Florida Agenda

Alex Vaughn

No, five grand per month is not what I earn. Nor is it, as some claim, what I outlay monthly on my grooming or clothing. Five thousand dollars a month is what someone could expect to pay for HIV medication in Broward County.

If you don’t have insurance that is the minimum it would cost you for the crucial medications that would keep you alive. If you have insurance, it’s a different story. Otherwise, five grand is your bottom line – not including doctor’s visits or anything other than the pills themselves.

Since many people here in Florida don’t have medical coverage, and state AIDS programs are completely underfunded, then you are pretty much screwed.

In this economy, you would be very lucky to be pulling in $5,000 per month. Would it be possible for anyone to expect someone to spend their entire paycheck solely on meds without even taking into account basic living expenses?

Well the answer is yes. Yes, it is very possible to expect because, as with every healthcare system all over the world, it is flawed. If you earn below a certain amount, you can be eligible for a program that will cover your meds. However, once you exceed that cap, you will be dropped. So realistically without insurance, if you exceed the cap, the only way to do it and to pay for your meds would be to pull in the salary of a banker.

Why does this happen? Well partly due to the fact the state can’t pay for everyone’s meds who don’t have insurance. The money simply isn’t there.

The bigger question, however, is how can the drug companies justify the expense, when countries all over the world including the UK offer HIV meds for free? Well that in itself is an explanation. The US HIV positive individuals are largely contributing to the funding for the drugs for all over the world!

As World AIDS day arrives, we can look back over 30 years of a disease that has changed the face of the globe and put the gay community’s progress back immeasurably. The question everyone asks is why has a cure not been found? Why is there still no complete vaccine?

We hear every so often in the news about “being close to a cure,” about vaccines,  and about new ways of using drugs to prevent infection in the first place including the use of Truvada. Yet realistically, there seems to be a major stick when it comes to the cure.

Many argue this is because the drug companies don’t want to find a cure. They are making far too much money off the drugs they offer currently. In addition as highlighted by Christian Alexander in the Florida Agenda a few weeks ago, they are no longer focused on producing new medications. Instead, they are recombining and configuring older medications to ensure that patents exist and that generics can’t be offered at a lower cost in their place.

From an outsider to the pharmaceutical industry, as many of us are, it seems the companies are so busy redesigning the drugs that they have lost sight of the aim of drugs in the first place; to help keep people alive.

The worrying part of this perceived loss of focus is found in those for whom the new combinations haven’t worked . Their only hope now is a miracle. These people are not responding to the old drugs in new packaging, just as they didn’t respond the regime in its old format. They are asking the question we all should be asking–where are the new meds?

Many people are still arguing that the medical research community has all but abandoned the search for a cure, saying that a vaccine and treatment are more viable routes to take because many people are able to survive due to antiviral drugs, turning HIV into a chronic condition rather than a death sentence.

In the news this week alone, there has been talk of a cure. The information comes from a man who had treatment for leukemia and through an intense bone marrow procedure, now tests as HIV negative. Though promising, this type of treatment is not logistically possible as a cure. In addition, it is extremely risky.

The reason it was successful is because the donor was in the 1% of people who are naturally immune to HIV. Scientists have noted that these special donors lack the CCR5 gene, which is a protein on the surface of immune cells that the virus uses as an entry portal.

This has led scientists to explore this further, yet they are clear to say it could be years, if ever, that a cure is found. All of which leads us back to the question of why? With so much information, generated by the discoveries gathered over 30 years, shouldn’t there be a clearer goal of an AIDS-free generation in sight?

Finance is always key. According the New York Times just this week, The National Institute of Allergy and Infectious Diseases says a cure is one of its top priorities, this year awarding grants that could total $70 million. More grants are coming. California’s stem-cell agency has committed a total of $38 million to three research teams over five years to fund projects intended to find a cure.

Companies like Merck, Gilead Sciences, Sangamo BioSciences and Calimmune have begun research.

As we observe World Aids Day, we have to remember those lost, and stand united in finding a cure. Donate money, talk to your doctors and do your research. Remember the one pill-a-day myth may not apply to you and, even if it does, you may need $5,000 a month to pay for it.

Alex Vaughn is the Editor-in-Chief of the Florida Agenda. He can be reached at editor@FloridaAgenda.com

ALEX VAUGHN

There is a new blue pill that is set to revolutionize our attitudes towards HIV and safe sex. I’d even go as far as to say that this pill will make us question the entire idea of sexual responsibility. The pill is Truvada PrEP (pre-exposure prophylaxis) and it is already available in a pharmacy near you.

