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  • 10
    Apr
    2013
    12:19pm, EDT

    Research finally shows that online education works — for sex, alcohol and health

    TeachAIDS

    Students at the Shirimatunda Primary School in Tanzania use a Swahili version of an online course about AIDS created by a company called TeachAIDS.

    By Anya Kamenetz, The Hechinger Report

    Asia Jackson likes to learn at the computer because she can work at her own pace, which is usually faster than her classmates’. Al-Tariq Linton says, “It’s one on one. If I have a question, instead of competing for the teacher’s attention, I can go back and read it on my own.” Wanda Williams says her favorite part of the online course she’s taking is the narrator of the videos it includes. “Rufus made it funny,” she says. “It was fun.”


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    As interest in online education rages, these 17- and 18-year-old students at Newark, N.J.’s West Side High are guinea pigs in a global experiment to answer a key but surprisingly elusive question: whether and when it actually works.

    Evidence is mixed about how well online courses teach core subjects such as science, math or reading, with a recent large-scale Columbia study showing disadvantages to online learning for community college students. (The study was done at Columbia’s Teachers College, which is also home to The Hechinger Report, producer of this story.) But new research shows that, in certain topics—as for these students in Newark — computer-based instruction is not only just as effective as the old-fashioned, in-person kind. It’s more effective.

    These topics include sex, drugs and health — subjects in which privacy, personal comfort and customized information are especially important, and embarrassment or cultural taboos can get in the way of classroom teaching.


    Simple video- and animation-based interactive courses in these disciplines turn out to be good ways of teaching subjects you may have giggled through in health class. And they’re increasingly being used all over the world with success now confirmed by peer-reviewed, controlled research. The results are important as online education continues to expand faster than its impact and effectiveness can be fully measured.

    “We’re seeing significant and large effects on attitudes, knowledge, and also behaviors” from online courses in nontraditional subjects, says Marco Gonzalez-Navarro, an assistant professor at the University of Toronto who coauthored one study of the subject.

    Sex in Colombia
    Gonzalez-Navarro, working with researchers at Yale and the University of Ottawa, found that Colombian students in an 11-week online course in safer sex created by Profamilia, part of the International Planned Parenthood Federation, knew more about safer sex practices than students who took the conventional, state-mandated health class. And their knowledge was put into practice. For every 68 students who took the online course instead of the traditional course, researchers estimated by reviewing students’ medical records and comparing them to those of peers who didn’t take the course, up to two sexually transmitted infections were prevented. The students were also 10 percentage points more likely than their counterparts to redeem vouchers for free condoms offered six months later.

    It’s not just that students often feel embarrassed to talk about sex in conventional classrooms, the researchers found. Teachers don’t like teaching about it, making them less effective — assuming they even broach the topic.

    “A lot of teachers are just not comfortable teaching these subjects,” says Gonzalez-Navarro. “The central education ministry might say you have to give this sex-ed course, but it’s not happening.”


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    Another series of independent research studies has confirmed the effectiveness of online education about alcohol awareness in the United States. In the largest, the researchers found a short-term reduction in harmful behaviors related to drinking among college freshmen at 15 colleges who took an online course called AlcoholEdu. Similar studies at the University of West Florida and Villanova and Roger Williams found similar results.

    AlcoholEdu is produced by EverFi, a venture-funded startup backed by a group of high-profile Silicon Valley investors, including Amazon's Jeff Bezos, Google's Eric Schmidt and Twitter's Evan Williams. In addition to alcohol education, EverFi offers animation, video and game-based courses in sexual violence awareness, financial literacy and digital citizenship, reaching 69 of the nation's largest 100 school districts, and 33 percent of the nation's incoming freshmen.

    Five and a half million students have already completed EverFi courses, according to CEO Tom Davidson, each of which includes eight to 10 hours of instruction. Some are used as part of for-credit courses while others are woven into freshman orientation.

    “You can’t get your dorm key at NYU until you do our sexual violence prevention course,” says Davidson.

    The NIH-funded study of the company’s online alcohol-awareness course found that it was most effective when more freshmen took the class at the same time, suggesting that peer pressure plays a role — though the results had dissipated by the spring semester, meaning more follow-up was needed.

    Tackling cultural taboos
    Other ongoing research supports the use of online courses for sex education. Students in China, India and South Africa who completed an online sex-education program called TeachAIDS were 91 percent more knowledgeable about HIV than before they took the course, compared to an improvement of 73 percent for students who were taught the conventional, state-mandated curriculum.

    TeachAIDS became a nonprofit in 2009. It was founded by Piya Sorcar and her husband, Shuman Ghosemajumder, who had spent six years in high-level jobs at Google, along with several others. In her Stanford dissertation, Sorcar had examined the role of cultural taboos in dealing with issues of sexual and reproductive health in India.

    “Sex education has been banned in some states in India,” she says. “There have been incidents of teachers burning curricular material in the streets.” In Andhra Pradesh, a state with a population of 85 million, HIV-positive students have been expelled.

    Sorcar set out to create a curriculum for HIV/AIDS that would be both culturally acceptable and scientifically rigorous, and that would attack social stigmas by showing what AIDS is, how the virus is transmitted and how to protect against it.

    The TeachAIDS course combines a 20- to 25-minute animated video with interactive quizzes. So far, she said, it has been produced in 15 languages and used in 74 countries. For added appeal and to make it more relatable for young people, each country and region features likenesses of and voiceovers by local celebrities. In Botswana, the program stars a hip-hop artist named Scar, who hosts the TV show Idols East Africa; in India, it features Shabana Azmi, an award-winning Hindi actress.

    “Our culture doesn’t talk about love or what comes out of it,” says Tristha Ramamurthy, who uses the TeachAIDS curriculum with seventh- through 12th-graders in a network of private schools she oversees in Bangalore, India. “We have arranged marriages — we’re very caste-driven. Sex itself is very uncomfortable to talk about, and in school it’s not taught.”

