
New Paradigms of Risk and Protection: Understanding the HIV Epidemics among Gay and Bisexual Men
Friday, December 7, 2012
Presented By
HIV epidemics among gay, bisexual, and other men who have sex with men (MSM) are fundamentally different from other groups at risk. These differences help explain why HIV epidemics among these men are expanding in low, middle, and high income countries, including the US, and why current HIV prevention and treatment programs are not working as well as they should. Biological, network, and social/structural factors combine for these men and lead to more rapid and efficient HIV spread in their communities—individual risk behaviors for HIV infection contribute only modestly to these dynamics. Responding to the epidemics of HIV among gay and other MSM will be challenging and require leadership, vision, and new science. This response is critical in order to achieve global control of HIV in the years to come.
This conference will explore how novel and more effective HIV prevention programs for MSM may reduce infectiousness through markedly expanding testing and treatment of HIV-positive men, and reduce risk of acquisition among HIV-negative men through the use of Pre-exposure Prophylaxis (PrEP), the development of a rectal microbicide, and increased access to and coverage for condoms and condom-compatible lubricant. Current prevention tools and the policy reforms and structural changes key to expanding coverage and reaching men with culturally competent care will be examined. Finally, biologically based efforts, focused on the delivery of effective interventions, to address each gap in the testing to treatment cascade, and ensure safe and affirming spaces for prevention, treatment, and care will be explored.
*Networking reception to follow event.
This event will also be broadcast as a webinar; registration is required.
Please note: Transmission of presentations via the webinar is subject to individual consent by the speakers. Therefore, we cannot guarantee that every speaker's presentation will be broadcast in full via the webinar. To access all speakers' presentations in full, we invite you to attend the live event in New York City where possible.
Registration Pricing
By 11/7/2012 | After 11/7/2012 | Onsite | |
Member | $25 | $35 | $40 |
Nonmember | $25 | $35 | $40 |
Registration includes a complimentary, one-year membership to the New York Academy of Sciences. Complimentary memberships are provided to non-members only and cannot be used to renew or extend existing or expiring memberships. A welcome email will be sent upon registration which will include your membership credentials.
Presented by
Agenda
* Presentation times are subject to change.
Friday, December 7, 2012 | |||||||||||||
12:00 PM | Registration | ||||||||||||
1:00 PM | Welcome Remarks | ||||||||||||
1:20 PM | Introduction | ||||||||||||
1:30 PM | Global Epidemiology of HIV Infection in Men Who Have Sex with Men | ||||||||||||
1:45 PM | Successes and Challenges of HIV Prevention in Men Who Have Sex with Men | ||||||||||||
2:00 PM | Comprehensive Clinical Care for Men Who Have Sex with Men: An Integrated Approach | ||||||||||||
2:15 PM | Comparisons of Disparities and Risks of HIV Infection in Black and Other Men Who Have Sex with Men in Canada, UK and USA: A Meta-analysis | ||||||||||||
2:30 PM | Networking Coffee Break | ||||||||||||
3:00 PM | Common Roots: A Contextual Review of HIV Epidemics in Black Men Who Have Sex with Men Across the African Diaspora | ||||||||||||
3:15 PM | Call to Action for Comprehensive HIV Services for Men Who Have Sex with Men | ||||||||||||
3:30 PM | Special Guest Speaker: | ||||||||||||
3:45 PM | Panel Discussion
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4:35 PM | Closing Remarks | ||||||||||||
4:45 PM | Cocktail Reception | ||||||||||||
6:00 PM | Conference Adjourns |
Speakers
Special Guest Speaker
Thomas Farley, MD, MPH
New York City Department of Health and Mental Hygiene
Dr. Farley is Commissioner of the New York City Department of Health and Mental Hygiene. Under his leadership, the agency is addressing the social and environmental factors underlying the nation's greatest public health threats, including smoking, obesity, diabetes and heart disease. Dr. Farley is trained as a pediatrician and served in the Centers for Disease Control's Epidemic Intelligence Service. He has conducted research and published articles on a wide range of topics, including Legionnaires' disease, prevention of HIV/STDs, youth violence, infant mortality, and obesity. He is coauthor with RAND Senior Scientist Deborah Cohen of Prescription for a Healthy Nation.
