Conversion [lucky to know]

This is the first in a wonderful new series of intensely personal posts via the CROWOLF blog that we are delighted to share with our LifeLube family. As CROWOLF explains, "this is the first of a series of articles that Marc will be writing for my site on his recent conversion to being HIV positive.  Finding out this information can be a life changing event, and it’s not difficult at all to find yourself thrown into the deep end of the pool and unable to tread water.  Everything from finding a medical service provider, learning the in’s and outs of being covered under the Ryan White Care Act, a medical regiment, and having “the chat” with your partner that you’re positive can be overwhelming. Marc feels that sharing this new path he’s on will have a two-fold positive impact: he’ll be able to sort things out in his own head as he writes things down, and maybe someone reading this change in his life will benefit from realizing they’re not alone." 

by Marc Alexander (not his real name)

There is no good way to find out that you are HIV positive, but how I found out was particularly bad. It was early in the morning on Friday September 1st. I had just gotten home from dropping my mom off at U-Haul where she was picking up a truck that would take my furniture down to my new apartment. It had been three and a half months since I had graduated from college and I had recently finished my second week of graduate classes. I was looking forward to my birthday only a few months away. I had just let the movers hired to pack the truck into the apartment to survey what needed to be moved and we were simply waiting for my mom to come home. I had lost my keys and gotten a loan refund check in the mail from my grad school. That was when my doctor called.

I had known in the back of my mind that something was up when I didn’t get a quick negative from my tests. My doctor didn’t know if I had already moved to my new place, so he broke his established protocol and told me over the phone instead. I had known that there was something strange going on with my blood work because it had been almost five days since I got tested and I hadn’t heard back yet. Normally I get the all-clear call within two days. I had become a bit worried, but I had just pushed it to the back of my mind. The fear came flooding back, however, when I heard my doctor on the phone.

He told me that the test was back and the results were not good. When he said that, it felt like something heavy had fallen from my head deep into my gut. Like an elevator crashing. I immediately responded, “Oh god, what do I have?” I was impatient to hear it, in a way, and frightened to death of what the results were. I ran through in my head the full list of STDs I had been tested for and their symptoms and treatments. I was less concerned about HIV than I was ones that could actually cause huge immediate problems. My biggest fear was syphilis. But in the mere moments before my doctor spoke again, I had managed to worry about everything.

Then it came: “You tested positive for HIV.”

I remember that moment with vivid clarity, can still feel everything I felt. The chairs had all been taken outside for the movers to put in the truck, I couldn’t sit down. I stumbled a bit. It felt like a thin slit had been cut below my chest, between the bottom of my ribs, and someone was slowly and methodically pulling my intestines through. It honestly felt like something was being pulled from my body. I pressed my hand to where the sensation was coming from and entered the denial stage of grief. My first thought was that I was dreaming, but I knew that wasn’t true. Then I began to question if it was a false positive, but I had my blood drawn and a Western Blot test done, something I have never known to be wrong. I felt crippled and like my entire life had shrunk down to keeping my composure and trying to stay clear while on the phone with my doctor. I asked him questions I already knew the answer to, but I had started to doubt everything I knew about HIV.

My doctor wanted me to come in that day and see him, but I had a busy day of moving before me and my mom had walked in the door. Seeing her walk in was a reminder that there were other people who were going to be affected by my conversion. I knew I was going to have to be strong and not let the news cripple me. I would have my break down later, but my mom needed me to be strong and help with the move. She needed me to keep it together. But she also needed to know in case I broke down during the move. She needed to know so that she could help me deal with the news.

My mom and I walked outside away from the movers and I told her I had just been diagnosed as HIV positive. Understandably, her first reaction was, “What?” But the second thing she said to me was, “Thank god you get tested as often as you do.”

Somehow my mom had said the very thing that I needed to hear at that moment. Earlier that summer she had been surprised at my habit of getting tested every three months, thinking it was a little excessive, but now she was praising me for doing so, for being brave enough to know. She helped me realize something very important in that moment. I am lucky to know, and I am happy to know. I’m not happy to have converted, but I am better off knowing the truth. I know the fear of the virus that can cripple people. Plenty of people will say that they don’t care what their status is, but that isn’t true. They do care; they are just frightened of the answer. But now that I know, I can be sure that I take precautions in my life. I can protect myself from opportunistic infections and stop myself from spreading the virus. A lot of the reason for the spread of HIV is lack of testing and education about testing. As far as I know, everyone I had sex with in the past six months knew their status, and knew their status was negative. Clearly one of them was either lying or doesn’t know. That means whoever infected me could be infecting others and getting sicker and sicker, all because they don’t know.