    What makes the TeachAIDS material acceptable to her students, Ramamurthy says, is the use of culturally specific euphemisms. For example, a honeymoon suite and two lovebirds kissing suggests intercourse; images of a woman holding a baby stand in for childbirth.

    Digital downsides
    There are downsides to using online courses to cover health topics. Both the software and the hardware cost money, and funding is often a problem in schools worldwide. TeachAIDS’ video-based course has been projected on a wall in villages in Nepal and shown on outdoor screens in Rwanda in between World Cup soccer matches, which extends the program’s reach but sacrifices the advantages of interactivity and privacy. Even at West Side High in Newark, Everfi had to provide a version of the course loaded on a jump drive, because the school had problems with its Internet connection.

    EverFi licenses its material to colleges for a fee, but public schools like West Side High can get it free with the backing of corporate or local business underwriters, which have included the National Basketball Association and Capital One bank.  The sponsorships, which can include prizes and giveaways, are seen by some critics as an unwelcome intrusion of business into the classroom.

    Nor do any of these courses constitute a hands-off, digital-only solution. The learning effects are strongest in most cases when the programs are used as part of for-credit courses, with teachers in the room to guide and motivate students, and when students take the courses together. And companies like EverFi need to provide ongoing support and professional development for teachers.

    But the need for easy-to-use, compelling resources to cover topics that teenagers are not all that eager to discuss with adults is likely to grow, opening more markets to organizations such as EverFi and TeachAIDS.

    EverFi is already expanding its offerings. And TeachAIDS is being adopted as part of the official high-school curriculum in Karnataka, an Indian state with a population of 60 million, and the company plans to grow to 50 countries with 90 percent of the world’s HIV cases by 2018.

    “We see such a need for these ‘everything else’ areas outside the core curriculum,” Davidson says of the apparent effectiveness of using online education in this way, and continued research into it. “New mandates are coming down at the state level, and schools are having trouble getting their arms around them. This is a model that we're following with the development of all our courses:  develop, test, redevelop.”

    Related stories from The Hechinger Report

    • New online venture promises small classes and college credit
    • My first MOOC: Online class about how to create online classes failed miserably
    • Online testing is heading to New Jersey schools

     

     

     

     

    3 comments

    Sorry, Denver Who said that it does not work for Science and Maths? I am teaching Physics and effectively so. Recently WizIQ used its virtual classroom for blended classes for management studies effectively and was warded for it effort. Online Education will work for every field with required modi …

    Show more
    Explore related topics: schools, education, aids, online-learning, sex-education, hechinger-report
  • 3
    Mar
    2013
    4:33pm, EST

    A baby now free of HIV has doctors talking about 'cure'

    Doctors are hopeful for a cure after a newborn with HIV who received immediate treatment is virus free two years later. NBCNews.com's Dara Brown reports.

    By Maggie Fox, Senior Writer, NBC News

    A baby born infected with the AIDS virus who got immediate treatment now has no detectable virus in her blood – not quite a cure, but so close to one that it has doctors talking about the possibility.

    Her case, presented to a meeting of AIDS researchers that started Sunday, will prompt questions about how early babies should be treated – and further illustrates the possibility that immediate treatment with HIV drugs might stop infection in its tracks and could even have an impact on the AIDS pandemic.

    “What we have identified is what we think is the first well-documented case of a functional cure in a neonatal child,” Dr. Deborah Persaud of the Johns Hopkins Children’s Center, the virologist who led the study, told NBC News.

    A functional cure, says Persaud, means the virus isn’t entirely gone, but it’s not doing any damage, either. Doctors think it was because they began therapy for the baby within 48 hours of being infected, she told a conference in Atlanta of HIV specialists.

    The child, who lives in rural Mississippi, is now 2 1/2 and healthy. She was, like so many, born to a mother who didn’t know until right before she gave birth that she had the human immunodeficiency virus (HIV) that causes AIDS. Mom and baby both got a standard dose of HIV drugs right away – something that has been shown to prevent what’s known as mother-to-child transmission of the virus in newborns.

    Johns Hopkins Medicine

    Dr. Deborah Persaud of the Johns Hopkins Children's Center. She helped discover the case of a toddler who is close to being "cured" of HIV.

    The baby was a little premature and so stayed in the hospital. Within 30 hours of birth she was re-tested and had clear evidence of HIV infection. Unusually, she then got a cocktail of three drugs at a dose normally reserved for more advanced cases.  It worked really well – pushing her virus down to what’s called undetectable levels. This is what doctors want with HIV, because if the virus can’t be found in the blood, then it can’t be spreading and damaging the immune system. HIV doesn’t kill directly – it kills patients by damaging their immune systems so bad they can’t fight off other infections.

    The baby and her mom, who doctors aren't naming, got regular care and treatment by Dr. Hannah Gay at University of Mississippi Medical Center until she was 15 months old. Then, like so many children, she disappeared off the doctors’ radar screens. The mother brought her back briefly at 18 months but disappeared again but she missed at least eight months worth of drugs. When Gay caught up to her again, the baby was still well, despite having received no treatment. More remarkably, tests showed the virus had not come back.

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    “My first thought was, ‘oh my goodness. We have been treating an uninfected child,” Gay told NBC News. "But I checked the records which confirmed she was, in fact, infected.”

    Dr. Katherine Luzuriaga of the University of Massachusetts Medical School, who also worked on the study, piled on with a battery of tests. Even a sensitive test called PCR, which can help find tiny bits of genetic material from a virus, couldn’t detect any evidence of HIV. This went far beyond the usual definition of "undetectable" in treating the AIDS virus - there really was no evidence the virus was there.