Speakers
Stefan Baral, MD, MPH, MBA
Johns Hopkins Bloomberg School of Public Health
Chris Beyrer, MD, MPH
Johns Hopkins Bloomberg School of Public Health
Chris Collins, MPP
The Foundation for AIDS Research (amfAR)
Michael J. Klag, MD, MPH
Johns Hopkins Bloomberg School of Public Health
Kenneth Mayer, MD
Harvard Medical School, Fenway Health
Gregorio Millett, MPH
Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention
Ellis Rubinstein
The New York Academy of Sciences
Patrick Sullivan, PhD, DVM
Emory University
Abstracts
Successes and Challenges of HIV Prevention in Men Who Have Sex with Men
Patrick Sullivan, PhD, DVM
Lancet. 2012 Jul 28;380(9839):388–399. Epub 2012 Jul 20.
Comprehensive Clinical Care for Men Who Have Sex with Men: An Integrated Approach
Kenneth Mayer, MD
Lancet. 2012 Jul 28;380(9839):378–387. Epub 2012 Jul 20.
Global Epidemiology of HIV Infection in Men Who Have Sex with Men
Stefan Baral, MD, MPH, MBA
Lancet. 2012 Jul 28;380(9839):367–377. Epub 2012 Jul 20.
Comparisons of Disparities and Risks of HIV Infection in Black and Other Men Who Have Sex with Men in Canada, UK, and USA: A Meta-analysis
Gregorio Millett, MPH
We did a meta-analysis to assess factors associated with disparities in HIV infection in black men who have sex with men (MSM) in Canada, the UK, and the USA.
Methods:
We searched Embase, Medline, Google Scholar, and online conference proceedings from Jan 1, 1981, to Dec 31, 2011, for racial comparative studies with quantitative outcomes associated with HIV risk or HIV infection. Key words and Medical Subject Headings (US National Library of Medicine) relevant to race were cross-referenced with citations pertinent to homosexuality in Canada, the UK, and the USA. Data were aggregated across studies for every outcome of interest to estimate overall effect sizes, which were converted into summary ORs for 106,148 black MSM relative to 581,577 other MSM.
Findings:
We analyzed seven studies from Canada, 13 from the UK, and 174 from the USA. In every country, black MSM were as likely to engage similarly in serodiscordant unprotected sex as other MSM. Black MSM in Canada and the USA were less likely than other MSM to have a history of substance use (odds ratio, OR, 0•53, 95% CI 0•38-0•75, for Canada and 0•67, 0•50-0•92, for the USA). Black MSM in the UK (1•86, 1•58-2•18) and the USA (3•00, 2•06-4•40) were more likely to be HIV positive than were other MSM, but HIV-positive black MSM in each country were less likely (22% in the UK and 60% in the USA) to initiate combination antiretroviral therapy (cART) than other HIV-positive MSM. US HIV-positive black MSM were also less likely to have health insurance, have a high CD4 count, adhere to cART, or be virally suppressed than were other US HIV-positive MSM. Notably, despite a two-fold greater odds of having any structural barrier that increases HIV risk (eg, unemployment, low income, previous incarceration, or less education) compared with other US MSM, US black MSM were more likely to report any preventive behavior against HIV infection (1•39, 1•23-1•57). For outcomes associated with HIV infection, disparities were greatest for US black MSM versus other MSM for structural barriers, sex partner demographics (eg, age, race), and HIV care outcomes, whereas disparities were least for sexual risk outcomes.
Interpretation:
Similar racial disparities in HIV and sexually transmitted infections and cART initiation are seen in MSM in the UK and the USA. Elimination of disparities in HIV infection in black MSM cannot be accomplished without addressing structural barriers or differences in HIV clinical care access and outcomes.
Lancet. 2012 Jul 28;380(9839):341–348. Epub 2012 Jul 20.
Common Roots: A Contextual Review of HIV Epidemics in Black Men Who Have Sex with Men across the African Diaspora
Gregorio Millett, MPH
Lancet. 2012 Jul 28;380(9839):411–423. Epub 2012 Jul 20.
A Call to Action for Comprehensive HIV Services for Men Who Have Sex with Men
Chris Collins, MPP
Lancet. 2012 Jul 28;380(9839):424–438. Epub 2012 Jul 20.
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