In the early 1980s, following confirmed reports of an outbreak of Kaposi's sarcoma (KS) and Pneumocystis carinii pneumonia (PCP) among homosexual men in several states in the U.S, several studies were conducted to identify the risk factors associated with the disease(s), related trends and other associated issues. From these studies and CDC reports on the disease, several issues and trends emerged . Among the trends and the issues identified in the said studies and reports is that the prevalence of the disease was higher in homosexual men.
Some lifestyle aspects, common among the infected patients, were linked to the high diseases occurrences among men. Particular risk factors associated with the diseases were higher number of male sexual partners per annum, substance abuse, syphilis and non-B hepatitis history, fecal exposure during sexual intercourse and treatment for enteric parasites. Cellular immune deficiency was also found among patients with the two diseases, implying an underlying infection by agent (s) sexually transmitted among sexually active homosexuals. Consequently, the sexual partner (s) of the patients is (are) likely to develop KS and /or PCP. Most patients in the cluster of PCP and KS in Orange and Los Angeles counties were found to have been exposed “street” drugs at some point .
There is need to have a system that would help better understand the diseases, predict an outbreak, to develop intervention strategies and evaluate the efficacy of the intervention. On the planning phase, it is necessary to hold a stakeholders meeting to draw an intervention road map. Such a meeting should incorporate willing infected patients, homosexual activists, health workers and policy makers. The planning phase should also include activities that discourage stigmatization of homosexuals and development of a research and development (R&D) arm specifically addressing the risk factors, treatment and prevention. Intervention strategies should draw from the results of the R&D arm. Creating awareness on the diseases and the associated risk factors is a major intervention strategy. As an intervention strategy, there is need to establish units dedicated to attending to homosexuals complaining of KS and PCP symptoms. These units would facilitate early diagnosis and treatment of the disorder as well as evaluation centers. The units should be adequately equipped with good record keeping systems so as to capture and report cases of the diseases. In addition, the units should have a follow-up team that is in regular communication with those diagnosed with the disorder. A good surveillance system will help evaluate the effectiveness of the intervention strategies.
References
CDC. (1982 , June 18). A Cluster of Kaposi's Sarcoma and Pneumocystis carinii Pneumonia among Homosexual Male Residents of Los Angeles and range Counties, California. Retrieved August 8, 2013, from Morbidity and Mortality Weekly Report:CDC: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001114.htm
CDC. (1982, July 8). Kaposi’s Sarcoma (KS), Pneumocystis Carinii Pneumonia (PCP), And Other Opportunistic Infections (0I): Cases Reported To CDC As Of July 8, 1982. Retrieved August 9, 2013, from http://www.cdc.gov/hiv/pdf/statistics_surveillance82.pdf
Jaffe, H., Choi, K., Thomas, P., Haverkos, H., Auerbach, D., Guinan, M., et al. (1983). National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results. Annals of Internal Medicine , 99 (2), 145-51.
Rogers, M., Morens, D., Stewart, J., Kaminski, R., Spira, T., Feorino, P., et al. (1983). National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. Annals of internal medicine , 99 (2), 151-8.
