A&U October 2015 by A&U: America's AIDS Magazine

OCTOBER 2015 • ISSUE 252 • AMERICA’S AIDS MAGAZINE

gilles

MARINI

THE FRENCH SERVICEMAN-TURNED-ACTOR & U.S. CITIZEN IMPORTS HIS PASSION FOR LIVING AND FOR FIGHTING AIDS

rethinking pleasure

HOW DO OLDER GAY MEN NAVIGATE SEX IN THE ERA OF PrEP?

FURRY BEST FRIENDS

WHEN DOGS HEAL, A NEW PROJECT, SHARES PORTRAITS OF WELLNESS

plus • 2015 Christopher Hewitt Award Winners

COMPLERA is a prescription medicine for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood. COMPLERA can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. COMPLERA combines 3 medicines into 1 pill to be taken once a day with food. COMPLERA should not be used with other HIV-1 medicines.

Just the

one

for me

COMPLERA is a complete HIV-1 treatment that combines the medicines in TRUVADA + EDURANT in only 1 pill a day.*

Ask your healthcare provider if COMPLERA may be the one for you. *COMPLERA is a combination of the medicines in TRUVADA (emtricitabine and tenofovir disoproxil fumarate) and EDURANT (rilpivirine).

Pill shown is not actual size.

COMPLERA does not cure HIV-1 infection or AIDS.

To control HIV-1 infection and decrease HIV-related illnesses you must keep taking COMPLERA. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them. It is not known if COMPLERA is safe and effective in children under 18 years old.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about COMPLERA?

COMPLERA can cause serious side effects: • Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. • Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions. • Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking COMPLERA, your hepatitis may suddenly get worse. Do not stop taking COMPLERA without first talking to your healthcare provider, as they will need to monitor your health. COMPLERA is not approved for the treatment of HBV.

Who should not take COMPLERA?

Do not take COMPLERA if you: • Take a medicine that contains: adefovir (Hepsera), lamivudine (Epivir-HBV), carbamazepine (Carbatrol, Equetro, Tegretol, TegretolXR, Teril, Epitol), oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin, Dilantin-125, Phenytek), rifampin (Rifater, Rifamate, Rimactane, Rifadin), rifapentine (Priftin), dexlansoprazole (Dexilant), esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole sodium (Protonix), rabeprazole (Aciphex), more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate, or the herbal supplement St. John’s wort. • Take any other medicines to treat HIV-1 infection, unless recommended by your healthcare provider.

What are the other possible side effects of COMPLERA?

Serious side effects of COMPLERA may also include: • Severe skin rash and allergic reactions. Call your doctor right away if you get a rash. Some rashes and allergic reactions may need to be treated in a hospital. Stop taking COMPLERA and get medical help right away if you get a rash with any of the following symptoms: severe allergic reactions causing a swollen face, lips, mouth, tongue or throat which may lead to difficulty swallowing or breathing; mouth sores or blisters on your body; inflamed eye (conjunctivitis); fever, dark urine or pain on the right side of the stomach-area (abdominal pain). • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood tests to check your kidneys before starting treatment with COMPLERA. If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider may also check your kidneys during treatment with COMPLERA.

Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: feeling sad or hopeless, feeling anxious or restless, have thoughts of hurting yourself (suicide) or have tried to hurt yourself. • Changes in liver enzymes: People who have had hepatitis B or C, or who have had changes in their liver function tests in the past may have an increased risk for liver problems while taking COMPLERA. Some people without prior liver disease may also be at risk. Your healthcare provider may do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking COMPLERA. •

The most common side effects of COMPLERA include trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, and depression. Other common side effects include vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), and pain. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What should I tell my healthcare provider before taking COMPLERA?

All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, mental health, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking COMPLERA without first talking with your healthcare provider. • If you take rifabutin (Mycobutin). Talk to your healthcare provider about the right amount of rilpivirine (Edurant) you should take. • If you take antacids. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. • If you take stomach acid blockers. Take acid blockers at least 12 hours before or at least 4 hours after you take COMPLERA. Ask your healthcare provider if your acid blocker is okay to take, as some acid blockers should never be taken with COMPLERA. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking COMPLERA. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in COMPLERA can pass into breast milk, and it is not known if this can harm the baby. •

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.

Brief Summary of full Prescribing Information COMPLERA® (kom-PLEH-rah) (emtricitabine 200 mg, rilpivirine 25 mg, tenofovir disoproxil fumarate 300 mg) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information, including Patient Information. What is COMPLERA? • COMPLERA is a prescription medicine used as a complete HIV-1 treatment in one pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood (this is called ‘viral load’). Complera can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. • COMPLERA is a complete HIV-1 medicine and should not be used with any other HIV-1 medicines. • COMPLERA should always be taken with food. A protein drink does not replace food. • COMPLERA does not cure HIV-1 or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider about how to prevent passing HIV-1 to others. Do not share or reuse needles, injection equipment, or personal items that can have blood or body fluids on them. Do not have sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. What is the most important information I should know about COMPLERA? COMPLERA can cause serious side effects, including: • Build-up of an acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take COMPLERA or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: – feel very weak or tired – have unusual (not normal) muscle pain – have trouble breathing – having stomach pain with nausea or vomiting – feel cold, especially in your arms and legs – feel dizzy or lightheaded – have a fast or irregular heartbeat • Severe liver problems. Severe liver problems can happen in people who take COMPLERA. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems: – your skin or the white part of your eyes turns yellow (jaundice) – dark “tea-colored” urine – light-colored bowel movements (stools) – loss of appetite for several days or longer – nausea – stomach pain • You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time.

• Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take COMPLERA, your HBV may get worse (flare-up) if you stop taking COMPLERA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. COMPLERA is not approved for the treatment of HBV, so you must discuss your HBV with your healthcare provider. – Do not run out of COMPLERA. Refill your prescription or talk to your healthcare provider before your COMPLERA is all gone. – Do not stop taking COMPLERA without first talking to your healthcare provider. – If you stop taking COMPLERA, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking COMPLERA. Who should not take COMPLERA? Do not take COMPLERA if you also take any of the following medicines: • Medicines used for seizures: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal); phenobarbital (Luminal); phenytoin (Dilantin, Dilantin-125, Phenytek) • Medicines used for tuberculosis: rifampin (Rifater, Rifamate, Rimactane, Rifadin); rifapentine (Priftin) • Certain medicines used to block stomach acid called proton pump inhibitors (PPIs): dexlansoprazole (Dexilant); esomeprazole (Nexium, Vimovo); lansoprazole (Prevacid); omeprazole (Prilosec, Zegerid); pantoprazole sodium (Protonix); rabeprazole (Aciphex) • Certain steroid medicines: More than 1 dose of dexamethasone or dexamethasone sodium phosphate • Certain herbal supplements: St. John’s wort • Certain hepatitis medicines: adefovir (Hepsera), lamivudine (Epivir-HBV) Do not take COMPLERA if you also take any other HIV-1 medicines, including: • Other medicines that contain emtricitabine or tenofovir (ATRIPLA, EMTRIVA, STRIBILD, TRUVADA, VIREAD) • Other medicines that contain lamivudine (Combivir, Epivir, Epzicom, Triumeq, Trizivir) • rilpivirine (Edurant), unless you are also taking rifabutin (Mycobutin) COMPLERA is not for use in people who are less than 18 years old. What are the possible side effects of COMPLERA? COMPLERA may cause the following serious side effects: • See “What is the most important information I should know about COMPLERA?” • Severe skin rash and allergic reactions. Skin rash is a common side effect of COMPLERA but it can also be serious. Call your doctor right away if you get a rash. In some cases, rash and allergic reaction may need to be treated in a hospital. Stop taking COMPLERA and call your doctor or get medical help right away if you get a rash with any of the following symptoms: – severe allergic reactions causing a swollen face, lips, mouth, tongue or throat, which may cause difficulty swallowing or breathing – mouth sores or blisters on your body – inflamed eye (conjunctivitis) – fever, dark urine or pain on the right side of the stomach-area (abdominal pain) • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking COMPLERA. If you have had kidney problems in the past or need to take another medicine that can cause kidney problems, your healthcare provider may need to do blood tests to check your kidneys during your treatment with COMPLERA.

• Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: – feeling sad or hopeless – feeling anxious or restless – have thoughts of hurting yourself (suicide) or have tried to hurt yourself • Change in liver enzymes. People with a history of hepatitis B or C virus infection or who have certain liver enzyme changes may have an increased risk of developing new or worsening liver problems during treatment with COMPLERA. Liver problems can also happen during treatment with COMPLERA in people without a history of liver disease. Your healthcare provider may need to do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms and face may also happen. The cause and long term health effect of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having any new symptoms after starting your HIV-1 medicine. The most common side effects of COMPLERA include: • Trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, depression Additional common side effects include: • Vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), pain Tell your healthcare provider if you have any side effect that bothers you or that does not go away. • These are not all the possible side effects of COMPLERA. For more information, ask your healthcare provider. • Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What should I tell my healthcare provider before taking COMPLERA? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, mental health, bone, or liver problems, including hepatitis B or C infection. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn child. – There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed if you take COMPLERA. – You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. – Two of the medicines in COMPLERA can pass to your baby in your breast milk. It is not known if this could harm your baby. – Talk to your healthcare provider about the best way to feed your baby.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements: • COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. • If you take certain medicines with COMPLERA, the amount of COMPLERA in your body may be too low and it may not work to help control your HIV-1 infection. The HIV-1 virus in your body may become resistant to COMPLERA or other HIV-1 medicines that are like it. • Be sure to tell your healthcare provider if you take any of the following medicines: – Rifabutin (Mycobutin), a medicine to treat some bacterial infections. Talk to your healthcare provider about the right amount of rilpivirine (Edurant) you should take. – Antacid medicines that contain aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. – Certain medicines to block the acid in your stomach, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine hydrochloride (Zantac). Take the acid blocker at least 12 hours before or at least 4 hours after you take COMPLERA. Some acid blocking medicines should never be taken with COMPLERA (see “Who should not take COMPLERA?” for a list of these medicines). – Medicines that can affect how your kidneys work, including acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex), and valganciclovir (Valcyte). – clarithromycin (Biaxin) – erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) – fluconazole (Diflucan) – itraconazole (Sporanox) – ketoconazole (Nizoral) – methadone (Dolophine) – posaconazole (Noxafil) – telithromycin (Ketek) – voriconazole (Vfend) Know the medicines you take. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Do not start any new medicines while you are taking COMPLERA without first talking with your healthcare provider. Keep COMPLERA and all medicines out of reach of children. This Brief Summary summarizes the most important information about COMPLERA. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about COMPLERA that is written for health professionals, or call 1-800-445-3235 or go to www.COMPLERA.com. Revised: May 2015

COMPLERA, the COMPLERA Logo, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, TRUVADA, VIREAD, and VISTIDE are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners.

AIDS WALK

LOS ANGELES OCT. 11, 2015 A fundraising walk starting and ending in West Hollywood Benefiting

and more than 20 other L.A. County AIDS service organizations.

213.201.WALK PREMIER SPONSORS

A special thank you to A&U Magazine #aidswalkla aidswalkla

aidswalkla

Created and produced by MZA Events. AIDS Walk Founder/Senior Organizer: Craig R. Miller. ÂŠ MZA Events, 2015

c o n t e n t s October 2015

38 Cover Actor Gilles Marini Talks with A&U’s Sean Black About How His Formative Years in France Shaped His Compassion & Why He Is Dedicated to Revving Up Funds and Awareness for HIV/ AIDS Here in the U.S.