Truvada has been widely used in the treatment of HIV positive individuals. However, as early as this year, the FDA is poised to approve the drug as a means to prevent infection. The Centre for Disease Control and Prevention (CDC) already have in place a set of guidelines for using this pill as a prevention method against HIV.

In theory, this little blue pill has the potential to do as much harm as good, just like Viagra has. Of course with Viagra the situation is markedly different. As with all medications, Viagra comes with side effects and warning labels. It isn’t, or shouldn’t be, a daily pill. There is no regime to be followed. There is also a completely different minds

et attached to it. Viagra is not a preventative health aide; Truvada is.

The studies shown to determine the effectiveness of the pill as a preventative method were favorable, obviously leading to the FDA’s considerations. The variables and conditions to its success, however, are many and they are all relevant. The fear of course is those concerns will fall to the wayside when we are discussing the simplicity of one blue pill to protect you from the worst contagious disease affecting the community and the world.

When taken daily, Truvada had been shown to be 95% effective at preventing infection with HIV. Those who did become infected during the trial period were shown to not have enough of the drug in their systems indicating that these subjects did not adhere to the daily regime.

The study has clearly shown that one must be completely strict with the one-aday regime. Unlike Viagra, Truvada is not a “pop it on the weekend” sort of recreational drug. It is a lifestyle choice. With multiple partners and promiscuity, protection will not exist if one only pops a pill before hitting the hay.

In addition, the studies indicate that the best role for this pill is in relationships that are serodiscordant. Meaning one partner has HIV and the other doesn’t. In this situation, adherence is more likely as there is a strong mutual desire for protection.

Furthermore Truvada is not something you can pick up from a buddy with a party supply kit. It simply won’t work. You need to consult with an HIV specialist and determine whether it is for you, while noting that this is not a 100% protection against HIV.

Sex, as pleasurable as it is, comes with other risks, syphilis, HEP and a host of nearly 12 million other STDS. Truvada doesn’t protect you from any of these. Only condoms will.

This is undoubtedly a great step forward and an amazing change to the landscape of sexual interaction between partners of mismatched status. In addition with the hope that it remains successful, it will help breakdown prejudices towards HIV+ people.

That said, the danger of unleashing such a powerful statement into the community is astronomical. The reality is that the warnings are going to get lost in the simple message of “one little pill for HIV protection.” There will be many responsible people who will research, try, test and get to grips with this pill. There are more who will breathe a sigh of relief and pop a pill before they do the deed and think nothing of it.

This will also go a step to downgrade HIV further, from a dangerous and life threatening disease with potential complications to a totally manageable disease. After all, how bad can it be if you can prevent it with a little blue pill? The real danger is that this disease will no longer be seen as manageable with side effects, but rather as no big deal at all.

As HIV infections continue to rise in Florida, the need for prevention is undoubtedly present and the message needs to be loud and clear. Though the study was quick to indicate that condoms were offered free of charge and that their use in studies had increased, the reality is who will bear that in mind. If you are less than strict with your condom use, are you really going to become more stringent when you know you’ve popped a pill?

This “pop a pill” mentality is found not only within the community, but in the nation as a whole. You can’t watch TV for more that 20 seconds before some pill is being advertised, for something or other, from depression to restless leg syndrome.

Add the prospect of another pill, and it doesn’t faze or frighten everyone. It, in fact, makes life so much easier. Why worry about condoms or status when you just need to remember to pop a little pill everyday?

The flip side is that despite the fact that you are not sick, you are providing your body with a medication to which it may react badly, and all to avoid a condom? There is also the question of what happens if you do maintain the treatment, yet still fall into the 5% that contract the virus anyway. Have you screwed yourself ? Will your body have built a tolerance to one of the most widely used treatments for HIV?

It has been noted by the study’s doctors that resistance cannot develop with the use of this pill since actual infection has not taken place. However condoms remain the main protector. Unfortunately, at the same time, the same doctors noted that many people had already stopped using condoms. Truvada would offer another protection route.

The coverage of one-a-day medications complete with the shiny happy people on the HIV medication adverts suggests that life goes on. This has allowed a generation who never experienced the 80’s to have a blasé attitude to the disease. The real danger is that lost amid the excitement of the availability of Truvada, the horror of AIDS will be forgotten.

Alex Vaughn is the Editor-in-Chief of the Florida Agenda. He can be reached at editor@FloridaAgenda.com

Alex Vaughn

A perception is a judgement and every minority – and, by token, the majority – has been labelled. We see a particular person and make a judgement, about who they are, where they are from, what they do and how they think all from a set of benchmarks we have either been taught or have compiled from experience.

Recent statistics have shown that acceptance of the gay community is on the rise and coming into a clear majority. But, when you get down to the nitty-gritty, you have to ask how much have perceptions changed?