I am happier knowing. Now I know what I have to do and I can get on top of the virus. I have the tools in front of me and the support I need. I can do what needs to be done. I’m lucky. How many people are there now who are untested and don’t know what is happening to their immune system? It is frightening to think that something could be breaking you down without you being aware. I know, and I can use that fear to fuel my drive to live.

To be continued….

Debt deal could jeopardize HIV/AIDS funds

via Washington Blade, By Chris Johnson

The resolution of the debt ceiling negotiations between the White House and congressional leaders has HIV/AIDS advocates concerned that federal funds for prevention and drug initiatives could be on the chopping block as a result of the agreement.

The agreement — which enables President Obama to raise the debt ceiling by $2.1 trillion and eliminates the need for another increase until 2013 — also requires a total of nearly $2.5 trillion in spending cuts to reduce the federal deficit, which could affect federally funded HIV/AIDS programs.

Carl Schmid, deputy executive director of the AIDS Institute, said any cuts to federal spending as a result of the deal will likely “impact HIV programs in a negative way.”

“There will be less money to go around and it will be more competition over that smaller amount of funding,” Schmid said. “And there can be direct cuts to our programs particularly if they are taken across the board. Not going in the right direction if we are going to end AIDS let alone prevent new infections and provide care and treatment to people with HIV/AIDS.”

All federal funding of discretionary HIV/AIDS programs could see an impact as a result of the decision, Schmid said, including the Centers for Disease Control & Prevention, the Ryan White HIV/AIDS Program and AIDS research programs. Additionally, Schmid said AIDS Drug Assistance Programs could be cut and already lengthy wait lists to receive medication through this program could be extended.

“It’s going to be harder and harder to make the case for our programs, but, hopefully, Congress will be receptive to our voices and concerns about the importance of preventing HIV in our country and to provide care and treatment for people who are HIV positive,” Schmid said.


Read more. 

New H.I.V. Cases Persist at 50,000 a Year

via New York Times, By Donald G. McNeil Jr.

Despite years of great progress in treating AIDS, the number of new infections with the virus that causes it has remained stubbornly around 50,000 a year for a decade, according to new figures released on Wednesday by federal officials.

The American epidemic is still concentrated primarily in gay men, and is growing rapidly worse among young black gay men.

That realization is causing a rift in the AIDS community. Activists say the persistent infection rate proves that government prevention policy is a flop. Federal officials are on the defensive even as they concede that the epidemic will grow if prevention doesn’t get better, which they know is unlikely while their budgets are being cut.

And some researchers believe it is impossible to completely wipe out even a fatal, incurable disease when it is transmitted through sex and carries so much stigma that people deny having it and avoid being tested for it.

Looking backward, epidemiologists at the Centers for Disease Control and Prevention believe new cases peaked at 130,000 a year in the 1980s, sank slowly during the 1990s and plateaued at 50,000 around the year 2000.

Both Dr. Kevin Fenton, chief of AIDS prevention for the C.D.C., and Dr. Anthony S. Fauci, chief of AIDS research at the National Institutes of Health, took issue with Mr. Kramer’s interpretation. While both agreed that 50,000 new annual infections was, in Dr. Fauci’s words, “a great concern,” both pointed to some areas where substantial progress had been made and said that new studies were seeking ways to get more people tested and treated early in the course of the illness, which would make them less infectious and drive transmission rates down.

“The C.D.C. is absolutely not resting,” Dr. Fenton insisted. “It was a major accomplishment to drop infections from 130,000 to 50,000, and we’re dealing with an epidemic that is dynamic.”

But, he conceded, 50,000 is an “unacceptably high level,” and without better prevention efforts, “we’re likely to face an era of rising infection rates.”

Read more.