Departments

Features 30 Gallery Photographer J. Tomás López Revisits Faces of AIDS, His Seminal Series That Helped Bring Beauty and Dignity to Individuals Living with the Disease

Frontdesk

Mailbox

NewsBreak

Ruby’s Rap

34 When Dogs Heal A New Photographic Project Features Individuals Living with HIV & Their Canine Companions in an Effort to Show the Power of Therapeutic Relationships

Just*in Time

TYing It All Together

Our Story, Our Time

Brave New World

48 Christopher Hewitt Awards 2015 A&U’s Literary Editor Brent Calderwood Presents the Winners of Our Third Annual Literary Contest: Dale Corvino, Victoria Noe, Noah Stetzer & Sean Patrick Mulroy

Treatment Horizons

Hep Talk

Destination: Cure

The Culture of AIDS

Lifelines

Survival Guide

cover by Sean Black

viewfinder

lifeguide

A&U Frontdesk

Vive La France!

ctober marks the anniversary of Rock Hudson’s death from AIDS-related causes at age fifty-nine. October 2, to be exact. It had only been a few short months since the hunky leading man of the 1950s and 1960s had held a press conference with his Pillow Talk costar and friend Doris Day to announce the launch of her new cable show, and the press and the public began buzzing about his haggard appearance. A few weeks later, Hudson collapsed while staying at a Paris hotel and his publicist released a statement to explain: the effects of liver cancer. Then, a few days later, another press statement was released. Hudson was living with AIDS. He had been diagnosed as HIV-positive a year earlier. In that time, he had traveled to France for tests and potential treatments unavailable in the U.S. AIDS panic, driven by the press and the public, swirled in the wake of his announcement and death, propelled at least in part about the gossip-ready fact that he had been gay, though closeted by Hollywood. Hudson himself seemingly fended off the moral judgments surrounding sex and HIV at the time by theorizing that he most likely contracted the virus from HIV-infected blood transfusions during heart bypass surgery in 1981. But, despite all the negativity that followed his disclosure, Rock Hudson propelled a wave of positivity. His willingness to talk about the disease helped the mainstream see the human side of the epidemic; people outside of the LGBT community and urban centers could no longer distance themselves from HIV and pretend it didn’t exist. His life and death not only amplified awareness—it produced a surge in research funding. Hudson himself bequested $250,000, the same amount Air France charged him to charter a 747 back to the States. This bequest set up the Rock Hudson Memorial Fund of AIDS Research, which helped launch amfAR, an AIDS research organization that had been cofounded by his close friend Elizabeth Taylor. How times have changed. Individuals living with HIV/AIDS are still nettled by stigma and discrimination, and dis-

A M E R I C A’ S A I D S M A G A Z I N E issue 252 vol. 24 no. 10 October 2015 editorial offices: (518) 426-9010 fax: (518) 436-5354

ease risk has been linked to social drivers like racism, gender oppression, and homophobia. And we still face barriers to care, financial and otherwise. We still risk pariah status if we disclose. Yet, the voices of the past, those who can no longer speak, still resonate through us. Their echoes have become our rallying cries. I don’t remember a time when so many individuals living with the disease have stepped forward to become advocates. How times have changed. Jane Fowler, an octogenarian and this month’s Ruby Comer interview, speaks about living with HIV whenever she can. She is a good example of the phenomenal women that our columnist Tyeshia Alston, a woman living with HIV/AIDS and founder of SAAVED, Inc., speaks about this month in her effort to empower female voices. That empowerment is also on display in “When Dogs Heal,” our feature about a photo project of the same name that showcases the images and stories of individuals living with HIV/AIDS and their therapeutic relationships with their canine companions. How times have changed. Now leading men can be leaders in the AIDS fight. In this month’s cover story by A&U’s Sean Black, we feature Gilles Marini. He is secure enough in his skin to embrace his gay fans. He is laser-focused on his career, and yet he makes time to participate in Kiehl’s LifeRide, a benefit for amfAR. Hailing from France and now a U.S. citizen, he is committed to making sure the public and our children are hyperaware of HIV/AIDS and the need for compassion and research funding: “It isn’t a victory until we end this disease.” None of this would have happened thirty years ago. None of this would have happened without Rock Hudson. Or amfAR. Or activists and researchers. Or the thousands of people who stood up for health justice along the way. And that’s an anniversary we should celebrate.

