HIV 101

When I speak to friends, loved ones, and internet trolls about HIV, there's a lot of missing facts and outdated information. Whether I'm explaining the difference between HIV and AIDS, or, why the stigma is doing more damage than the virus itself, people have no idea what I'm talking about.

I was on the verge of defriending anyone I thought would never get it, until I remembered what this blog is all about; Helping Ignorant Victims. Victims to their own ignorance, living in a world with no idea that the same virus that changed life as we know it is making a resurgence, and we can stop it. Taking away the one smart friend they have isn't going to help things. This is an important time to educate and be educated. It's time to smarten up!

 

HIV

Human immunodeficiency virus attacks important cells that fight infection and disease, destroying the immune system in the process. There's no cure (yet), but, due to the advancement of medicine, research, and treatment, HIV is treated as a chronic disease (like diabetes) and not a terminal illness. There are three stages of possible progression.

 

Acute HIV Infection - This refers to the first 1-4 weeks of contracting the virus, when seroconversion takes place. During this time, there may be physical symptoms attributed to HIV (of the 7 people in my life who are positive, three were diagnosed after seeking treatment for flu-like symptoms. Three friends found out after routine check-ups. Only two of my friends found out by getting tested). Symptoms include - but are NOT limited to: swollen glands, persistent fever, headache, and rash. It is also during this time that the person with the virus is highly infectious, making them vulnerable to transmitting HIV to others. This is why it is SO IMPORTANT to GET TESTED REGULARLY! CDC suggests annual testing (more frequent testing is suggested for those in high-risk categories).

 

Clinical Latency Stage - During this stage the virus appears dormant. It slows down producing copies of itself, and leaves few - if any, physical symptoms of its presence. However, HIV will continue to multiply in the system. When left untreated, the virus can remain dormant in the system for as long as ten years and as little as two.

 
According to a 2014 report from UNAIDS, 36.9 million people were living with HIV worldwide, with 2 million people infected across the world (50,000 new cases here in the states).

*For more information on HIV testing and treatment, go to aids.gov


 

AIDS

Acquired Immunodeficiency Syndrome is the most advanced,
progressive stage of HIV (often referred to as late-stage HIV). Depending on which report you read (I'm going with AVERTing HIV and AIDS ), studies show that individuals can live roughly 10 to 15 years with untreated HIV before the virus progresses to AIDS. By this time, the immune system has suffered extensive damage, and the body is vulnerable to different infections and illnesses.

People living with AIDS are vulnerable to tuberculosis, pneumonia, and other opportunistic infections. The CDC classifies an AIDS diagnosis as any HIV+ patient who develops one or more OI, regardless of their viral load or CD4 count.

Thanks to groundbreaking antiretroviral treatment (more on that in a bit), AIDS is not nearly as prevalent as it used to be in America. However, in many third world countries AIDS is a major issue. Here are a few quick facts (provided by dosomething.org) about how HIV/AIDS is affecting Africa:

 

·         Out of the 34 million HIV-positive people worldwide, 69% live in sub-Saharan Africa.

·         There are roughly 23.8 million infected persons in all of Africa.

·         91% of the world’s HIV+ children live in Africa.

·         More than one million adults and children die every year from HIV/AIDS in Africa alone.

·         In 2011, 1.7 million people worldwide died from AIDS.

·         Since the epidemic of HIV/AIDS, more than 75 million people have contracted the illness, and over 36 million have died from an HIV-related cause. 71% of the HIV/AIDS-related deaths in 2011 were people living in Africa.

 

*For more information on the plight of Africans fighting the war against AIDS, check out the AIDS Foundation of South Africa or UNAIDS.org

 

Viral Load

According to AIDS.gov, the term viral load refers to the amount of HIV in a sample of blood. A viral load test is a lab test that measures the number of HIV virus copies (particles) in a milliliter of your blood. A viral load test helps provide information on your health status and how well antiretroviral therapy is controlling the virus. A high viral load means that there's a high level of HIV present in the body; a low viral load means that the HIV is being controlled and suppressed.

In other words, there is a degree as to how much of the virus is in the blood stream. The higher the degree, the higher the risk of contracting an infection or illness, spreading the virus, and getting AIDS. In addition to reducing the amount of HIV in the body, HIV medicines greatly reduce the risk of transmitting to others. 