Over the course of many years, there have been cruel and unfounded beliefs about the community, that gay people are pedophiles or disease carriers. HIV/AIDS was initially dubbed ‘the gay cancer’ only affecting gay men.  It was seen as ONLY a gay disease. As education has evolved, so too have perceptions. Most of us now understand HIV/AIDS does not discriminate against gender or sexual orientation.

As understanding has developed, so too has acceptance. Times have undoubtedly changed and one could perceive that perceptions of the community have not only changed, but have evolved into the positive.

However, if we look a little deeper we can see that for every change there are still areas in which gay people are hugely discriminated against, even though there is scientific  evidence and statistics to the contrary.

One example: Statistics show that heterosexual men are more prone to pedophilia than gay men, and a lot of the ‘evidence’ that people used to support the idea gay men were pedophiles was what people referred to as ‘sexually deviant behavior’. Even though
evidence is now clear that pedophilia is rife in the heterosexual community, people still see gays as perverts and deviants.

In addition, just this week a straight man was turned away from a blood bank for looking ‘too gay’. There is still a FDA ban on gay men donating blood.

In the early stages before HIV/AIDS could be determined with a blood test, the fear was that a gay HIV-positive male could infect a blood supply. Fine. However, as we have moved on in our knowledge, before you now donate blood, tests for HIV/AIDS are mandatory for ANYONE donating blood. This fact has led activists – and even The Red Cross – to argue that the ban is clearly ‘medically and scientifically unwarranted’. If the ban was lifted, it is  estimated it would add 200,000 pints of  blood to the national supply.

The fact that it hasn’t been lifted shows in my mind that the reason to keep it – if it is ‘medically and scientifically unwarranted’ – is simply due to the fact that perceptions towards gay men have not changed and that the social stigma of the fear of the 1980’s has not dissipated as much as we would like to think.

Globally, when we talk about America, we mean Miami, New York, Boston, Seattle, LA, San Francisco, Washington D.C. and Fort Lauderdale to name but a few as meccas for the gay community, but those are just cities, they are not the majority of the USA. On the whole, however, these cities and others are, in effect, the parenthesis to the USA. The majority of the center and south is where the community still needs the proverbial makeover – where perceptions still need to be severely worked on to ensure that people see us as not only equal but, most importantly, not a threat.

Whilst writing this and thinking about perception, I can’t help but notice that in the community we have a considerable ‘perception PR’ issue. We look at subsets of the community without equality and judge swiftly. The stylish are arrogant, the slovenly considered junkies, the skinny must be meth heads or diseased, the fat are lazy and so on and so forth – and that’s not even getting into the mine field of gays vs. lesbians or gays and lesbians vs. transgendered. It’s odd, really; we work to get others to accept us because we offer the image that the LGBT and even Q is a uniquely dynamic and unified community. If we turn around, sadly we would see that our true perceptions of ourselves are not exactly what we project. Maybe we need to change the perceptions we have of each other, the fact we still call fellow gay men ‘her’ or ‘she’ or ‘faggot’ surely can’t help the cause!

Then, of course, we can’t forget the media, TV and movies have undoubtedly continued to lead people’s view of the gay community with their still stereotypical gay best friend, or the nympho or the lesbian who goes to Home Depot. On one hand, for comedic purposes one has to ask how harmful is it? Well, to someone who is educated about the community, it’s not. But if you are still trying to show people equality and change the perception that not every gay man sounds like he is on helium, is bouncing from boyfriend to boyfriend and has a penchant for jazz hands, then perhaps those less stereotypical need to stand forward.

Stereotypes come from somewhere and they do exist, but there is a great deal of people in the LGBT community who don’t fit the mold and, ironically, they can really help the cause of enhancing and clarifying others’ perceptions of the community as a whole.

However, you would never know them – they aren’t at gay pride, or the bars, or circuit parties or clubs. They aren’t in malls working behind the perfume counters.  They are the bankers, lawyers, waiters, tech guys and the like who have adapted into society without flair or scene, but are happy to have a life unburdened with the fight. In a way, that is what the fight is for:normality.  To be left in peace and treated equally, yet they are perceived by their own community as hiding and ashamed.

Maybe; maybe not.

The fight goes on for equality and for the future, and that is necessary and will be a long one but, as individuals, you can check yourself.  Before you let your perceptions of others lead you to judge and dismiss, remember someone is doing the same to you right now!

