(Article) Portland Observer: "Women at Risk for HIV"

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While in massage school in the late- 1980s in Boulder, Colorado, Jacki Gethner, a Portland massage therapist and practitioner of the healing arts, remembers when she received the phone call that her girlfriend had contracted HIV after a relapse in substance abuse.

At the time, she said, HIV was a fairly new deal.

"We only knew it surrounding gay men," she said. "And there weren't many women at that time who had been diagnosed."

She said there was such a stigma surrounding the disease that society feared being around those who had been diagnosed, and more than often, they were greeted with masks and gloves. "People weren't considered touchable," she said.

The same year she began school, however, Boulder hosted the AIDS Medicine and Miracle conference, which was the first holistic and western medicine AIDS conference within the United States.

At the event, Gethner and a friend, without knowing what the response would be, decided to set up a massage area in the building. "We provided massage chairs, and massaged over 300 people in four days," she said. "It was very powerful. Some of them hadn't been touched in months."

After realizing, first-hand, the healing impact mere touch can have in the healing process, Gethner returned as an integral component of the conference each year, and became determined to share her skills through community outreach and healing and support workshops. She began working with the support communities of those living with the disease. "Many people who had contracted HIV were abandoned by their biological families," she said. "So these people, their 'families of choice,' all wanted to know what they could do to help their loved ones."

"Skin is the largest organ of your body," she said. "It only makes sense to teach them how to touch."

Today, Gethner has worked with over 15,000 individuals from all walks of life, both locally and world-wide, through education, her knowledge of reflexology, and at her practice Regenerative Therapies located in northeast Portland.

Her current mission, however, has been to educate the community on HIV prevention, especially for women 50-years and older, who currently represent the fastest growing demographic of people diagnosed with HIV and AIDS throughout the country.

In an effort to support women who are infected or impacted by HIV/AIDS, Gethner created the Women of a Certain Age Program in 2006, to support older women, who she said are severely underserved within the community.

The non-profit program was made possible after she received the Keiser Permanente National Diversity Award for her work in HIV and AIDS. Although there was a number of ways she could have used the funds she received, Gethner said she decided to focus on the age group in which she lives.

"I've never met anybody who does what I do," she said. "I used to work with youth, but as I got older, I kept hearing of older people becoming infected because of a lack of information about their risks."

Women, she said, often have a difficult time accessing support they need because of reluctance to talk about their sex lives.

"People don't think older people have sex," she said. "Doctors don't ask about it because it is like asking your mom if you have sex, but older people, I find, are incredibly sexual, and it is important for them to be informed."

But Gethner believes the more people talk about sex, the better.

According to The National Institute on Aging, one in four HIV cases within the United States are people over 50, and the heterosexual HIV transmission rate among women older than 50 has doubled within the past decade.

For many women, it is considered shameful to talk about their sex lives with their friends and medical advisers, so it is very unlikely an older female will attend a workshop on safe sex.

"We don't go planning on having sex, but you never know," said Gethner. "When you are 70-yearsold, you're not going to jump out of bed and grab a condom at the 7-11, I know!"

"So my program is about peer education," she said. "Women, who are well-known in some of their communities, will be a contact person, so that a person thinking about having sex will have someone to speak to."

She said her hope is that the individuals who go through her full-day trainings will go out into their pockets of the community, at church, schools, cafes, everywhere, and teach other women they know about HIV and STD prevention, which could save lives.

According to the Centers for Disease Control, more than one million people are living with HIV in the U.S., and one in five individuals living with HIV is unaware of their own infection.

Although the annual number of new HIV infections has remained relatively stable throughout the recent years, the CDC said an estimated 56,300 Americans are still becoming infected each year. The fastest group to contract the disease is women over 50-years-old, who never even realized they were at risk of the infection.

This is why, Gethner said, the program teaches women tools that will help them advocate for their own needs, so that they can be diagnosed in a timely fashion and receive the proper treatment to help control their illness.

"People don't think it will happen to them," she said. "But prevention is cheaper than treatment."