DAVID WAGGONER

Editor in Chief & Publisher David Waggoner Managing Editor: Michael Needle Senior Editors: Dann Dulin, Sean Black Editor at Large: Chip Alfred Special Projects Editor: Lester Strong Literary Editor: Brent Calderwood Arts Editor: Alina Oswald Consulting Editor: Nick Steele Copy Editor: Maureen Hunter Contributing Editors: Sarah Churchill Downes, Reed Massengill, Kelly McQuain, Lesléa Newman, Robert E. Penn Contributing Writers: Noël Alumit, V. Anderson, Heather Arculeo, Larry Buhl, Ruby Comer, Nancy Ellegate, Diane Goettel, Sally Hessney, Keiko Lane, Angela Leroux-Lindsey, Sherri Lewis, Mark Rebernik, Dale Reynolds, Elizabeth Rodgers, David Rosenberg, Corey Saucier, Mariel Selbovitz, Justin B. Terry-Smith, Patricia Nell Warren, Chuck Willman, Jeannie Wraight, Robert Zukowski Art Director: Timothy J. Haines Contributing Photographers: Jordan Ancel, Davidd Batalon, Mark Bennington, Tom Bianchi, Sean Black, Adam Bouska, Brian Bowen Smith, Fred Brashear, Jr., Tim Courtney, Duane Cramer, Stephen Churchill Downes, Greg Gorman, Francis Hills, Renée Jacobs, Tara Lessard, Tom McGovern, Nancy Perry, Annie Tritt National Advertising Director: Harold Burdick, Jr. Sales & Marketing: David L. Bonitatibus Advertising Sales Office: (518) 426-9010 National Advertising Representative: Rivendell Media (212) 242-6863 Subscription Info: (518) 426-9010 Circulation Manager: Robert Schelepanow Bookkeeper: Richard Garcia Board of Directors President: David Waggoner Vice President: Harold Burdick, Jr. Secretary: Richard Garcia Founding Board Members: Mark S. Labrecque, 1961–1992, Christopher Hewitt, 1946–2004, Mark Galbraith, 1962–2011 In Memoriam: Bill Jacobson, 1939–2005 Rhomylly B. Forbes, 1963–2011 Chris Companik, 1957–2012 A&U (ISSN 1074-0872) is published by Art & Understanding, Inc., 25 Monroe St., Suite 205, Albany, NY 12210-2743, USA. For A&U advertising information please call 518-426-9010; for subscriptions and address changes please call 518-426-9010; for letters to the editor and unsolicited manuscripts write A&U Magazine, 25 Monroe Street, Albany, New York 12210; fax 518-436-5354; or e-mail: mailbox@ aumag.org. All unsolicited manuscripts that do not have a S.A.S.E. cannot be returned and will not be acknowledged. ©2015 Art & Understanding, Inc. ALL RIGHTS RESERVED. A&U may not be reproduced in any manner, either in whole or in part, without written permission of the publisher. A&U and the graphic representations thereof are the registered trademarks of Art & Understanding, Inc., a 501 (c) (3) nonprofit organization. Individual Subscription rates: $24.95 (12 issues). Institutional rates: $80.00 (12 issues). For subscriptions outside the USA and possessions, $30.95/Canada, $49.95/international, payable in advance in U.S. currency. First North American serial rights revert to contributors upon publication. A&U retains the right to anthologize work in further issues, as well as in microform or reprinting on the Internet within the context of each issue. Statements of writers, artists and advertisers are not necessarily those of the publisher. Readers note: subjects and contributors to A&U are both HIV-positive and HIV-negative. In the absence of a specific statement herein concerning the serostatus of any individual mentioned in, or contributing material to, this publication, no inference is made with respect thereto and none should be implied. Letters written to A&U or its contributors are assumed intended for publication. Art & Understanding, Inc. assumes no responsibility or liability for unsolicited submissions and does not guarantee the return thereof. PostMaster: Please send address corrections to A&U Magazine, 25 Monroe Street, Suite 205, Albany NY 12210-2743, USA

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A&U Mailbox

x o b l i ma Rethinking Diva I don’t think that enough can be said about all the good things that Sheryl Lee Ralph [cover story, “Sing No Victim’s Song,” by Chael Needle, August 2015] has

multifaceted performer Sheryl Lee Ralph is. She has done just about everything on Broadway and in Hollywood. But she still has the time and effort to go out there and fight the stigma of HIV and AIDS. I mean the Diva Foundation, DIVAS Simply Singing, and many other charity events, it’s just out of sight. What else can you say about this fascinating woman? Just keep on doing what you’re doing, it’s just so wonderful. —Merrill Youngblood Carson City, Nevada

Straight from the Heart The article about Joshua Middleton [“Pozitive Hope,” by Robert Kingett, August 2015] was very heartwarming and touching. Here’s a straight man who contracts HIV and people around him can’t believe that a straight guy could possibly come down with a horrible disease that is supposedly only affecting gay people and drug users. Yes, believe it or not America, but HIV and AIDS do affect straight people, too. You would think that this would bring Joshua down, but it doesn’t. He started a blog to talk about

“Sheryl Lee Ralph had the guts, like Elizabeth Taylor, to take on the establishment and do what she could to help people dying and suffering from AIDS. I respect what she had to say: “So when as a young woman I saw how my friends were being stigmatized and marginalized in their time of sickness and great need, I had to put my fear aside and speak up. It didn’t make me very popular in some circles. But I have learned that what other people think of me is none of my business.”

It’s just amazing what a multitalented,

Not So Grand I’m sorry for being negative but I found the story on Steve Grand by Dann Dulin [“Vocal Embrace,” August 2015] to be a total puff piece. I thought it was really a waste of time. Okay, he is very cute, very good looking, has a very nice body. He may have some talent as a performer, who really knows? He does some AIDS benefits, all well and good, but I found his views as being very nothing. I feel like he may have read a book on AIDS and just repeated it to Dann Dulin in his interview. Please, please in the future do a real story about AIDS, and what a person has really done about the AIDS epidemic. —Walter Strasser Fayetteville, Arkansas

what he was going through. He says: “My goal is to help make sure that those living with HIV now get the emotional support needed in coping with this diagnosis.” What an incredible human interest story. —Judy Faslington Olympia, Washington`

Send e-mail to: mailbox@aumag.org Send letters to: Mailbox, A&U, 25 Monroe Street, Suite 205, Albany, NY 12210 Or click on “Mailbox” on our Web site’s home page: www.aumag.org Tweet Us @au_magazine Facebook: http://on.fb.me/AUFANPAGE All correspondence requires name, address, and daytime phone number for confirmation. Letters may be edited for length and clarity.

