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When I speak to friends, loved ones, and internet trolls about HIV, there's a lot of missing facts and outdated information.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                       







 

 

 

AIDS Jokes and Those Who Shame Them: Who's Getting the Last Laugh?

 

 

 

Question: How do you turn a fruit into a vegetable?
Punch line: AIDS


This 'joke' was told to me at work. Let's translate: How do you kill a homosexual? Punch line: AIDS.

*In the state of New York, 80% of newly diagnosed AIDS patients lived in New York City

*100,000 New Yorkers have died of HIV/AIDS related causes

*Men who have sex with men make up 4% of the US male population, but account for almost 78% of all new HIV infection

*93% of new HIV/AIDS diagnoses among females in New York City were in black or Latina women in the first half of 2011.

I'm begging you; show me the funny.

It was the summer of 2013. I had been employed at this cheesy midtown restaurant for almost a year. Long enough to know the in's and out's, but still unknown to the hire up's. It was the best shitty job I'd ever had, in the heart of Manhattan.

This 'joke' was being recited by a co-worker, who heard it from a cook who told it on a cigarette break. I immediately interpreted the 'joke' on a literal level; my reaction was visceral. I was both underwhelmed and disturbed at the hamburger-helpers I called peers who felt it appropriate to recite the slur. The verbal indignity was re-told in a very hush-hush, "I can't believe he said that, but isn't it funny?" manner. Even still, my disgust was targeted solely towards the cook. Was he making fun of queers or AIDS patients? Was anyone aware that the insult reiterated the myth that AIDS was a gay disease? The vacant space where his brain should have been found humor in that 'joke'. Apparently I was supposed to find the humor as well. Of course I let each moron within that circle know their humor lacked both compassion and comedy. And, of course, I stormed off knowing my scolding did the situation no justice.

I wanted heads to roll and knew exactly how to do it. By the time I got home at the end of my shift, I had drafted a 608-word, scathing email aching to be proofread and cc'd to anyone who had an iota of pull within the company. My words were sharp and abrasive with a hint of threat. I stated facts. I noted breached rules and regulations from the employee handbook. I suggested diversity training. And then, I waited.

While action was made (he was terminated within 72 hours), it had been done in silence with no warning to follow. One day the prick was at work. The next day he wasn't. No diversity classes. No reiteration of corporate conduct and ethics. No lesson.

Whispers turned into bold-faced accusations. By the end of the week there were a substantial amount of supporters of the 86'd cook. That zero-tolerance stance I took upon first hearing the 'joke' lead many to figure out I was the whistle-blower. The cold shoulders were relentless, as was the backhanded commentary. "Uh oh, Tamela's here. Everybody watch what you say before that girl gets you fired." Once, while having a simple difference of opinion with a co-worker she quipped, "Even if you're wrong, you're right. Please, please, don't get me fired!" Ironically, the consequence the prick paid for his own actions far outweighed the action that actually caused such consequence.

As time past, the termination scandal dissipated. By the time Christmas rolled around it felt as though the incident was a million miles away. Until it happened. She happened. Justine Sacco.

In route to Africa, Sacco made a vile 'joke' about being immune to AIDS because she's not a black African. Humor as cruel and ignorant as the one that prick told. However, there were more than just a few ears listening during a cigarette break. She broadcasted her Trumpesque humor for all the Twitter world to re-tweet. Sacco's consequence, by far, eclipsed that of the ex-cook. She wasn't just fired. By the time her feet touched African soil her reputation shear existence was ruined, social media style.

I used to think there would always be fool-proof gratification in seeing justice served. However, when the motive is misplaced or the lesson is lost, who's winning? Even if Justine Sacco evolved into an intellectual space that allowed her to understand the hurt and damage in that loaded gun she tweeted, her resentment towards those who rallied for her demise blares over her redemption song. Just as I assume that prick spends more time thinking about the bitch who got him fired than thinking about how hurt that bitch must of been that someone would mock a pandemic that's taken 40 million lives (and counting).

People have long-been comfortable with joking about AIDS. In their minds it has nothing to do with them. AIDS is little more than a punch line as far as popular culture is concerned.