If the doors of perception were cleansed everything would appear to man as it is,  infinite. – William Blake

Alex Vaughn is the Editor-in-Chief of the Florida Agenda. He can be reached at editor@FloridaAgenda.com

By Alex Vaughn

Thirty years ago Sunday, on June 5, 1981, the first cases of what would become known as AIDS were reported. The disease that was centered in San Francisco was first detected in Los Angeles. Those first cases were reported as “Pneumocystis carinii pneumonia (PCP).” A UCLA researcher, Dr. Michael Gottlieb, published articles about “otherwise healthy young gay patients experiencing fungal infections and PCP” in the Centers for Disease Control’s Morbidity and Mortality Weekly Report.

The articles caught the attention of doctors in the Bay Area, who noticed similar symptoms in their patients. San Francisco General Hospital admitted its first AIDS patient in July of 1981.

By October, five months after the first cases were reported, the Centers for Disease Control declared the new disease an epidemic. A year later, the CDC gave the disease a new name – Acquired Immune Deficiency Syndrome (AIDS). “They finally gave a name to the horror that was about to begin,” said West Hollywood Mayor John Duran, who was diagnosed with AIDS in 1994. “For many of us, it has been all encompassing for most of our adult lives.” The anniversary is top of mind for the hundreds of bicyclists who are spending this week raising money for AIDS research. The 7-day bike ride began in San Francisco Sunday morning and will end in Los Angeles next weekend. Riders say it’s a life-changing effort for the riders. Organizers say the ride is designed to advance their shared interest to end the pandemic and human suffering caused by AIDS. In the past 30 years, 25 million people have died due to AIDS-related illnesses. Right now, more than 33 million people are living with HIV/AIDS. More than two-thirds of the current cases are in Africa, where the epidemic rages out of control despite prevention efforts.

On the anniversary, however, hope is still powerful and, with advancements in medications, there is belief in the future. Michael Beatty is proof of the strides made since the disease was identified three decades ago.

“There was a time in my life I never thought I’d live to see 30,” Beatty told 7 NEWS Reporter Don Champion. He was infected in 1985. His diagnosis came at a time when the disease baffled doctors and scientists alike. Headlines back then referred to the disease as the “gay plague.” The survival rate was zero percent. Things started to change as the development of drugs like AZT helped prolong lives. Years later, in 1995, the approval of protease inhibitors began bringing patients back to life. Hope was born.

Dr. Benjamin Young, medical director at Rocky Mountain Cares, has studied HIV treatment since 1995. He admits that treatment is no longer a problem; instead, it is getting people tested. It’s a problem he blames on stigma. “The act of requesting a test can be seen as an admission of some sin and taboo,” Young said. “It’s a barrier to getting tested. It’s a barrier for doctors asking about getting tested.”

Colorado has played a major role in the fight against HIV/AIDS. The University of Colorado was the site of early research. The Denver Principles, which spell out rights and responsibilities of people living with HIV, were drafted here. The work hasn’t reduced the impact the disease has had on the state. According to Rocky Mountain Cares, between 350 and 500 new cases of HIV have been reported in Colorado every year since 1995. The numbers are one reason Beatty focuses his work on prevention. He works as Program Director of the Denver Element, a group that helps spread the word to gay men in the city.

For Shannon Southall, it’s about spreading the power of prevention to women. They make up more than half of infections worldwide. She tries to share a message that, Southall said, women in America have been slow to embrace, especially women of color. “It means we need to start doing more education. And not only with women that are putting themselves at risk, but also those who don’t realize they’re putting themselves at risk,” she said.

So, will we see a cure in the next 10 years

? “That ‘C’ word is a really big one,” Young said. “I’m very cautiously optimistic.”

At 58, Forest Frantz is old enough to remember the fear and the hysteria. “I remember from the very beginning, reading the first article in the early 80’s and being scared to death,” he says. The epicenter may have been 90 miles away from him in San Francisco, but the shockwaves were felt in Sacramento. It was the early 1980’s, Frantz was 28 and gay men were dying horribly painful deaths. “And looking for every lesion, every, everything that could possibly be. I watched people die for all these years.”

Skin lesions marked the earliest cases. ”My friend, we’re talking about thousands of men,” and a promiscuous Canadian flight attendant was branded patient one in the 1993 HBO Movie: And the Band Played On. At the time, the survival rate was zero. Diane Jones was a nurse at San Francisco General Hospital, “What is still happening is that if I sit down with someone and tell them they are HIV positive, they are still reacting the same way they did 30 years ago. Am I going to die? I can’t tell anybody.”

Even today, the social consequences can be severe, and gay advocate Paul Luna says he knows people who’ve lost jobs. ”People can’t say it because they could lose their friends, their family, their jobs? Yes!”

An estimated 1.7 million people have been infected with HIV in the United States since the start of the epidemic, and 600,000 have died. But new infections have dropped by two-thirds over the past three decades.