    “What we did then was to get a group of collaborating laboratories together to apply ultra-sensitive testing  and say ‘can we detect any evidence of virus’,” Luzuriaga says. They did eventually find pieces of genetic material from the virus.

    But Persaud has been unable to find any evidence of virus that can invade cells or replicate. “So the baby has remained off treatment. We are just watching and we will follow the baby and do additional testing.”

    It’s not a true cure – what doctors call a “sterilizing” cure. There is still virus in the toddler’s body. But it’s not is a form that seems to be doing any damage. It doesn’t seem to be able to spread from one cell to another and it doesn’t seem to be damaging the child’s immune system.

    About 34 million people globally are infected with HIV, the virus that causes AIDS; 25 million have died from it. While there’s no vaccine, cocktails of powerful antiviral drugs called antiretroviral therapy (ART) can keep the virus suppressed and keep patients healthy. No matter how long patients take ART, however, they are never cured. The virus lurks in the body and comes back if the drugs are stopped. Scientists want to flush out these so-called reservoirs and find a way to kill the virus for good.

    “This has major implications for how we begin to think about treating children,” Persaud says. “Perhaps we can spare them a lifetime of treatment.”

    But she adds, it’s one case.  “We need to figure out if this can be reproduced or replicated in other infants.”

    Babies born to HIV-positive women are different from other HIV patients. Doctors know the precise moment that they are infected and can treat them right away. But usually they treat them with low doses of drugs for about six weeks and then wait to see if infection has really developed before they treat them again. If done right, this treatment around birth can prevent 95 percent of infections.

    Up to now, only one person has been documented with a cure – the so-called Berlin patient, Timothy Brown, who was treated for leukemia with a bone marrow transplant that happened to come from a donor with a genetic mutation that makes immune cells resist HIV infection. The transplant replaced his own infected cells with healthy, AIDS-resistant cells. He is remains free of the virus more than five years later.

    Dr. Dan Kuritzkes of Brigham and Women's Hospital and Harvard Medical School is treating two HIV other patients who, like Brown, got bone marrow transplants for leukemia or lymphoma. His team wants to see if they, too, can be cured. “They are doing fine,” he says – but continue taking HIV drugs to be safe.

    But a third patient he was treating suffered a relapse of lymphoma and died. “It sort of underscores what these patients have been through,” he said. No one thinks a bone marrow transplant represents a real-life treatment for anyone with HIV, because it’s so hard on the body.

    Kuritzkes said AIDS experts have wondered whether very early treatment of newborns could be in fact treating their infection rather than preventing it.

    “It’s exciting because there are undoubtedly other children in this situation,” he said. His team is taking part in several studies looking at whether it is possible to eradicate the reservoirs of virus in adults that should have results within a year.

    There are also patients called “elite controllers” who seem to stay well and suppress the virus without the need for drugs.

    Luzuriaga says this toddler is not an elite controller. “You can detect HIV DNA in their cells. And you can culture virus from them,” she said. “We just think that this baby has much tighter control, much tighter control. This baby hasn’t rebounded off therapy.”

    “Our next step is to find out if this is a highly unusual response to very early antiretroviral therapy or something we can actually replicate in other high-risk newborns,” says Persaud.

    It might be that quick treatment stopped the virus from hiding out in the baby’s body, and allowed the drugs to do their work and stop the spread of the virus.

    Ami Schmitz contributed to this story.

    Talk about this story on the NBC News Health Facebook page.

    Related stories:

    Two HIV patients now virus-free. Is this a cure?

    Many new AIDS infections in US teens

    Pills can prevent HIV infection

     


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    Explore related topics: aids, hiv, virus, featured
  • 27
    Jul
    2012
    12:15pm, EDT

    75 percent of U.S. HIV patients lack effective care

    By Maggie Fox, Senior Writer, NBC News

    Only a quarter of Americans infected with the AIDS virus are getting effective treatment, according to a U.S. government report released Friday -- and the youngest patients are the worst off.  The numbers could worsen if states don’t broaden health care as called for under the 2010 health reform law, scientists worry.

    It’s the first comprehensive look by the Centers for Disease Control and Prevention at who is getting effective care, and it doesn’t paint a promising picture. The findings raise even more alarm bells as study after study presented at the International AIDS Conference in Washington this week show that treatment can help stop the spread of HIV.

    “The majority of people living with HIV in the United States are not on antiretroviral treatment, not in stable care,” Dr. Kenneth Mayer of The Fenway Institute and Harvard Medical School in Boston told a news conference. “They need to be in care first and then able to get treatment.”

    The study finds that just over a third of  HIV patients have steady care -- 34 percent  of African-Americans, 37 percent of Latinos and 38 percent of whites.

    Younger patients are the least likely to be getting the cocktails of drugs that can keep them healthy and help keep them from infecting others. Just 15 percent of those aged 25-34 had the virus suppressed to desired levels, compared to 36 percent of those aged 55-64. Only 22 percent of young adults were even getting HIV drugs to treat their infection, the CDC found.

    There’s no cure for the human immunodeficiency virus that causes AIDS and no vaccine. HIV has killed 25 million since it first started spreading globally in the early 1980s, and more than 33 million people are infected worldwide. About 1.1 million people in the United States have HIV, and the CDC estimates that 20 percent of them don’t even know it.

    “We have to continue to raise the alarm,” CDC’s top AIDS official, Dr. Kevin Fenton, said in an interview. “We have to find that sense of outrage.”

    The same factors are driving high transmission and poor treatment rates among some U.S. groups: poverty, a lack of access to medical care, and a lack of education about what causes HIV and what people can do about it. Policymakers need to understand that treating people with HIV saves money, Fenton said. 

    “What we now know is that treating HIV is cost-effective. For every dollar spent, you save $2,” Fenton said.

    Fenton said the U.S. should pull out the stops on providing condoms, counseling, testing and treatment.

