Interrelation Between Homosexuality And HIV

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Interrelation Between Homosexuality And HIV Essay

Homophobia and HIV
Homophobia continues to be a major barrier to ending the global AIDS epidemic.

The global HIV epidemic has always been closely linked with negative attitudes towards LGBT people, especially men who have sex with men (sometimes referred to as MSM); a group that is particularly affected by HIV and AIDS. Interrelation Between Homosexuality And HIV Essay

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At the beginning of HIV epidemic, in many countries gay men and other men who have sex with men were frequently singled out for abuse as they were seen to be responsible for the transmission of HIV. Sensational reporting in the press, which became increasingly homophobic, fuelled this view. Headlines such as “Alert over ‘gay plague’”,2 and “‘Gay plague’ may lead to blood ban on homosexuals”3 demonised the LGBT community.

LGBT people face specific challenges and barriers, including violence, human right violations, stigma and discrimination. Criminalisation of same-sex relationships, cross-dressing, sodomy and ‘gender impersonation’ feeds into ‘social homophobia’ — everyday instances of discrimination – and both factors prevent LGBT people from accessing vital HIV prevention, testing, and treatment and care services.4. As a result, some LGBT people are unknowingly living with HIV or being diagnosed late when HIV is harder to treat. Interrelation Between Homosexuality And HIV Essay

Moreover, research has shown that men who have sex with men may exhibit less health-seeking behaviour and have greater levels of depression, anxiety and substance misuse because of stigma they face6 For example, a study published in 2016 on men who have sex with men in China found that depression experienced by Chinese men who have sex with men due to community norms and feelings of self-stigma around homosexuality directly affected HIV testing uptake.7

A global study in 2013 found that young men who have sex with men experience higher levels of homophobia than older men who have sex with men, and also face greater obstructions to HIV services, housing and employment security.8The loss of these forms of security often lead young men who have sex with men to adopt behaviour that puts them at risk of HIV (such as injecting drugs or exchanging sex for money).9

Yet the percentage of young men who have sex with men who are able to access cheap condoms, information about how to prevent HIV and other sexually transmitted infections (STIs), HIV and STI treatment is extremely low. Nearly half of the study’s young respondents who were living with HIV were not on antiretroviral treatment, compared to 17% of older respondents. Interrelation Between Homosexuality And HIV Essay

In 2014, MSMGF (the Global Forum on men who have sex with men and HIV) conducted its third biennial Global Men’s Health and Rights Study of just under 5,000 men who have sex with men from countries across the world. The results, published in 2016, indicate significant gaps in HIV prevention and treatment for both HIV-negative and HIV-positive men who have sex with men. It found perceptions and experiences of sexual stigma and discrimination to be associated with lower access to HIV services and lower odds of viral suppression, which is when treatment has successfully reduced the level of HIV in someone’s body to such a low level they are in good health and are unlikely to pass the virus on to someone else. Interestingly, participants in the study who reported higher levels of engagement with the gay community were significantly more likely to have had an HIV test and received the result; to have participated in HIV prevention programmes and, for those living with HIV, were significantly more likely to be retained in care, giving them higher odds of viral suppression. Interrelation Between Homosexuality And HIV Essay

Similarly, a study of men who have sex with men in Tijuana, Mexico found that self-stigma, or what the study describes as ‘internalised homophobia’ caused by cultural norms of machismo and homophobia, was strongly associated with never having tested for HIV, while testing for HIV was associated with identifying as homosexual or gay and being more ‘out’ about having sex with men. The study cites evidence of HIV-positive men who have sex with both men and women yet avoid affiliation with the LGBT community out of fear of homophobia. It argues that innovative strategies are needed to engage non-gay-or-bisexual-identifying men who have sex with men in HIV testing programmes without exacerbating experiences of stigma and discrimination.12

A large proportion of men who have sex with men in both West and Central Africa and East and Southern Africa also engage in heterosexual sex, often with wives or other long-term female partners. For example, a 2015 study of men who have sex with men in Abidjan, Côte d’Ivoire found the most widespread sexual orientation among men who have sex with men to be bisexuality.13 The HIV epidemic among men who have sex with men is therefore interlaced with the epidemic in the wider population in these regions. Interrelation Between Homosexuality And HIV Essay

How homophobia affects HIV service provision
The provision of HIV services that are specific to the needs of LGBT people remains inadequate in many countries, as the needs of people from these groups are not given priority by governments. HIV data relating to LGBT people is also grossly under-reported, inconclusive or not reported at all.15 For example, while Ukraine’s National Target Program calls for tolerance and less discrimination towards people living with HIV, it does not specifically mention stigma against men who have sex with men or transgender people. As a result, these groups have very limited access to specialised programmes, even in comparison with other key populations such as people who inject drugs and sex workers.16 In addition, many programmes are typically focused on medical interventions and do not take into account human rights issues.17

Homophobia around the world
Despite the important number of countries repealing laws that discriminate against LGBT people, same-sex sexual acts were illegal in 73 countries and five entities as of June 2016. This is a decrease from 92 in 2006.18 Homosexual acts are punishable by death in 13 states (or parts of) including Sudan, Iran, Saudi Arabia, Nigeria and Somalia19, an increase from 9 countries in 2006.20

Such criminalisation can deter men who have sex with men from seeking out HIV prevention, testing, treatment and other services when they need them.21 Interrelation Between Homosexuality And HIV Essay

Societal opinions about the acceptance of homosexuality vary between regions, with acceptance prominent in North America, Western Europe and most of Latin America. Rejection was reported in Muslim nations, Africa, parts of Asia, Central and Eastern Europe and Russia. Secular countries, as opposed to religious countries, are more accepting of homosexuality.22

