Sept. 17-30,2011. Vol 26, No 10. FREE.
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reaching the
INVISIBL
POPULATIO
Local AIDS group reaches out to
Appalachian men at risk for HIV
Compiled by Rodney Tucker and Matt Comer
HICKORY — The Centers for Disease Control and
Prevention estimates that men having sex with men (MSM)
account for just four percent of the U.S. male population
aged 13 and older, yet the rate of new HIV diagnoses among
MSM is more than 44 times that of other men and more than
40 times that of women. In the rural Appalachian Mountains
and foothills of Northwestern North Carolina, a few addi
tional statistics caught the attention of local AIDS service
organization, the AIDS Leadership Foothills-area Alliance
(ALFA). In 2010, a shocking 90 percent of new clients came
into medical care with an AIDS diagnosis and almost 70
percent of the clients self-identified their risk factor as men
who have sex with men.
"We just couldn't stand around waiting for people to
come to us fortesting. We had to develop proactive tools and
strategies to provide targeted testing, build trust and market
our services," said Rodney Tucker, ALFA's executive director.
"While the rest of the country seemed to be moving past gay
white men and targeting African-American women as at-risk
populations, we realized that our region was trending 10 years
behind the national curve with new infections. I was shocked to
see the statistics with 40-year-old men self-identifying as having
•sex with other men coming into care with an AIDS diagnosis."
Outreach begins
ALFA knew they had to begin better and more strategic
outreach to MSM communities. Approaching the situation
blindly wasn't an option. Step one in the group's outreach
plans was to interview MSM and find out where and how they
were meeting other men for sex. Witfi a push from Michelle
Hudgens, a local disease intervention specialist with the North
Carolina Department of Health and Human Services, ALFA
hosted their first MSM Taskforce meeting in one of nine rural
counties in February 2011.
"Oh, if we could only go back in time and try this one
again" said David Zealy, ALFA director of education, with a
smile. "We did everything wrong. We tried the straight-up
honest approach with our community and called it exactly
what it was and who we wanted to attend. We used local gay
social groups and even the newspaper to advertise the meet
ing. Five people showed up—five scared people."
All wasn't lost. ALFA learned a great deal from the
encounter. Online hookups were a normal way for men to
meet other men for sex and some MSM were engaging in sex
in public parks, gyms and rest areas. The men's choices for
sexual encounters were limited by their life experiences; many
weren't "out" to friends or family and a lack of gay nightclubs
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