PrEPing for the end of the HIV/AIDS epidemic

 via The Madison Times, By Phil Wilson


We have reached a deciding moment. HIV is 100 percent preventable, including among some of our most at-risk populations: women, gay and bisexual men and young adults.  HIV is also 100 percent diagnosable and in many cases treatable.  Our prevention toolbox is now exploding with options. We now have the all of the tools needed to end the AIDS epidemic!

The promising new PrEP results arrive at a critical time.  Wednesday marked the one-year anniversary of the launch of the historic National HIV/AIDS Strategy, the nation’s first comprehensive roadmap for fighting the epidemic, and one that places the well-being of Black people front and center. We also have health-insurance reform to provide care to the least among us.

But the anniversary and this remarkable string of study results come during an economic downturn that has seen many people lose jobs and others slip through the proverbial “safety net”—losing health insurance, unemployment, and other benefits.  It also comes at the same time many states are cutting funding for HIV/AIDS-prevention programs and the AIDS Drug Assistance Program (ADAP).

So while we have the toolkit to end the epidemic, the question remains whether we have the political will to invest in using the tools strategically, effectively and compassionately.

Read more.

Abbott's HIV Combo Test Detects Infections Earlier, Provides Valuable Information to Help Prevent Further HIV Transmission and May Save Treatment Costs

via PR Newswire

Hospital and public health laboratories across the country are now detecting early-stage HIV infections much sooner than previous tests since the launch of Abbott's ARCHITECT® HIV Ag/Ab Combo assay, a combination antigen-antibody test, in 2010.

Researchers reported finding early stage infections in places not known for high HIV prevalence like Sioux Falls, S.D., where HIV infections are believed to be low.  Experts presented their observations this week at an Abbott-sponsored workshop at the American Association for Clinical Chemistry annual meeting.

This year marks 30 years since the first U.S. reports of HIV and AIDS. While there have been significant advances made in the detection and treatment of the virus, each year more than 56,000 people in the U.S. are infected with HIV, according to the U.S. Centers for Disease Control and Prevention (CDC) — and one in five people don't know they have it. The CDC also has reported that more than half of new HIV infections are transmitted by recently infected, highly contagious individuals unaware of their HIV status.

The Abbott ARCHITECT HIV Ag/Ab Combo assay is the first test approved in the United States that can simultaneously detect both HIV antigen and antibodies. HIV antigen is a protein produced by the virus immediately after infection, whereas antibodies are developed days later as the body works to fight off the infection. Studies have demonstrated that Abbott's test may detect HIV up to 20 days earlier than antibody-only tests, which is important in controlling the spread of the virus. This is particularly important because individuals who receive false negative results remain unaware that they have HIV and are not able to take proper precautions.

Read more. 

Gay men ‘unaware of HIV symptoms’

via  Pink News, By Jessica Geen

Sixty per cent of gay men are unaware of the symptoms of early HIV infection, a large-scale survey has found.

According to the research by National AIDS Trust, most of the men surveyed could not name the ‘triad’ of a sore throat, rash and fever as the most common symptoms occurring together.

Between 70 and 90 per cent of people experience symptoms soon after HIV infection but fewer than one in ten respondents were aware of this.
While 31 per cent said they would go to the doctor if they experienced the symptoms, 28 per cent said they would wait to see if the symptoms go away.

Read more.

Changing the Landscape of HIV Prevention: What a Difference a Year Makes

via CDC, By Kevin Fenton

On July 13, 2010, President Obama released the National HIV/AIDS Strategy (NHAS). The Strategy outlines bold new steps for responding to the domestic HIV epidemic at a critical time in the U.S. HIV incidence has been stable, but health inequalities are worsening, and many Americans no longer feel that HIV is a serious health threat.

The NHAS addressed the long-expressed need to refocus national attention on the domestic HIV epidemic. It established a bold vision, clear goals, and concrete steps for implementation.

The NHAS was indeed the game changer we had hoped for.Yet a strategy would be only words on paper if it is not accompanied by broad-based support, a willingness to re-examine current approaches and robust measures for  accountability. The good news is that all of these elements are in place.

So at the one year anniversary of this landmark policy, let us reflect on how the NHAS is radically changing the landscape for HIV prevention as the epidemic, and our tools for addressing it, continue to evolve.