Ever improving drugs are allowing the infected to live longer. But 30, even 20 years later, young gay men are again promiscuous; many, simply never seeing the consequences, never seeing someone die from AIDS. ”Certainly it was a pressing issue when I came out. The first thing my mother did was break down and cry and said: ‘I don’t want you to die of AIDS,’ says Camera Scot who came out of the closet when he was 19.

Forest Frantz has been HIV positive for 25 years, “Every time a person passed away, you thought of your own mortality.” Frantz says he was infected by his first love, a man who died 3 years ago. ”It brings back a lot of memories because I’ve seen a lot of people that were close to me, really close to me, that are gone.”

More than one million people are living with some form of AIDS today in America. But the Centers for Disease Control states 1-in-5 people don’t know they’re infected.

Who Knew?

By Sam Knew

Most of us spend our lives avoiding contracting even the slightest germ, much less an infective virus. We live in a world of hand sanitizer stations at shopping centers and medicine cabinets filled with multi-vitamins and some sort of natural tea product. So, it may be unimaginable that there are individuals intentionally seeking out diseases, hoping they will be lucky enough to get bitten by “the bug”. They are called bug chasers. This term usually refers to a sub-culture of gay men that intentionally seek to get infected with Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS).

It is still not understood what motivates these individuals, but many theorize it may be the desire for a sense of belonging. Bug chasers may long to be part of a nurturing and compassionate part of a community, as found within the HIV+ population. Others conclude some people feel so overwhelmed by the possibility of contracting HIV, they prefer to “get it over with.” The short film The Gift explores this rare phenomenon, documenting a young man’s sense of relief after being diagnosed HIV+. The Gift’s director, Louise Hogarth, adds the increasing false sense of the lack severity in contracting the virus may also be a contributing factor. Some believe the disease has become more of a manageable illness, controllable with just a pill. This school of thought has encouraged individuals to let down their guard, being less disciplined in their safe sex practices.

This fringe population of bug chasers is accommodated by “gift givers.” These are individuals that are willing to infect bug chasers.

This pairing of bug chasers and gift givers usually comes together online. Though the compilation of these two groups is a very small subset of the population, they have developed a culture of their own, including “conversion parties.” This is one means by which HIV+ men and those looking to be infected can meet.

Usually only one individual is HIV+ (known only to the individual himself and the host); the other members of the party participate in unprotected sex in hopes of being infected, commonly referred to as  getting “pozzed up”.

The question of these individual’s mental health and legal responsibility are just beginning to be examined. There is still little research or actual statistics on how many people are purposefully seeking sero-conversion, and less  on people who have sero-converted  intentionally. Additionally, nearly half the states have laws against infecting individuals, but even most of those laws are not prepared to address the consensual transmission of HIV.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

Photo: (top) This graphic image is being used in a French HIV/AIDS?awareness campaign.

What the HPTN 052 Study Means for Gay Men

By STEPHEN FALLON, PHD

Big news lit up the Internet this week: HIV treatments seem to block the virus from spreading during sex. Researchers from the National Institutes of Health tracked more than 1,700 couples and found that “earlier initiation of (the medicines that fight HIV) led to a 96 percent reduction in HIV transmission to the HIV-uninfected partner.”

How does this work? Anti-HIV medicines interrupt the virus’ ability to multiply inside a person. Scientists suspected that if there’s less HIV in a person it’s less likely that any will leak out in their sexual fluids.

Up until now, most prior studies have traced backwards from outcomes.  Researchers couldn’t be sure if some other cause might have lowered contagion. This time, they enrolled people first then watched what happened when they took medicines. That makes this study more convincing.

• Isn’t this great news in the battle against AIDS?

Don’t flush the condoms yet. It turns out, 97% of the couples studied were heterosexual, and half were women. While the protection afforded during straight vaginal sex probably applies to gay anal sex, too, this wasn’t specifically proven.

More importantly, nearly all of the patients studied were living outside the United States. Researchers had “difficulties enrolling (U.S.) participants into the study.” It’s possible that patients in the other countries (Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, and Zimbabwe) were more diligent about taking their medicines than typical Western patients are, because the consequences of HIV are starkly more visible in their homelands.

Unfortunately, HIV is not a forgiving disease; if patients skip more than a few doses the virus roars back. In the U.S. and Europe, patients who start out faithfully taking HIV medications typically backslide after two years on treatment, dropping to take less than three-out-of-four doses on time.

If people skip doses, their virus levels won’t drop enough, and any prevention benefits will disappear. Worse, if they spread HIV now, it will probably be a more deadly, drug resistant virus. A 2002 study found that among people unable to fully control their virus, every tenfold increase in HIV levels made them 81 percent more likely to pass HIV to a partner.