 

 

Undetectable Viral Load

 

“... When an HIV-infected person takes antiretroviral therapy that keeps the virus suppressed, the treatment is highly effective at preventing sexual transmission of HIV to an uninfected heterosexual partner.” Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases

This is a moment when every poz patient should give themselves a gold star. Celebration need be had when your doctor tells you that your viral load test came back undetectable. So long as you take care of yourself and take your medicine, you stand a good chance of living a full and healthy life.

The correlation between preventing those who are negative from contracting the disease, and keeping those who test positive undetected cannot be overstated. Keep the patient healthy and undetected. This way, they live long, productive lives with unlikely risk of transmitting HIV. Keep negative patients negative with regular testing and proper prevention. It’s that simple! Or, so it would seem…

 Only about 25 percent of people living with HIV in the U.S. have achieved viral suppression. African Americans are least likely to have controlled HIV in this manner, with 21 percent achieving viral suppression, compared to 26 percent of Hispanics and 30 percent of whites.

data retrieved from Illinois HCC 

 

Undetectable means that after a series of tests, results show that a person living with HIV no longer shows traces of the virus. However, ven though ART's and a healthy lifestyle have suppressed the virus to untraceable levels, it's still there. Without ART's, copies of the virus will most likely resurface and multiply in the blood. No drug holiday's for poz patients.

 It may seem like a drag for *serodiscordant couples to rely on condoms as a sole mean of protection. Especially since there is no 100% guarantee against contracting HIV or any other STD/STI when it comes to shared-needle usage or sexual contact. However, there are ways to further protect and intervene HIV transmission.

 *Serodiscordant is a term used to describe couples with differing HIV status; one partner is HIV+ and the other is negative. Such couples are also referred to as magnetic or mixed-status. In the event that both partners are HIV+, they are then in a seroconcordant relationship.


Antiretroviral Treatment (or therapy)

HIV/AIDS-related deaths has dropped dramatically since it's inception in 1981. The reason is ART. This form of treatment has been a key factor in viral suppression, as well as increased lifespan of HIV+ patients.

ART is a combination of medicines used to fight HIV. The combination, dosage, and amount differs for each person. Some people have to take a few pills in the morning and a few pills at night. Others take much more (I have a few friends who take a single pill once a day). There's a variety of contributing factors; prescriptions, dosage, existing medical condition, cost, etc.


For more information on antiretroviral treatment, go to advent.com 
 

 

PEP

 Post-exposure prophylaxis is the usage of ART's to prevent HIV from making copies of itself and spreading in an HIV negative body after a single high-risk event. PEP must be started as soon as possible to be effective, and always within 3 days of possible exposure.

 

You read it right. The same drugs used to suppress HIV can prevent you from getting it. While its inception is news to most, PEP has been around for well over a decade, used to prevent seroconversion in rape victims and many in the medical field who've been exposed to HIV.

 When you think PEP, think the morning-after pill. The only exception is that PEP requires 28 days of continuous use to work, and has little affect if taken improperly or outside the 3-day window of exposure.

 

 PrEP

 PrEP (re-exposure prophylaxis) is the controversial practice of using antiretroviral drugs to prevent HIV infection before exposure. When used correctly, *PrEP can build up to a 92% immunity against HIV.

Condomless sex outside of primary relationships or marriage happens with regularity. While an undetectable status reduces risk of transmission - dramatically, because of the virus' presence, it still poses a miniscule risk. For that reason, doctors will always advice PrEP users to proceed with condoms.

 

Truvada is currently the only medication available for PrEP use. It's only been on the market since 2012, but there is much hype, stigma, and gossip surrounding the prophylaxis.

When you think of Prep, think the birth control pill. It doesn't work right if you don't take it every day, and it's not necessary to take it if you're not active or no longer fall in the high-risk category. However, if you find yourself involved with someone who's positive, PrEP is an amazing option that would allow you and your partner to engage in the safest sex possible.

 

*Depending on which source you go by, the effectiveness of using Truvada for PrEP will vary. prepfacts.org gives it a 92-99% rating in effectiveness. Other sources give it approximate percentage rates - all ranging past 90%. However, there are those in the medical field, as well as the HIV/AIDS community who both question the effectiveness of prophylaxis as well as the intention of it. There will be a more detailed post on PrEP to come.

 

The Virus vs. The Stigma

I've yet to publish a post that doesn't make mention of the nasty stigma. A cluster-fuck of dated information, myths, shaming, and even heavier consequences (such as incarceration), prevent many from getting both tested and treated. Fear of the backlash drives them to put any relation of them and the virus in the far-back of their brains. Even those at high-risk can convince themselves they have unlikely chances of contracting HIV. Besides that, the humiliation and shame associated with the virus sends many into a mean depression and downward spiral.