In 2016, the International Lesbian, Gay, Bisexual, Trans and Intersex Association began a yearly global attitudes survey to gather credible data on public attitudes to LGBTI people on every continent. The first year findings included responses from 54 countries and revealed strong regional differences. For example, to the question of ‘How would you feel if your neighbour were gay, lesbian or bisexual?’, less than half (43%) of African respondents and just 50% of Asian respondents said they would feel ‘no concern’. More than three quarters of respondents answered positively in the Americas (81%), Europe (74%) and Oceania (83%). It is notable that 39% of respondents in Africa and 28% of respondents in Asia would be ‘very uncomfortable’. The North African states of Egypt (26%), Morocco (33%) and Algeria (34%) displayed the least level of ‘no concern’ in Africa, and Indonesia (26%), Jordan (27%), Saudi Arabia (32%) in Asia.23 Interrelation Between Homosexuality And HIV Essay

Interestingly, more than 50% of participants from each of the countries included in the survey responded favourably to the statement: ‘Human rights should be applied to everyone, regardless of whom they feel attracted to or the gender they identify with’. Algeria was the lowest at 50%, and both Ireland and Italy were the highest at 78%. This suggests that many people living in countries with regressive legal and policy frameworks have attitudes that contradict their government’s stance.24

The economic cost of homophobia
As well as having a very real human cost, homophobia is also damaging to a country’s economy. This is because stigma and discrimination based on sexual orientation and identity can result in fewer earnings, and fewer employment opportunities, for people who are LGBT, which results in less money going towards a country’s gross domestic product (GDP). The barriers to health care faced by people who are LGBT, coupled with violence and mental health issues experienced by this population due to homophobia, can also cut short the number of years LGBT people are able to work, which again affects GDP.25 Interrelation Between Homosexuality And HIV Essay

To highlight this, UNAIDS included findings from the global Homophobic Climate Index (HCI) in its 2016 Prevention Gap Report. The HCI takes into account a country’s laws on homosexuality, as well as its levels of ‘social homophobia’. The closer the HCI is to 1.0, the higher the homophobia in that country.2627

The HCI found homophobic laws and social norms could be costing the world up to US $119.1 billion of global GDP each year. It found the highest total cost of homophobia to be in Asia and the Pacific at US $88.3 billion annually, although the region with the highest cost of homophobia as a share of GDP was the Middle East and North Africa, reaching 0.59% of GDP or US $16.92 billion. The lowest cost of homophobia as a share of GDP was in Western and Central Europe and North America, at 0.13% of GDP, although this was still estimated to be costing the region US $50 billion each year. Homophobia was estimated to be costing Latin America and the Caribbean up to US $8.04 billion, Eastern Europe and Central Asia up to US $10.85 billion and sub-Saharan Africa up to US $4.9 billion.2829 Interrelation Between Homosexuality And HIV Essay

What can be done to tackle homophobia?
Public campaigns
Public campaigns have proven successful in reaching large numbers of people with messages challenging homophobia.

In June 1969 LGBT people in Greenwich Village, New York City, staged an uprising against police harassment, centered around the Stonewall Inn. This marked the beginning of the Gay Pride movement and the explosion of hundreds of Gay Pride events that celebrate people who identify as LGBT in order to combat the stigma and discrimination that arises from homophobia.30

InterPride, which represents Pride organisers around the world, estimates that more than 900 Gay Pride events take place each year. New York, Madrid and São Paulo hold the biggest Pride events. Increasingly, Pride events are being held in countries with explicitly hostile environments for LGBT people. For example, Pride events began in Rwanda and Jamaica in 2014 and 2015, respectively.31 However, other countries are seeing Pride events closed down as environments become more hostile towards LGBT people. For example, in May 2014 Crimea passed legislation which effectively prohibits any public displays of LGBT activities, which resulted in the banning of Crimea Pride in August 2015.32 Interrelation Between Homosexuality And HIV Essay

LGBT organisations in Uganda have been holding Pride events since 2012, which include a lesbian and bisexual night, a transgender beauty pageant and the distribution of lubricants and condoms in Kampala. In 2016, police raided the Uganda Pride beauty pageant and arrested around 16 people. According to Human Rights Watch, police “detained hundreds more for over 90 minutes, beating and humiliating people; taking pictures of lesbian, gay, bisexual, transgender, and intersex Ugandans and threatening to publish them.”33

Other large-scale public campaigns against homophobia have targeted specific areas of society such as sport. For example, the Rainbow Laces campaign in the UK encourages football players to wear rainbow laces in their football boots to show support for LGBT football players, reaching a wide audience with this positive message.34

Schools
Schools have an important part to play in challenging homophobia. Homophobia is fuelled by lack of awareness, and educating young people about LGBT issues is fundamental to overcoming widely accepted prejudice.35 However, even in countries that are more accepting of people who are LGBT and where legal frameworks are less hostile, education relating to LGBT sexualities and gender identity is often lacking. For example, in 2016 the Terrence Higgins Trust released a report on sexual and reproductive education (SRE) in British schools, based on a survey of more than 900 young people (ages 16-24). It found that only 5% had been taught about LGBT relationships during SRE lessons Interrelation Between Homosexuality And HIV Essay