It's easy to laugh at strangers when we've convinced ourselves that they're in a land far, far away; too distant to provoke care or compassion. This ill-willed mindset not only encourages the stigma to grow, it eggs it on. Taking a pandemic and talking it down to a punch line is a defense mechanism that comforts many in the high-risk category. Believe it or not, there are many ignorant victims in this world convinced that as long as they're not checking a homosexual and/or substance abuse box, they're in the clear. If only those who laughed at AIDS knew exactly how at-risk they are, I assure you they would not be laughing. Ironically, if those who are at high-risk knew what that risk meant, as well as why the odds are so high against them, their personal fear and concern would dramatically reduce the risks and leave little room for humor.

I'm sure there are many who are still committed to the old adage, "Sticks and stones may break my bones" (if one more person tells me, 'but it was just a joke', I'm probably going to vaporize them). It's easy to follow that chant until you're the one who loses your job, your kids, your dignity, or your privacy because you contracted a chronic illness. Who gets the last laugh then?

There are HIV positive people living in New York that have the same chance as anyone else to live long, healthy lives. But, they'll never know because we're laughing them out of the waiting rooms. Can you believe that there are people who willingly decline FREE HIV/AIDS testing? Too scared to know (insert sad face here).

The correlation between that prick's circumstances, as well as Sacco's, as well as many, many, many others is the fact that the space to educate those too desensitized to pass up laughing took a backseat to blaming/shaming the ignorant. In my experience, I was the one on the blame/shame end of the stick, unlike Sacco who had to carry the consequence of an ignorant culture on her own.

 I do not endorse the public shaming of any individual for something said. But, not for any righteous or humbling reason. Simply because, it's a fucking distraction. I'd give less than two shits about morons telling bad jokes if it weren't for the fact that the humor is killing us. Literally. People are dying. All over the world. Of AIDS. Babies. Children. People. We're not going to accomplish anything by going after the wrong target.

One night, while downing craft beers and Fireball with a co-worker, he finally asked the question he and many other's wanted answered.

"Why'd you have to get him fired? I mean... he really wasn't a bad guy. And, it was just a joke." He proceeded to inform me that many people sympathized with the terminated supervisor, mainly because he was soon-to-be married and needed his job to pay for wedding expenses.

"There's no such thing as a funny AIDS joke," I responded after a moment's pause. I then said things that, until that moment, had been unsaid. "More than two-third's of my loved ones are gay, and more than a handful are HIV positive. I just can't stop thinking about what that joke would do to them, how it would make them feel if they heard it. I think about that and it makes my skin crawl." We continued to debate about stigmas, consequence, and general opinion.

In the end, my email didn't change the way popular culture addresses the lack of compassion, understanding, and logic towards those with AIDS. And, while I take no pride in the loss of someone's wages, I'll never regret taking a stand. It's going to take a lot of people, a lot of emails, and a lot of, "That shit's not funny bro," before the masses wise up. The only way to kill the stigma is by changing the narrative. If there's one lesson I took from my experiences with AIDS 'jokes' it's that it's more important to shame the humor and the narrative than it is to shame the individual sharing it. The prick who got fired, along with Justine Sacco are nothing more than ignorant victims who've got a lot to learn.

*statistics compiled by New York City Aids Memorial January 2013

Why I Won't Stop Talking About HIV

February 13^th, 1990. I’m home from school watching the Phil Donahue show.  Don’t ask why seven-year-old me had no desire to watch child-friendly television; I haven't the slightest idea.

In a land far away, many moons ago... before things went ‘viral’ and newsfeeds telling us what to care about, the Phil Donahue Show was a true Huffington Postesque outlet. Sexism, racial tension, economic decline, all topics Donahue stirred in his pot. My young eyes and ears absorbed more facts and realities than they were built to take in. Still, I would sit with my Bagel Bites and Sunkist, the volume on low, eyes wide open, nodding my head when a valid point had been made, or chucking  a dry piece of bagel at the screen when someone said something wrong. Or stupid. Or a word I’d yet to learn the definition of. There was a lot of Bagel Bites crumbs thrown at Daddy’s TV on February 13^th, 1990.

Peter Staley. Gregg Gonsalves. Robert Garcia. Greg Harrington. Ann Northrop. And, the man who changed my life, Larry Kramer. Four gays and a woman. What could have been a great mix for a sitcom ahead of its’ time is instead a ragtag group of vigilantes for HIV/AIDS research, funding, activism, and concern. AIDS Coalition To Unleash Power (ACT UP; little did they know, they had me at coalition). This sincerely frightened group of five were ready to shout facts, demand research, and take on the audience, the American medical system, and the world. There were more acronyms than I could keep track of, more facts than I understood. But, I was a little black girl who could not stop crying. The topic had nothing to do with me (yet), but I inherently knew that this will have so much to do with the advocate I would become. I was not wrong.

