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1st appeared 3 August 1998 A Focus on Tailoring Prevention Efforts to Specific Populations Hundreds of health care providers as well as researchers and activists attended the 20th annual National Lesbian and Gay Health Association (NLGHA) Conference in San Francisco last week, a main focus of which was developing HIV prevention strategies that fit the needs of varied populations. Several UCSF researchers from the AIDS Research Institute made presentations, as did UCSF's new coordinator of Lesbian, Gay, Bisexual and Transgender Resources, Michael Scarce. In addition to being featured in an "Author Meets Critics" session, Scarce, the author of "Male on Male Rape: The Hidden Toll of Stigma and Shame," was co-presenter of a talk on gay men's sexual culture and a panelist at a forum on Viagra. Scarce's controversial presentation on "barebacking" -- which he defines as the premeditation and eroticization of unprotected anal sex -- drew some criticism, as well as a crowd of over 150 people. "It was different than past discussions of gay men's unsafe sex because we talked about barebacking as emerging as its own sexual subculture," said Scarce, who says that barebacking as a concept represents a rebellion against absolutist prevention efforts. "Men who identify themselves as barebackers have made up their minds not to use condoms and they're pretty defiant when encountered with safe sex messages." Scarce discussed strategies for health care providers and activists to assist this population in reducing their risk of HIV infection. "I think we need non-condom strategies for reducing the harmful consequences that are associated with barebacking, rather than driving that behavior further underground," he said. In addition to Scarce, UCSF researchers attended the conference, which also featured workshops on lesbian and transgender health issues. Researchers from the Center for AIDS Prevention Studies (CAPS) displayed posters from the recent 12th World AIDS Conference in Geneva and Cynthia Gomez, an assistant professor of medicine, served on a panel that gave an update of the conference. Robert Hays and Greg Rebchook of CAPS led a workshop on the HIV prevention program for young gay and bisexual men that they, along with Susan Kegeles, developed. Just as Scarce's presentation discussed prevention strategies that might work effectively with the barebacking subculture, Hays' presentation discussed strategies for effectively communicating and disseminating prevention messages among the young gay male community. "The general consensus of the conference seems to be that prevention for gay men has to go to the next level, addressing the broader lives of gay men in the context in which they live and in which they have sex," Hays said. Young gay men are turned off by lectures from older people, Hays said, but they respond to programs, such as the CAPS-developed Mpowerment Project, that are peer-run and create "social opportunities and community building." The Mpowerment Project is targeted at gay men between the ages of 18 and 27 who live in medium-sized communities. "A norm for safer sex is infused throughout the program in a way that doesn't turn them [young gay men] off," Hays said. "It's a peer-run and peer-designed program. What we're trying to do is create a process for young gay men to communicate about safe sex and we want them to diffuse messages of safer sex among themselves." Hays says the program has been successful in the cities in which it has been employed, including Albuquerque, NM; Eugene, OR; and Santa Barbara and Santa Cruz. "The program has recently received a grant from the Center for Disease Control and Prevention to develop a 'replication package' about the program so other communities can start it up," Hays said. "At the conference, we wanted to let people know about that the package would be available so that interested organizations could start up the program in their communities." This year the program will be begun in Austin, TX and San Jose. Links: National Lesbian and Gay Health Association Center for AIDS Prevention Studies Daybreak article on Michael Scarce by Paula Murphy |
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