| Fighting the Pandemic in
Every Community
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One-third
of all people living with HIV do not know their status.
African American and Hispanic women together represent
less than one-fourth of all U.S. women, yet they account for
more than three-fourths (78%) of AIDS cases reported to date
among women in our country.
The fears associated with coming out, sexual risk-taking,
and the isolation felt by young people are still pervasive.
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These staggering numbers demand a swift, sophisticated, and efficient
response. HIV prevention — including testing, education, and outreach
in the field — and its ability to connect people with care remains
a critically effective strategy to stop the spread of the pandemic.
GMHC targets vulnerable populations, provides up-to-date information,
connects with people in their communities, and promotes safer sexual
behavior — thereby altering the course of the epidemic and, most
importantly, saving lives.
The Institute
for Gay Men's Health
The creation of GMHC's Institute for Gay Men's Health is an acknowledgment
that HIV infection and risk of infection occur within the larger
scope of gay men's sexual health. The Institute integrates many
of GMHC's existing prevention programs, like HIV education and outreach,
into a comprehensive promotion of wellness among gay men
and the numerous varied communities from which they hail. The Institute
disseminates explicit and non-judgmental prevention messages specifically
designed for each different community; connects gay men with mental-health
and substance-use counseling; and spearheads social and behavioral
research that provides the groundwork for policy and advocacy action
surrounding gay men's health. The Institute perpetuates GMHC's legacy
of successfully promoting sexual health with its expertise in direct
support service provision.
 The
multiple impacts of HIV remain central to any discussion of gay
men's health. The Institute includes in that discussion, however,
HIV as gay men experience it within the larger context of their
lives — socially, emotionally, and physically. The Institute's harm-reduction
method reduces the likelihood of potentially high-risk behaviors
by providing a safe and non-judgmental space for clients to assess
their own behavior and set their own goals. For example, there exists
a broad and complex spectrum of choices in assessing the consequences
associated with substance use and sex. GMHC meets the client where
they are in that spectrum, provides them with accurate information,
access to services, and then assists them in the choices they make
within a context of peer-level support.
The Institute has an enhanced capacity for evaluating important
data collected from our clients for social and behavioral research.
This evaluation helps GMHC refine our programs to best serve our
constituents, leverage additional support, and take the lead on
national health issues effecting gay men. GMHC organized and participated
in the New York State Gay Men's Health Summit — part of a movement
looking at gay men's health beyond, but including, HIV infection.
Attended by service providers, medical practitioners, and advocates
from around the region, the conference provided a valuable opportunity
for the Institute to engage others concerned with gay men's health
with our expertise in HIV prevention, outreach, service, and grassroots
policy action. In addition, the Institute developed its own landmark
community-based research project — the Latino Survey. Results from
the survey, which will be made available in the approaching months,
will provide much needed information that will enhance and shape
our prevention efforts geared toward Latino men.
The Institute houses GMHC's four community-specific, peer-driven
prevention and outreach programs. By integrating the effects of
multiple cultural variables — including ethnicity, sexuality, and
socioeconomic status — GMHC's prevention messages are specifically
constructed to connect with the communities most at risk — men who
have sex with men, young men, and men of color. Combined, these
programs distributed over 10,000 condoms and pieces of literature
regarding sexual health, sexually transmitted infections, HIV, and
drug use to clubs, balls, sex venues, bars, and parks.
Proyecto P.A.P.I.
 Proyecto
P.A.P.I. (Poder, Apoyo, Prevención, e Identidad [Power, Support,
Prevention, and Identity]) uses trained peers and volunteers from
Latino communities to bring prevention messages to both Latino and
Latino immigrant communities. This past year, P.A.P.I. produced
and disseminated two Guías de Salud Sexual Para Hombres Gays (Sexual
Health Guides for Gay Men) entitled, “Sexo Oral y Salud Sexual”
(Oral Sex and Sexual Health) and “Drogas y Sexo” (Drugs and Sex).
Their frank depictions of sexual behavior, substance use, and the
risks associated with both speak directly to, and provide much needed
information in Spanish for, a community often overlooked, underserved,
and at high risk for HIV. Likewise, P.A.P.I.'s offshoot program,
QUE (Queer Urban Explorers), targets Latino gay youth.