A&U • OCTOBER 2015

photo by Sean Black

done and keeps doing to fight AIDS. Sheryl Lee Ralph had the guts, like Elizabeth Taylor, to take on the establishment and do what she could to help people dying and suffering from AIDS. I respect what she had to say: “So when as a young woman I saw how my friends were being stigmatized and marginalized in their time of sickness and great need, I had to put my fear aside and speak up. It didn’t make me very popular in some circles. But I have learned that what other people think of me is none of my business.” I say do your own thing and screw other people. Anyway, I say what a great article on a great lady. —Lloyd Bantine Pueblo, Arizona

NEWSBREAK

photos by Alina Oswald

Power, Strength, Truth On September 27, National Gay Men’s HIV/AIDS Awareness Day, a new initiative and companion website launched a rainbow of warrior spirit to combat HIV/AIDS. The website features the stories of young men living with or affected by HIV—HIV Warriors—who are commited to destigmatizing the disease, educating, and promoting testing and treatment. Saturated with pride colors, these HIV Warriors are trained peer educators who will share their experiences and truths across their communities. The young men embody the strength-in-diversity that the rainbow flag symbolizes: “I am the Orange Warrior. My power is healing. I am a professor, and an inventor. My goal is to eliminate HIV from the world....” “I am the Green Warrior.... My truth is about the power of family. I’ve learned so much since my diagnosis, and it all comes back to this Audrey Hepburn quote: ‘The best thing to hold onto in life is each other.’” The vibrant voices are accompanied by stunning photographs of each Warrior, shot by Alina Oswald, A&U’s Arts Editor, who frequently participates in community-based AIDS awareness projects. The site connects users to free testing resources and PrEP/PEP resources, as well as a way to connect via Facebook. A national tour of the photographs is in the works. The creators plan on adding new Warriors to the rainbow roster as well. HIV Warriors was created by ASCNYC, in partnership with HeadsOrTailsNYC.com. ASCNYC, a multiservice community organization that creates a safe, support network for New Yorkers living with and at risk for HIV/AIDS, offers peer education and training, harm reduction, specialized women’s services, HIV counseling and testing, mental health services, medical and holistic care, case management, and support groups, among others. An NYC DOHMH-funded demonstration project, Heads or Tails creates cutting-edge HIV and STI educational materials targeted toward young men. For more information about HIV Warriors, log on to: www.hivwarriors.com. OCTOBER 2015 • A&U

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NewsBreak

PrEP Efficacy No new infections—that was the upshot of the findings of a study of PrEP that followed patients over more than two and a half years of observation. Recently published in the journal Clinical Infectious Diseases, the Kaiser Permanente study is one of the largest of its kind to look at the efficacy of preexposure prophylaxis in a clinical setting, that is, in a real-world context three years after its FDA approval. Some critics had cautioned that the efficacy of PrEP shown in a controlled trial or demonstration project might not bear out in everyday use, away from the support of a controlled trial. The authors, led by Jonathan Volk, MD, MPH, physician and epidemiologist at Kaiser Permanente San Francisco Medical Center, suggest that PrEP, a fixed-dose daily regimen of emtricitabine and tenofovir, may even work among individuals considered at highest risk for contracting HIV. Across thirty-two months of observation at Kaiser Permanente San Francisco Medical Center, 657 individuals started PrEP out of the 1,045 referrals that had been made for the prevention tool. Average length of use during study time was 7.2 months, or 388 person-years of PrEP use observation. Average age was thirty-seven, with ninety-nine percent of PrEP users men who have sex with men (three heterosexual women and one transgender MSM). PrEP users were more likely to report having multiple sexual partners, though not more likely to report engaging in sexual activity with an HIV-infected partner, compared to those individuals who did not use PrEP. Seventy-four percent of the 143 patients who were asked about behavior change after six months of PrEP use reported their number of sexual partners remained unchanged. Fifteen percent reported a decrease, while eleven percent reported an increase. The use of condoms remain unchanged for fifty-six percent of the PrEP users, with a decrease reported by forty-one percent and an increase reported by three percent. Though no new HIV infections occurred across the full study period, thirty percent of PrEP users were diagnosed with at least one sexually transmitted infection (STI) after six months of starting. After twelve months, fifty percent had been diagnosed with any STI: rectal STI (thirty-three percent), chlamydia (thirty-three percent), gonorrhea (twenty-eight percent), and syphilis (5.5 percent). The study authors note that it is hard to assess these rates of STI infections without a control group, that is, individuals not on PrEP; they point out that patients are ongoingly and regularly screened and treated for STIs, a practice that is key to any PrEP treatment program. They also point out that patients on PrEP should be monitored for side effects, such as changes in kidney function, associated with PrEP, which is also known as Truvada. While the patients followed were overwhelmingly men who have sex with men, the study authors cited the need for outreach to others at risk for contracting HIV, such as transgender women, heterosexual men and women, and those who use injection drugs.

photo by Thomas Evans

The Sky Is the Limit The U.S.-based social media campaign HIV Equal, dedicated to destigmatizing HIV and increasing awareness and access around testing, recently unveiled a new vibe in its design at the 2015 United States Conference on AIDS. The visual rebranding heralds a different showcase for its core message: We are all equal across serostatuses. Its creators feel the shift in color palette, from magenta to a more gender-neutral sky-blue, will promote inclusiveness and help nurture more conversations about stigma and testing. The images still feature personalized, pink-colored messages of empowerment: “I Am _______. I Am HIV Equal.” Participants who agree to be photographed for the campaign are still offered free, confidential HIV testing, and the shoots attract celebrities and non-celebrities alike. HIV Equal regularly holds testing events in cities across the U.S. In a prepared release, Dr. Gary Blick, Chief Medical Officer of World Health Clinicians, the originator of the HIV Equal initiative, shared, “We’re committed to ending HIV stigma and stigma that prevents people from getting HIV tested. In doing so, we will stem and reverse the rise in HIV infection rates among men who have sex with men, and other vulnerable populations, here in the States. I began my work in the field at the beginning of the epidemic, and like my colleagues I find a rise in infection rates unacceptable. We’re bringing awareness to youth who need it most, and we’re doing it in a very creative, proactive, and affirming way.” For more information, log on to: www.hivequal.org. OCTOBER 2015 • A&U