    “We need to ensure that states have policies that support routine HIV testing,” Fenton said. “Clearly, this is going to be more challenging in some states than in others.”

    Top AIDS experts in the U.S. say no matter what people may think about the moral implications of some of the behavior that leads to HIV infection, it will benefit everyone to get people tested, treated and counseled about controlling their infection.

    “Every state really must enact the Affordable Care Act,” said Dr. Judith Aberg, president of the HIV Medicine Association and an AIDS expert at New York University. “States need to fund HIV treatment and prevention. We need to continue this fight.”

    Governors of several states have said they will not expand Medicaid, required by the health care law, because they cannot afford it. The U.S. Supreme Court ruled last month that states can decide whether to abide by that provision. States refusing expansion now include Texas, Florida, South Carolina and Louisiana. Medicaid, the state-federal health insurance plan for the poor, currently does not cover most low-income adults with HIV. AIDS activists say it’s essential to controlling the epidemic to get coverage for young adults with HIV, and at risk for HIV.

    Opening this week's International AIDS Conference was Dr. Anthony Fauci, one of the most influential, leading scientists in the decades-long search for a cure. Fauci discusses how far we've come and how far we have to go in the battle against HIV/AIDS.

    Related stories:

    • Circumcision advocate tackles the cringe factor
    • Two patients with HIV now virus-free. Is this a cure?
    • The female face of AIDS -- not who might think

    355 comments

    Okay GOP, what is your plan to help on this one... or is it, "Sorry, we are not responsible"

    Show more
    Explore related topics: politics, aids, medicaid, hiv, cdc, featured, aids2012
  • 26
    Jun
    2012
    6:10am, EDT

    AIDS in the pews: Son's secret divides Southern Baptist minister and his church

    By Joan Garrett
    The Chattanooga Times Free Press

    Jake Daniels / The Chattanooga Times Free Press

    Even on a Sunday morning, former Southern Baptist minister Matt Nevels reads the newspaper with his wife, Frances, at their home in Red Bank, Tenn., outside Chattanooga. Since the church's reaction to the death of their son Stephen, many of the Nevels' Sunday mornings have consisted of reading the paper, private devotionals, and watching services on television.

    RED BANK, Tenn. — It's Sunday morning, and Matt Nevels is at home again.

    From his front yard, he almost can see the white steeple of Red Bank Baptist Church. Less than a mile down the road, he knows, the church parking lot is clogged with members. Traffic backs up onto Dayton Boulevard. Crosses dangle from rearview mirrors. Bibles slide on dashboards.

    Matt, 78 now, with wrinkled knees and sagging cheeks, was once minister of education at the red-brick church. His babies grew up there. Stephen, his middle son, sang tenor in the choir. Vicki, their only girl, played in the youth softball league. Keith, the youngest, went to backyard Bible club.

    Every Sunday for nearly three decades, Matt put on a crisp shirt and tie, trained Sunday school teachers and glad-handed newcomers. But it was more than that, more than just tradition.


    See more photos of Stephen Nevels and his family at The Chattanooga Times Free Press.


    From the Southern Baptist church he drew his purpose, his worth. The calling had come when he was in his early 20s, fresh out of the Army.

    But that all ended 17 years ago.

    These days Matt watches recent reruns of Red Bank services on a television in his kitchen while his wife, Frances, putters around the house. Sometimes he'll move his lonely worship into his study and read through the Bible again. The only sound in the background is the dull hum of an air conditioner. On the wall, a hand-sketched portrait of Stephen reminds Matt of all that's gone. It hangs over him.

    He carefully reads the red letters in the Word, the phrases Jesus spoke. Books like Leviticus, he skims.

    Leviticus, with its hard words about abominations and detestable sin, just doesn't speak to him anymore.

    •••

    There are more than a dozen churches along Dayton Boulevard, just a speck on the congregational landscape of the city. These are the gathering grounds of Red Bank, where business is done and children are bragged about and standards are passed down. These are the places where people come for their beginnings and ends.

    In Chattanooga, and in the one-red-light towns and the farmland of North Georgia and North Alabama -- the buckle of the Bible Belt -- Christian faith is a thread that runs through everything. High school cheerleaders paint Bible verses on signs. Hamilton County commissioners bow their heads before meetings. Store owners use little Jesus fish on their advertisements.

    Believers call that faith the community's bedrock. Scriptures tell them to do good, love their neighbors, be faithful to their husbands and wives. They tell them not to steal or kill.

    But while these beliefs knit people together, they also tear apart. As Jesus said in Matthew, they turn sons against fathers, daughters against mothers.

    The faithful hold firmly to God with one hand, family with the other. But sometimes we are forced to choose. If we can't hold onto both, which one do we let go?

    In 1991, after 25 years of defining himself by his position in the church, Matt Nevels' faith abruptly and irrevocably collided with the death of his middle son.

    •••

    Stephen left Chattanooga for Atlanta in 1985 after graduating from college. He told Matt the jobs were in the big city. And, after uprooting his life, the 24-year-old seemed to do well there.

    He worked at Macy's, selling fine china, and drove a Mazda RX-7. He called home regularly and told his parents he wasn't skipping Sunday services. He brought friends home, men and women.

    Matt was proud. He had retired from working as minister of education at the Hamilton County Baptist Association after a massive heart attack in 1982, and life had settled into a quiet routine. He and Frances continued attending Red Bank Baptist, but just as congregants.

    Then, one morning in the fall of 1991, Stephen, 30 years old at the time, called Frances at her job at Provident insurance company and told her he was sick. Something was wrong with his lungs. His breathing was labored.

    He called again that afternoon and told her he was being admitted to the hospital. Tests had been ordered, but it looked like pneumonia. He told her to bring his father to Atlanta to see him the next day.

