Dan O’Neill and Dr. Terence Gerace: The New Gay Interview
TNG reader and GWU grad student Chad submitted this interview.
These days Dan O’Neill and Dr. Terence Gerace frequently have cock on their minds. In particular, they have your cock on their minds. That’s because while gay, bisexual, and trans men comprise only 5-7% of the US male population, they account for around 70% of American men living with HIV/AIDS (1995 statistic). In scientific and medical communities we are referred to as “MSM,” or men who have sex with men. And HIV incidence in the US among MSM has been increasing at an alarming rate since the year 2000.
Dan and Terry met as volunteers at the Whitman-Walker Clinic’s Gay Men’s Health and Wellness Center. Terry, who graduated from Georgetown University School of Medicine and did his internship in emergency medicine, was a volunteer physician at the clinic. Dan volunteered as an HIV counselor and STD medical screener. Becoming acutely aware of the reality of the HIV/AIDS epidemic in DC during their time at Whitman-Walker, the two sensed a desperate need in the District for better targeted prevention strategies to defend against HIV infection. In an effort to fulfill this need, they have strategized a “safer-sex kit” campaign to improve the continual dissemination of STD-prevention tools to at-risk communities, promote awareness of safe-sex practices, and more fully engage MSM in the fight against HIV/AIDS.
Two latex condoms, a packet of lube, and an informational insert displaying proper condom donning technique comprise the contents of the safer-sex kits; and are conveniently wrapped in a pocket-sized plastic envelope. Kits will be freely distributed from custom-made dispensers, and come in two varieties, the Fuk!t and the Toolk!t. The Fuk!ts, as one might guess, use a more provocative and explicit model to illustrate condom donning, which can be appropriate for distribution in bars, nightclubs, and gay gyms. Toolk!ts have less sexual/more diagrammatical instructions, which adapt the kit to broader distribution, either at more conservative venues, or to a target population who may not self-identify as gay. Informational inserts also provide a suitable space for safer sex messaging, targeted health alerts to the local MSM community, and for directing individuals to useful websites. One such website is the campaign homepage which holds a wealth of information about sexual health, HIV prevention, and STD testing facilities; and enlists sexy local models (such as their headliner Devon Hunter [not work appropriate]) to help point you in the right direction. (Um, basically straight up… if you catch my drift.)
At once creative, focused, and enterprising, Dan and Terry exude remarkable sincerity and passion in their desire to support their community. While preparing Fuk!ts and Toolk!ts to be distributed during Capital Pride, they sat down with me to discuss the launching of the safer-sex campaign. See the full interview below, and visit the Fuk!t website (not work appropriate) to learn more about safer-sex or volunteering for this cause. To learn more about the HIV epidemic in general, or DC-specific statistics, find pertinent data below the interview.
The New Gay: How did the safer-sex kit idea originate?
Dan O’Neill: Terry and I had both been working on the front lines of the HIV epidemic, and were frustrated that there was so little traction for HIV prevention strategies in the District. In August, around the same time Terry and I began talking about a project, I spoke with David Mariner, the Executive Director of The Center, about what we saw happening and the fact that there really still needed to be a lot more work done in terms of HIV prevention outreach to our diverse community. Soon afterward, the Center’s Gay/Bi/Trans HIV Prevention Working Group was formed. In December, The Center had a Town Hall meeting on gay men and HIV, and one of the prevailing themes from that was that there were no condoms around.
Dr. Terence Gerace: From speaking with local businesses, and in getting free condoms delivered from the DC Department of Health, we started recognizing that there was no convenient distribution method to circulate the tools of HIV prevention—condoms. Boxes of thousands of condoms just show up to a business, but they are all attached and the best you can do is just leave a pile of them by the door. They aren’t approached with the right mindset, and they don’t become effective in the community.
DO: Terry had worked with The Great American Condom Campaign and came into this with that experience of condom distribution. Also, I had experienced a campaign in 2005 in Manchester, England run by The Lesbian and Gay Foundation (LGF) in which condoms and lube were stocked in kits and mounted behind bars at local gay establishments. You would just go up to the bartender and ask for them at the same time you got a drink. It empowered people to do more than just take a drunk handful of condoms, and I liked the fact that the LGF thought ahead to the kit end-user and supplied necessary lube. We tried to model our safer-sex campaign after what our experiences told us could work. [Incidentally, Dan and Terry have recently been given the Homo Heroes Award by LGF for there pioneering work in the District.]
TNG: Can you tell us about the program, and its details?
TG: The main idea is just to have the safer-sex kits and safe-sex information freely and reliably accessible to the public. The DC DOH is willing to give out 3 million condoms and lube packets to local organizations each year; we want to make sure they are effectively used by the community. We put a lot of thought into designing an honest product that is practical, and relevant and approachable to a wide base of MSM.
DO: Right now, we have 3 main dispensers set up at Town, and are passing out kits to be hand-distributed by other local groups… like at TNG’s Homo/Sonic events. We eventually want to have dispensers to give out to local bars, retail stores, gyms, music venues, and cross-over places where people who don’t identify with more traditional gay culture can have access to them.