Read more.

HIV positive man claims he was denied medication while jailed

via Chicago Sun-Times

A South Shore man claims he was denied HIV medication for a week while he was imprisoned in a downstate jail last year, a case that advocacy groups cited as an example of a hidden problem in correctional facilities.

Arick Buckles, 39, was detained in the Bureau County Jail in Princeton last fall after learning he was the subject of an outstanding arrest warrant for forgery charges.

Buckles said he “stressed to every jailer I came into contact with” that he was HIV-positive and needed to take antiretroviral medication daily. But he did not receive medication or see a doctor during his weeklong stay at the jail, the American Civil Liberties Union wrote in a June 20 letter to Bureau County Sheriff John Thompson.

Buckles, who said he experienced severe diarrhea after his release, described his time behind bars as terrifying, because “I didn’t know what the offset of my not having those medications would be.”

“I often wonder, if I had been a diabetic, would I have been denied medication,” he said.

Jail officials allegedly told Buckles they could not give him his medication because of the cost of the drugs, a justification the ACLU letter called “inappropriate and unconstitutional.”

Read more.

Winning the Battle Against HIV/AIDS

via Champions of Change, by David Ernesto Munar

Ed. Note: Champions of Change is a weekly initiative to highlight Americans who are making an impact in their communities and helping our country rise to meet the many challenges of the 21st century.

I am honored that the White House chose to commemorate the 30th Anniversary of the HIV/AIDS pandemic with me and other openly HIV-positive organizers from across the country. We gathered recently with federal officials to reflect on the salient lessons learned and milestones marked in the fight against HIV/AIDS over the past three decades.

Reflecting on this solemn occasion stirs a mix of emotions.

In 30 years, HIV has caused tremendous loss and human suffering in every corner of the inhabited world. But it has also inspired heroic acts of kindness, generosity, and leadership. Looking back, we must laud the significant medical, political, and scientific advances achieved but also sustain a firm understanding of the unfinished work that lies ahead. With record numbers of people living with HIV and increasing numbers of new infections, we must reinvigorate efforts to provide people with and at risk for HIV/AIDS with the health and social services, housing, prevention, and human-rights protections they so desperately need and deserve. HIV knows no borders and neither should our compassion and actions.

Recognizing the rapid maturity of HIV medical, behavioral and social sciences, the U.S. Centers for Disease Control and Prevention now considers HIV a winnable battle. To truly win the future, the U.S. must not relent until we’ve won the fight against HIV/AIDS.

Read more.

Trans Actions Transgender Conference May 19th - CHICAGO

Increasing workplace opportunities for the transgendered population is an important way to stop discrimination. You are invited to the Service Providers Council’s Transgender Conference to be held Thursday, May 19, 2011, from 9:00 a.m. to 3:30 p.m. at the University Center, 525 S. State Street in Chicago. The conference is entitled “Trans Actions;” its theme is “Increasing Access to Care.” The 2011 conference is organized by the AIDS Foundation of Chicago Service Providers’ Council (SPC) Prevention & Care Committees and the ad-hoc host committee.

It will bring together local, state and national leaders to discuss “best practice,” cultural competency, employment issues, research-based programs and HIV/STI prevention for and with transgendered populations.

Featured Speakers are:

* Joanne Herman author of “Transgender Explained For Those Who Are Not”
* Jamison Green, PhD, an international leader in transgender, health, policy, law and education from the University of California, San Francisco
* Amanda Simpson a political and transgender trailblazer

Who should attend? The conference will appeal to anyone interested in providing services to and increasing workplace opportunities for the transgendered population. It will be of particular value to professional educators; service providers in the areas of mental health, substance abuse prevention, intervention, treatment, prevention education, treatment and adherence education (i.e., health care providers, prevention and community health workers, nurses, health educators, program directors, social workers, case managers) as well as resource managers, labor and diversity specialists.

Register today!

Trans Actions Transgender Conference May 19th - CHICAGO

Increasing workplace opportunities for the transgendered population is an important way to stop discrimination. You are invited to the Service Providers Council’s Transgender Conference to be held Thursday, May 19, 2011, from 9:00 a.m. to 3:30 p.m. at the University Center, 525 S. State Street in Chicago. The conference is entitled “Trans Actions;” its theme is “Increasing Access to Care.” The 2011 conference is organized by the AIDS Foundation of Chicago Service Providers’ Council (SPC) Prevention & Care Committees and the ad-hoc host committee.