• Whether or not HIV medications stop new infections for U.S. gay men, shouldn’t everyone who’s HIV+ take medicines right away, to protect their own health?

Here, things get much murkier. The question about when to start treatment has been debated for years. Delivered at the right time, anti-HIV medications add years, or even decades to life expectancy.  But they also often trigger troublesome side effects such as diarrhea, nausea, fatigue, sleep problems, sexual dysfunction, and even hair loss. Over time, their effects on the body’s balances can lead to heart attacks and strokes, liver failure, anemia, diabetes, chronic depression, kidney failure, embarrassing changes in body shape, and more. So the rationale has been to spare people these effects, and only start prescribing medicines when they’re truly needed to support life.

The new NIH study may lead physicians to prescribe HIV treatment even earlier than the nation’s guidelines currently recommend. But it’s not yet entirely clear that the earliest possible treatment lengthens life. It might just add more years of side effects without any net benefit.

Even this week’s study did not find a definite life benefit for those under early treatment. The authors noted, “There were also 23 deaths during the study. Ten occurred in the immediate treatment group and 13 in the deferred treatment group, a difference that did not reach statistical significance.”

• “It’s time for you to take my pills for me.”

The new study raises an ethical question: who is treatment for? If HIV treatment can truly stop the virus from spreading, then shouldn’t it be “forced” on people living with HIV, whether it adds years to their lives or not? Is treatment supposed to benefit the person living with HIV, or protect the person who might have sex with you?

Unfortunately, very early treatment for the sake of prevention might cause people to “burn through” the best medicines early in their infection, leaving nothing to fall back on when their immune prognosis becomes dire. This would consign those living with HIV to additional years living with complications, and possibly a shorter life expectancy, all in the name of protecting others.

Public health officials do impose treatment for medical conditions such as multi-drug resistant tuberculosis, which can is passed to others through casual contact. But HIV is not that sort of disease. It transmits only through specific, intimate contacts (unprotected sex, sharing needles, nursing babies, rare hospital mistakes). So uninfected people can consciously protect themselves from HIV.

In fact, the most important step to prevent the spread of HIV is simply getting people tested. The vast majority of diagnosed people take steps to protect their partners. Diagnosed people living with HIV have just a one-to-two percent chance of passing their virus each year, and that number is driven up by a few bad players; many never infect anyone else.  Even in the NIH study, only 27 partners of the nearly 500 persons not taking treatment became infected over six years.

What if the gay community comes to believe that treatment provides the best firewall against infection? Will guys be less likely to use condoms? Is the pill bottle a more effective condom?

Pills can’t help when nearly ten percent of all people newly infected had caught HIV from someone else who was himself also just infected. During this early phase, the tests often can’t detect HIV.

Here’s a scarier reason not to count on someone else’s medicines to protect you: it’s easier to verify that a guy is wearing a condom right now than to prove he has taken his medicines all week. What if a horny guy just tells you that he’s on treatment?

Medications should be dispensed primarily to benefit people living with a disease, not packaged in a rationale to defend the rest of us from their illness.

Of course, there will always be slip-ups: popped condoms and missed doses.  That’s why neither condoms nor medicines alone will prevent every infection.  We need treatment and prevention, not treatment as prevention.

SOURCES:

HIV Prevention Trials Network Report 96% reduction in HIV transmission with treatment:  National Institutes of Health, National Institute of Allergy and Infectious Diseases. “Treating HIV-infected People with Antiretrovirals Protects Partners from Infection: Findings Result from NIH-funded International Study.”  May 11, 2011. http://www.niaid.nih.gov/news/newsreleases/2011/Pages/HPTN052.aspx

Newly infected heterosexual with high viral load 12x more likely to infect their wives: Wawer M.  “Rates of HIV-1 Transmission per Coital Act, by Stage of HIV-1 Infection, in Rakai, Uganda. The Journal of Infectious Diseases.” Journal of Infectious Diseases, May 1, 2005;191:1391-1393,1403-1409.

HIV levels in semen typically 20x higher during first two months of infection: Pilcher C.,
et al. “Estimating transmission probabilities over time in acute HIV infection from biological data,” 9th Conference on Retroviruses and Opportunistic Infections, Feb. 24-28, 2002; Poster 366-M.

Low adherence rates with other chronic diseases:
Glaucoma Kass et al.  (asymptomatic) AJO, 101:515, 1986.
Epilepsy, Cramer et al.  (asymptomatic, until episodes) JAMA 261:3273; 1989.
Ankylosing Spondylitis (pain causing condition) de Klerk & van der Linden.