 

 

 

           The phenomenal five, schooling Donahue and the world on why radical activism was necessary

Eight years after the first 41 people diagnosed of what was referred to as ‘gay cancer’, society had just enough information to drop the cancer. Yet, the notion that HIV/AIDS was still a gay disease continued to linger, allowing the hetero world and hetero America in particular to blow off concern of the deadly plague because, what’s it got to do with them anyway?

The first cord that struck me was the level of which ACT UP had organized and informed themselves. This was done not out of leisure, but fear and desperation. It’s one thing to fight for your own life, another to fight for the lives of others. And, to do both at the same time? Unheard of, and previously unseen. Eight year old Tamela knew she was listening to the gospel from her tribe.

Fast forward 25 years. HIV/AIDS is no longer deemed an epidemic, rather a chronic disease.  While lack of knowledge, medicine, and research were the biggest dangers in the 80’s and 90’s, the same lack thereof has been dragged into the new millennium, along with race, and ethnic disparities. In other words, HIV is continuing to attack the blacks, Latinos, and queers. As a black Latina queer, this affects me.

The passing of time has not lessened the reality of the silent killer that no one wants to talk about. I still light a white candle on the 1^st of February to honor the life of Bob Rafsky. I still tear up when I sit down to read anything written by Larry Kramer. And, I still want to talk about the spreading of HIV/AIDS and it’s effects on the global community to anyone who will listen.

While I've maintained a status of HIV negative SEVEN of my loved ones have been diagnosed with HIV. Without realizing it, I've begun to adopt a mentality familiar to Mickey Marcus when he angrily questioned the status of both himself and Bruce Niles, character's from The Normal Heart. Both Mickey and Bruce had lover's who'd died of AIDS and yet, the remaining lover's were presumed to be HIV negative.

Somewhere between fighting for Ryan White's right to use a public restroom, and Magical's Johnson being so fucking rich we forget it has HIV, we stopped talking about it. We stopped wearing our red ribbon. We stopped teaching about the dangers of drugs and mental illness, and how it correlates to the spreading of STIs. We stopped keeping track of who's getting infected to the point where women of color are walking around with a God damned bulls-eye on their forehead. But, most don't know because we stopped talking about it. We stopped rallying. We stopped caring. We stopped taking care of one another. Well, I'm not going to stop. I. AM. NOT. GOING. TO. STOP.

The magical one-a-day pill that people in-the-know refer to is indeed magical. It can morph your status into undetectable and give you over 90% chance of keeping the virus to yourself even in situations where you engage in unprotected sex. The one-a-day is awesome. If you have health insurance. And, you take care of yourself. And, you're not so strung out on drugs that you remember (or care to) take them. If you can't check those boxes, then baby, you as good as gone. I know. I've seen it happen.

So, why the fuck did we stop talking about it again?

And, when I refer to ignorant victims, I'm not talking about people living with HIV/AIDS. I'm talking about us. Me. Those of you who, like myself, want to believe that wearing a ribbon and donating to ACT UP during Pride Week is good enough. Thinking that even though we can't eradicate the virus, we've got it 'under control'. I assure you, it is far from controlled. We're victims because this affects us - ALL OF US, whether we acknowledge it or not. And, we're ignorant for simply resting comfortably in our lack of knowledge and action.

I've got more questions than answers. I've got my own bag of misconceived notions about the virus. What it is, what it means, how to treat it, how to control infection. How to help those who've tested positive, while still rallying and protecting those at risk. I'm not really sure how to approach or even discuss it. But, I know I won't figure it out if I stop talking about it.

I am both anxious and afraid to learn more and speak louder about the plague. Believe you me, I will be stating things that may not always be 100% right. I'm prepared to write that off as an educational expense.

I cannot force anyone to care as much as I do about what this virus is doing to our lives. The lives of our friends and our families. Our global community. I can only hope that we go on this informative journey together. That we feed off of each other's ideas and concerns, in a good way.

I. Am. Not. Going. To. Stop. Talking. About. HIV and AIDS.