Now it’s my turn. Ruby Comer: It’s so nice to meet you, Jane. [She’s on the horn this afternoon from her home in Kansas City.] Why is HIV infecting older populations? Jane Fowler: Because of the lack of information! There’s also a belief that at “this age” there’s nothing to fear. There’s a supposition that HIV is a disease of “them”—meaning the younger set, the promiscuous, and so on. Also, medical providers tend to ignore the fact that many older persons, despite myths and stereotypes, remain sexually active. And, elders are less likely to consistently use condoms during sex because of a generational mindset and unfamiliarity with HIV prevention methods. Jane, do you think many doctors talk to their over-fifty patients about HIV? Too many physicians and other health

service providers are reluctant to even discuss or question matters of sex with this age group. How can we reach out more to senior citizens? Ya know, I never liked that term. I prefer “Seasoned Citizens.” And we are! One way would be for HIV educators to be more media-focused and savvy. Find ways to promote awareness and knowledge for the uneducated Seasoned Citizens through newspaper and magazine articles and radio and television reports. Establish a kind of speakers’ bureau in which volunteers would contact senior centers and retirement sites and ask to give educational programs for clients and residents. Good deal. What advice would you give someone who’s newly diagnosed? Immediately accept the fact of your virus. Waste no time in seeking medical A&U • OCTOBER 2015

Ruby illustration by Davidd Batalon; photo courtesy J. Fowler

t’s no myth. Us oldsters do have carnal relations. We can bend, twist, turn, bump and grind just like any youngster, though the bends are not quite as deep and then there’s my trick knee that often bothers me…but I digress. Just because we’re past a certain age doesn’t mean we can’t scratch that itch now and then! Just ask Jane Fowler. At forty-eight, after the dissolution of her twenty-four year marriage, she started dating again. Unfortunately, he was infected with HIV, and in 1991, Jane tested positive. Depression set in. After four years of semi-isolation, upon the advice of her only child, Stephen, she began to speak about the epidemic in churches, high schools, and community centers. This brave woman put a face to the HIV-over-fifty-set. At one appearance, the Kansas City native wittingly bantered, “I decided to speak out and put an old, wrinkled, white, heterosexual face to this disease.” That’s mu kind of gal! In 1995, Jane and some friends founded the National Association on HIV Over Fifty (NAHOF), where she served as co-chairman of the board for five years. In 2002, she established HIV Wisdom for Older Woman (HIV WOW), which is primarily a program of prevention and support. It’s a one-woman organization with Jane reaching out to others through her speeches (she’s racked up over 1,500 speeches) and through oneon-one talks with those in need. She’s also a founding member of the national Positive Women’s Network. Jane, an eighty-year-old grandmother of two, who could be Betty White’s sister, is a true revolutionary. She’s not done yet! Jane hopes to fill her calendar with more speaking engagements to share her message. And people do listen. She’s appeared on CNN, PBS, and The Oprah Winfrey Show. Barbara Walters interviewed her on an episode of 20/20, and Good Housekeeping and People profiled her, as well.

JANE FOWLER

The longest consecutive running musical AIDS benefit in the country!

Have you lost anyone close to you from this disease? No, fortunately….[She stops abruptly.] Wait. The man who infected me died. Sometime following my diagnosis in 1991, I phoned to tell him about my situation, as we were no longer seeing each other. He chose to do

and social services assistance. Study and learn about HIV and AIDS and understand that it’s no longer a death sentence. It’s now termed a chronic disease for those who are adherent to prescribed medications. Also, you might look outside yourself and consider, if possible, making some kind of contribution to the cause. My coming out as positive and doing the work that I do, has been extremely liberating and gratifying for me. Perhaps it would be for you, too. In a nutshell, when you speak about HIV, what do you say? I mean: What do you say to high Jane Fowler with son Stephen and granchildren school or college kids—and—what Tilda and Milo Fowler do you say if you are addressing seniors? nothing about his infection. Essentially the same thing to both groups. I tell audiences that HIV, transOy! [There’s a short silence.] On the lighter mitted sexually or by sharing intraveside, I want to know what’s your favorite nous needles, does not discriminate, film of all time? that it can infect anyone, regardless of [She responds swiftly.] Lawrence of Araage, race, sexual orientation, education, bia. It came out in 1962, a biopic about socio-economic status, religion, politics, British officer T. E. Lawrence, directed by etc. I remind everyone: you never know David Lean and starring Peter O’Toole. It the sexual or drug history of anyone but was a magnificent, memorable cinema exyourself. Everyone is at the same risk. perience. I drove up to Chicago so I could If one has unprotected sex, unless in a see it, since it was several weeks away mutually monogamous relationship, or from opening in Kansas City! shares needles, one is at risk for contracting HIV. And it need not happen. You sly dog you! Oh, the movie is one Remember that this is a preventable of my faves too. So at sixty, Jane, HIV disease, so be careful and cautious.

profoundly changed your course in life. It transformed you from a professional journalist into a media interviewee, from private person into a public activist. Yes indeed, Ruby! I traded my typewriter for a microphone and embarked on a career as a prevention educator, speaking in thirty states, from New York to California, Minnesota to Texas and on foreign lands in South Africa, Switzerland, France, and Canada. Your son, Stephen, must be very proud of you. You certainly are a role model, Ms. Fowler. Whom do you look up to? I don’t consider myself a role model [she states sincerely, her voice indicating “why would I think that?”], and you’d have to ask my son if he’s proud of me. But, interestingly, it is my son who I look upon with gratitude and appreciation for the manner in which he has supported me. He was the first person I told about what had happened to me, and there’s never been any hint of disgust or disappointment. In fact, before protease inhibitors were introduced and my T cells began to fall, he knew I was worried. He volunteered to leave his home in San Francisco and return temporarily to Kansas City if necessary. But that did not need to happen, for which I was thankful. Who are your heroes in the epidemic, my dear? For me, there’s not one hero but a band of them. The non-infected individuals who have chosen to work in the HIV and AIDS field, like medical personnel, social workers, administrators, and volunteers. They all have dedicated their lives to saving lives, with an end goal of helping to eliminate the epidemic. For more information about speaking engagements, please contact Jane Fowler by e-mail at janepfowler@gmail.com or by phone at (816) 421-5263. Ruby Comer is an independent journalist from the Midwest who is happy to call Hollywood her home away from home. Reach her by e-mail at MsRubyComer@aol.com. A&U • OCTOBER 2015

photo scourtesy J. Fowler

Say, when did you first hear about the epidemic? In 1985 when Rock Hudson was dying of AIDS. Most of us thought then that AIDS was an epidemic only in the white gay population, so what did we heterosexuals have to fear?...Oh my, had I only known the truth! [She whispers in a low register.]