TG: I had the dispensers custom-made by my handymen, so it takes some time… and we are in the process of making more for other venues. It takes about 2,000 safer-sex kits to fill the dispensers just at Town, so it looks like for the immediate future we are going to need volunteers to help in assembling more kits. We are hoping that soon, though, we may be able to contract out the kit assembly or work out some agreement directly with Durex. We are also continuing to work on our branding and visibility so that there is a solid infrastructure from which the kits, and website, can be available to a more diverse audience.
DO: The Center is also helping out with funding, in addition to what Terry has been contributing.
TNG: The launch party of the safer-sex kit campaign was May 29th at Town. How did it go?
TG: It was really fun, you can see a little bit of it here. Also, we went through about a thousand kits that weekend… which we will record so that we can start to anticipate how much product venues will need.
TNG: How did provocation become part of the campaign? Has it had success elsewhere?
DO: Terry came up with the provocative edge. He ran across a Brazilian site that had success using a similar approach. TG: We wanted people to be interested in and excited about using these kits, we wanted them to make a difference. And how better to engage people in safe-sex than by showing them safe-sex and how much fun it can be?
TNG: Where did you find models for the website?
DO: We approached local people. We went to Secrets and found professional dancers, we approached the DC Gay Men’s Chorus, the DC Cowboys, and other friends… just reached out to our social networks.
TG: It is important to say here, that all of this is by volunteer basis. We’ve had a lot of help and input from the community (photography, modeling, kit assembly, etc), and no one is getting paid for this. I think it helps show that we believe in having an honest product, and the community believes in it too.
TNG: Are we being more sexually risky now compared to the recent past?
DO: During The Center’s Town Hall meeting in December, this was one of the questions raised… why have we backtracked in terms of safety as gay men, and why condoms aren’t as prevalent in public spaces.
TG: A new generation of gay men is growing up without seeing the devastating effects of HIV. They see on TV commercials for therapeutics from drug companies with sexy and healthy people living with the disease… and some of the fear goes away. Also, younger people look to porn for ideas on what is normative behavior. They see things like barebacking and don’t automatically understand the inherent dangers in it, or have that gut response to protect themselves.
DO: Also our community is very complex. There are people indulging in sexual behavior that they wouldn’t necessarily talk about or own up to in their immediate social group. We know a lot about what needs to happen for safer-sex, and we need a way of getting that information to these groups.
Thanks Dan and Terry for taking time to talk with me! Keep up the good work, and hope to see you at the next safer-sex kit assembly event!
General Info: The Human Immunodeficiency Virus (HIV) is an enveloped retrovirus that, while not very stable outside of the body, is amazingly adapted to persistent infection within a host. It is transmitted through blood, semen, pre-ejaculate, vaginal fluid, and breast milk; and enters the body through the mucosa (mouth, vagina, rectum) or open wounds. Once inside your body, its high rate of mutation allows it to quickly adapt to individual anti-viral drugs… which necessitates the use of multiple anti-viral drugs used together in a “cocktail” such as HAART (highly active anti-retroviral therapy). Recent studies suggest that post-exposure prophylactic drug treatment may help prevent HIV infection if started within 48-72 hours after an exposure event (unprotected sex, needle sharing, etc). The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimated that, as of January 2006, AIDS has killed more than 25 million people since it was first recognized in 1981. Importantly, however, correct and consistent use of latex condoms can reduce the risk of sexual transmission of HIV by nearly 85%.
DC Stats: An epidemiological review of HIV issued by the DC Department of Health (DOH) reported that, as of the end of December 2007, 3% of District residents over 12 years of age (some 15,120 individuals) had been positively diagnosed with HIV; 72% were men, and 28% were women. This statistic corresponded to a 22% increase in cases reported since just the previous year, and does not account for the significant portion of the population which may still be unaware of their infection. While such a dramatic rise in reported infections within the District may be predominantly due to impressive efforts by the DC DOH to increase HIV testing, a broader analysis of five major US cities (Baltimore, Los Angeles County, Miami, New York, and San Francisco and the Greater Bay Area) also revealed a steady increase in HIV incidence rate. Overall, contact between MSM represented the predominant form of viral transmission (37%) in DC; followed by heterosexual contact (28%), then injection drug use (18%). Women who have sex with women was sadly not even considered as a mode of transmission in the DC DOH report; but must logically represent some portion of the female HIV cases which did not fall into the categories of heterosexual contact or drug use. Suffice it to say that this was a small fraction of reported HIV cases (roughly 4.3% of total cases, or less than 645 individuals).
In the urban five-city examination, risk analysis of routes of transmission between MSM was analyzed. The riskiest behavior was unprotected receptive anal intercourse (accounting for 69% of HIV infections within the MSM trial population). In comparison, unprotected insertive anal intercourse accounted for 28% of infections, and oral sex accounted for 2% of infections. Shockingly, most HIV transmission occurred between main sex partners… because of the frequency of sex acts between main partners, more frequent roles in anal sex with main partners, and low condom use during anal sex with main partners. Often main partners either were not aware of their HIV status or had engaged in unprotected sex with a casual partner.
Take away message: Use condoms! Get tested! Communicate sexual risk behaviors candidly with your sexual partners and discuss negotiated safety with long-term/main partners! (And for women, I’m sorry about the under-representation! The Center does offer dental dams which you can stop by and pick up for free… also I ran across a journal article which said that the website Girl2girl.info as a good source for safer-sex information.)
Fuk!ts will be available at TNG’s Safer Sex Party on Thursday, June 18th.
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