Her goal for the coming year is to do at least four trainings in Oregon, where everyone who goes through the program will receive certification, basic information, hear from someone living with HIV, and have the opportunity to truly look at their own sexual histories and the obstacles they have experienced.

For women who have HIV, the goal is to "help lengthen their lives, educate them and get them on treatment," she said.

For more information about the
Women of a Certain Age Program,
visit HealthyWomenOver50.org
or call 503-790-0974

(Article) The Scribe: "HIV Increasingly Strikes at Older Adults"

By Cliff Collins
for The Scribe

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When Portland health educator Jacki Gethner gives talks to women over 50 about the risks of HIV, their reaction typically is, "That's interesting." But then they walk away, thinking the information doesn't apply to them.

They're wrong, though. As of 2007, about one-fourth of all HIVinfected adults are 50 or older, a figure that could rise to half by 2015, according to federal estimates. The two main reasons for the increase are that patients with the virus are living longer owing to the development and availability of antiretroviral therapy, and also that more older people are contracting the disease.

Acco rding to AARP, older adults comprise the fastes t-growi ng segment of the HIV-posi t ive population. Of the estimated 1.1 million Americans with HIV, some 407,000 are over 50. And one in seven new diagnoses of HIV or AIDS is in someone over 50. Last year the Centers for Medicare and Medicaid Services began covering HIV screening for Medicare beneficiaries, citing statistics suggesting that 53 percent of people age 65 to 74 are sexually active, as well as 26 percent of those 75 to 85.

But testing for the virus among adults 65 and older lags far behind testing of other Americans, and experts worry that HIV cases in older people go undiagnosed. A 2009 Kaiser Family Foundation survey found that only 16 percent of Americans 65 and older had ever been tested for HIV, compared with 40 percent of those age 50 to 64, 61 percent of those 30 to 49, and 54 percent of people 18 to 29.

"As the U.S. population continues to age, it is important to be aware of specific challenges faced by older Americans and to ensure that they get information and services to help protect them from infection," according to the CDC.

Minorities are disproportionately affected. In 2005, the rates of HIV or AIDS among people 50 and older were 12 times higher among blacks than whites, and five times higher among Hispanics compared with whites. Older members of minority groups may face discrimination and stigma that can lead to later testing, diagnosis and reluctance to seek services, according to the CDC. HIV transmission through injection drug use accounts for more than 16 percent of AIDS cases among people 50 and older.

According to the Office on Women's Health in the U.S. Department of Health and Human Services, about one in four Americans living with HIV are women.

Gethner, a licensed massage therapist and certified drug and alcohol counselor who won a 2009 national Kaiser Permanente HIV/AIDS Diversity Award, said many older women may have been in a monogamous marriage for decades and, after losing their husband, find themselves unprepared and "naïve" when re-entering the dating scene.

Health-care professionals may underestimate their older patients' risk for HIV and thus may miss opportunities to deliver prevention messages, offer HIV testing or make an early diagnosis that could help their patients get early care.

Also, the CDC said physicians may miss a diagnosis of AIDS because some symptoms can mimic those of normal aging, such as fatigue, weight loss and mental confusion. In addition, the stigma of HIV and AIDS may be more severe among older adults, leading them to hide their diagnosis from family and friends. 

Gethner said women over 50 may not realize they have to practice safer sex — and enforce their partners to. Some older people may be less knowledgeable about HIV than are younger adults, and therefore are less likely to protect themselves. Older women may be especially at risk because age-related vaginal thinning and dryness can cause tears in the vaginal area.

Gethner said when she gives talks before women over 50, she emphasizes that they must learn to be assertive in dating situations and, if necessary, to "walk away." One of the questions she asks groups of women is whether they have ever had sex against their will. About one-third usually say they have.

George A. Kuchel, MD, director of the University of Connecticut Center on Aging, told The Hartford Courant that doctors often miss the diagnosis in older adults "because people don't think about it. Clinicians will often think, 'Well, it's not a disease of older adults; we don't see it.' (But) it does happen."