It will bring together local, state and national leaders to discuss “best practice,” cultural competency, employment issues, research-based programs and HIV/STI prevention for and with transgendered populations.

Featured Speakers are:

* Joanne Herman author of “Transgender Explained For Those Who Are Not”
* Jamison Green, PhD, an international leader in transgender, health, policy, law and education from the University of California, San Francisco
* Amanda Simpson a political and transgender trailblazer

Who should attend? The conference will appeal to anyone interested in providing services to and increasing workplace opportunities for the transgendered population. It will be of particular value to professional educators; service providers in the areas of mental health, substance abuse prevention, intervention, treatment, prevention education, treatment and adherence education (i.e., health care providers, prevention and community health workers, nurses, health educators, program directors, social workers, case managers) as well as resource managers, labor and diversity specialists.

Register today!

Trans Actions Transgender Conference May 19th - CHICAGO

Increasing workplace opportunities for the transgendered population is an important way to stop discrimination.You are invited to the Service Providers Council’s Transgender Conference to be held Thursday, May 19, 2011, from 9:00 a.m. to 3:30 p.m. at the University Center, 525 S. State Street in Chicago. The conference is entitled “Trans Actions;” its theme is “Increasing Access to Care.” The 2011 conference is organized by the AIDS Foundation of Chicago Service Providers’ Council (SPC) Prevention & Care Committees and the ad-hoc host committee.

It will bring together local, state and national leaders to discuss “best practice,” cultural competency, employment issues, research-based programs and HIV/STI prevention for and with transgendered populations.

Featured Speakers are:

* Joanne Herman author of “Transgender Explained For Those Who Are Not”
* Jamison Green, PhD, an international leader in transgender, health, policy, law and education from the University of California, San Francisco
* Amanda Simpson a political and transgender trailblazer

Who should attend? The conference will appeal to anyone interested in providing services to and increasing workplace opportunities for the transgendered population. It will be of particular value to professional educators; service providers in the areas of mental health, substance abuse prevention, intervention, treatment, prevention education, treatment and adherence education (i.e., health care providers, prevention and community health workers, nurses, health educators, program directors, social workers, case managers) as well as resource managers, labor and diversity specialists.

Register today!

Positively Aware Releases 15th Annual HIV Drug Guide

Positively Aware's 15th annual HIV Drug Guide is out. Containing information about each HIV medication currently available, the issue also includes information on side effects and drug interactions. Also, learn how to get assistance in paying for HIV meds.

It's a must have.

We like to tear out the super-hot drug centerfold and tack it to the wall ---- it's so hard to remember which drugs we're currently hooked on :) You too can get a hard copy from the publishers, Test Positive Aware Network.

Chicago POZ Guys of Color! Regain control of your healthcare with Project IN-CARE

Project IN-CARE is a new program offered by AIDS Foundation of Chicago, Brothers Health Collective, Howard Brown Health Center, Ruth M. Rothstein CORE Center and Test Positive Aware Network.

IN-CARE is about men supporting men in regaining control of their healthcare and their lives. This project is designed specifically to assist bisexual, gay/same-gender-loving and down low/discrete men of color who’ve recently tested positive for HIV or have been positive for some time but haven’t seen a doctor in at least 6 months.

IN-CARE participants are paired with a Peer Health Navigator - someone who is successfully managing their own health care and knows the resources available in Chicago as well as how to access them. Peer Health Navigators work with participants to help them access HIV medical care, as well as the knowledge needed to gain and maintain their health and many other resources they may need.

For further information please contact …

Test Positive Aware Network – Juan Mercado 773-989-9400 ext. 294

CORE Center – Kathy Jacobs-McLoyd 312-572-4633

Brothers Health Collective – Leveon Perkins 773-363-0055

Howard Brown Health Center – Julio Maldonado 773-388-1600

Chicago POZ Guys of Color! Regain control of your healthcare with Project IN-CARE

Project IN-CARE is a new program offered by AIDS Foundation of Chicago, Brothers Health Collective, Howard Brown Health Center, Ruth M. Rothstein CORE Center and Test Positive Aware Network.