The vulnerability of lesbians and women who have sex with women (WSW) to HIV
infection is a complicated public health issue that is perplexing to some and ignored
by many. In fact, female-to-female sexual contact is a much less efficient route of HIV
transmission when compared to male/male or male/female sexual contact. According to
the CDC, there are no confirmed cases of HIV from female-to-female transmission.
With more than 15 years of experience with lesbians and WSW, the Lesbian AIDS
Project (LAP) at Gay Men’s Health Crisis (GMHC) knows first hand that there are
lesbians and WSW living with HIV. We set about to research the risks lesbians and
WSW face in this, the third decade of the HIV epidemic.
This research indicates that some lesbians/WSW engage in high risk
behaviors that place them at risk for HIV transmission. Some WSW use
injection drugs and may share needles and works. Some WSW have sex,
or sexual histories, with HIV-positive men and/or injection drug users.
Furthermore, our observations in LAP also suggest that WSW of color
in New York City experience a number of environmental adversities
that drive risk and confound expectations based solely on their sexual
orientation. Interrelation Between Homosexuality And HIV Essay
Lesbians, long ignored in HIV prevention and service programs, need
and deserve tailored interventions and better health outcomes. Beyond
that, the examination of the HIV and health risks lesbians face is an
examination of the intersection of sexual health, sexuality, identity and
stigma in public health programming and policy. This examination yields
lessons that should be shared.
The review of the literature makes the case that the risk of contracting
HIV is directly related to a woman’s experiences and behaviors. The
objective of this paper is not to argue that lesbians/WSW are at the same
risk as their heterosexual counterparts, but to acknowledge that there is significant risk of
HIV, other STIs, and other health disparities for lesbians. These risks are exacerbated by
racial disparities in health care access, as well as by homophobia, sexism, and stigma.
Furthermore, this paper seeks to clarify confusion regarding lesbians and WSW risk in
order to create visibility for this marginalized subpopulation of women. Prevention and
policy interventions must reach more deeply into communities of women and take into
account the context of their lives. Interrelation Between Homosexuality And HIV Essay

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Part I: Questions and Answers
for Young People and Students
There are many reasons for a young person to want information about
HIV. Maybe you have a school project to complete, or maybe a friend or
family member has been affected by HIV. Maybe you realize it’s important
to know about HIV because you are responsible for your own health and
sexual health. Whatever your reason for wanting to know more about HIV,
this document is a good starting place.

