by Matthew S. Bajko
http://www.ebar.com/news/article.php?sec=news&article=1213

  Advertisement The Bay Area Reporter Online

  Issue:  Vol. 36 / No. 41 / 12 October 2006
  Serving the gay, lesbian, bisexual, and transgender
  communities since 1971

AIDS main killer of men in SF

NEWS

  Published 10/05/2006

by Matthew S. Bajko

  m.bajko@ebar.com
  m.bajko at ebar.com

  Brian Basinger. Photo: Rick Gerharter

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  It has been eight years since the Bay Area Reporter 's
  now-historic front-page headline "No Obits" and news
  story detailing that for the first time since the AIDS
  epidemic began the paper had no death notices in its
  August 13, 1998 issue. Since the introduction of
  antiretroviral treatments in 1996, AIDS is no longer
  seen as a death sentence and HIV is largely considered
  to be a manageable disease.

  While it is true most people diagnosed with HIV who
  have access to AIDS drugs are living longer, the
  reality is that in San Francisco, AIDS is still the
  leading cause of death within men ages 15 to 54 years
  old, and is considered to be the main killer of gay men
  ages 15 to 64.

  Death reports do not list a person's sexual
  orientation, but AIDS advocates said due to the fact
  that nearly 90 percent of the city's AIDS cases are gay
  and bisexual men, it is no leap to say that AIDS is the
  leading cause of death in the gay male community.

  "There is not a doubt in my mind that AIDS is the
  leading cause of death in gay men in San Francisco,"
  said Brian Basinger, the founder of the AIDS Housing
  Alliance, who last month asked city health officials
  about the impact of AIDS on death rates after he
  attended a meeting this summer and heard one official
  state that people are no longer dying from AIDS.

  "That doesn't jibe with my personal experience and my
  work experience," said Basinger, who has lost five
  alliance members this year and has several friends who
  are currently battling life-threatening illnesses. "Our
  community is bearing huge, huge loses. It is so extreme
  in gay men those numbers are trumping the death rates
  of all men in San Francisco."

  Ling Hsu, co-director of the department's HIV/AIDS
  Statistics and Epidemiology Section, in an e-mail to
  Basinger noted that HIV/AIDS was the leading cause of
  death for men ages 15 to 54 years in 2003, the most
  current year with complete data available in San
  Francisco. According to the section's data, Hsu said
  there were 52 HIV/AIDS related deaths per 100,000 San
  Francisco male residents in that age group.

  When men ages 55 to 64 were added to the analysis, Hsu
  found that the rank fell down to third, with 58
  HIV/AIDS deaths per 100,000 men, next to heart disease
  and cancer (72 and 71 deaths per 100,000,
  respectively). As a comparison, Hsu stated that in
  California and the United States, HIV/AIDS ranked about
  the sixth cause of death among males 15 t
  o 54 years old.

  In her e-mail to Basinger - and a subsequent e-mail to
  the B.A.R. - Hsu stressed that while the department
  does have an estimated population size of gay men in
  the city, it does not have cause of death data among
  gay men nor the age breakdown. However, Hsu wrote in
  her e-mail to Basinger that "I think it is reasonable
  to assume that HIV/AIDS would be the #1 cause of death
  among gay men ages 15-64, because of the high HIV
  prevalence among gay men and that most HIV/AIDS deaths
  occurred during that age group."

  HIV prevention officials said the numbers bear out what
  many people have assumed all along regarding the impact
  of AIDS on the city's gay male community.

  "I think what she is suggesting in there - and the
  reason you haven't heard it before - is everyone
  assumed it was the case in San Francisco given the
  number of deaths," said Steven Tierney, deputy
  executive director of the San Francisco AIDS
  Foundation. "I think people haven't made a newsworthy
  piece of it because people assumed it was true. I think
  people have a right to know that; it might have some
  impact in people's decision making."

  Jennifer Hecht, education manager at the Stop AIDS
  Project, added that the death statistics are "a
  reminder we are living in a community still seriously
  affected by HIV and AIDS. I think a lot of men are very
  aware of improvements made in HIV medications and less
  aware that men are dying from AIDS and AIDS-related
  deaths."

  As the number of people dying each year due to AIDS
  continues to decline in San Francisco, the age of those
  who do die continues to rise. According to the city's
  2005 annual report on HIV and AIDS, the number of AIDS
  deaths declined between 2002 and 2004; however,
  reporting of deaths in recent years is not yet
  complete.

  Cumulatively, the report said that most deaths occurred
  in the 30-39-year-old age group; but in recent years,
  the largest number of deaths occurred in the
  40-49-year-old age group. In 2005, the report listed
  228 AIDS deaths, with 100 people dying between the ages
  of 40 and 49, with the next largest number of deaths,
  66, occurring in people 50 to 59. In 2004, the report
  listed 224 deaths, with 90 among people 40 to 49 and 57
  among people ages 50 to 59. In 2003, there were 297
  deaths and in 2002 there were 316.

  The report also states that the proportion of deaths in
  which HIV/AIDS was listed as the underlying cause of
  death decreased from 88 percent of AIDS deaths
  occurring between 1992-1995 to 72 percent in 2000-2003.
  Other frequently occurring underlying causes of death
  in 2000-2003, states the report, include non-AIDS
  cancer (6.7 percent), heart disease (5.2 percent) and
  liver disease (2.3 percent), diseases that may be due
  to HIV-related risk behaviors or tobacco use. The
  report also noted that the proportion of persons with
  AIDS who died of these non-HIV/AIDS-related conditions
  increased over time.

  Basinger said it is important that the LGBT community
  knows how AIDS is impacting its members, especially at
  a time when lawmakers in Washington, D.C. want to shift
  federal AIDS funding away from California to other
  areas of the country.

  "If we minimize AIDS by spreading inaccurate
  information it makes it okay to do that because AIDS
  isn't a problem anymore," he said. "It allows for what
  is going on in Congress right now where they have been
  attacking San Francisco's funding and playing games
  with the funding formula to try and dismantle the San
  Francisco model [of care]."

  The same sentiments are behind the L.A. Gay and Lesbian
  Center's new "HIV is a Gay Disease" campaign, which
  some in the LGBT community have attacked as another
  fear-based message that inaccurately blames gay men for
  the spread of HIV. But center chief of staff Darrell
  Cummings said the campaign is meant to bring attention
  to the fact that especially on the West Coast, it is
  gay men who make up most of the HIV cases.

  "Back in the 1990s we stopped talking about gay and bi
  men and instead about men who have sex with men. I
  realized we were de-gaying the epidemic in a way I
  thought could have a negative impact in the future,"
  said Cummings, 49, who is himself gay. "We were talking
  about a sexual behavior and ignoring the cultural
  context we as gay and bi men find ourselves in.
  Addressing this epidemic without [addressing]
  homophobia is a huge mistake."

  Cummings said he agrees with Basinger that the gay
  community needs to be reminded that AIDS still
  disproportionately impacts its members. He said that in
  Los Angeles County gay and bi men make up less than 7
  percent of the county's population but account for
  almost half of the 700 AIDS deaths it will record this
  year.

  "Our community is no longer recognizing that reality,"
  he said.
http://www.ebar.com/news/article.php?sec=news&article=1213
by Matthew S. Bajko