IN-CARE is about men supporting men in regaining control of their healthcare and their lives. This project is designed specifically to assist bisexual, gay/same-gender-loving and down low/discrete men of color who’ve recently tested positive for HIV or have been positive for some time but haven’t seen a doctor in at least 6 months.

IN-CARE participants are paired with a Peer Health Navigator - someone who is successfully managing their own health care and knows the resources available in Chicago as well as how to access them. Peer Health Navigators work with participants to help them access HIV medical care, as well as the knowledge needed to gain and maintain their health and many other resources they may need.

For further information please contact …

Test Positive Aware Network – Juan Mercado 773-989-9400 ext. 294

CORE Center – Kathy Jacobs-McLoyd 312-572-4633

Brothers Health Collective – Leveon Perkins 773-363-0055

Howard Brown Health Center – Julio Maldonado 773-388-1600

Chicago POZ Guys of Color! Regain control of your healthcare with Project IN-CARE

Project IN-CARE is a new program offered by AIDS Foundation of Chicago, Brothers Health Collective, Howard Brown Health Center, Ruth M. Rothstein CORE Center and Test Positive Aware Network.

IN-CARE is about men supporting men in regaining control of their healthcare and their lives. This project is designed specifically to assist bisexual, gay/same-gender-loving and down low/discrete men of color who’ve recently tested positive for HIV or have been positive for some time but haven’t seen a doctor in at least 6 months.

IN-CARE participants are paired with a Peer Health Navigator - someone who is successfully managing their own health care and knows the resources available in Chicago as well as how to access them. Peer Health Navigators work with participants to help them access HIV medical care, as well as the knowledge needed to gain and maintain their health and many other resources they may need.

For further information please contact …

Test Positive Aware Network – Juan Mercado 773-989-9400 ext. 294

CORE Center – Kathy Jacobs-McLoyd 312-572-4633

Brothers Health Collective – Leveon Perkins 773-363-0055

Howard Brown Health Center – Julio Maldonado 773-388-1600

Tree Tells His Story - "HIV has changed my life completely"

[today is Natl Black HIV/AIDS Awareness Day]

I was born August 1986 in the crazy streets of Chicago. I spent most of my childhood on the South Side, and when I tell you my life was full of events…. It truly was! 

 
via HIV Stops With Me

"HIV has changed my life completely. Before I was an actor, now I’m a producer. I don’t just “act” like who I want to be….I am who I want to be! I can now experience life as it is. My career has changed a bit. At the time when I found out, I was a fitness trainer. Now I have committed myself to HIV/AIDS care and prevention. This came about when I attended groups and heard all the horror stories of disclosure. I also thought back to my high school’s sex ed class and just remembered hearing about how to get tested and that HIV leads to AIDS. But I remember that picture of that guy with the gonorrhea in his eye, and that picture of the penis with warts the size of Reese cups, and more. So where were the pictures of HIV? I think we need more education on HIV/AIDS worldwide, especially with youth. The only way to do that is to show them a picture. Show people that HIV really does exist, and that’s it’s not just something from T.V. or from the distant past."

Read all of Tree's story.

Condoms Aren’t Enough! Will Pills and Lubes Define the Future Of Sex?

More than 100 of the  world's top experts on  human rights and HIV among  sexual minorities led presentations and  workshops in Vienna  on July 17 at BE HEARD,  an all-day  conference event that addressed soaring global rates of HIV  among men who  have sex with men  (MSM). The event preceded  the launch of AIDS 2010, the XVIII International AIDS  Conference (IAC) and had nearly 600 participants.

Our friend IRMA (International Rectal Microbicide Advocates) and led the very interesting session called "Condoms Aren’t Enough! Will Pills and Lubes Define the Future Of Sex? An Overview of New HIV Prevention Tools in Development."

Below are 5 of the presentations - which IRMA is lovingly sharing with LifeLube. The first - directly below - begins with Kenyan researcher Dr. Gaudensia Mutua's talk - "Basic Concepts about AIDS Vaccine Research."