Physicians may be hesitant to talk to older patients about sex, or to discuss risks and prevention of HIV. Gethner said it's important for doctors to feel comfortable talking with their older female patients, but that younger physicians especially may feel impeded to do so because they may be the same age as the patient's child or grandchild.

Gethner runs an educational project called Women of a Certain Age, which supports women who have HIV or AIDS in facing the challenges their diagnosis presents. According to Gethner's website, the program aims to provide "participants with useful tools to help them advocate for themselves and their needs, so that they are diagnosed in a timely manner, given the appropriate treatment, are regularly included in protocols, and receive nothing less than the highest quality of services available."

By Cliff Collins For The Scribe

(Article) Association Of Body Work and Massage Professionals (ABMP)

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Innovative, bold thinking characterizes the career of Jacki Gethner.This ABMP member won the Kaiser Permanente HIV/AIDS Diversity Award in November 2009, a signature achievement that includes a $10,000 award. Born in Chicago,Gethner became an advocate for patients with HIV-related complications in 1987 following a friend’s diagnosis. Now hard work, determination, and a talent for identifying grant opportunities has extended her advocacy to an international audience through speaking engagements, workshops, and training seminars.

What led you to become a massage therapist?
I was a mental health worker. I worked as a counselor in a psychiatric unit. I learned quickly that the body is the vehicle for some of the issues that people experience mentally. The body kept repeating the cycle of the abuse or the neglect, so I wanted to treat the body as well as the mind.

How did you become involved with HIV advocacy?
Back in the mid-’80s, there just weren’t many resources for people with the virus. More to the point, people who had HIV just weren’t touched. Or if they were, it was through layers of gloves. So part of it was developing training programs and workshops. “Train the trainers” is one of my ongoing goals. The gift goes much further when we can teach skills to groups who then work with others within their scope of practice.

What’s your focus at the moment? Right now, HIV rates are increasing among my own demographic. Infection rates among people over 50 have increased from 15 to 18 percent. That might not seem significant, but it definitely is. I plan on taking part of the grant money from the Kaiser award to create a self-supporting, peer-based education program for women over 50. The goal is to teach women to teach others within their peer group—however that peer group may be defined—where to get tested, how to be assertive with a potential partner about practicing safe sex, and how to find the vital information they need.

You’ve been particularly innovative about getting grants to support your work. How do you do so?
It’s very tricky. Aggressiveness and assertiveness have to do with some of it. Many government grants are awarded specifically to nonprofits. I collaborate with a fiscal agent, the Community Education Center—a nonprofit that sponsors my work. This allows me to work under the umbrella of a nonprofit, without having to take on the work of running one. That sort of grant work helped me contribute through an HIV awareness program that I gave in Oregon’s state penitentiary four times a year. You can also promote yourself to local government agencies, offering research information about massage. While they don’t always advertise it, most have health promotion departments with money that needs to be spent. I’m just forthright and bold enough to promote my services to them.

Those services usually involve workshops and trainings.How do you develop them?
By first finding the need. For example, I created a class on family massage and respectful touch among family members. You might have a child learn how to help a disabled sibling. Likewise, you can teach children and parents how to positively de-stress each others’ muscles. It empowers and strengthens the family bond. That sort of program you can advertise to local organizations like the PTA.

You seem to be very involved in your community. Tell us about some of your outreach initiatives.
Outreach is a huge need. The most unfortunate thing I see is that massage therapy’s involvement in community spirit is increasingly revolving around athletic events—Walk-a-Thons and that sort of thing. Massage therapy means significantly more than that.

I’ll give you an example. My first year in Oregon, I participated in an event called Project Stand Down. It’s a nationwide event to help the homeless. I pitched an idea to the local director and I taught these folks reflexology over three days. I made up 85–100 reflexology charts to give to them. Afterward many told me they had the best night of sleep they could remember. Some showed up years later, still holding on to now-tattered charts. That’s an incredible reward. The bottom line is massage therapists need to get outside of their offices.