    At first, Frances didn't worry much about the call. Stephen had run a marathon that year and had a muscled body from years of shouldering women as a cheerleader at the University of Tennessee at Chattanooga. But as the day unfolded, she started to wonder about the urgent calls, the tiny tremble in his voice.

    Pneumonia in young, healthy men was uncommon, and she knew from her days volunteering at the hospital that it was typically linked to something more deadly. Pneumocystis pneumonia crept into the bodies of people with weakened immune systems -- people in the last stages of AIDS.

    Then another thought came.

    The year before, Stephen had come home to bury his roommate, with whom he had moved from Chattanooga to Atlanta. Everyone said the young man had died of Crohn's disease.

    Then another thought came.

    AIDS could show up in blood-transfusion recipients, drug users or babies, but its most common victims were men who had sex with other men. But her son wouldn't have sex with other men, she thought. Her son wasn't gay.

    Was he?

    Family photo

    Stephen Nevels is surrounded by friends in his hospital bed.

    That night she asked her son Keith if he knew anything about Stephen that she should know before she and Matt went to Atlanta. Was there anything she should tell his father?

    What Keith said shocked her.

    So she walked to the study where Matt was and sat beside him on the couch. She spoke plainly.

    "Stephen is gay," she told Matt.

    Matt didn't speak.

    "I think what we are facing tomorrow is AIDS," she said.

    In the quiet, Matt thought back to a day years before when he and his oldest son, Tim, were driving together. Tim nearly made his father's heart stop when he asked if Matt thought Stephen was a homosexual.

    Matt gave a firm "no." There was no reason not to. So Tim never mentioned it again, and Matt buried the memory.

    To acknowledge that Stephen had kept a secret like that would shatter the image of his family. All sins were equal to God, but not to many in the church. There was something about homosexuality that made people want to turn away.

    Matt stood up and walked outside. Frances left him alone. He stayed in the backyard for what felt like hours, pacing. Finally, he looked up at the black sky and pleaded.

    God, this is beyond my imagination. This is beyond my ability to accept.

    •••

    The two-hour drive to Atlanta was quiet. Neither knew what to say. The Nevelses were the kind of people who didn't take well to mess. The tops of the picture frames were dusted, the beige carpet was always lined with vacuum marks.

    They thought they knew their son. Everyone called him Steve. He was handsome, with a firm chin and steely blue eyes.

    As a boy, he dressed like his two brothers. He had played sports like his brothers, cross-country and softball. He got good grades and grew to 5 feet, 11 inches. Frances made his three-piece suits for church. She knew the length of his inseam and the width of his chest.

    Matt and Frances knew about the time he burned his little bottom on the house heater, how he loved to eat hot fudge cake, how he broke his pinky finger once while setting the table with his grandmother.

    And what they didn't know for certain they assumed -- one day, Stephen would get married and have babies like they had. One day, Stephen would come home to Red Bank and sit beside them on the 10th pew.

    When Stephen started dating women in high school, Matt had a single talk with him about waiting to have sex until marriage. Stephen nodded, just like his brothers had.

    But by the time Matt and Frances pulled into the Atlanta hospital, they imagined their son a stranger.

    Riding the elevator to the fourth floor, the infectious disease unit, Matt vacillated. He pictured the face of a younger Stephen. Innocent. Buzzed haircut. Dewy eyes. A pouty lower lip. Two big front teeth.

    Regardless of who his son was, Matt knew only that he didn't want to lose him, not ever.

    Stephen's room was on the middle of the hallway. They walked fast.

    •••

    In all his years as a minister, Matt never spoke in depth with anyone about homosexuality. In seminary, the topic wasn't studied. It didn't often crop up in sermons or in prayer requests. If a parent or a child had faced it, he never knew.


    See more photos of Stephen Nevels and his family at The Chattanooga Times Free Press.


    But he did know the Bible verses that seemed to condemn homosexuality: 1 Corinthians 6:9-10 and 1 Timothy 1:10, Romans 1:21-28, Genesis 19, Jude 7 and the fiery passages in Leviticus.

    "If a man also lie with mankind as he lieth with a woman both of them have committed an abomination; they shall surely be put to death; their blood be upon them."

    Matt had called it a sin and, like any unrepented sin, he believed it could lead to separation from God after death.

    But he also knew the 505 Bible passages about love, and those words undergirded him through most of his church life. And he had seen the signs of love in churches.

    He received thank-yous sent after visiting the sick. Congratulations when his daughter married. In 1971, the youth at Red Bank Baptist made him a plaque for his service. "You're a good man, brother Matt," it read.

    When he moved from his job as minister of education at Red Bank Baptist that same year to work for the Hamilton County Baptist Association, the church staff got him a cake and made him feel as if he would be missed.

    Years later, when he had the heart attack, Fred Steelman, the head pastor of Red Bank Baptist -- everyone respectfully referred to him as Dr. Steelman -- came to the hospital and prayed over him, and Matt healed.

    Matt assumed somehow that when he learned that Stephen was dying of AIDS, the church would come alongside him in this strange place. That's what churches were supposed to do.

    When he and Frances walked into the hospital room, Stephen was lying in the bed in a thin gown. His body white and weak. The same blue eyes, but hollow underneath.

    Stephen looked at his father. The room felt tight with fear and embarrassment. Matt knew his son was waiting to hear his voice, listening for reassurance.

    And Matt began to cry in front of his son. Frances held her hands over her mouth and cried, too.

    "Son, it's OK," Matt said. "We are going to love you the way you are."

    Stephen sobbed. He crawled out of bed and into Matt's lap and Matt held him like he did when he was just a boy. Stephen put his arms around his father's neck and kissed him on the cheek.

    "Son, don't worry," Matt said softly. "Nothing between us is going to change."

    •••

    Once home in Chattanooga, Matt kept the news about Stephen a secret from the church and opened his Bible. The sight of his son stirred questions.