HIV treatment adherence declines by two years:  Lima V, Harrigan R, Bangsberg D.  “The Combined Effect of Modern Highly Active Antiretroviral Therapy Regimens and Adherence on Mortality over Time.”  Journal of AIDS 2009, Vol. 50; No. 5: P. 529-536.

Old belief that medicines could push HIV out of a person forever:  Ho D.  “Toward HIV Eradication or Remission: The Tasks Ahead.“ Science 19 June 1998:
Vol. 280 no. 5371 pp. 1866-1867
Ho D.  “Can HIV Be Eradicated?” 4th Conference on Retroviruses and Opportunistic Infections, January 22-26, 1997, Washington, DC.

Directly observed TB therapy:  Salomon J, et al.  “Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis,” Public Library of Science Medicine 2006;3(7):e241.

Acutely infected account for spread of 9% of all new infections: Pinkerton S.  How many
sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission?  AIDS. 2007; 21(12): 1625–1629.

Risk of a PLWH passing virus is 1% – 2% per year: Holtgrave DR, Anderson T. Utilizing HIV transmission rates to assist in prioritizing HIV prevention services. Inernational Journal of STDs and AIDS. 2004;15:789-792.
Holtgrave D. “Estimation of Annual HIV Transmission Rates in the United States, 1978-2000,” Journal of Acquired Immune Deficiency Syndromes 2004;35(1):89-92.

First true link demonstrates decreasing VL = decreasing odds of transmission for HIV 1-E: Tovanabutra S, et al.  “Male Viral Load and Heterosexual Transmission of HIV-1 Subtype E in Northern Thailand. Journal of Acquired Immune Deficiency Syndromes. 29(3):275-283, March 1, 2002.

Patients can burn through all available medicines in a few years:  Sabine C, et al.  “Treatment Exhaustion of Highly Active Antiretroviral Therapy (HAART) Among Individuals Infected with
HIV in the United Kingdom: Multicentre Cohort Study,” British Medical Journal March 2005;330:695.

FORT LAUDERDALE, FL – In July, Broward House plans to open its twelfth facility. After six months and over $200,000 of renovations, the newest facility will be open in Sailboat Bend.

The project has 2 2-bedroom units and 7 1-bedroom units that will house individuals and families living with HIV/AIDS. These units are made affordable through a subsidy from HOPWA (Housing Opportunities for Persons With AIDS/HIV).

The new housing facility was made possible through a recent grant from Doug Greene of the Green Family Foundation, which helps with the landscaping of the property. Broward House is looking for other individuals, corporations and foundations to help the project come to fruition. They are also looking for help with painting the outside of the building and make other minor touches throughout the property.

One of the units has already been adopted by the Samuel and Hannah Holzman Trust. A plaque outside will be hung recognizing and thanking them for their generosity.

WASHINGTON, D.C. – The Smithsonian’s National Museum of American History will mark the 30th anniversary of the emergence of what became known as the HIV and AIDS epidemic with a three-part display and website beginning June 3.

“HIV and AIDS Thirty Years Ago” will look at the public health, scientific and political responses in the early phase (1981-87) of the global pandemic. This showcase will be located in the museum’s “Science in American Life” exhibition, which focuses on the connections among science, culture and society in American history. The display will feature photographs, magazine covers and other graphics plus equipment that Dr. Jay Levy used to isolate the virus in his lab at the University of California,  San Francisco, a copy of the Surgeon General’s 1986 report presenting the government’s position, samples of the drugs AZT and Retrovir and public health information pamphlets from AIDS service organizations.

The website is available at americanhistory.si.edu/hivaids.

In “Archiving the History of an Epidemic: HIV and AIDS, 1985-2009,” the museum’s Archives Center will show how individuals and society were affected by the epidemic through a selection of archival materials from its collections, including posters for the 1993 movie Philadelphia with Tom Hanks and Denzel Washington and the 1989 film Longtime Companion, brochures, photographs and other popular culture materials and quotes from oral histories of people affected by the epidemic.

Pride Center Testing Adds Locations Throughout Broward County

Photo: Listron “Blue” Mannix 

Recently, Pride Center Testing (PCT) began off-site HIV counseling and testing in several new locations throughout South Florida.

The Club Fort Lauderdale, a local private gentleman’s club, welcomed PCT to provide testing services on Tuesdays and Thursdays from 8 p.m. to 12 midnight and at the popular Sunday poolside barbeque from 12 noon to 5 p.m. PCT added three private testing sites through Broward Addiction and Recovery Centers in Coral Springs and Fort Lauderdale. The Pride Center now also provides weekly testing at Ana G.

