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The most obvious public health shortcoming is not listed in the article, that is, many HIV+ gay men practice unprotected sex because they feel "they already have the disease." In many HIV+ circles, unprotected sex is expected. There is extremely limited public health outreach specific to the HIV+ community about the benefits of protected sex (or dangers of unprotected sex).
Early detection is KEY to successful treatment. I wish articles like this would summarize risk factors, for those who don't read the report. The obvious reason why HIV+ are getting HCV sexually is because HIV is easier to get (sexually) than HCV. It's blood-borne, so fisting and sex toys are obvious. However, tops with multiple bottoms (taking the blood/virus from one bottom to another) is a primary mode-it happened to me. It's much riskier than 1on1,even unprotected, and no so hard to avoid
Scott
Ditto for ron. "Gay health" begins and ends with the HIV test, and we're basically viewed as walking corpses by other gays, our doctors and our families once we seroconvert. Its hard NOT to adopt a fatalistic attitude once that happens. In a world where 1/5 of gay men are already poz, and HIV is not the worst thing that can happen, we're sorely overdue to re-evaluate this model of thinking. For that, we need the negative community we all come from, to change first. Good luck with that one.
February 4, 2012