    Stephen had a partner named Rick, and he told his father he wasn't going to give up the relationship. Stephen told Matt he had been sexually abused by an authority figure on multiple occasions as a teen, but had never wanted his parents to know.

    The events confused and hurt Stephen, but he said he had always been attracted to men. He was born gay, he said.

    Still, Stephen told his father, he believed he was a born-again Christian.

    Matt had believed another narrative about sexual identity. He had heard that homosexuality was a choice to ignore God's design. Ministries that worked with what they called the formerly gay said it was a phase caused by abuse, absent fathers and overbearing mothers. The cure was repentance, sometimes celibacy, a hope that the desires could quiet with help from the almighty.

    But when Matt thought about the stories his son had told him in the hospital that weekend -- stories of friends turned out of their families and churches, stories about bullying by people who knew their secret, stories of double lives and failed marriages -- he couldn't help but wonder who would choose to be gay.

    He read and reread the Bible's passages on homosexuality. Then he read and reread different interpretations of the Scripture. He wondered if the verses mentioning homosexuality were meant to condemn rape or pedophilia and not love relationships between two men or two women. And holes started to form in his tight theology.

    He prayed to God, long prayers full of questions.

    Why would you make someone like this? Why would you tell them they have to be alone?

    He didn't want to tell Stephen's friends that they were in sin. He didn't want to tell his dying son that his soul was sicker than his body.

    So over the months, a new belief took hold. In Matt's mind, there was no conflict between homosexuality and Christianity, and the hundreds of years of church tradition had been missteps.

    It was only a matter of time before the church realized as much, he thought.

    In the meantime, word spread from the AIDS outreach organizations across the Chattanooga area that a minister's son had caught the virus, and the Nevelses were asked to speak at an evening service at First Baptist in the Golden Gateway. It was considered a watershed moment, because few parents were willing to talk about the infection at the time.

    It would be Matt's first plea with a church to alter its thinking.

    "All have sinned," he said.

    "We have got to quit trying to play God."

    The next Wednesday the Nevelses went to a small evening service at Red Bank Baptist, and Matt spoke up during the prayer requests.

    "It's true that our son Stephen is sick," he told the congregation. "He has full-blown AIDS, and also he is gay. This is like a double whammy that has come to us, and we need all the support and prayer that you can give."

    No one said anything. A handful of women hugged them afterward. They told the Nevelses they would pray. Matt said he watched everyone else disperse.

    •••

    Months later, Matt and Frances moved their son home to die. He'd been whittled away from 160 pounds to 72 pounds. His legs thinned to matchsticks. His cheekbones created a gray frame on his face.

    Experimental medicine ravaged his nerve fibers, and the feeling of the sheets touching his feet at night made him scream for Jesus to take him.

    Cards arrived, with reassurances about resting in God's will. But few hinted at the gay issue. Dr. Steelman sent three notes that Frances kept in a box with all the other condolences, but he didn't visit them or come talk to Stephen.

    One of Dr. Steelman's cards read: "Someone mentioned to me yesterday that Steve's condition has declined rapidly. ... We are praying for both of you that God will grant you the needed strength to deal with your tragedy."

    At the time, Stephen asked his father why no one from the church leadership visited. Matt didn't know what to say. He figured some people were afraid of touching his son. Maybe they were afraid any kindness could be translated as acceptance.

    In 1991, a public battle was raging over homosexuality. The Chattanooga City Council debated whether to allow a gay pride parade through downtown. Students at UTC rejected, then accepted a charter for a gay support group at the college. Gay men were being arrested at popular cruising spots. Pastors were weighing in. Church denominations were splintering.

    When Matt and Stephen were alone at home, the two read the Bible together and tried to make sense of it. Stephen told his father that, four years before, when he found out he had HIV, he promised God he would turn from his sin if God would heal him.

    He tried to change, he told his father. He even told Rick that he was moving out and that he wouldn't be gay anymore. But then he prayed again, he said, and a still, small voice told him to have peace.

    "Am I going to hell after I die?" Stephen would ask his father.

    "What determines if you go to heaven is that you accept Jesus Christ as your savior," Matt told him. "Once you are accepted in God's family, you are not going to be kicked out."

    By Dec. 3, 1992, Stephen was in the hospital again, this time with a jaw infection so bad he couldn't swallow. For 12 days, Matt and Frances took turns staying with him around the clock. He screamed from the pain, and the nurses kept bumping up his morphine.

    Matt read a devotional book aloud to Stephen every afternoon and, on Dec. 16, he watched his son's breathing slow. He kept reading.

    "For I am already being poured out like a drink offering and the time has come for my departure," the verse in 2 Timothy read. "I have fought the good fight. I have finished the race. I have kept the faith."

    As he read, Matt's cheeks grew wet, and the words on the page began to blur.

    •••

    Dr. Steelman visited the Nevelses' home the day after Stephen died. He told Matt and Frances he was sorry for their loss. Frances asked why he had waited so long to come. He said he hadn't known Stephen was home. Matt kept quiet.

    Part of Matt could understand the view of the church, the view that Dr. Steelman held.

    In the beginning, God created man and woman and joined them together. The Bible's words against homosexuality seemed to be written in stone. For centuries, church leaders had either condemned it or buried it. And to alter your thinking on the topic just posed more questions.

    But here Matt was, swallowed by questions.

    How was a man supposed to read Scripture? What else did the church get wrong? Can you toss out certain parts of the Bible and not others? Why were divorce and premarital sex and greed -- all condemned in the Bible -- overlooked but not homosexuality?

    He had watched Stephen die, holding on to God with one hand and the hand of his partner with the other -- unapologetic to the end.

    Stephen had wanted his funeral in the church where he grew up, but he wanted his father -- not Dr. Steelman -- to lead it. All that was left to do was to get the church's permission.

