I’m glad to see that the Strib is still covering the story involving Rep Emmer and his bill to eliminate state funding for MAP. This story in particular really highlights all of the efforts MAP has made over the last 22 years.

Bravo, Strib & Warren Wolfe!

Story reprinted below because articles on the Strib website expire.

Article reprinted from the Star Tribune.

Out front on HIV

Warren Wolfe
May 1, 2005

For a decade, Minnesota’s war against AIDS has relied literally on hand-to-hand combat — activists from the Minnesota AIDS Project (MAP) handing out thousands of condoms in gay bars and urging sexual caution.

Now AIDS workers say that troubling new trends are forcing them to take the fight into far more challenging combat zones.

More gay and bisexual men have found the Internet to be a new meeting ground for anonymous and unprotected sex, fueled by rising use of the drug crystal methamphetamine. And the rate of HIV, which leads to AIDS, is rising among heterosexual African immigrants.

Prevention has slowed the AIDS epidemic in Minnesota since new HIV cases peaked at 367 in 1992. But for the past decade the number of new cases has stayed stubbornly around 300 a year.

“We’re concerned that with these new problems, the HIV numbers may go up,” said Tracy Sides, an AIDS epidemiologist at the state Health Department.

MAP’s challenge grew more complicated Friday when the House passed a budget bill excluding it from Health Department funding. The cut was proposed by Rep. Tom Emmer, R-Delano, who said he objected to sexually explicit language on a MAP website.

“It’s ironic,” said Lorraine Teel, MAP’s executive director, “that some people think it’s OK to use sex to sell cars and soap, but not HIV prevention.”

One of the MAP foot soldiers entering the new AIDS battlefront is Andy Ansell, a k a PozAnswerMan, who cruises Internet chat rooms. That’s where men can hook up for PNP — short for “party and play,” or unprotected sex, often including drug use.

Another is Dori Makundi, who teaches African-born men and women about the risks of unprotected heterosexual sex.

“Our traditional face-to-face contact in gay bars has been tremendously successful,” Teel said. MAP trains and sponsors the crews that last year handed out about 120,000 condoms. “New infections have been kept in check.”

“But the world is changing, and so are we,” Teel said.

With 60 employees and about 1,400 volunteers, the 22-year-old MAP is the state’s oldest and largest nonprofit agency fighting HIV and AIDS. It uses a wide range of education, counseling, disease testing, legal help and social services, state health officials say.

Since Minnesota’s first case, reported in 1982, HIV has infected 7,547 Minnesotans. Of those, 2,697 have died.

New drugs since 1995 help people with AIDS live longer. But the dark side of that success, officials say, has been a more relaxed view of the risk of HIV.

“Too many of my patients see HIV as just another chronic disease,” said Dr. Keith Henry, an AIDS researcher and a physician at Hennepin County Medical Center in Minneapolis.

Cruising for trouble

For the past four months, Ansell has spent most weekdays from 3 to 5 p.m. visiting two gay-oriented chat rooms on the Internet.

With national surveys showing that about 55 percent of gay men don’t always use condoms, Ansell counsels men about the risks of specific sexual practices and helps those with HIV cope with the disease.

“A lot of people just don’t know enough about how to stay safe,” he said, his fingers flying as he juggled two online conversations with gay men.

Ansell, HIV-positive for 18 years, is a health education coordinator with a MAP program called Positive Link, begun by men with HIV to help others cope with the disease.

MAP staff members say the online contacts appear to be more open and honest than those made by the condom crews in gay bars.

“In the bars, we get five seconds with somebody,” said Keith Pederson, a coordinator with another MAP program, PrideAlive. “But online, in the privacy of their home or office cubicle, people get right to the point, a real teaching moment.”

Internet outreach is becoming increasingly important, said Kip Beardsley, state AIDS director at the Health Department. “To connect with communities of people at risk of HIV, you have to be where they are.”

Online inquirers typically are polite, grateful and graphically explicit.

“If you expect to communicate with high-risk groups about sexually transmitted diseases, you have to talk the language — body parts, sex practices and all,” Ansell said.

Some legislators such as Emmer say some explicit language in AIDS prevention work is gratuitous and childish. The health budget bill passed by the House would require state-funded AIDS prevention work to avoid sexually explicit language. And it would eliminate MAP’s Health Department funding, which totals 10 percent of the nonprofit’s $4.4 million annual budget.

The Senate health bill does not include HIV spending restrictions. MAP lobbyists expect them to be proposed in amendments on the Senate floor.

Neither the PrideAlive program nor the material that disturbed Emmer receives state money, but Emmer said any use of sexually explicit language by MAP shows that it “can’t be trusted to do the job right.”

Condoms in bars

The core of the fight against AIDS remains face-to-face work with gay and bisexual men, who account for about 60 percent of all HIV cases.

Dampened by drizzle, Pederson and his crew dodged from bar to bar in downtown Minneapolis one recent Friday night, dispensing smiles and protection against HIV.

Amid the din of music and voices in the Saloon, volunteer Nick Hahn connected with bar patron Jonathan Schulze just long enough for Schulze to grab a few condoms from the proffered tray and smile in thanks.

“Everybody says he’s HIV-negative. Maybe so, but man, I never take a chance,” said Schulze, 26, waving a packaged condom for emphasis. “I’m always protected.”

Like most AIDS prevention workers, those working the bars try to encourage safer sex, not safe sex.

“We talk about all types of protection, including abstinence. But the minute we start preaching, we lose them,” said Pederson, 44. “We’re talking about risk management.”

The fight against HIV probably won’t end, he said, at least not until scientists develop drugs to kill the disease.

“People take risks, and most younger guys never went through the years of losing dozens of friends to AIDS,” he said. “It’s too easy to get complacent.”

“That’s why we need to be out here — on the streets, on the Internet, in the African community — reminding people to think: Don’t take drugs that blur your judgment, use protection with sex, and for heaven’s sake, don’t hesitate to ask for help.”

Work with Africans

HIV prevention work is harder among new immigrants from Africa, where AIDS has killed millions. Cultural, religious and social differences among those new Minnesotans make sex and HIV difficult topics.

“You can’t overestimate the stigma of AIDS in the African-born community,” said Sides, the AIDS epidemiologist.

African immigrants are about 1 percent of Minnesotans, but last year they accounted for 20 percent of the new HIV cases, more than half of them women.

“For many of them, sex is very private, something you don’t talk about,” Sides said. “Even starting the conversation is difficult, let alone convincing people to be tested for HIV.”

Makundi is trying to break through those cultural barriers with a new MAP program called the African Service Initiative.

“First we want to help more people get in for HIV testing,” said Makundi, who came from Tanzania eight years ago.

Most immigrants are not familiar with health screenings. “In Africa, you go to the doctor when you are sick. So people think if you get an HIV test, it must mean you already have AIDS and are dying,” she said.

“We have to convince people that it’s safe to talk, to be tested and to get help, whether you test negative or positive,” Makundi said. “We’re crossing these barriers one client at a time.”

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