Equality Forum's International Healthcare Panel Discusses Issues of Concern to LGBT Community
by Emily A. Cheramie

Led by Dr. Paul Scoles, former president of the Philadelphia Community Health Alternatives (PCHA), Equality Forum's International Healthcare Panel held Tuesday focused on the prevention of HIV/AIDS, the "remedicalization" of the disease, and the politics of both the United States and German healthcare systems, as well as a number of other health concerns affecting the LGBT community. The panel -- Thomas Niederbuehl, a German AIDS activist and Munich city councilman; Dr. James Witeck, chair of HIV/AIDS Medicine at Drexel University's College of Medicine; and Nurit Shein, executive director of PCHA -- expressed their concerns over HIV testing and the normalization of an epidemic which is growing in intensity.

Thomas Niederbuehl kicked off the evening's discussion by providing a brief overview of Germany's current HIV/AIDS situation. A member of Germany's Rosa Liste ("Pink List"), a gay political party, Niederbuehl is also the general manager of Munich's AIDS health organization, one of 120 such organizations in Germany, and what he called a "self-organized service organization."

According to Niederbuehl, there are currently 34,000 people in Germany affected with HIV. Five thousand are living with AIDS. More than 50 percent are gay men and 200 new infections occur every year.

Providing practical solutions and realizing the reality of gay life is how Niederbuehl says Germans are fighting the disease. The focus lies on individual counseling, prevention and listening above all else.

"The 80s climate of fear and uncertainty in Germany dissolved into the new AIDS mentality that the disease is just another treatable STD," he said.

This, he believes, is the result of the discovery of successful new therapies.

"The old methods of prevention and care no longer work," said Niederbuehl.

Dr. James Witeck was next to speak, saying that his interest in HIV/AIDS medicine stemmed from the fact that it directly affected his community. He now sees the demographics of the disease changing. Forty percent of the people that come through his medical practice today are heterosexuals. Forty percent are women. Thirty percent are intravenous drug users. Only 30 percent are homosexual.

"The population affected by this disease has changed and that has changed the way we deliver care," said Witeck. "We're having to rethink how we do things."

About one million people in the United States are living with AIDS, according to Witeck, and one third of them aren't aware that they are infected. Initially, prevention methods were targeted toward the gay community, therefore others at risk of infection missed out on important prevention education. Witeck said most of the heterosexual patients that come into his practice are already in advanced stages of the disease, as opposed to the homosexual patients who come in regularly for HIV testing.

"It should be part of routine care to inform people that anyone who has sex or has ever used drugs is at risk," said Witeck.

Witeck also stressed that secondary prevention -- "Not spending as much time with people who do not have AIDS and focusing our attention on people who do" -- is paramount.

Nurit Shein described her concerns about the politics of healthcare for the LGBT community.
"One of the outcomes of the AIDS epidemic is that it has enabled us to move into the next stage of LGBT health, in general," said Shein.

While HIV/AIDS awareness has increased in the LGBT community, Shein points to other issues -- hepatitis and breast cancer -- which remain unaddressed. Shein criticized the current administration for making it harder to address these unanswered LGBT health concerns.

"Our work over the last 20 years is being eroded," said Shein.

She then praised Mayor Street "for making huge strides over the last few years in helping to create a platform for the community" and for appointing an official liaison between the LGBT community and the local government. She urged the community to become vocal and demand to get the recognition they deserve.

"Are we victims of our own success?" asked Scoles in response to the panel's comments. He pointed out that many of the stigmas attached to the disease have disappeared but that the disease hasn't.

"The problem is that many have lost sight of prevention in the population as a whole," said Witeck.

Niederbuehl concluded the evening by offering his advice for the future.

"Everything is connected. We need to support our people to come out and be self confident. We need to personalize and change the frame in which this disease is viewed."

Note: Due to an unexpected conflict, Carmen Vasquez was unable to travel to Philadelphia to participate in the event.