 

Hosted by the Global  Forum on MSM  & HIV (MSMGF),   BE HEARD focused on challenges and  solutions to  achieving  universal  access to HIV-related prevention, care,  treatment,  and  support  services for sexual minority communities  worldwide.

A third of HIV+ gay men show signs of PTSD

via PinkNews

A study has found that one third of gay and bisexual men diagnosed with HIV show signs of post-traumatic stress disorder (PTSD)

Researchers from the NHS Foundation Trust in London surveyed 100 gay and bisexual men who had been diagnosed with HIV. The study results were published in the latest edition of the journal AIDS Patient Care and STDs
They found that 33 per cent of the men met the criteria for having PTSD, which is a psychological disorder that can develop in people who have experienced or witnessed traumatic events.

Symptoms can include flashbacks, guilt, depression, addiction and physical complaints such as headaches.

The researchers were surprised to find that beginning antiretroviral therapy was marginally the strongest trigger for PTSD developing and theorised that this may be because the men feared how a medication regime could affect their lives.

Read the rest.

New Day Redux: The National HIV/AIDS Strategy Arrives

by Mark Hubbard
[pictured below]

“Vision for the National HIV/AIDS Strategy: The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.” *

On Tuesday of this week, the Obama administration began movement towards atonement for the mortal sins perpetrated to a lesser or greater degree by each and every administration since AIDS was first recognized.  

I was honored to be one of many individuals invited to the release of the United States’ first National HIV/AIDS Strategy and later to a reception in the White House honoring the HIV/AIDS community and featuring a speech by President Obama.

A blueprint for addressing the domestic epidemic, the strategy outlines challenges faced, steps to be taken, and five-year goals in a reasonably comprehensive and detailed manner.  To reflect a line from Jeffrey, this historic action cannot reverse the losses created by years of inaction, neglect, distraction, and dogma (vs. science)-driven policy, but it is the opposite of those losses.

Making the Promises

Driving home from last August’s National HIV Prevention Conference (NHPC) in Atlanta, I tried to process what I’d experienced.  One aspect of the event struck me as odd and even a little annoying.  I couldn’t help comparing the plenaries there to those I’d attended at other research conferences where the field’s latest discoveries are typically painted in broad but succinct strokes.  Most of the NHPC plenaries felt like cheerleading sessions – big pep rallies for the team.  It was great to have our activist ideals validated, but wasn’t all of that just so much preaching to the choir?  As I got closer to Nashville my thinking changed.  I came to believe the plenaries had effectively emphasized one simple message: 

It’s a new day.

Eight years of slogging under an anti-science, anti-data, anti-expert administration had taken a bitter toll.  The quietly (and not-so-quietly) suffering folks who’d remained at the CDC during the previous administration must have realized that professionals and volunteers on the front lines had experienced an unprecedented level of frustration and cynicism. 

The doctor’s orders were to provide a hopeful indication that staying engaged, involved, and dedicated would be worthwhile.  The organizers filled that prescription with both words and actions.  The remarkably consistent message presented was affirming, focused, and unfettered:  the Obama administration would return to science, address stigma, recognize the significance of social injustice, embrace the idea of “combination prevention,” and quickly get about the work of developing a National HIV/AIDS Strategy.  One of the first of fourteen community discussions on the strategy was held then and there at the conference. 

“The United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men.”*

Who spoke in Atlanta mattered as much as what they said.  A highly experienced, diverse, and qualified leadership had been appointed.  Conference organizers had clearly made an attempt to address the Prevention Justice Alliance’s demand for participation by a wide range of federal agencies and departments beyond the CDC and DHHS. 

One by one, a series of new appointees and guests, many of them openly gay and/or HIV-positive, began to hold forth.  We laughed and cheered in shared relief when the words of one guest speaker, “ding, dong, the witch is dead,” rang amplified through the huge ballroom. 

“Another issue involves trying to assess the effect of incarceration on these communities and the impact it has on HIV transmission.”*

Robert Fullilove addressed the social context of the epidemic, dramatically asserting that reducing the impact of mass incarceration of those most at risk is “the greatest opportunity for transforming the social environment and the social drivers of HIV/AIDS at this point in the 21st century.”