    Dr. Steelman wanted the funeral to be tasteful and respectful of the church, he said he told Matt. The pastor had no questions about what he believed: Accept the Bible entirely or not at all. We all have to walk away from sin, no matter how natural the sin feels.

    The church staff grieved over Stephen, but they were also pained to see how Matt was changing.

    Dr. Steelman said he remembers the helpless feeling. He would be heartless or faithless, depending on what he said.

    But regardless of how Matt was struggling, Dr. Steelman made it clear that he did not want the funeral to be a celebration of Stephen's lifestyle. There were lines the church couldn't cross, Dr. Steelman said.

    But Matt couldn't see them.

    More than 700 people came to the funeral. Stephen's gay friends from Atlanta and Chattanooga and members of Red Bank Baptist sat in the same pews. Dr. Steelman came with his wife and sat in the back because of the crowd.

    A man read a poem in the sanctuary full of people and said Stephen had been a Christian inspiration.

    Rick, Stephen's partner, walked in the processional with the family. He kissed the casket before it was covered with dirt.

    After burying Stephen, the Nevelses kept attending church, but their involvement dwindled. They stayed away from Dr. Steelman and the leadership.

    Other gays at Red Bank Baptist would approach Matt and tell him in confidence that they hoped he could help make a change. One former church member who was gay and dying asked Matt to lead his funeral service at Red Bank.

    As Matt became more outspoken about gay rights, Dr. Steelman worried about his influence. He asked Matt again to be careful about what he said at the funeral.

    A week after Matt buried the man in 1995, three years after Stephen's death, Dr. Steelman chose to make his stance from the pulpit.

    The pastor felt he had to be at least as public as Matt had been with his views.

    He spoke firmly: The institution of the family was under siege, and softening toward sin was shortsighted and wrongheaded. Homosexuality was a sin. Don't be fooled. The church would not change its position on that.

    A few people walked out.

    Matt had his Bible in his lap. His skin turned gray. Frances looked over and worried he was going to have another heart attack.

    Dr. Steelman's words felt like an assault.

    After the service, Matt marched out. He didn't speak a word.

    He never went back.

    •••

    Nearly 20 years have passed since the day the Nevelses left Red Bank Baptist. But on the third Sunday of every month they tell their story at a support group, Parents and Friends of Lesbians and Gays, also known as PFLAG.

    There are no sacraments here, just chips, M&Ms and cheese squares.

    But the people are lost, and in need of a shepherd.

    Matt glad-hands visitors when they enter, pats their backs and tells them what a pleasure it is to see them.

    One week, there is a grandmother with a tight perm and tinted glasses who cries about her grandson. A former lawyer who talks about his dead gay brother. There is a lesbian couple and a transsexual woman and her wife. Another week, there is a couple with a gay son in his 40s and a couple with a gay son who is 12.

    Many of the families tell stories of leaving churches or being asked not to come back.

    Matt tells them about how he and Frances walked away from Red Bank Baptist. How hard it is to find a place now for his faith. He doesn't say it aloud, but he still longs for his traditions, his church.

    When he is alone, he thinks of this absence as a kind of emptiness. He tried other churches but could never bring himself to pull his name from the Red Bank membership roster. His son Keith is still a member there. Matt knows that even Keith and his other children don't believe as he does. They don't think that their brother was born gay.

    Matt doesn't pressure them to change their minds.

    Sometimes he regrets leaving the church. Sometimes he doesn't. He wishes for some grand middle ground. A Red Bank Baptist that teaches the Bible but doesn't talk about "the gays."

    The country's views continue changing. There are medicines for HIV, and people no longer call it a "gay disease." Children will grow up and know the word "gay." They will see gay characters on television and in the movies. They will know that gay marriage is allowed in some states, that the president of the United States recently said he supported it.

    Change has come to Red Bank Baptist, too, although its doctrines remain the same.

    The body recently hired a new pastor, a young man from Louisiana, and Matt wonders if this could be the time to return to the church, to accept its imperfections -- and his own -- and start over.

    "You can't exert any kind of influence if you are outside," he tells his followers at PFLAG. "That is what I am struggling with now."

    •••

    Matt and Dr. Steelman have seen each other around town over the years, at the dentist's office or the grocery store. Neither has waffled publicly on his views, each a stalwart on opposite sides in the culture war. The Southern Baptist church still believes that homosexuality is a sin. So does Dr. Steelman.

    And Matt still believes Jesus doesn't need gays to change.

    When they see each other in public, the two men exchange nods, but for both a strain has remained, disappointment over the other's values.

    But a few weeks ago, a moment revealed a softening between them. Matt began telling people that he was planning to go back to Red Bank Baptist. Dr. Steelman, who still works as an interim pastor at local Baptist churches, heard the news and was surprised, given all that had happened. He felt glad to know Matt and Frances might go back, that the church had meant something to the Nevelses.

    They saw each other from across the meat section at the Walmart in Hixson. Dr. Steelman waved, then disappeared around a corner.

    A few minutes later, the Nevelses saw him coming back around the corner toward them, smiling. He put out his hand to Matt, and Matt took it.

    "I was not trying to avoid you," Dr. Steelman said. "How are you doing?"

    "We are fine," Matt said.

    "How is your family?" Frances asked. "How is your daughter?"

    "She is doing fine," Dr. Steelman said. "I understand y'all are considering going back to Red Bank."

    "Yes," Matt said. "We are going back this Sunday."

    Dr. Steelman nodded. He said he thought that was a good thing.

    To Matt, the little kindness felt like a suture on an unhealed wound.

    •••

    A week later, the Nevels home is busy with Sunday-morning ritual.

    Matt and Frances gather up their Bibles. They banter about the best spot to park. They don't talk about their nerves. It's a short drive to the Red Bank parking lot.