Soul Food
Like P.A.P.I., Soul Food is a community-specific prevention outreach
program. Focusing on health and wellness promotion for black men
who have sex with men, Soul Food connects men with a supportive
environment where they gather, be they HIV-positive or negative,
to discuss their emotional and physical health, their sexual lives,
and their relationships. Soul Food offers participants a reading
group, discussions about safer-sex practices and spirituality (like
the Sacred Space discussion group) volunteer opportunities for further
community outreach (such as handing out condoms and safer sex materials
in bars and clubs in the neighborhoods where they live), as well
as one-on-one support.
House of Latex
 For
over 12 years, the House of Latex has provided an ever-growing and
highly respected community education and social support network
to the House and Ball community. Through safer-sex education and
outreach all year long, the House of Latex recognizes, respects,
and affirms young, gay, bisexual, and transgendered people. The
House of Latex activities culminate yearly in the largest community-wide
ball in the nation. The House of Latex Ball, with attendees and
participants numbering more than 3,000, is a valuable and unique
opportunity to promote sexual health in the context of a hugely
popular event.
Gay Gotham
Gay Gotham, an initiative helping all gay- and bisexual-identified
men, uses peer-driven community outreach to effectively raise awareness
of HIV prevention and sexual health in all five boroughs. Included
in Gay Gotham, Tribe is a group of trained peers and volunteers
that do outreach in sex venues around New York City, distributing
condoms and safer-sex literature and providing men with information
about GMHC's services.
These four programs successfully address the issues of sexual health
confronting at-risk young men by providing information, support,
and, perhaps most importantly, direct access to the Institute's
two primary services: Substance Use Counseling and Education (SUCE)
and the recently expanded Gay Men's Counseling and Education (GMCE).
Since substance use often plays a large role in sexual decision-making,
SUCE and GMCE provide workshops, seminars, both long-term and drop-in
counseling, prevention support, and referral services geared toward
reducing the risks of sex and substance use, among other high-risk
behaviors.
The David Geffen Center
for HIV Prevention and Health Education
 The
David Geffen Center for HIV Prevention and Health Education houses
the Testing Center, the HIV/AIDS Hotline, the Nutrition and Wellness
Program, and the Treatment Education unit. The Geffen Center's client-focused
approach identifies each client's specific needs and addresses the
numerous obstacles that stand in the way of getting tested, accessing
care, getting treated, and enhancing one's quality of life.
The Testing Center
Of the more than 1,300 tests conducted by the Testing Center this
past fiscal year, there was a marked increase in the number of people
of color and young people accessing testing services. This increase
is a clear testament to the effectiveness of our community-based
outreach programs and their ability to connect at-risk populations
with testing.
The Testing Center is considered by many to be one of the premier
testing facilities in the country because of the consistency of
care a person receives. From the moment a person walks into the
Testing Center, they work with the same rigorously trained counselor
from beginning to end. Both blood and oral mucus-based testing are
available by appointment and during our extensive walk-in hours
six days a week. Our incredible return rate for test results, which
increased to more than 99% this past fiscal year (the highest rate
of return in the nation), combined with the fact that 99% of people
who test positive at the Testing Center have an appointment with
a primary care physician within two weeks of their initial test,
is evidence of our efficacy and care.
Last fall, in response to the alarming increase of syphilis cases
among gay men in New York City, the Testing Center began testing
for syphilis as well, held a seat on the Citywide Syphilis Advisory
Group, and distributed over 20,000 pieces of safer-sex literature
addressing HIV, syphilis, and other sexually transmitted infections.
The epicenter of the syphilis outbreak shared the same ZIP code
as GMHC's Tisch Building, in the Chelsea neighborhood of Manhattan.
Our geographical proximity to the population most affected has been
essential in our efforts to connect the community with testing and
care.
The Hotline
GMHC's HIV/AIDS Hotline has expanded over the past two decades
to become a national and international resource for counseling and
information on both HIV/AIDS and other related health issues, including
sexually transmitted infections. Highly trained volunteer peer counselors
use a client-centered, interactive, one-on-one approach to increase
the caller's understanding of high-risk behavior and to provide
support, counseling, and referrals six days a week. Our referral
database, with over 10,000 service providers, is administered by
over 70 volunteers in both Spanish and English. This past year,
the Hotline responded to over 35,000 calls from across the country
via our local and 800 numbers. In addition, use of our Hotline Online
increased extensively, expanding access to our services and allowing
people around the world at any time day or night to get answers
to questions, many of which they might feel uncomfortable asking
in person.
