then focused in on my interest in Latin America.  I capped-off the talk with a call to advocacy, inviting the audience to take part in IRMA by visiting our website, joining a conference call or taking part in a more formal way. 

To my surprise no one fell asleep (well, one guy dozed…but it was late in the afternoon and the room was stuffy) and afterwards there were about 30 minutes of lively dialogue.  Some questions had to do with what the microbicide field should do in terms of acceptability work, making reference to the struggles other interventions have had in being fully accepted (e.g. the Female Condom). Another person, working in the area of medical history, wondered why RM research lagged behind vaginal microbicides and there was discussion of how homophobia may shape scientific discovery.

All-in-all, once I got into the presentation, I felt like “Hey, this is something I can do!” which leads me to the last thing I’ll say: being part of IRMA implies speaking up in each of our own ways about RM.  If you have the opportunity to speak, no matter how informally, give it a go!  Lots of organizations (community centers, universities, professional societies) are looking for people to give chats on a range of topics.

One thing I learned is that just the title itself – “Rectal Microbicides” – raises eyebrows and piques interest.  With IRMA’s excellent library of resources, you can easily put together a professional presentation with slides  that are up-to-date and easy to explain.  So, give it a go; there’s an advocate in all of us!


[IRMA references]

Community Presentations
Teleconference Materials
IRMA-Specific Materials(e.g. our reports)
Other Published Materials

We are always happy to help!

Send an IRMA Advocate to Pittsburgh!

Will you chip in?

by Roy Wadia, IRMA Steering Committee Member

I was one of the lucky recipients of the first round of John Shaw scholarships, to attend Microbicides 2008 in New Delhi. I'd been with IRMA (the former IRMWG) for a while by that time, and while I'd done a lot of HIV/AIDS advocacy and communications work during my time at WHO China and then at the BC CDC in Canada, I'd never really focused on microbicide issues until my introduction to this amazing group.

The more I delved into the subject matter, which initially seemed rather arcane, the more I realized its importance in the global response to the prevention and control of HIV/AIDS and STI. By focusing on rectal microbicides, an issue linked directly to the need to focus on anal sex and its role in the HIV/AIDS picture -- and yet one that is still not widely discussed or given its due in both scientific and advocacy circles -- IRMA and its membership has helped fill a conspicuous gap, prodding scientists, researchers and advocates alike.

The Delhi conference itself was an amazing chance to network, to meet some extraordinary individuals, and to experience that rather wonderful and long-overdue moment when the health minister of India, the conference host country, mentioned rectal microbicides as a weapon in the (if you'll pardon the unfortunate pun) arsenal to fight HIV/AIDS. It brought home the work that IRMA had been doing, and renewed our sense of mission and purpose. For this scholarship recipient it vindicated the work that's being done by so many of us, and I can only say that the John Shaw scholarship (named after a fearless advocate and lovely man) needs to continue and to be strengthened in the years to come.

-------------

IRMA created the John Shaw Memorial Scholarship Fund in late 2007. John was a valued, enthusiastic and delightful member of the IRMA Steering Committee for over a year. He passed away Thursday, September 27, 2007. An LGBTQ/human rights advocate for over 20 years, John was also a Person With AIDS since at least 1990.

His fund helped rectal microbicide advocates attend the M2008 conference in New Delhi. Click here for a list of scholarship recipients.

TODAY - thanks to the generosity of the Elton John AIDS Foundation, we already have $3,000 in the Fund to help support IRMA advocates to attend the Microbicides 2010 conference this coming May in Pittsburgh.

We would like to bring that total to $10,000 - and here is where you come in. Will you chip in to help a rectal microbicide advocate attend M2010?

To donate to the John Shaw Memorial Scholarship fund, you may do so securely right here on this blog. In the upper left hand corner, there is a Chip In! box that allows you to donate whatever amount you would like via PayPal - securely.