Do you have a particular philosophy about your work?
I’m very passionate about it. I think one of the most important things I tell myself is that I’m not an expert, even though I qualify as such in my field. When I quit being the student, I quit being the teacher. The other thing I feel massage therapists need to keep in mind is that people are capable of change and improving themselves. It’s sort of like we help them find the beginning of a ball of yarn so our clients can make a sweater.

-Sean Eads

Sean Eads is a freelance writer and reference librarian living in Denver, Colorado.

(Article) Kaiser Permanente HIV/AIDS Diversity Award Press Release

The City of Roses blossomed another honor with the recent recognition of Jacki Gethner, a pioneer massage therapist in the treatment of HIV/AIDS infected clients by Kaiser Permanente who presented her with the Kaiser Permanente HIV/AIDS Diversity Award at their 32nd Annual Diversity Conference in San Francisco in November 2009 Ms. Gethner is a renowned international and national health advocate/activist/educator based in Portland, Oregon where she provides massage therapy to a devoted clientele who appreciates her expertise and compassionate spirit felt through her healing touch. In addition, Ms. Gethner has worked in collaboration with a variety of health educators, partners and advocates including pharmaceuticals, faith-based organizations, civic and government agencies to help minimize the spread of AIDS among vulnerable communities.

In 1987, Ms. Gethner began her involvement in HIV/AIDS education and advocacy work after learning about a girl friend's diagnosis and discovering the limited resources and service available to persons diagnosed with the virus. Her first opportunity to work was as a student at the Rocky Mountain School of Massage where she refined her skills and knowledge of massage therapy. Later that same year, she would attend the "1st Annual Holistic and Western Medicine Conference: Aids, Medicine and Miracles" in Colorado where her epiphany would take place as a pioneer in the treatment of HIV/AIDS patients via massage therapy.

Ms. Gethner recognized the myths and challenges that limited HIV/AIDS patients from receiving massage therapy so she convinced conference organizers to let her present a workshop at the conference to educate practitioners and clinicians, as well as providing an on-site team to work on conference participants. Since the inception of her pioneering efforts, Ms. Gethner has utilized her "touch and energy" to treat numerous patients and consulted thousands concerning the positive side to treating positive HIV/AIDS patients.
 

As the second largest provider of HIV care in the United States (Kaiser Permanente and Group Health Cooperative collectively), Kaiser Permanente is committed to addressing health disparities in HIV/AIDS incidence and care in the United States. Initiated in 2006
 

To mark the 25th anniversary of the discovery of HIV, the Kaiser Permanente HIV/AIDS Diversity Awards are presented to external individuals and organizations that work to reduce and eliminate disparities in HIV incidence and care in KP regions and include a $10,000 grant. KP Regions are Colorado, Georgia, Hawaii, Northern and Southern California, Ohio, Northwest (Oregon and Washington) and the Mid-Atlantic States (Virginia, Maryland and Washington, D.C.).

Past award recipients include the Asian & Pacific Islander Wellness Center and Ron Chavez, Grupo Fremont VIH in 2008, Allen Temple AIDS Ministries and the Cascade AIDS Project in 2007, and Phil Wilson of the Black AIDS Institute and Debra Fraser-Howze of the National Black Leadership Commission on AIDS in 2006.

The Kaiser Permanente HIV/AIDS Diversity Awards Selection Committee looked at the following criteria in awarding the Kaiser Permanente HIV/AIDS Diversity Awards:

  • Identified HIV/AIDS prevention and/or care practices that are replicable
  • Implemented innovative and promising practices in HIV/AIDS prevention and/or care
  • Demonstrated effective and impactful HIV/AIDS prevention and/or care strategies to curtail spiraling rates of HIV infection and AIDS
  • Contributed to reducing and eliminating disparities in HIV/AIDS incidence and care
  • Significant community involvement and collaboration efforts in HIV/AIDS prevention and/or care

National Diversity, Kaiser Permanente presented the 2009 Kaiser Permanente HIV/AIDS Diversity Awards to two organizations, the Antioch Development Corporation and the Central City Lutheran Mission and one individual, Jacki Gethner, during the 32nd Annual National Diversity Conference in San Francisco, California.