GMHC's A-Team crisis-intervention and counseling service — the
only one of its kind in the country — is available on a walk-in
basis five days a week, nine hours a day. The A-Team is a one-time
service available to anyone with HIV or AIDS and, like the Hotline,
is administered by trained volunteer counselors. Often, men and
women who drop in for A-Team sessions are in crisis. After receiving
support, they are, if necessary, referred to other departments within
GMHC for additional longer-term care.
Treatment Education
 One
of the first of its kind when it was created in the 1980s, GMHC's
Treatment Education program addresses the gaps in HIV and AIDS treatment
knowledge and, in turn, provides information and support in achieving
optimal healthcare. This devastating gap in treatment knowledge
and access is most prevalent in communities hardest hit by HIV.
By providing information and support to these communities free of
charge and available regardless of HIV status, GMHC effectively
reduces the risk of further HIV transmission and enhances the ability
of our clients to address their own health needs.
Workshops — offered both on and offsite, in Spanish and English
— on issues ranging from dosage to opportunistic infections, from
managing the side effects of medications to knowing how to talk
to your doctor, happen on an ongoing basis, often to standing-room-only
crowds. In September of 2001, Treatment Education created the increasingly
popular adherence support program, Stick With It! Designed
to assist the often rigorous and debilitating struggle to consistently
adhere to a demanding medication regimen, Stick With It!
offers help with nutrition, strategy building, and coordinating
treatment plans. Stick With It! counselors are also available
to make supportive reminder phone calls. In addition to workshops,
Treatment Education offers 33 Fact Sheets in Spanish and English
that cover the spectrum of specific HIV- and AIDS-related issues,
like lipodystrophy and vaginal thrush, in an easy to understand
format.
The Rachel Berger Treatment Library at GMHC supplements our workshops
and printed materials with a highly respected specialist's collection
of HIV- and AIDS-related treatment and information. The library
also offers internet training classes to maximize the internet access
we readily make available. The library, visited by more than 250
people every month, is one of our most valued services.
Nutrition and Wellness
 GMHC
strives to provide a variety of approaches to our clients in order
for them to improve and maintain their health. The Nutrition and
Wellness Program is an integrated service containing many of those
approaches, including nutrition counseling with information about
supplements and herbs, exercise classes, weekly workshops (both
on and offsite, in English and Spanish), and monthly cooking classes.
Professional HIV nutrition specialists help HIV-positive individuals
learn how to strengthen their immune systems, maintain and increase
lean body mass, increase energy levels and enhance quality of life.
Nutrition counseling can also help ameliorate the side effects often
experienced with many of the medications HIV-positive people must
take. In addition, the Nutrition and Wellness Program's integrated
approach to whole-body health — which includes an array of complementary
therapies such as massage, full-body acupuncture, reiki, yoga, and
therapeutic touch — works together with nutritional protocols to
assist clients in their efforts to achieve optimal health and well
being.
A growing number of HIV-positive people are also co-infected with
hepatitis B and C. In response, Nutrition and Wellness published
a resource book entitled The Liver, which is available
to GMHC clients as well as other community-based organizations.
Extremely informative and popular, The Liver provides increasingly
important information about HIV and healthy liver function.
Women and Family Services
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By
the year 2010, it is estimated that women will represent 50%
of all AIDS cases in the United States.
Women are one-and-a-half times more likely to die
from AIDS due to the lack of extant services and the added
stigma women may carry with the disease — stigma that may
prevent them from accessing care.
The average age of transmission continues to plummet
with younger and younger women testing positive.
GMHC's female clients mirror these emerging trends,
being primarily women of color — many who are single parents,
living on severely limited incomes, and/or are unemployed.
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GMHC's Women and Family Services department continues to address
this growing crisis in a number of interrelated and effective ways
that focus upon self-esteem and self-worth in women. The more opportunities
women have to become leaders in their own lives, the more likely
they are to become leaders in the communities they represent. Those
opportunities are far more profitable in the safe environment provided
by GMHC than in the hostile, isolated, and/or stigma-ridden environments
from which our women clients often hail. All of the Women and Family
Services programs are easy to access — consisting primarily of individual
and group services. Coupled with the help of peer educators, Women
and Family Services' programs are both effective and reciprocal
in their success — benefiting the peer educators as well as the
clients they serve.
