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HIV/AIDS and High Risk PopulationsIntegrating Social Science and Public Health to Reduce the Transmission of HIV/AIDS among Men Who Have Sex with Men and Injection Drug Users Date: June 2, 2005 Contact: Greg Scott, Department of Sociology (gscott@depaul.edu) (Phone: 773.325.4893)
The Department of Sociology and the Office of the Dean of Liberal Arts and Sciences have jointly organized a public symposium that will showcase current efforts to combine epidemiology and social science research to develop a more comprehensive and actionable understanding of HIV/AIDS transmission and prevention among men who have sex with men (MSM) and injection drug users (IDUs). Researchers affiliated with the National Centers for Disease Control and Prevention (CDC) will present recent, groundbreaking work in this public health domain. Kicking off the panel, which will be open to the entire community, Stephanie Behel (CDC, Atlanta, GA) will describe her efforts to characterize persons newly diagnosed with HIV infection in Chicago and Los Angeles. Her presentation will underscore the need to identify the social, psychological, and environmental context of transmission behaviors as a way to guide front-line HIV prevention programs targeted toward populations that currently have the highest probability of infection. Trista Bingham from the Los Angeles Department of Health Services will deliver a talk entitled "How a public health epidemiologist found her home in gay men's bathhouses." Ms. Bingham plans to describe her epidemiological work in gay men's bathhouses in Los Angeles, CA. Encountering very little literature to guide the implementation of on-site HIV testing clinics in this setting, she and her counterparts at the Centers for Disease Control and Prevention embarked on semi-structured qualitative research with bathhouse staff and clientele between 1999 and 2000. This was an anonymous, cross-sectional (i.e., "snapshot" of the situation) HIV incidence study of men seeking HIV testing during their bathhouse visit. Results of the Bathhouse Study and a supplemental exit survey of a sample of patrons will be presented. Finally, Ms. Bingham will discuss the political implications of working in bathhouses in the third decade of HIV/AIDS epidemic, concluding with a description of her ongoing work with community agencies and business owners dedicated to prevention work in these high-risk settings. Following Ms. Behel's and Ms. Bingham's presentations, Nikhil Prachand of the Chicago Department of Public Health will give a presentation on the use of crystal methamphetamine among gay men in Chicago. He will begin by documenting how several recent high-profile incidents have placed the spotlight on the use of crystal methamphetamine among MSM in Chicago. While the relationship between crystal meth use and high risk sex behavior has been well described on the East and West coasts of the United States, relatively little is known about the extent of the problem in Chicago. In the past year, the Chicago Department of Public Health has completed several projects to help shed light on crystal meth use in the city and its association with risky sex behavior among MSM. Preliminary results reveal that up to 10% of MSM have reported using methamphetamine in the past year, and that up to 30% of MSM newly diagnosed with HIV have reported recent meth use. Both HIV-negative and positive MSM who used meth were significantly more likely to report a variety of high-risk sex behaviors, and have higher risk sex partners than non-meth users. However, the data also suggest that meth-using MSM tend to be more "OUT" than non-meth users, and tend to be more connected to existing health care, STD/HIV prevention/treatment, and MSM-oriented services than non-meth users. This would suggest that unlike other high-risk substance abusing populations, MSM meth users are not a 'hidden' population. Mr. Prachand's presentation will conclude with reflections on the epidemiology of meth use among MSM and the potential for significant disease-reducing impact of interventions that integrate intensive substance abuse education/treatment into existing MSM-oriented services and STD/HIV prevention and treatment programs in Chicago. Finally, Dr. Greg Scott (symposium convener) will relate the results of his research on IDUs in Chicago and Los Angeles while also providing a glimpse of the national IDU scene. Dr. Scott's presentation will focus on injection drug use practices, which collectively represent the second leading "vector" of HIV and hepatitis B/C transmission in the U.S. His presentation is based on three years' worth of ethnographic and survey-based research in Chicago and short-term intensive fieldwork in L.A. The main point of his talk is to convey the prevalence of specific injection practices and how they contribute to the enduring, and in some places escalating, incidence of new HIV infections among IDUs. His presentation will include photographic and videographic evidence collected in the natural settings that IDUs occupy (residences, alleyways, homeless encampments, etc.). Dr. Scott's presentation will conclude with (1) a discussion of current trends in public policy and lawmaking, (2) how these trends contribute to increased risk of HIV incidence among IDUs, and (3) practical suggestions that non-governmental and community-based organizations might consider when attempting to help IDUs reduce their risk for HIV/AIDS, hepatitis, and other infections.
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