“… we need to adopt policies that will produce a workforce that is large enough to care for all people living with HIV, is diverse, has the appropriate training and technical expertise to provide high-quality care consistent with the latest treatment guidelines, and has the capacity, through shared experiences or training, to provide care in a non-stigmatizing manner and create relationships of trust with their patients.” *

Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services, gave the thumbs up from the podium to a group of us demonstrating for health care reform.  Congresswoman Maxine Waters unapologetically and emphatically made the case with great flair.  Various promises were made – there would be healthcare reform, the HIV entry ban would be lifted, and above all, the community would be consulted.

In short, we were inspired.

Releasing the Documents

Promises are just that, but those made at the NHPC have been kept.  A healthcare reform bill was passed, the entry ban was lifted, and the community was consulted.  Most importantly, a National HIV/AIDS Strategy is now a matter of public record.

It will take time for professionals and activists to thoroughly analyze the strategy.  Critique it they must and critique it they will.  The document isn’t perfect, but I view it as brilliant - brilliant because it’s grounded in current data and science, brilliant because the administration appointed the right people from within our midst to lead its development, and most importantly, brilliant as a result of having the rest of the community as its co-authors and editors. 

The primary goals announced at NHPC remain steadfast.  We must 1) reduce new HIV infections, 2) increase access to care and optimize health outcomes for persons living with HIV, and 3) reduce HIV-related health disparities.  A fourth goal has been added:  4) achieve a more coordinated national response to the HIV epidemic in the U.S.  (This explicitly includes monitoring and reporting on achievement of the goals detailed in a companion Federal Implementation

“…providing sterilized equipment to injection drug users substantially reduces risk of HIV infection, increases the probability that they will initiate drug treatment, and does not increase drug use.” *

There is some tiptoeing in the document (particularly the notable lack of mention of anything anal or rectal.) It and those who introduced it on Tuesday spoke plainly to issues that have been, are, and will continue to be difficult and controversial.  The mood among those in attendance was mostly enthusiastic, even triumphant.

“People at high risk for HIV cannot be expected to, nor will they seek testing or treatment services if they fear that it would result in adverse consequences of discrimination.

“In many instances, the continued existence and enforcement of these types of [HIV-specific, i.e. criminal transmission] laws run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment.” *

While the temptation to feel cynical about the community’s presence at what were clearly media events exists, I have consciously chosen to resist.  When I had the chance, I shook President Obama’s hand, looked him in the eye, and simply said, “Thank you.”  Having grassroots community attend these events made a profound statement:  “We couldn’t have and can’t do this without all of you.”

Moving Forward into Action

That’s the point, and it’s also the challenge.  We have a blueprint, but remodeling has yet to begin.  The administration does not serve in isolation.  Those who have opposed what’s needed in the past will continue to do so.  Funding will be a major challenge.  There will be pushback and compromises and setbacks and disappointments.  As the Coalition for a National AIDS Strategy and the Prevention Justice Alliance have reminded us, we must hold the administration’s feet to the fire and Congress must be pressured to act in accordance with the strategy.  A living process must be nurtured that is driven by aggressive implementation, ongoing research, and community activism.  We must continue to better address other aspects of the epidemic more specifically, including research.

“…safe and effective vaccines and microbicides are not yet available and investments in research to produce safe and effective vaccines and microbicides must continue.”

Perhaps the next conversation should involve creating a succinct National HIV/AIDS Research Agenda.  Based on ONAP’s contention that prevention resources must be targeted to address disparities and to help the most affected communities, such a plan must address the failure to equitably fund anorectal-focused research.  It must commit to an infusion of resources that will bring our scientific knowledge of the rectal compartment, lubricants we know are commonly used for anal sex, anorectal transmission, and new rectal-specific prevention technologies into parity with our knowledge of the vaginal compartment, products, transmission, and technologies.

Whoever you are, wherever you live, whatever you do, if you give a damn about HIV/AIDS in our communities, please read these documents.  The videos from Tuesday are also well worth your time.

• New Office of National AIDS Policy web presence
• Video of Strategy Announcement
• President Obama Speaks on the Strategy’s Release
• The Strategy
• The Implementation Plan
• The Presidential Memo

* Excerpted from The National HIV/AIDS Strategy for the United States