When we talk about people living with HIV, we are NOT talking about a threat to society. We are talking about a human being with a medical condition. Just like hepatitis. Just like herpes. Just like that nasty ass flu that was floating around New York City a few winter's ago. When it comes to medical conditions, they should always be treated with care and compassion.

The stigma is so threaded into our social dialogue, many rarely even notice its existence. Yet, every time someone treats AIDS as a punch line, insinuates that someone has it, shames someone living with AIDS for carrying the disease, or a person in the media mistakes HIV with AIDS (I know you hear me Howard Stern), the stigma is being perpetuated and allowed. It's going to a lot of acknowledgement, and a lot of conversations like this in order to get our way around the stigma.

 

The Virus vs. The Future 

This is when the people who nod off during HIV talks need to wake up.

With a steady combination of HIV treatment, prevention, and information, we have more power than ever. This might seem far-fetched at first read, but keep in mind that San Fransisco's last annual report of newly infected HIV patients was only 350. New York, not to be outdone has pulled together an aggressive Ending The Epidemic Task Force. The task force, along with governor Cuomo has pulled together an impressive 5 year plan to get newly infected HIV diagnoses down to three digits. The plan incorporates treatment as prevention, along with outpatient programs, and prophylaxis.

Despite the hurtles that stigma and lack of information have created, there's much to be optimistic about when it comes to HIV treatment and prevention.




Thanks to the following sources:

Centers for Disease Control and Prevention
spectator.com                         avert.org
aids.gov                                   dosomething.org
unaids.org                               Illinois HCC
advent.com                             Poz    
Ending The Epidemic Task Force                       







 

 

 

Good Luck, Charlie!

Charlie Sheen did something pretty rad Tuesday morning.

He had the balls to admit to contracting HIV to a merciless and misinformed American media, putting to bed the mythical "Hollywood Suparstar's Desperate Battle with AIDS" (way to go, Radar Online) . By the way, how much longer are we going to take professionals flamboyantly mistaking HIV and AIDS (Howard Stern, please rise)?

I'd also like to know when we got so dick deep in judging others that we abandoned our compassion? Seriously. Seriously! Where the fuck is our compassion? Because, I didn't hear it in that shitty Howard Stern interview, and I can't find it on my Facebook page. I had a longtime friend post a status that reiterated the shame and judgment hijacking almost every conversation about the contraction of HIV (he actually used the term, "Dirty needles and whores" in correlation with those affected by HIV/AIDS. He is evil and he must be destroyed).

Very 80's photo of Ryan White with Charlie Sheen and Marlee Matlin 

The New Out

Love of my life (in my head) Danny Pintauro said it best; HIV is the new closet. Admitting a positive HIV status in this era is the equivalent of a gay man's rite-of-passage; coming out of the closet. From the drum roll, right down to the misguided "how will this affect our children" babble. The outcome, clearly, will differ. However, the blueprint for a public coming-out is nearly identical. You get the interview. You get the magazine cover. You get the round of applause. You get the public shaming. And, you get to stand by and watch the most intimate parts of your life and sexual behavior dissected and judged before your very own eyes. 

I see HIV/AIDS advocates with the same precarious we-need-a-leader look in their eyes that I've grown desensitized to. Because, in the black community, that look has been present since the day the Reverend died. For each rise of a prominent figure in the center of any fight, is the fall of someone who gets demoted to what they could have been. Whether it's Caitlyn, or Danny, or Charlie, they come out to a lot of pressure. Pressure to speak up. Pressure to show up. Pressure to get it right. And when they don't measure up to our defining-as-we-go standards, we knock 'em down. Crabs in a barrel, I tell ya'.


Blind Reporting

"I want to know, do you...do you take responsibility for your actions, for being promiscuous, going into a lifestyle of having heightened sex...?" 
                              - Candace Cameron Bure, The View

The biggest detriment that stems from our ragtag media circuit is that it's stalling our need to spread information and resources. Long story short, the media isn't ready. If the American people are scared straight when it comes to HIV anything, then the American media is scared stupid. Howard Stern doesn't know the difference from HIV and AIDS (fact-checkers, anyone?) and Candace from Full House wants to know if you've repented for being naughty. What is going on?! This is the time to educate. I've seen better reporting from The Onion and the New York Post (literally).