  1. What is the history of HIV/AIDS?
    1981 – 1985
    In 1981, an unknown illness that affected gay men was reported in
    hospitals in Los Angeles and New York City. The illness was first called
    GRID (Gay-Related Immune Deficiency) and many people were dying from
    it. Soon the name was changed to AIDS (Acquired Immune Deficiency
    Syndrome). In the very early years, there were a lot of negative feelings
    (stigma) around AIDS because people were afraid of it. It was a deadly
    illness and people did not understand how it was passed from person to
    person. When many people get sick from an illness in the same area at
    the same time, it is called an epidemic. This was called the AIDS epidemic.
    In 1983, HIV (Human Immunodeficiency Virus) was discovered as the
    virus that causes AIDS. The Centers for Disease Control and Prevention
    (CDC) found that HIV was only passed, or transmitted, through contact
    with blood, semen and fluids from the vagina. It was also found that HIV
    could be passed from mother to child during pregnancy or childbirth or by
    breastfeeding.
    In 1983, the New York State Department of Health began supporting
    programs to educate people about HIV. Programs that support people
    affected by HIV/AIDS were also made available. In 1985, the Food and
    Drug Administration (FDA) approved the first blood test that could tell if a
    person had HIV. The health department began offering HIV testing.
    1986 – 1995
    HIV was found in men and women from all walks of life. Many new cases
    of HIV were happening in people who shared needles to inject drugs.
    This is because when two people use the same needle, they have contact
    with each other’s blood. By 1990, more than 28,000 people died of AIDSrelated causes in New York State. HIV was one of the top causes of death
    among men under the age of 45. Treatment was not very effective and
    the medications had many side effects. In the next five years, from 1990
    2
    to 1995, more than 74,000 people were diagnosed with AIDS and almost
    50,000 people died of HIV related causes in New York State.
    1995 – 2014
    In late 1995, new drugs became available that changed the path of the
    epidemic. For the first time, in 1996, the number of people dying from
    AIDS finally began to decrease. Looking back, that was the real turning
    point. With new treatments that combined different drugs, fewer people
    were dying from HIV. Programs that gave sterile needles to people who
    used drugs brought down the number of new cases among drug users.
    Another major victory was the use of medications to prevent HIV from
    being passed from a mother to her infant.
    2015 – current
    Today, there is still no vaccine or cure for HIV, but treatment is very
    effective. For many people, treatment for HIV has few or no side effects
    and is as simple as taking one pill, once a day. HIV is now considered a
    chronic or long-term illness that can be managed. This means that people
    living with HIV have healthy, full lives, just like people who are not living
    with HIV. There is still a lot of work to do to end the AIDS epidemic and
    remove stigma about HIV. To learn about New York’s plan to end the
    epidemic, see question 8 below. For a complete history of HIV/AIDS, visit: Interrelation Between Homosexuality And HIV Essay
    https://www.aids.gov/hiv-aids-basics/hiv-aids-101/aids-timeline/
  2. What is the difference between HIV and AIDS?
    HIV (Human Immunodeficiency Virus) is a virus that only affects
    human beings. A person develops HIV if the virus gets into his or her
    bloodstream and begins making more and more of itself, or reproducing.
    People living with HIV may have no symptoms for ten or more years. They
    may not even know they are living with the virus. An HIV test is the only
    way to find out if a person is living with HIV.
    Once a person is living with HIV, it will attack the body’s defense system,
    known as the immune system. Without treatment, most people living
    with HIV become unable to fight off germs and other viruses so they can
    become very sick.
    AIDS (Acquired Immune Deficiency Syndrome) is a late stage of HIV
    disease. According to the CDC, a person living with HIV has AIDS when
    he or she:
    • has a very weakened defense system, or
    • develops a serious illness that we know can be caused by HIV.
    For a list of these illnesses, visit: www.cdc.gov/mmwr/preview/mmwrhtml/
    rr5710a2.htm
    3
  3. What should I know about HIV prevention and sex?
    Adolescence is a time of growth from childhood into adulthood. As you
    make this change, you may become more interested in sex. You may also
    have questions about relationships. It is important to find good sources of
    information. This might be a health care provider, parent, family member,
    teacher or counselor. Interrelation Between Homosexuality And HIV Essay
    Definition of Sexual Health
    Sexual health is having a feeling of wellness related to
    sexuality. It applies to people of all ages. Sexual health is
    physical, emotional, mental, and spiritual. It is a central element
    of human health. Sexual health is based on a positive, equal,
    and respectful approach to sexuality, relationships and
    reproduction. Healthy relationships are based on free choice,
    and are without fear, violence, discrimination, stigma or shame.
    Sexual health includes: 1) the ability to understand the benefits,
    risks and responsibilities of sexual behavior; 2) the prevention
    and cure of disease and other negative experiences and,
    3) the possibility of having fulfilling sexual relationships.
    A good source of information about sexual health is the Take Control!
    Campaign.Take Control! encourages responsible sexual health choices.
    It offers condoms, HIV and STD (sexually transmitted disease) information
    and helps build communication skills with partners. The goals of Take
    Control! are to:
    • promote positive sexual health to New York’s teens and young
    adults;
    • link users to local resources;
    • encourage open and honest communication with partners and
    trusted role models;
    • increase awareness and prevention of STDs, HIV and unplanned
    pregnancy; and
    • encourage behaviors that reduce STDs, HIV, and unplanned
    pregnancy.
    Take Control! campaign includes a website made in partnership with the
    ACT for Youth Center of Excellence at Cornell University found at
    www.nysyouth.net/sexual_health and a Facebook page, www.facebook.
    com/takecontrol. Interrelation Between Homosexuality And HIV Essay
    4
  4. What should I know about HIV prevention and
    substance use?
    Making healthy choices about substance use is important for young
    people. There are many different drugs or substances that a young
    person might be exposed to at school, through friends or even at home.
    These can include things like:
    • Alcohol
    • Marijuana
    • Synthetic marijuana (sometimes called K2)
    • Prescription opioids like codeine, oxycontin, hydrocodone and others
    • Ecstasy
    • Attention deficit disorder (ADD and ADHD) drugs
    • Cocaine
    • Heroin
    Misuse of prescription drugs, especially pain killers, or any other
    substance might start out feeling OK. But it can quickly have negative
    effects on your health. It can also hurt relationships with friends and family.