The planners of M2010 are providing a large number of scholarships – so IRMA plans to fill in the gaps for rectal microbicide advocates who were unable to secure that support. We plan to release information on IRMA’s competitive scholarship process in December 2009. Microbicides 2010 will be announcing their scholarships on February 1 – and IRMA will announce recipients of our support by March 1, 2010. IRMA scholarship recipients are required to have applied for M2010 support to be considered.

Thank you for your support!

High prevalence of anal chlamydia in Swiss HIV-positive gay men

via Aidsmap, by Michael Carter

A large proportion of HIV-positive gay men in Switzerland have anorectal infection with chlamydia, investigators report in the November15th edition of Clinical Infectious Diseases. The researchers suggest that undiagnosed anal chlamydia infections could be contributing to the continued spread of HIV amongst gay men in Switzerland.

Gay and other men who have sex with men remain the group most affected by HIV in many industrialised countries, including Switzerland. Sexually transmitted infections also disproportionately affect gay men. If left untreated these infections, including chlamydia, can significantly increase the risk of acquiring HIV. As reported on aidsmap.com UK investigators found that many chlamydia infections in gay men were in the rectum, and that HIV-positive gay men were disproportionately affected by rectal chlamydia

Investigators from the Swiss HIV cohort therefore postulated that anorectal chlaymdia infection could be contributing to the ongoing HIV epidemic amongst gay men in the country.

They therefore screened 147 HIV-positive men who reported unprotected receptive anal sex in the previous two years for the infection. The aims of their study were to determine the prevalence and symptoms of anorectal chlamydia, and to see if they could identify any risk factors associated with the infection.

Read the rest.

The End is Near - Obama to Officially End Travel Ban - TODAY(?)

UPDATE - The ban has been lifted!!!

President Obama announced today that his administration is lifting travel restrictions into the country for those with HIV/AIDS.

"If we want to be a global leader on HIV/AIDS, we have to act like it," he declared, before signing a bill extending the HIV/AIDS treatment act named for Ryan White, who was diagnosed with AIDS at 13 and died in 1984. The bill provides medical care, medication, and support services to about 500,000, mostly poor, people.

The travel ban, imposed 22 years ago, will be lifted in January, according to a final regulation that will be published Monday, Obama said.

Read the rest.


via Advocate, by Kerry Eleveld

President Barack Obama is expected Friday to announce an end to the HIV Travel and Immigration Ban during a signing ceremony for the Ryan White HIV/AIDS Treatment Extension Act scheduled for 11:50 a.m., according to a source at an agency that works closely with the Administration.

"My understanding was that this would be announced the same day as the Ryan White Act was signed into law," said the source, who spoke to The Advocate on the condition of anonymity. "The White House wanted to be out in front on this."

Read the rest.

Read the rule from HHS.

Confusion surrounds HPV vaccine for men

Among HIV-negative gay men, the rate of anal cancer is "as high as cervical cancer in women before the introduction of Pap smears. And if you are HIV-positive, it's about double that," Chin-Hong said. 

via Bay Area Reporter, by Bob Roehr

Should men routinely receive the vaccine for human papillomavirus (HPV) that protects against cervical and anal cancers and warts? Those hoping for a clear answer will have to settle for something less, at least for now.

The federal Food and Drug Administration approved Gardasil for use in women in 2006 to protect against four types of HPV that cause the vast majority of cancers and warts. It waited for completion of a trial in gay men to give the nod for that indication on October 16 of this year.

But a week later, on October 23, a Centers for Disease Control and Prevention advisory committee said Gardasil should not be added to the recommended list of vaccines for all pre-teens. That is important because the vaccine is most effective if it is given before one becomes sexually active.

Read the rest.

Related: Despite Approval, Evident Roadblocks to HPV Vaccine for Males Continue

BBC: Kenya to launch homosexual census

"Most of the gay community think that having sex with men is safe. There's no information here about safety measures."
 - Gay rights activist Peter Njane

via BBC

Kenya is to carry out a census of its gay population in an effort to bolster the fight against HIV/Aids - despite homosexuality being against the law.

