by Mike Crawmer
Major news outlets reported breathlessly last year that the incidence of AIDS was increasing in major East Coast cities. Words like “alarming” and “epidemic”—largely relegated to the trash bin of HIV history—were used, especially when describing the rate of HIV infection in Washington, D.C.
As a trend, this one was going the wrong way for two all-too-familiar reasons. As the rate of HIV infection increased nationally, researchers saw the same two groups appearing over and over again in the statistics: young African-American men who had sex with other men and older gay white men.
What applies to the rest of the country applies to Pittsburgh as well. While the rate of increase in HIV infections is lower in Pittsburgh than nationally, “the rate for African-American gay or bisexual men is higher—increasingly higher—than the rest of the population,” said Kathi Boyle, executive director of the Pittsburgh AIDS Task Force.
While declining to cite exact numbers, Boyle did say that the rise in the infection rate in Pittsburgh “is a reflection of a national trend, one that is moving across the country.”
Boyle added that, like every other major metropolitan center in the U.S., Pittsburgh has seen an increase in HIV among older gay white men.
(In Allegheny County, Boyle said, gay men account for fifty percent of all new HIV infections.)
The trend did not creep up out of nowhere.
According to Boyle, a slight increase in infection rates has been occurring “over the last couple years.”
Part of it can be attributed to the fact that, especially among older gay males, people have forgotten about the deaths associated with the early years of the AIDS epidemic.
“AIDS amnesia” is just one of two persistent attitudes the staff at the Task Force and others in the fight against AIDS are facing, Boyle said.
“There’s also the Magic-Johnson-was-cured attitude,” she said, referring to the NBA star who broke many barriers when he acknowledged that he had AIDS.
That attitude, Boyle added, “brings with it a so-all-you-have-to-do-is-take-a-pill mind-set.”
Whether called “attitudes” or “mind-sets,” these entrenched beliefs are now the target of an innovative and comprehensive community awareness and education project managed by the PATF called M2M.
Under the direction of project manager John Green, M2M enlisted key members of Pittsburgh’s gay community—the so-called “stakeholders”—in a wide-ranging effort to help men who have sex with men adopt behaviors that reduce the risk for HIV.
Included among these stakeholders are members of the local gay male community (young, old, white, African-American, etc.) gay bar owners and PATF staff—some of whom, like Green, were hired specifically for this project—and volunteers.
This collaborative effort—the “most comprehensive” tried in Pittsburgh to date, Boyle observed—is taking on both unsafe sex practices and substance abuse with a goal of changing behavior.
That job is a daunting one, as Boyle explained in addressing unsafe sex.
“Everybody knows they should use a condom,” Boyle said, quoting another AIDS activist, “yet everybody has 98 reasons why they don’t. Our job is to show people that they can have fun sex without getting AIDS.”
Green described a two-layer approach. “One layer is to educate the community, like throwing the balls, doing PRIDE—which give us visibility in the community—and other social outlets such as hosting movie nights, meeting with the Frontrunners (an LGBT running group).”
This outreach included a staffed display in March at Outrageous Bingo, the monthly fundraiser held at Rodef Shalom in Oakland, the proceeds from which benefit the Gay and Lesbian Community Center and Shepherd Wellness Community.
And the second layer? “That is providing people with opportunities to get involved,” Green explained.
The approach the M2M project is taking is unlike any other tried before in the city, Boyle and Green explained. The project began as a collaboration between PATF, Persad Center, the University of Pittsburgh’s Graduate School of Public Health and the Pitt Men’s Study.
That collaboration continues, with other groups joining, such as the Positive Clinic at Allegheny General Hospital.
“What we’re doing is reinforcing the importance of collaboration among prevention providers in Pittsburgh,” Green said. “Simply, we accomplish a greater goal if we’re all working together.”
Or, as Kathi Boyle pointed out, “We’re getting groups together to talk about what we’re doing, and so we’re working smarter.”
This “working smarter” approach is evidenced in the founding of the M2M project.
A PATF press release that announced the M2M project implementation last fall reported that Ron Stall, a substance abuse expert at Pitt, and Anthony Silvestre, from the Pitt Men’s Study, created a “prevention cocktail” (playing off the term for HIV medication) that focuses on a person’s physical, emotional and psychological needs.
“This is not just about someone’s genitals,” the press release quoted John Green as saying. “It’s about the whole person. There needs to be more substantive intervention.”
In its statement, the Task Force said that the M2M team “will go to places where men congregate and where they are most at risk—where alcohol and drugs collide with judgment.
The overarching goal…is to help people shift to an approach of taking care of one another, a long-term approach, in order to reduce risk.”
The design for the M2M project comes from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Strategic Prevention Framework. SAMHSA allocated monies to help educate gay men via the M2M model in late 2008.