    Use of substances can affect your judgment and lead to sexual behavior
    that puts you at risk for HIV and other STDs. Too many young people think
    that taking prescription opioids is safe but it can quickly lead to addiction
    and injecting drugs. There are some good resources for information about
    young people and substance use. Check out the resources available at:
    www.oasas.ny.gov.
  5. If I need to write a school report about HIV /AIDS, where
    can I find information and statistics?
    Part Two of this document has a lot of information about HIV. So does the
    Department of Health website at www.health.ny.gov. You can find medical
    information, community resources and statistics. The Health Department
    tracks the number of cases of HIV. It is important to know how many
    people are living with HIV in different areas. The Health Department
    tracks the number of cases of HIV by gender, race, ethnicity and age.
    A person who studies numbers about health conditions is called an
    epidemiologist. The Department of Health prepares reports on HIV and
    AIDS that you can use in a school report. You can learn about this at
    www.etedashboardny.org or see the reports at www.health.ny.gov/
    diseases/aids/general/statistics/annual/
    Check out the Glossary if you are looking for
    information or specific vocabulary related to HIV/AIDS. Interrelation Between Homosexuality And HIV Essay
    5
  6. What is the New York State Youth Sexual Health Plan?
    The New York State Youth Sexual Health Plan is a guide that was created
    to make sure that all New York State youth have access to correct sexual
    health information and health services. The Youth Sexual Health Plan
    was developed by the New York State Department of Health with other
    state agencies. The plan includes ideas for schools, community leaders,
    parents, health care providers and others. There are also ideas about
    how young people can educate each other and help their communities. If
    you would like to learn more about the plan, check it out at: www.health.
    ny.gov/community/youth/development/docs/nys_youth_sexual_health_ Interrelation Between Homosexuality And HIV Essay
    plan.pdf
    You can be a leader in your community!
    Do you have a passion to help others or do you see something
    in your community that needs change? Get involved with
    others and take initiative. You may find that you can meet or
    exceed your goals.
  7. How can I get involved in helping others and being
    a leader?
    The ACT for Youth Network is for young people from all over New York
    State who want to help make their health and wellness, and that of others
    in the communities they live in, better. The ACT for Youth Network:
    • Creates ways for youth to be heard by decision makers;
    • Connects policymakers to young people’s ideas and knowledge;
    • Supports health and leadership among young people;
    • Links youth to one another to share ideas, challenges, and
    strategies
    You can learn more at www.nysyouth.net/.
  8. Will we ever see an end to the HIV/ AIDS epidemic?
    In 2014, New York State Governor Andrew Cuomo announced a plan
    to end the AIDS epidemic by the end of 2020. The goal is to lower the
    number of new HIV cases to fewer than 750 per year. Other goals put in
    place by New York State are to have no new cases of HIV from injection
    drug use, and to have no deaths caused by AIDS. The plan calls for better
    access to HIV testing, HIV treatment and HIV prevention resources. Efforts
    to end the AIDS epidemic may lead to young people, like you, being part
    6
    of the first AIDS Free Generation. You can learn more about the effort
    to end the AIDS epidemic at www.etedashboardny.org or www.health.
    ny.gov/ete. You can also learn about the different programs and services
    that are available to address HIV by visiting About the AIDS Institute.
    In the next section you will find more detailed information
    about HIV transmission, prevention, testing, importance of
    health care and treatment, and human rights, stigma, and
    confidentiality. It is a little more explicit and intended for older
    adolescents or adults.
    You’ve already started doing your part to help end the AIDS
    epidemic! By reading either part of this document you are
    getting the right information, which helps to end stigma and
    promote healthy communication. At the end of this document,
    you will find a glossary and a list of resources that can help you
    if you need more information for yourself or a school report.
    If you have questions, you can talk to a parent, health care
    provider (doctor or nurse), a teacher, or any trusted adult.
    7 Interrelation Between Homosexuality And HIV Essay
    Part II: Questions and Answers About HIV
    Transmission
  9. How is HIV transmitted?
    HIV is spread when blood, semen or vaginal fluids from a person living
    with HIV who is not virally suppressed gets into the bloodstream of
    another person. These body fluids are present during sexual activity,
    which explains why HIV can be passed from one person to another
    during different sexual behaviors. The risk of transmission depends on
    the type of sexual behavior. Oral sex, when a person puts his or her
    mouth on another person’s genitals, has a low risk of passing HIV. Vaginal
    intercourse, when a man puts his penis inside a woman, is a higher risk
    activity for passing HIV. The sexual behavior with the highest risk is anal
    intercourse, when a man puts his penis into the anus of another man or
    woman. If either partner is living with HIV, the virus may be transmitted,
    especially if blood is present during sex. The risk of transmission for any
    of these behaviors can be lowered in a variety of ways, including:
    • Condom use (see question #5)
    • Antiretroviral treatment for the person living with HIV
    • Pre-exposure prophylaxis or PrEP, a daily medication that a person
    who is not living with HIV can take to protect themselves (see
    question #14).
    A person living with HIV who is on HIV treatment and virally suppressed
    for 6 months or longer has effectively no risk of passing HIV to a partner
    through sex.
    Substance Use Transmission: Sharing needles and works during injection
    drug use is a high-risk behavior for passing HIV from one person to
    another. Since blood may be present in the needle, syringe, cooker or
    water used during injecting, HIV can be easily passed when people share
    any of these equipment items. By always using sterile injection equipment
    and not sharing equipment can help protect people who inject drugs
    from HIV. A special assessment must be conducted for people who inject
    drugs under 18 years of age who request enrollment in syringe exchange
    programs. To find syringe exchange programs near you, visit
    www.thepointny.org.People who inject drugs may also consider taking
    PrEP, a daily medication that can prevent an HIV negative person from
    getting HIV. Please see questions 6 & 7 to find out more about how to
    protect yourself and obtain new injection equipment in New York State.
    Mother to Child Transmission: HIV can also be transmitted from
    mother to child. Please see question #3 for more information.
    8
    Blood Transfusion: At the beginning of the AIDS epidemic, some people
    became a person with an HIV diagnosis from receiving a blood transfusion.