Mendez University in Miramar on Fridays from 10 a.m. to 5:30 p.m. and provides testing at Florida Atlantic University health fairs and other local events.

“We’re excited about these expansion opportunities,” says Listron “Blue” Mannix, Minority Testing Initiative Manager for the Pride Center. “As we further develop our relationship with the communities we serve, Pride Center Testing will flourish. We continue to encourage the community to seek testing. We commit to providing timely results and offering thoughtful, compassionate counseling. We continue our role in the overall strategy to fight HIV/AIDS in our communities.”

In 2008, the Center began off-site testing — in addition to its popular on-site Rapid HIV Testing — at the Cooperative Feeding Program, a local homeless shelter. The Center continues to test there every Monday and Friday from 9 a.m. to 1 p.m. The Center also began testing at the Black Banana Night Club in 2008. Since then, PCT has been involved in testing at community events, health fairs and other organizational locations.

“Over the years, we’ve developed a good reputation and relationship both with the Florida Department of Health (DOH) and Centers for Disease Control and Prevention (CDC) allowing us to become a leading provider of HIV testing, counseling, referral and linkage to care in the community,” says Mannix. “We’ve been doing this well for over 15 years.”

At the Equality Park campus on Dixie Highway in Wilton Manors, the Pride Center’s free Confidential Rapid HIV Testing hours for walk-ins are Monday to Friday 10:00 a.m. to 8:30 p.m. and Saturday and Sunday from 12:00 noon to 4:30 p.m.

For additional information, please email FreeHIVTest@pridecenterflorida. org or call (954) 566-3553.

By SAM KNEW, MSW

If there’s one word that pervades gay communities around the country its “PRIDE.” It’s symbolized with rainbow flags, public displays of affection among our love ones and the occasional parade down Main Street. But oddly enough there is one place gay and bisexual men are neglecting to show their true colors – their doctor office. New York’s Center for Disease Control (CDC) released a study showing that 4 in10 gay men were not out to their doctor. It identified minorities at the top of the list, contributing to them being less likely to be tested for infectious diseases and other illnesses.

As discussed in my recent article, “Save the Tatas: Male Breast Cancer,” when it comes to any illness, early detection is key. However, patients and doctors share this responsibility. The CDC recommends that doctors make screening for specific infections regular practice – and it’s not all about HIV/AIDS. Dr. Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, shared with the New York Times that other infectious disease, such as syphilis and gonorrhea are a “major threat to gay and bisexual men’s health.” One study showed that more than a third of men who tested positive for gonorrhea, were initially missed due to the fact doctors did not test patients from all potential points of infection (throat, genitals and rectum).

In some of these cases doctors may have been more vigilant if patients had shared their sexual practices. Fair or not, gay and bisexual men are at greater risk of some infections. 17% of these men are more likely to develop anal cancer. Additionally, contraction of human papillomavirus (HPV) (a sexually transmitted infection) increases those risks, especially for individuals with already weakened immune systems.

So what’s a guy to do? How do you find the right

doctor and how do you identify yourself as a card-carrying member? For starters, when looking for a general practitioner ask your friends for referrals or your local GLBT community center. You can also contact your insurance provider and ask them for a list of gay-friendly doctors. Many physical and mental health professionals will make this information available. It also may be easier to ask the tough questions before you make an appointment by phone. When you contact the office ask, “Does your practice have any GLBT patients?” One benefit of this is that you don’t have to give any personal information. But most importantly, know what to ask your doctor.

Gay/Bisexual men have unique needs. You should be able to talk with your doctor openly about your sexual practices. This includes sexually transmitted infections (STI) prevention techniques to routine medical practice, such as undergoing anal pap smears. If you’re uncomfortable asking these questions directly consider e-mailing your doctor ahead of time, or create a list you can hand to the doctor. Aside from having a healthier, more open relationship with your doctor, these practices also may relieve increased levels of depression and anxiety. Gay and bisexual men have been shown to be at higher risk of mood disorders – also putting them at greater risk of suicidal behavior, by a whopping 16% greater than their straight counter parts. That behavior can manifest beyond the traditional concepts – such as taking one’s life. In some cases, individuals participate high-risk sexual practices, purposely contracting and spreading infections.

The numbers alone can – and do – scare us away from the doctor. Some individuals suffer an onset of increased blood pressure just walking into the office (usually referred to white-coat syndrome). We also have our own cultural misconceptions; such as if you go to the doctor you’ll get sick. Additionally, there’s the fear of being discriminated or denied service. These are no easy hurdles for potential patients, but make no mistake – your well-being depends on overcoming them. And that’s something you can take real pride in.

Sam Knew, MSW is an educator and local counselor. He can be reached at SamKnewMSW@gmail.com