    "Come on, honey. Come on," Frances calls after Matt. She wants to get in the doors before the orchestra starts. They both wonder what will happen in the sanctuary.

    They trickle in with the crowd through the front doors where deacons in black suits hand out church bulletins and good-mornings. The sanctuary is different now. Projection screens come down from the ceiling. New paint is on the walls.

    Yet Matt can't help but remember another day. Looking toward the pulpit, he pictures Stephen's casket. He pictures Dr. Steelman, firm and resolute.

    But the vision is quickly interrupted by voices. Graying women and men bring handshakes and hugs.

    "Where have you been?"

    "I thought about you the other day when I was up at the cemetery."

    "It's good to see you."

    "I haven't seen you in a long time."

    Matt's face brightens. He walks toward the front.

    The doors close at 10:30 a.m.

    The trumpet sounds and the people sing.

    "Rejoice. Rejoice. ... O Church of Christ, rejoice."

    Matt's voice rises above the rest.

    •••

    Reprinted by permission from The Chattanooga Times Free Press, June 24, 2012. Contact reporter Joan Garrett here.

    Show more
    Explore related topics: gay, religion, aids, chattanooga, homosexuality, baptist-church
  • 30
    Dec
    2011
    2:58pm, EST

    Michigan man may have intentionally infected hundreds with HIV

    A Michigan man has admitted to police, and at least one victim, that he intentionally infected sex partners with the HIV virus. WOOD's Leon Hendrix reports.

    By M. Alex Johnson, NBC News

    Updated at 4:50 p.m. ET: David Dean Smith's attorney, Richard E. Zambon of Grand Rapids, tells msnbc.com that he plans on "exploring all options" in defending Smith, saying specifically that "I am concerned about his mental health."

    Zambon said he hadn't yet seen all of the police and medical records in the case and couldn't talk about specifics, but he said the law under which Smith was charged is a "relatively new statute with not many cases having interpreted" it, meaning few court precedents have been established. 

    Original post: A Michigan man has been charged with felony sex offenses after he told police he was HIV-positive and had set out to intentionally infect as many people as he could, police said. Health officials have issued an alert warning that "possibly hundreds of people have been exposed to HIV."

    The man, identified as David Dean Smith, 51, of Comstock Park, north of Grand Rapids, was arraigned Wednesday on a second count of "AIDS-sexual penetration with an uninformed partner" after police said they had identified a second possible victim.

    Smith was initially charged with one count after he went to Grand Rapids police last week and said he had intentionally had unprotected sex with as many people as he could over the last three years, according to police.


    According to documents on file with Grand Rapids 61st District Court, Smith claimed to have had sex with "thousands" of partners, intending to kill them by infecting them with HIV. Some of those people are from outside the Grand Rapids area, including people Smith met over the Internet, he told police, according to documents.

    Follow @MAlexJohnson

    Smith faces separate preliminary hearings on the two charges on Jan. 4 and Jan. 9. He remains in the Kent County Jail in lieu of $100,000 bond. Smith's attorney did not immediately reply to requests for comment.

    The Kent County Health Department issued an alert Tuesday warning that "hundreds of people may have been exposed to HIV," urging potential victims to come forward and encouraging everyone who may have concerns to be tested for HIV.

    Vitals: AIDS discovery could put virus on the run, bioethicist says

    One of the two possible victims police say they have found so far said in an interview with NBC station WOOD-TV of Grand Rapids that she was diagnosed with HIV in October 2008.

    The woman, whom authorities and NBC News are not identifying, said she knew immediately that it was Smith — whom she said she met through an ad on the Yahoo! Personals website — who had infected her. She called him "a predator" and "a sociopath."

    The woman said Smith sent her a text message letting her know that he was going to surrender to police. The message read: "Turning myself into the law, my life is over. Take care. Always love you."

    "It's something he should have done years ago," she said. "He shouldn't get a pat on the head for what he did."

    Smith said at his arraignment Wednesday that he has been undergoing counseling. Court documents show that Smith was admitted to Pine Rest Christian Mental Health Services recently because he was "suicidal" and had tried to kill himself at least once.

    The records say the hospital determined that Smith is "sexually aroused by causing pain to females."

    A Facebook page with Smith's name, address and pictures says he graduated from Harry Hill High School in Lansing in 1978 and studied at the University of Phoenix, a for-profit online institution. It shows that he has worked in telecommunications for several companies.

    Posts to the account stopped on Nov. 30. Before then, the account owner posted some messages that could possibly be interpreted as alluding to his situation.

    "Someone special to me asked me a question about scandulous people, this was my thought," he wrote on Nov. 5. "Let me know what ya think. When you are young you believe people will love you like you want and keep an eye out for those scandulous people...as you get older you realize most everyone is scandulous so you dont trust anyone but keep an eye out for the special ones that truley care."

    A day earlier, this message appeared:

    "I pray for blessings to all I know, for forgiveness for my shortcommings to them and that they may no peace. And last, that I love them all as much as I can."

    Vitals: Double whammy of setbacks cripple war on AIDS

    The woman who spoke to WOOD said she had no doubt that there are many other victims. She said Smith told her that he had had sex with as many as 3,000 people, including men as well as women.

    "He hits drifters," she said in the interview. "He hits people who are young. He hits young women, and from what I understand, he hits men, too. Those are his targets."   

    Dani Carlson and Leon Hendrix of NBC station WOOD of Grand Rapids, Mich., contributed to this report. Follow M. Alex Johnson on Twitter and Facebook

    More content from msnbc.com and NBC News:

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    • Butt injections, free breast exams: Florida's 2011
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    865 comments

    by the looks of this guy i think 5 might be a little closer then 1000's.well at least he doesn't have self esteem issues

    Show more
    Explore related topics: michigan, aids, crime, hiv, featured

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