    With testing of the blood supply since 1985, there is no longer a risk of
    getting HIV when receiving a transfusion.
  10. What are the ways that HIV cannot be transmitted?
    HIV is not like the flu or a cold. It is not passed through casual contact or
    by being near a person who with HIV. It cannot be transmitted through
    saliva, shaking hands, kissing, mosquito bites, living in the same house
    as someone living with HIV (including sharing utensils or drinking cups), Interrelation Between Homosexuality And HIV Essay
    using restrooms, swimming pools, hot tubs, or drinking fountains.
  11. Can a woman living with HIV pass the virus on to
    her baby?
    Yes. A woman who has HIV can pass the virus to her baby during:
    • pregnancy
    • delivery
    • breastfeeding
    There are medicines that a woman living with HIV should take during
    pregnancy, labor, and delivery to protect her health and greatly reduce
    the chance that she will pass the virus to her baby. Medication is also
    given to the infant right after birth and for the first weeks of life. It is very
    important for all women to know their HIV status before they become
    pregnant, or very early in their pregnancy, so that they can take full
    advantage of these medicines and make informed decisions. A second
    HIV test is also recommended late in the pregnancy to identify if the
    woman was exposed to HIV during the pregnancy. Since HIV is also found
    in breast milk, women living with HIV should not breastfeed their babies.
  12. What does Undetectable = Untransmittable (otherwise
    known as U=U) mean?
    U=U means undetectable = untransmittable. U=U was put forth by
    the Prevention Access Campaign (https://www.preventionaccess.org/
    undetectable). The Prevention Access Campaign is a health equity
    initiative to end the dual epidemics of HIV and HIV-related stigma by
    empowering people living with, and vulnerable to HIV, with accurate and
    meaningful information about their social, sexual, and reproductive health.
    In developing U=U, the Prevention Access Campaign reviewed data from
    several large-scale studies and compiled the findings into a statement
    which many leading scientists and public health organizations have
    endorsed.
    9
    The U=U Consensus Statement is:
    People with HIV on ART with an undetectable viral load in their blood
    have a negligible risk of sexual transmission of HIV. Depending on the
    drugs employed it may take as long as six months for the viral load to
    become undetectable. Continued and reliable HIV suppression requires
    selection of appropriate agents and excellent adherence to treatment. HIV
    viral suppression should be monitored to assure both personal health and
    public health benefits.
    When making decisions about HIV prevention, individuals and couples should
    explore their level of comfort with the full range of prevention options and
    make decisions regarding use of U=U, condoms or PrEP accordingly.
    Prevention
  13. What can a person do to avoid getting HIV through
    sexual behavior? Interrelation Between Homosexuality And HIV Essay
    There is no vaccine to prevent HIV but there are several ways a person
    can feel confident about avoiding HIV through sexual behavior. Practicing
    abstinence, that is, not having vaginal or anal intercourse, is one way
    to protect yourself from HIV. Cuddling, hugging, kissing or mutual
    masturbation have no risk of passing HIV from one partner to the other.
    Mutual monogamy, where both partners have been tested and know
    they are both HIV negative and are not having sex with anyone else, also
    provides protection.
    Here are other choices that some people make to avoid HIV. These
    approaches offer a very high level of protection:
    • If you have a partner who is living with HIV, if he or she is on
    effective treatment and maintains an undetectable viral load (i.e. the
    person is virally suppressed), for 6 months and beyond the risk of
    transmission through sex is negligible.
    • Using a condom consistently and correctly every time you have sex
    is extremely effective in preventing HIV.
    • Pre-Exposure Prophylaxis (PrEP): PrEP is a once-a-day pill for HIV
    negative individuals to take in order to prevent HIV. When taken
    consistently, PrEP has been shown to reduce the risk of HIV by
    92-99%.
    • Giving and receiving oral sex is considered a low-risk activity for
    HIV transmission.
    If a person has vaginal or anal intercourse without condoms or PrEP,
    there are important ways to reduce the risk of HIV transmission. These
    are considered harm reduction strategies, because there is still a risk of
    getting HIV if a partner is living with the virus and is not virally suppressed. Interrelation Between Homosexuality And HIV Essay
    10
    Use of lubrication: Extra lubrication, like KY jelly, can reduce the chance
    of cuts and tears in the skin or mucus membranes of the penis, rectum or
    vagina. This reduces the chance of blood being present and reduces the
    ability of HIV to enter the body.
    • Strategic Positioning: During anal sex, there is a penetrative partner
    (“top”) and a receptive partner (“bottom”). Being the penetrative
    partner is less of a risk for acquiring HIV than being a receptive partner.
    However, there is still an element of risk involved in both positions.
    • Frequent STD screening and treatment: A sore or inflammation
    from an STD may allow HIV to enter the body of a person who does
    not have HIV, when it typically would have been stopped by intact
    skin. For people living with HIV, having an STD/STI can increase the
    chance of passing the virus to others.
  14. How can a person get condoms to prevent HIV?
    A person can get condoms in a variety of ways. The following programs
    provide condoms free of charge.
    NYS Condom Access Program: The Department of Health makes free
    condoms available to eligible organizations which provide them to the
    public. For information about nearby organizations visit: http://www.health.
    ny.gov/diseases/aids/consumers/condoms/nyscondom.htm or send an
    e-mail to: nyscondom@health.ny.gov . Call or visit the organization to learn
    about how to get condoms and how many they provide at a time.
    New York City: NYC Condom: Free male condoms, female condoms and
    lube. For more information, dial 311 or visit https://a816-healthpsi.nyc.gov/
    CondomOrder/
    Condom Access in Schools: School districts may make condoms available
    to students as part of their district’s HIV/AIDS instruction program. The
    New York State Education Department (NYSED) has established a process
    and an assessment rubric (http://www.p12.nysed.gov/sss/documents/
    NYSED-CAP-update.4.25.14.pdf) for the establishment of a Condom
    Availability Program(CAP), which should be completed and forwarded to
    NYSED for review and approval. Following approval, school districts can
    then request condoms from the NYS Condom program (available at https://
    www.health.ny.gov/diseases/aids/consumers/condoms/nyscondom.htm).
    Condoms are also being distributed through the Statewide Hotline
    (800-541-2437) or the HIV Counseling Hotline (800-872-2777). Currently, Interrelation Between Homosexuality And HIV Essay
    their policy is to restrict the orders to 10 condoms per call; ages 18 years
    and above; only New York State addresses.