Bringing hearts together since 1998

P zMatch.c m

Hey Justin— Can I ask you something about STDs? I’m from Turkey so my English isn’t so good. That can lead to death right? Sorry 4 asking. I’m just so scared about that thing. Please message me back as soon as u read my message. Thanks. Is STD may lead to death? —Noel Thank you for your question. Well, I would need to know what STD you are talking about. (Also we are trying to not say STD anymore we try to use STI or sexually transmitted infection, as this helps decrease stigma for people who live with STIs every day.) Now, let’s start with early detection; early detection is paramount when dealing with any STI. The earlier that you find out that you have an STI the more options you will have to deal with the STI itself. Any STI that you let linger inside your body will only get worse. Most STIs have cures but some only have options to suppress the STI. Here is a list of curable STIs: chancroid, chlamydia, crabs,

gonorrhea, scabies, syphilis, trichomoniasis, yeast infection, vaginosis, and yeast in men. Here is a list of incurable STIs, but I will go into more detail about them. Hepatitis can be very tricky, because there are five types and they are hepatitis A, B, C, D, and E; some are curable and some are not. Presently, there is no cure for hepatitis A, B, or D, though there is a vaccine for hepatitis A and B. There are new drugs that cure hepatitis C that been shown to cure hepatitis C at an effective rate of ninety-five percent. Hepatitis directly affects and damages the liver. There is no cure for HIV/ AIDS. HIV is the virus that causes AIDS, but with medication can be suppressed to the point where someone can live just as long as someone without HIV. HPV/ Warts, which is an infection on the genitalia and a women’s cervix, are also cureless. Herpes is a common disease that can present itself in the mouth (cold sore), anus, vagina, and/or penis. Herpes presents itself as a blister on the regions of the body listed above. Whether or not a STI is curable or incurable, the important thing to remember that it is you who has control over what you do next. I have friends who are co-infected with hepatitis and HIV, and who continue to live long healthy lives. But to live a long healthy life one

must make certain provisions to one’s own lifestyle. I’ve been living with HIV for ten years and I have made provisions but I also fall short in some of them. When I was diagnosed with HIV nine years ago, I was a wreck, I did drugs and drank entirely too much. I decided to make a change. I started running three miles regularly and working out when I could find the time. I also changed my eating habits. Since the medication I was on made my cholesterol increase I needed to change my diet. So I don’t eat pork as much and I decrease my egg intake. I started eating more and more fruit and started shopping for more low fat and low sodium foods. I may not be the epitome of good health, but I push onwards and upwards. Having an incurable STI is hard, but it doesn’t mean you should give up. Once you are defeated in the mind, your body will follow and falter. It’s not the end of the world, but it is another reason why you should live your life healthier than before. There are incurable diseases in the world and some we may not even know about yet; and on that note, I will leave you with these famous words by Nobel Prize-winning biologist Joshua Lederberg: “The single biggest threat to man’s continued dominance on this planet is the virus.” ◊

Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal. blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.

A&U • OCTOBER 2015

Ride the Tides we can be phenomenal women!

OCTOBER 2015 • A&U

supporter in your corner like this young man’s father in Ride who will say to you, “I just want for you to be happy.” Seriously, we all have hard times but we have to learn to find the good out of all the bad, because there is always some good in the midst of the bad. You just have to keep searching for that treasure and cherish it when you find it. Being HIV-positive has its own set of

problems. We are prejudged by others who think that they have HIV-positive people all figured out and some of those living with the virus are even ridiculed by the members of their own household. I met a young man who recently survived the worst stage of AIDS and the words he said that his mother spoke to him were words that no mother should say to her child. In response, he said “I didn’t try to get AIDS; I just thought that he loved me.” I don’t believe that he should have had to find comfort from a complete stranger; he should have been able to find comfort from the ones dearest to his heart. Nevertheless, my Pastor and I gave him words of encouragement and an ear that was willing to listen and right there in the hospital, with his approval, we prayed for him and I told him my story. At that moment, I realized that

we as individuals living with HIV/AIDS, no matter how we acquired the disease, must become a family that is ready to uplift one another at any given moment. Through SAAVED INC., I wrote a curriculum for HIV-positive women who are ready to move beyond their HIV diagnosis. This program is called “Phenomenal Woman.” The Phenomenal Woman Program is a mentorship program that is based on the triune being. I am glad to say that this program has been funded by Janssen and we are taking enrollments for October 2015. As women living with HIV we are looked down upon but, no matter how bad the situation, we must learn to stick together and become supporters of one another. I hate to say that I’ve met many HIV-positive women who at some point in their lives have lost themselves and have forgotten how valuable they are. I know, because I almost allowed HIV to define me until I looked at myself in the mirror and I reminded myself that “I was phenomenal before HIV and I am Phenomenal with HIV.” I believe that it is my job to help other women to rediscover the phenomenal woman that is locked within and, once they have rediscovered her, they must learn to ride the tides of life and live. Live phenomenally and then you would have lived your best life! Tyeshia Alston is a native of Dallas, Texas, and an HIV/AIDS activist, who “will go anywhere where people will listen.” She has done everything from travel to D.C. to speak with legislators about better healthcare access and how the disease has impacted communities to serving on panels for NMAC and other organizations and bringing her message to talk shows. In 2005 at the age of twenty-five, Alston was diagnosed with HIV and she has been on a mission since 2006 to educate people (especially our youth) about HIV/ AIDS. Visit www.saaved.org to learn more about her community-based work. Also, if you have any questions or comments please feel free to email Ms. Alston at saaved2heal@gmail.com.