 Charlie gave us so much to talk about that morning. Like, how alcohol and substance abuse spike the risk factors of contracting HIV. How mental health has strong ties to substance abuse. This is an amazing opportunity for us to drop our systematic, incorrect views on the virus and use a more adult, tactical approach to how we treat HIV prevention and infection. This is what we should be talking about. This is what we need to be talking about. But, of course, we get caught up trying to figure out how many grams Danny smoked, and how many prostitutes Charlie ran through. People walk away with no real, fruitful insight on the issues. Slaves to the stigma. As Peter Staley puts it, "The stigma has made the front end work frustratingly inefficient. It always comes down to the stigma."

If American society had the intellect to discuss the behavior of Charlie Sheen in correlation with HIV contraction, this would be an entirely different discussion. Unfortunately, the intellect is lacking so the progression has stalled. If there's any doubt about this fact, simply check the comment section of any article written on Charlie Sheen (like this one). You'll find it infested with bad humor and heartless judgment. People who attack Charlie Sheen for having HIV don't talk about him like he's a person. People talk about him with free range to take shots at his health, his future, and his livelihood, like this dick. They talk about him the same exact way they talk about anyone who's contracted HIV. It's a fucking shame.

He Had it coming

What do you say to a stage-four lung cancer patient who used to smoke a pack a day? Do you say, "Ha! That's what you get! What were you thinking?" If the judgment and ridicule overrides a person's medical condition, than the person doing the judging is an asshole. There's no such thing as a disease deserved. Every time you cast shame and judgment on anyone for their medical condition (mental, clinical, acquired, etc.), you're playing for the wrong team. And, scaring people from getting tested, protected, and educated on their health. True story.

If the "that's what happens" adage is a nod to his colorful sexual past, than you are absolutely right. Contracting HIV is certainly something that can happen when you engage in unprotected sex, and disregard sexually transmitted diseases (and other consequences. Like babies). But, just to be clear, only half of young adults are using condoms on a consistent basis. Should we treat the other half that's at a higher-risk than their peers like many morons are treating Charlie, because that's what happens? Compassion? Anybody?


Why should anyone feel sorry for that degenerate? He's no hero!

When I talk about Charlie Sheen today, I could give two-shits about who he was yesterday. His penchant for fast drugs, good times, and long nights are not unlike my own. No, I never paid for a whore. But, I sure did enjoy brushing arms with them. And, I use(d) to do a lot of drugs. Drugs that provoke a slew of bad decisions and risky behavior. I haven't contracted HIV like Sheen. But, that doesn't make me better or smarter. It just makes me (dare I say it) lucky. What if I did have HIV though? Would you just throw me out to pasture, forget you ever knew me? Would you tell me I had it coming? Would you think my karma caught up with me? If so, I would ask you, "Where the fuck is your compassion?"

Don't trust anybody who's got the guile to tell you who deserves what - not even yourself. Rest assured, sooner or later, we will all find ourselves on the losing side of compassion. Maybe you'll get fired for screwing up, or a suspended license for a DUI, or your lover will leave you because they're tired of your shit. Whatever it is, the other shoe is going to drop. You're going to realize you don't know it all. It's going to dawn on you that, perhaps, you played it all wrong. And then, that's when you'll have some empathy for the Charlie's in the world. I say, don't wait for the other shoe to drop. Muster up some compassion and logic now.

The bottom line is that we're living in an era that has yet to properly address and get a handle on how we're going to deal with HIV/AIDS moving forward. We can't afford to pick and choose who we support in the HIV/AIDS community. We can't afford to pass up the opportunity to educate and inform a generation that treats a fucking plague like an ancient, common cold. And, we most certainly cannot afford to not give a round of applause to any human (no matter what past precedes them) who has balls big enough to tell the world he's positive on national TV. Thanks to Charlie, the conversation is full-throttle. People are talking, and they're learning, honey! He may not be a hero to many due to his past discretions, bu,t make no mistake, admitting to being HIV positive in this country is a very brave thing to do.

It's going to be a very long, very winding road to getting American media and society to treat HIV treatment, prevention, and patients with the respect and facts deserved.
In the end, we'll never know why the good Lord would tap on a womanizing degenerate like Charlie Sheen to be the latest messenger. What we know to be true is that there's been enough divide in the fight against HIV/AIDS. Like it or not, he's on our team now.