ORDER HERE NOW

Medicaid will also cover the cost of condoms. Providers can write a
prescription for them, but you will need to ask your medical provider to do
so. You can also buy condoms at grocery stores, drugstores and online.
11

  1. What can a person do to avoid HIV through drug use?
    People who use drugs should always use new needles, syringes, and works
    and avoid sharing them. If getting new equipment is not a possibility, people
    who inject drugs can lower the risk of HIV transmission by cleaning needles
    and works with bleach immediately after use and just before reuse.
    Directions for cleaning your syringes:
    Step 1: Rinse the syringe with sterile water.
    Step 2: Rinse the syringe with bleach.
    Step 3: Rinse again with new sterile water.
    New York State has many ways to get new, clean syringes, please see
    question #7.
    8.How can a person who injects drugs or other substances
    obtain sterile injection equipment?
    People who inject drugs are encouraged to seek out Syringe Exchange
    Programs (SEPs) to receive free sterile syringes to prevent HIV among
    themselves and their peers.
    Three ways to get new, sterile syringes in New York State are:
  2. At a Syringe Exchange Program, also called needle exchange
    programs: At SEPs, located in some areas of New York State,
    people who use drugs can exchange used syringes for new, sterile
    syringes. To find SEPs, call the New York State HIV/AIDS Hotline
    at 1-800-541-AIDS (English) or 1-800-233-7432 (Spanish). Visit
    http://www.thepointny.org/ to find Syringe Exchange places
    near you.
  3. At a drug store: In New York State, the Expanded Syringe Access
    Program (ESAP) allows registered drugstores to sell up to ten syringes
    at a time, without a prescription, to adults 18 years or older. To find
    ESAP pharmacies, and for answers to questions about HIV/AIDS and
    safe syringe and needle disposal, call the New York State HIV/AIDS
    Hotline at 1-800-541-AIDS (English) or 1-800-233-7432 (Spanish).
  4. From your healthcare provider: Under ESAP, health care facilities
    as well as doctors and other health care providers can prescribe
    syringes and provide syringes without a prescription. Talk to
    your doctor about ways you can get access to sterile needles
    and syringes.
    To find pharmacies that participate in the ESAP Program, visit:
    https://www.health.ny.gov/diseases/aids/consumers/
    prevention/needles_syringes/esap/provdirect.htm
    12
  5. What can people who are living with HIV do to avoid
    passing the virus to others?
    There are a number of steps people can take to avoid passing HIV
    to others. To avoid passing the virus to others, people living with HIV
    are encouraged to see their healthcare provider regularly. When
    someone stays in healthcare and takes their medication, that person
    will have a higher likelihood of being virally suppressed (also known as
    undetectable). Undetectable means the virus is present at such low levels
    that it is not detected in blood. Having a consistently undetectable viral
    load for 6 months and beyond greatly lowers your chance of transmitting
    the virus to your sexual partners who are HIV-negative. Because of
    U=U (undetectable = untransmittable), we now know the risk of sexual Interrelation Between Homosexuality And HIV Essay
    transmission of HIV from someone with a fully suppressed HIV viral
    load is negligible, meaning so small or insignificant it is hardly worth
    considering. Depending on the comfort level of each partner, other
    prevention methods such as use of condoms or PrEP may be used (for
    more information on PrEP, see question 14).
  6. What can I do if I think I was exposed to HIV?
    New York State Department of Health’s HIV Clinical Guidelines recommend
    non-occupational post exposure prophylaxis (nPEP or PEP) at certain times
    when a person is potentially exposed to HIV, for example when a condom
    breaks, during a sexual assault, with sharing needles or works, or during
    other exposures to blood or other potentially infected body fluids. PEP
    involves taking a combination of HIV medicines for 28 days. PEP should be
    started as soon as possible, ideally within 2 hours of exposure. Decisions
    regarding initiation of PEP beyond 36 hours but no longer than 72 hours
    after the exposure are made on a case by case basis, keeping in mind that
    the medicine is most effective the closer it can be taken to the exposure.
    The DOH has a fact sheet that a person who has been exposed to HIV
    can take to the emergency room to explain his or her special need.
    You can find that fact sheet at: https://www.health.ny.gov/diseases/aids/
    general/prep/docs/fact_sheet.pdf
    For PEP to work, every dose of each medicine prescribed must be taken,
    for the full period of time. PEP can be expensive and insurance coverage
    may vary, but options for payment assistance can be found on the
    NYSDOH website at: https://www.health.ny.gov/diseases/aids/providers/
    standards/docs/payment_options_npep.pdf
    Payment is available for sexual assault victims. Talk to your healthcare
    provider or an emergency room doctor right away if you think you’ve
    recently been exposed to HIV.
    13
    Testing
  7. Why is HIV testing important?
    Testing is important because it is the only way to know if you have HIV.
    The sooner that HIV is detected, the sooner medical care can begin.
    Getting early HIV treatment will help keep you healthy and prevent HIV
    from affecting how long you live or how well you feel.
  8. How does HIV testing work?
    Most people who are living with HIV will have a reactive test, meaning
    the test found evidence of HIV, within one month of transmission. The
    period of time after transmission, before the HIV test turns reactive is
    called the “window period.” When transmission first occurs, the virus
    begins to reproduce and the body makes antibodies to fight HIV. When
    enough virus is present or antibodies are developed, the HIV test will be
    reactive. Most people living with HIV will develop enough antibodies or
    have enough virus present to be detected by the latest testing technology
    two to four weeks after the exposure. Virtually all cases of HIV can be
    detected by three months after transmission occurs.
    For a standard HIV test, a blood or oral fluid sample is taken and sent to
    a laboratory. You will need to call or come back about a week after the
    test to get your test result. At some clinics and doctors’ offices, you can
    get a rapid HIV test, which can give you a preliminary result that day. The
    test takes about 20 minutes. If your rapid HIV test is reactive (meaning
    HIV virus or antibodies were found), you will need additional testing that
    is sent to a laboratory. While you are waiting for the final test result, you
    should practice HIV prevention techniques to protect your partners. When
    you get your final test result, you will receive information about what the
    result means, and linkage to care as necessary.
    A home HIV test kit is sold over-the-counter at pharmacies and other
    stores. With the home test kit, you take a finger-stick blood sample and
    send it to a laboratory. Later, you call to get the test result over the phone,
    using an anonymous code number. Follow up with a healthcare provider if
    have a reactive test or have any questions regarding your result.
    If you have a negative test result, please see question number 14 for
    more information.
    If you have a reactive test result, please see question number 15 for
    more information.
    To find out more about getting tested, call your healthcare provider,
    1-800-541-AIDS (English)/ 1-800-233-7432 (Spanish) or visit:
    www.hivtestny.org.
    14
  9. Where can I get an HIV test?
