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JOURNAL OF SEX RESEARCH. 1998 Nov; 35(4):390-6.Using both national surveys and surveys of self-identified gay men in the United States, the numbers, age distribution, life expectancy, and marital status of men who have sex with men is examined. It is concluded that five types can be distinguished.... These five categories have different patterns of sexual behavior, and the numbers in each category are influenced by changing social conditions, in particular the growth of gay neighborhoods, and public tolerance. The typology is used to explain the low rate of reported HIV transmission from bisexual men to their female partners. (EXCERPT)
London, England, Taylor and Francis, 1994. viii, 179 p. (Social Aspects of AIDS)Community involvement in the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic has been central to helping to create the social, political, and cultural response to HIV/AIDS. At this point, no government or international agency HIV/AIDS program can be effective if it does not cooperate with and support grassroots responses. Moreover, the AIDS epidemic has been a powerful impetus to grassroots organizations of groups that have been marginalized as a result of gender, sexual orientation, race, or poverty. On the other hand, the emerging global AIDS industry has the potential to subvert traditional power structures and become isolated from those it claims to serve. Community groups can be co-opted into carrying out the agenda of this "industry" or they can continue to be subversive of the dominant social order. The central challenge facing the community movement is how to strengthen its political effectiveness without compromising its basis in grassroots participation and control. Of concern are emerging tensions within community-based organizations between activism and service provision, altruism and self-help, volunteer participation and management control, and fluidity of function and increasing bureaucratization. Another concern is the potential for effective community and nongovernmental organization-sponsored programs to take the pressure off of governments to provide or reform essential health services. Direct community sector involvement in the policy making process represents the best strategy for ensuring that national AIDS policies are responsive to those most affected by the epidemic.
FAR EASTERN ECONOMIC REVIEW. 1992 Feb 20; 28-9.As the AIDS epidemic and HIV transmission in India increasingly resembles that observed in sub-Saharan Africa, Indian society's arrogant perception of invulnerability to the pandemic is proving to be considerably ill-conceived. The dimensions of the epidemic have multiplied greatly since AIDS was 1st identified among prostitutes in Madras, with the trends observed in Maharashtra and Tamil Nadu being especially ominous. AIDS has forced Indian society and research professionals to acknowledge the existence of domestic prostitution, homosexuals, and drug users. While only 103 AIDS cases and 6,400 HIV infections have been officially identified, it is clear that these cases represent only a tiny fraction of the true extent of the epidemic in India. The government will therefore spend up to US$7.75 million on an anti-AIDS program aimed at ensuring secure blood supplies, and checking heterosexual transmission through education and the promotion of condoms. The program also targets IV-drug users and truck drivers for education and behavioral change. India is the 2nd country after Zaire to accept foreign loans for such a purpose. It will receive US$85 million over 5 years from the World Bank in addition to supplemental funds from the WHO and the U.S. Weak attempts, however, have been made to test blood supplies, with only 15% being tested in Tamil Nadu. A large gap also remains between health educators and needy target groups. Finally, while some top officials realize the need for immediate action against AIDS, broad public awareness and coping will come only after AIDS mortality begins to mount in the population.
WORLDAIDS. 1992 Jan; (19):10.White, U.S. homosexual males were primarily affected in the early stages of the AIDS pandemic. Some Western researchers argued, however, that the syndrome originated in Africa. Strong political and social response to this notion resulted in only an anemic response to the growing AIDS epidemic in Nigeria. Nonetheless, the Stop AIDS Organization finally launched the Motor Park AIDS Education Program (MPAEP) in 1988, for health and education outreach to populations at risk of STDs and HIV infection. Specifically targeted are long-distance truck drivers, their young male assistants known as motor boys, and the barmaids, prostitutes, and homeless juveniles who frequent motor parks where these drivers rest while on the road. Many of these long-haul drivers have unprotected casual and commercial sex, both homosexual and heterosexual, take drugs, and suffer high rates of STDs. Marginalized, 75% illiterate, and speaking a variety of languages, these populations tend to be largely ignorant of the incurable nature of AIDS. Over 45% of motor park populations are estimated to be infected with an STD, or to have a future re-infection. These drivers are optimal vectors for the spread of HIV both internationally and within Nigeria. MPAEP workers work 6 days/week in the larger interstate motor parks to reach out to their predominantly male customers. They meet a host of primary health needs, and refer STD clients for testing and treatment. Drug use and homosexuality are 2 topics of discussion especially taboo in African society which have nonetheless been vigorously researched by MPAEP. Many drivers are unacknowledged bisexuals who have sex with their motor boys. Workers therefore explain the need to use condoms in same-sex activity without specifically mentioning homosexuality. Many Nigerians deny the existence of HIV and AIDS, are reluctant to speak about sex, and consider MPAEP workers to be intruders. Despite opposition in Muslim- dominated Northern Nigeria, however, program efforts continue.
AIDS ACTION. 1991 Sep; (15):4.Bombay has a teeming and mobile, yet comparatively invisible, population of approximately 600 male prostitutes who ply their trade on and from Chowpatty beach. These men, aged 12-50 years, masturbate and/or perform fellatio for male clients in exchange for financial reward ranging from US$0.75 - $2. Unprotected penetrative anal sex also takes place, though it is generally not acknowledged by the prostitutes. These men and their clients are therefore in great need of information and access to condoms for the practice of safer sex. Both self- and social denial of the practice of anal sex must, however, be overcome. To this end, Bombay Dost, the 1st openly gay organization in India, distributes condoms and information to gay men on railway platforms, and in public toilets and parks. These efforts are unfortunately not welcomed by the prostitutes of Chowpatty beach for fear that acceptance of the intervention would imply their practice of anal sex and a more substantial degree of homosexuality within their subpopulation. Recruiting and training men as health educators from their ranks may be a viable, effective promotion approach. Any interventions must also understand the friendly and supportive, yet competitive, relationships within this community.
Trends in HIV / AIDS behavioural research among homosexual and bisexual men in the United States: 1981-1991.
AIDS CARE. 1991; 3(3):281-7.Reviewing the existing research, this article traces the behavioral change among homosexual and bisexual men in the US between 1981-91, and discusses behavioral research goals for the future. First detected in 1981, AIDS quickly became associated with the homosexual and bisexual male community. Between 1981 and 1984, the research community made remarkable advances in coming to understand the epidemic. Case-control studies pointed out the high AIDS risk associated with some of the sexual practices of homosexual and bisexual men: multiple sex partners, anonymous partners, and unprotected anal intercourse. With the aid of behavioral experts, the gay community began conducting an array of information and education programs. In 1983, the Center for Disease Control developed "safer sex" guidelines, which revolved around the use of condoms. From 1984-88, education efforts led to dramatic behavioral changes, which led some to believe that AIDS had been conquered among the homosexual and bisexual population. But the AIDS epidemic brought along with it discrimination against gays. Calls for HIV counseling and testing intensified. As the epidemic moves into its second decade, researchers have noticed a relapse into unsafe sexual practices. Researchers have also found that the incidence of HIV has not decreased among special subgroups of the homosexual and bisexual community: younger men who recently became sexually active, blacks and Hispanics, men of lower socioeconomic status, those who life outside large urban centers, and those who do not identify with the gay lifestyle. For this decade, behavioral research goals include maintaining the existing educational programs and revising them as new developments necessitate, and working towards long-term maintenance of behavioral change.