Nicholas Muraguri, head of Kenya's Aids prevention programme Nascop, told the BBC it was vital that the government reached out to the gay community.

He said gay people suffered from a lack of information about the disease.

But analysts say many gay people will be afraid to come forward in a country where homosexuality can result in jail.

Mr Muraguri conceded that an accurate count was unlikely.

But he told the BBC's Network Africa programme that getting a clearer idea of the number of gay people would be a huge help with targeted interventions such as provision of condoms.


Read the rest, including audio.

Kenya Update - politics and planning in heteronormative society

by IRMA Steering Committee Member Larry Misedah

Kenya has been seen as one of the progressive countries given a public health approach in dealing with MSM and WSW. The Kenya National AIDS Strategic Plan recognizes these subgroups as the most at risk populations which are part of the target groups for intervention in the HIV/AIDS pandemic.  There have been research programs that have been carried out in both Nairobi and Mombasa about MSM. In one of the current research program led by Dr. Vasu and Dr. Theo, one of the recommendations was to have research on the efficacy of the different kinds of lubricant people use locally and their efficacy, a common idea shared with Ishtar MSM during their strategic Planning Process.

Where as it may be seen that the political situation in Kenya is different from the neighbouring East African Countries, the Constitutional Review Committee already pointed out that they will not include lesbian or gay issues in the constitution as this will lead to its rejection in the referendum - a controversial issue even within the National AIDS Intervention Programming.  This therefore pauses a major questions about the future of further researches i.e. on rectal microbicides in a heteronormative society where sex is only viewed when done through the vagina and the penis. This notwithstanding the fact that even  heterosexual couples have anal sex and that most MSM in Nairobi also have sex with Women because of the cultural reasons that have led them to get married.

There is therefore a need for an analysis and proper strategies to be put in place to ensure the continuity of the already ongoing work that has been taking place and a bold step to take in issues of rectal microbicides in the already ongoing programs.  Perhaps an issue that needs to be picked up with the newly formed Panafrican MSM Network AMSHeR.

Sudan: Addressing an African Taboo, HIV Prevention with MSM

via International AIDS Alliance

[thanks to the Global Forum on MSM and HIV for putting this on the IRMA radar.]

Talib Aboi stands in a small courtyard building in Juba, south Sudan. He talks to a group of men about HIV, telling them how to protect themselves by using a condom.

He is a courageous, pragmatic man, who is willing to tackle a subject that in Sudan and across Africa is taboo – HIV prevention for men who have sex with men (MSM).

“If we don’t teach about HIV all our other work will mean nothing. For the children who came to adolescence during the war they didn’t become the people expected by the community. They don’t know what it is to be good, what it is to be bad.”

Aboi is the humanitarian director of Mubadaroon a development organisation, supported by the International HIV/AIDS Alliance. He has been working in development for over ten years.

“People are not coming out about men who have sex with men. We are learning that older people are infecting young boys. We want more information but most people are illiterate so we need materials that they can use. We need to do something specifically for men who have sex with men.

Read the rest.

How American Evangelicals are Killing Gay People in Africa

via Change.org, by Michael A. Jones

Hate never made for a good export. But that hasn't stopped a prominent group of American evangelicals from trying to ship their anti-LGBT principles abroad. One glaring example of right-wing theology run amuck across the globe is fresh out of Uganda, where legislative efforts to attack Ugandan LGBT people reached fever pitch this week.

Uganda is an interesting example of how the radical religious right in the United States has sought to take their battle against all things related to homosexuality to a global level. Earlier this year, a prominent group of evangelicals -- among them representatives from Exodus International and Defend the Family International -- attended a conference in Uganda aimed at discussing ways to fight homosexuality. The goal of the conference was to brainstorm ways that the government, schools and churches in Uganda could "wipe out" homosexuality from the country.