    Many people have a primary care provider that they see regularly. At least
    once in the course of regular medical care, you should be offered an HIV
    test if you are over the age of 13. If you are not offered one, you can ask
    for an HIV test.
    If you would like an HIV test but do not have a regular primary care
    provider, there are many places you can go for an HIV test. You can make
    an appointment with a primary care doctor, go to a community based
    organization that offers HIV testing, go to your local health department,
    family planning clinic, or even find a mobile van at a community event
    where HIV testing is offered. You can find out about places that offer HIV
    testing at www.hivtestny.org. Interrelation Between Homosexuality And HIV Essay
  10. How often should a person be tested?
    Health care providers should test everyone at least once as part of routine
    health care. However, if you continue having unprotected sex or sharing
    injection drug equipment, you should get tested at least once a year.
    Sexually active gay and bisexual men may benefit from more frequent
    testing (e.g., every 3 to 6 months). If you think you have had a potential
    exposure to HIV, you should consider PEP and get tested as soon as
    possible. If you receive a negative test result, you may want to consider
    PrEP (please see question #13 for more information on PrEP)
  11. What does it mean to have a negative test result?
    A negative test result generally means you do not have HIV. However, if
    you have had a recent exposure you may be in the “window period.” The
    window period is the period of time between someone potentially being
    exposed to HIV and when the test is able to detect it. If the first result
    comes back negative and there is still concern, getting tested again 3
    months after the last possible exposure can help you to be sure.
    People who have a negative test result but would like to reduce the risk of
    HIV may want to consider Pre-Exposure Prophylaxis (PrEP). PrEP is a daily
    pill that people take so they can reduce their worry about acquiring HIV,
    and keep HIV from entering your body.
    You may want to consider taking PrEP if you are:
    • A gay or bisexual man who has unprotected sex
    • A transgender woman who has sex with men
    • In a relationship with a person who is living with HIV
    • Someone who has condomless sex with multiple partners
    • A person who has been diagnosed with an STD in the past
    6 months
    15
    • People who have injected drugs in the past six months and have
    shared needles or works
    • Considering getting pregnant and have a partner who is living
    with HIV
    If taken daily, PrEP works very well at preventing HIV. People wishing to
    take PrEP need to see their healthcare providerr for a prescription, and
    follow up with testing every 3 months. Many insurance plans, including
    Medicaid and private health insurances will cover the cost of PrEP. Visit
    the DOH website for information about how to pay for PrEP, including the
    DOH PrEP-Assistance Program (PrEP-AP) at: https://www.health.ny.gov/
    diseases/aids/general/prep/prep-ap_provider.htm
    Programs that help pay for PrEP include:
    • Gilead medication assistance program for people who do not have
    health coverage, visit http://www.truvada.com/truvada-patientassistance or call 1-855-330-5479.
    • Co-pay Coupon Card from the drug manufacturer if you have health
    coverage but the amount of medication co-pay would present a
    financial challenge, you may be eligible for one. Visit http://www.
    gileadcopay.com/or call 1-877-505-6986 for more information.
    • Patient Advocate Foundation Co-Pay Relief Fund- Provides financial
    assistance to financially and medically qualified patients for copayments, co-insurance, and deductibles. Patients, their medical
    providers, or their pharmacists may submit applications 24 hours a
    day via the Online Application Portal at www.copays.org/gateway or
    Monday – Friday 8:30am – 5:30pm EST via phone at (866) 512-3861.
    • Partnership for Prescription- Designed to help uninsured Americans
    get the prescription medicines they need at no or low cost. Visit
    www.pparx.org, enter the names of the medicines taken and
    answer a few questions to determine what options are available.
    Call the toll-free number if there is difficulty with the web site. Call
    toll-free 1-888-4PPA-NOW (1-888-477-2669) for a trained specialist Interrelation Between Homosexuality And HIV Essay
    to answer questions and help with the application.
    • PrEP-AP – A NYS Health Department program to assist people
    without insurance or who are underinsured with the cost of health
    care appointments or lab work needed for people taking PrEP
  12. What does it mean to have a test that results in an
    HIV diagnosis?
    If you have a test result that results in an HIV diagnosis, you will receive
    post-test education about the meaning of the test result and the
    importance of health care. HIV treatment is effective, easy to take and
    has few or no side effects. The HIV testing provider will schedule an
    appointment for HIV care on the spot.
    16
    If you a person living with HIV, it will be important to reduce the risk of
    passing the virus to others.
    The HIV testing provider will talk to you about the importance of notifying
    partners of possible exposure to HIV and the importance of HIV testing.
    The provider will report known partners and spouses to the Department
    of Health. However, persons who are diagnosed with HIV can choose
    from the following options on how they would like to have their partners
    informed that they have been exposed to HIV:
    • A counselor from the New York State Health Department PartNer
    Assistance Program (PNAP) or the Contact Notification Assistance
    Program (CNAP) in New York City can tell partners without revealing
    the identity of the person
    • People can tell their partners with the help of their healthcare
    provider or PNAP/CNAP counselor
    • People can tell their partners themselves
    Help from PNAP/CNAP is free. For more information, call the New York
    State Department of Health HIV/AIDS Hotline (see the Resources section).
    In New York City, call CNAP at 1-212-693-1419.
    Importance of Health Care and Treatment
  13. How does HIV affect a person’s health?
    The signs and symptoms of early/ acute HIV can begin 2 to 4 weeks after
    transmission occurs with HIV. During the initial weeks after transmission,
    about 80% of people will develop symptoms similar to the flu. This may
    include things like fever, fatigue, sore throat, headaches and swollen
    lymph nodes. Although many of symptoms are similar, there are some
    differences to look for between HIV and the flu. Early HIV may cause rash
    or mouth sores. Flu signs that differ may be nasal congestion, cough and
    sneezing. Symptoms can last for just a few days or weeks, and in rare
    cases for several months. After that, the person may feel and look fine for
    some time. HIV testing is the only way to know if a person has HIV.
    If HIV is left untreated, over time it will seriously damage the person’s
    immune system and leave him or her open to life-threatening infections
    and even death. Early in the epidemic, before our current treatments
    were available, most people living with HIV died within 12-15 years. Today,
    once a person has a reactive (meaning the test found evidence of HIV)
    test result, he or she will be linked to a health care provider who will
    provide care and prescribe medication they need. With treatment, people
    living with HIV can stay healthy and live life fully. HIV is no longer a death
    sentence. Now people living with HIV are living as long as those who do
    not have HIV. Interrelation Between Homosexuality And HIV Essay