Women and Family Services spent the past year focused on numerous
community-wide research initiatives that identify and assess the
specific needs of emerging populations. For example, in collaboration
with the Mailman School of Public Health of Columbia University,
GMHC conducted a study analyzing the stigmatization experienced
by lesbian mothers. The data, available in the coming months, will
help guide and direct GMHC's ongoing efforts to respond to the issue
of stigma, as it is experienced by women with HIV and AIDS. In addition,
GMHC Women and Family Services conducted groundbreaking work on
HIV prevention with the female condom (GMHC created the first and
only how-to female condom prevention kit). GMHC's work in this area
has sparked an enormous interest in woman-focused HIV prevention,
which has provided many partnership opportunities that will build
on the important prevention work accomplished over the past 12 months.
The Lesbian AIDS Project
 In
1992, The Lesbian AIDS Project (LAP) was established to respond
to and remedy the invisibility of lesbians living with HIV and AIDS.
Ten years later, LAP provides support to HIV-positive lesbians living
with AIDS and HIV prevention education to at-risk women in multiple
communities. LAP also advocates for more research and education
on woman-to-woman HIV transmission, as well as proactively seeking
partnership opportunities that will benefit lesbian sexual health.
At the heart of LAP is the Lesbian Leadership Initiative, an important
peer training program. Peer educators are at the core of all the
direct services provided by LAP, and an essential component in community-building
and neighborhood outreach and education. LAP connected more than
15,000 women from across New York State with HIV information and
safer-sex kits.
LAP also developed the Latina Initiative, which addresses language,
culture, and immigration as they are encountered by Latina lesbians.
Though the Initiative's specific purpose is to meet the needs of
Latinas, it also successfully integrates Spanish-speaking women
into the wide range of services provided by the Women and Family
Services department, and GMHC as a whole. In addition, the Latina
Initiative is part of a larger community-building effort, collaborating
closely with other Hispanic/Latina organizations to assure and enhance
the provision of services to lesbians. These collaborations have
become exceedingly important as new and more diverse populations
of immigrant women have turned to the Latina Initiative challenging
us to expand our cultural and linguistic specificity. By partnering
with other community-based organizations — like the Latino Commission
on AIDS and Alianza Dominica, to name a few — we have been able
to maximize our services and resources to best serve these clients.
Women in Action
Women in Action, and its Spanish counterpart, Mujeres en Acción,
is a family-centered harm-reduction program aimed at helping HIV-positive
women in all stages of substance use, relapse, and recovery cope
with their lives, begin or continue recovery, prevent relapses,
and avoid infecting others with HIV. The program connects more than
2,500 participants with services via crisis intervention, counseling,
acupuncture, and support groups both onsite at GMHC and offsite
in two underserved communities farther afield from GMHC — in Lower
Manhattan through the AIDS hospice Rivington House, and in Brooklyn
through the Haitian Women's Project. Frequently, recovery from substance
use is made more daunting for many of our clients due to the degenerative
effect of HIV disease on their bodies, leading them to return to
comforting but damaging behaviors. By engaging women in their own
process of change, Women in Action helps them achieve self-esteem
and psychosocial stability — both tools that help access and maintain
HIV treatment and reduce HIV transmission.
Child Life
 GMHC
offers support services directly tailored to the more than 850 families
enrolled in our ten-year-old Child Life Program. These services
include nutritional counseling and support, the distribution of
emergency food packages, hundreds of one-on-one and group counseling
sessions as well as numerous workshops in both Spanish and English
on and offsite, and child-sitting in our renowned Johnson Playroom.
The nature of Child Life's services has evolved with the epidemic
as the number of children becoming infected with HIV through mother-to-child
transmission has been all but eliminated in the United States, and
as many of our HIV-positive parents, previously negotiating an imminent
death, are now living longer and facing new challenges. Our response
has been twofold: to provide the many children who have become adolescents
— clients who have literally grown up at GMHC — with age-appropriate
education and information that is still sensitive to, and respectful
of, the ongoing issues surrounding HIV in their families; and to
encourage parents — both mothers and fathers — to access our services
specifically geared toward increasing the quality of their lives.
The Elizabeth Ross Johnson Food Pantry, a pivotal component of
the Child Life Program, continues to be essential for our clients
from across all five boroughs of New York City. In addition to distributing
over 1,400 emergency food packages, the Food Pantry works in conjunction
with GMHC's Nutrition and Wellness Program to provide parents with
information about cooking healthy and affordable meals for children
and family members with HIV and AIDS. During the holidays, our food
packages include food for an entire celebratory meal plus a coupon
for a free turkey.
Contents
© 2003 Gay Men's Health Crisis
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