KING COUNTY, WA - Today, community representatives joined King County Executive Ron Sims and Public Health - Seattle & King County in announcing new actions and strategies to curb a persistent and unacceptable resurgence of sexually transmitted diseases (STDs) and a potential increase in HIV rates in gay and bisexual men.

"These new health trends are a wake up call for King County, and we all must join in working towards solutions," said Sims. "In the past we've shown determination in confronting STD and HIV epidemics, and I don't doubt that we can do it again."

On World AIDS Day (December 1, 2000), 60 representatives from Public Health, HIV/AIDS service organizations, and the gay community came together to identify the main causes for STD resurgence and the possible community-based responses.

"We have carefully analyzed the factors and circumstances that have led to the current rise in STDs and risky sexual behavior. Today, community and Public Health representatives are announcing new strategies to revitalize our STD and HIV prevention programs," said Dr. Alonzo Plough, Director of Public Health - Seattle & King County.

New STD and HIV challenges in King County

Syphilis, gonorrhea and chlamydia rates among gay and bisexual men in King County have risen to epidemic levels during the last two years. "King County joins other major metropolitan areas, like New York and San Francisco, by reporting a resurgence in STDs and potentially HIV," said Dr. Bob Wood, Public Health AIDS Control Officer.

The STD increases indicate that HIV among these men may also be spreading. The sexual behaviors that transmit STDs also transmit HIV, the very presence of a STD makes HIV transmission easier, and many gay and bisexual men with these conditions also indicate they carry HIV.

For example, infectious syphilis had been completely eliminated among all populations in King County in 1996, but today, estimated syphilis rates among gay and bisexual men are back up to 1982 levels of 150 per 100,000.

Main factors in STD resurgence are:

• Improved HIV therapy
  "Due to HIV treatments, there is the misperception that HIV/AIDS is curable. People have started to believe that there's no need to protect themselves and reduce risky behaviors," said Derek Myricks-Harris, CDC Program Manager at People of Color Against AIDS Network (POCAAN).
• "Epidemic fatigue" and "safer sex burnout"
  "After many years of the HIV/AIDS epidemic, people are no longer putting the same emphasis on safer sex. Simply put, they are tired of hearing the same messages," said David Richart, Director of Education and Prevention at Lifelong AIDS Alliance.
• Substance abuse
  "We have found that drug use, including crystal methamphetamine and inhaled nitrites, is connected to the acquisition of STDs, including HIV," said Jim Holm, Co-chair of the Seattle HIV/AIDS Council.

Community-based responses

"We must re-double our efforts in coalition building. Also, it is essential that we provide services and new preventive messages that are appropriate to ever-changing community needs and norms," said Plough.

Community and Public Health leaders expressed a commitment to support and carry out a large number of recommendations and actions. These include, but are not limited to:

• Clinical services: Based on current community health needs and qualitative data (such as interviews now being conducted locally by CDC staff), identify and select appropriate clinic services and implement new approaches to service delivery. There must be emphasis on mental health, substance use treatment, and community systems, among others.
  
  
• Coalition building and resource development: Establish and support a strong prevention coalition to strengthen and update current prevention efforts, generate more funding, and link to high risk settings and mental health agencies.
  
  
• Community-driven prevention messages: Community organizations and Public Health must jointly develop, disseminate and support new prevention messages that appropriately address current community beliefs and practices.

The full report, including a complete list of recommendations and actions, can be found at www.metrokc.gov/health/reports/hivstdsummit.