Read the rest.

Related:  read "The Final Solution"? Gay Ugandans Could Face Death Penalty Under New Law on RH Reality Check

Ten percent of South African women report anal sex in the past three months

via Aidsmap, by Roger Pebody

A cross-sectional survey has found that 14% of men and 10% of women in Cape Town, South Africa, report having heterosexual anal intercourse. Condoms are used at roughly equivalent frequency as for vaginal sex, it is reported in the online edition of Sexually Transmitted Infections.

The study’s authors believe that while anal intercourse needs to be addressed in behavioural interventions, it makes only a minor contribution to the South African epidemic.

However, the authors of an accompanying editorial argue strongly that this conclusion is premature, and point out that unaccounted-for anal intercourse could skew the findings of microbicide trials.

Anal intercourse between men and women has generally not received as much attention as anal intercourse between men. However, there is evidence (especially from the United States) that anal sex is practised by large numbers of sexually active adults, suggesting that it may play an important role in HIV transmission amongst heterosexuals.

Read the rest.

Related: Check out the presentations below from the IRMA teleconference exploring this subject

Implications of Anal Intercourse and Rectal use of Products in Vaginal Microbicide Trials (Ian McGowan) 

Measuring Anal Intercourse in Microbicide Studies (Pamina Gorbach)

Anal cells appear to be the major HIV risk factor

via GayNZ.com

The risk of anal transmission of HIV appears to be more associated with the presence and concentration of vulnerable cells than to low level physical damage associated with anal sex, according to information presented to a sexual health conference at the weekend.

Anal sex, sexually transmitted infections among gay men, and biological infection risk factors were hot topics at the 21st NZ Sexual Health Society conference which convened in Paihia.

Read the rest.  

New Coalition to Address MSM Issues in Africa

via Behind the Mask, by Simangele Mzizi

In their effort to step up the fight against the high HIV prevalence amongst men who have sex with other men (MSM) some concerned men have formed a coalition titled African Men for Sexual Health and Rights (AMSHeR) aiming to increase visibility of issues affecting MSM in Africa.

Established in March this year, “AMSHeR was formed to strengthen the capacity of national agencies and individuals working to improve legislation and programming related to MSM’s sexual and reproductive health”, said Joel Nana, Executive Officer for AMSHeR.

The coalition consists of 15 organisations from 13 African countries working with lesbian, gay, bisexual, transgender and intersex (LGBTI) people, mainstream HIV and human rights organisations that work to address the vulnerability of MSM to HIV.

“We intend to extend invitations to other countries and organisations to ensure the visibility and representativeness of all aspects of MSM and transgender lives in the continent”, Nana said.

Currently AMSHeR is hosted by OUT LGBT Well-being, a South African LGBT health organisation based in Pretoria.

As a regional coalition of MSM and LGBTI led organisations, AMSHeR also aims to advocate for the elimination of discriminatory laws and policies affecting MSM.

Nana pointed out that, AMSHeR’s development process has been divided into two phases and the first phase started on 1 October this year and will end on 30 March next year.

 “During this period, AMSHeR intends to develop its management mechanisms, establish its administrative systems, acquire a legal identity, develop its strategic plan and strengthen its funding base for the implementation phase or second phase”, said Nana.

According to a 2006-2007 HIV and AIDS report by UNAIDS to the UN General Assembly Special Session, MSM are a group that has long been overlooked with no documented evidence to confirm their existence.

Meanwhile studies show that research on MSM in Africa has been limited and largely focused on the heterosexual spread of HIV and as a result leaves MSM highly stigmatised and hard to reach, even though this population is particularly vulnerable to HIV infection.

The executive committee of the coalition includes Samuel Matsikure from the Gays and Lesbians of Zimbabwe, Steave Nemande from Alternatives-Cameroun, David Kuria from the Gay and Lesbian Coalition of Kenya and Chivuli Ukwimi from Zambia.