illustration by Timothy J. Haines

ecently, I had the opportunity to watch a Netflix movie with Helen Hunt called Ride. Ride was based on a young man’s journey to live the best life he could live because he didn’t want to “live to work” but “work to live.” The challenge of his journey to live life was overcoming the burdens of his mother who lived her life through him, trying to overcome the one mistake that has haunted her throughout the years and that mistake (spoiler!) was leaving the room and her other son accidently dies. In the process of her overburdensome agendas and the harsh words of an overly expressive son, the two found themselves separated but forced to the ocean to surf the California waves. For my readers, here are a few words of encouragement. As we are challenged by the circumstances of life, whether good or bad, we must learn to not lose focus but learn to ride the tides of this game we play called “life.” One thing that I’ve learned is that not all tides are fun tides to surf. Yes, there are some waves that come to a surfer that makes them scream “Yeah” while throwing both hands up in the air because of the liberty they found while surfing through nature and successfully riding the waves. However, we must always consider those tides that we do not envision. Those are the currents that have knocked many surfers off of their boards. Some are able to return to standing back on their boards while there are others who simply couldn’t recover from the blow received by the wave that they attempted to ride. This is true in life. We must learn to follow our hearts but we must remain steadfast on fulfilling our dreams no matter what obstacle that has been thrown our way. Always have that one friend or

WHAT IS PREZCOBIX™ ?

• It is not known if PREZCOBIX™ is safe and effective in children under 18 years of age. • When used with other antiretroviral medicines to treat HIV-1 infection, PREZCOBIX™ may help:

Medihaler,® Migergot,® Wigraine,® Wigrettes®), methylergonovine (Methergine®), lovastatin or a product that contains lovastatin (Altoprev,® Advicor,® Mevacor ®), lurasidone (Latuda®), oral midazolam (Versed®), pimozide (Orap®), ranolazine (Ranexa®), rifampin (Rifadin,® Rifater,® Rifamate®, Rimactane®), sildenafil (Revatio®) when used for pulmonary arterial hypertension (PAH), simvastatin or a product that contains simvastatin (Simcor,® Vytorin,® Zocor ®), St. John’s Wort (Hypericum perforatum) or a product that contains St. John’s Wort, or triazolam (Halcion®).

○ reduce the amount of HIV-1 in your blood. This is called “viral load.”

• Serious problems can happen if you take any of these medicines with PREZCOBIX.™

○ increase the number of CD4+ (T) cells in your blood that help fight off other infections.

What should I tell my healthcare provider before taking PREZCOBIX™ ?

• PREZCOBIX™ is always taken in combination with other HIV medications for the treatment of HIV-1 infection in adults. PREZCOBIX™ should be taken once daily with food. • PREZCOBIX™ does not cure HIV-1 infection or AIDS, and you may still experience illnesses associated with HIV-1 infection. You must keep taking HIV-1 medicines to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider if you have any questions on how to prevent passing HIV to other people. • Please read the Important Safety Information below and talk to your healthcare provider to learn if PREZCOBIX™ is right for you.

• About all health problems. Tell your healthcare provider if you have liver problems, including hepatitis B or hepatitis C, have kidney problems, are allergic to sulfa (sulfonamide), have diabetes, have hemophilia, or have any other medical condition, are pregnant, breastfeeding, or plan to become pregnant or breastfeed. Tell your healthcare provider if you become pregnant while taking PREZCOBIX.™ • About all medicines you take. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines interact with PREZCOBIX.™ Keep a list of your medicines to show your healthcare provider and pharmacist. Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take PREZCOBIX™ with other medicines.

IMPORTANT SAFETY INFORMATION

What are the possible side effects of PREZCOBIX™ ?

What is the most important information I should know about PREZCOBIX™ ?

• The most common side effects of darunavir, one of the medicines in PREZCOBIX,™ include diarrhea, nausea, rash, headache, stomach area (abdominal) pain, and vomiting.

• PREZCOBIX™ may cause liver problems. Some people taking PREZCOBIX™ may develop liver problems which may be life-threatening. Your healthcare provider should do blood tests before and during your treatment with PREZCOBIX.™ ○ Chronic hepatitis B or C infection may increase your chance of developing liver problems. Your healthcare provider should check your blood tests more often. ○ Signs and symptoms of liver problems include dark (tea-colored) urine, yellowing of your skin or whites of your eyes, pale-colored stools (bowel movements), nausea, vomiting, pain or tenderness on your right side below your ribs, or loss of appetite. Tell your healthcare provider if you develop any of these symptoms. • PREZCOBIX™ may cause severe or life-threatening skin reactions or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. Call your healthcare provider right away if you develop a rash. ○ Stop taking PREZCOBIX™ and call your healthcare provider right away if you develop any skin changes with symptoms such as fever, tiredness, muscle or joint pain, blisters or skin lesions, mouth sores or ulcers, red or inflamed eyes like “pink eye” (conjunctivitis). • PREZCOBIX,™ when taken with certain other medicines, can cause new or worse kidney problems, including kidney failure. Your healthcare provider should check your kidneys before you start and while you are taking PREZCOBIX.™ Who should not take PREZCOBIX™ ? • Do not take PREZCOBIX™ with any of the following medicines: alfuzosin (Uroxatral®), cisapride (Propulsid®, Propulsid® Quicksolv), colchicine (Colcrys,® Mitigare,® if you have liver or kidney problems), dronedarone (Multaq®), dihydroergotamine (D.H.E.45®, Embolex ,® Migranal®), ergotamine tartrate (Cafergot ,® Ergomar ,® Ergostat ,®

• Other possible side effects include: ○ High blood sugar, diabetes or worsening diabetes, and increased bleeding in people with hemophilia have been reported in patients taking protease inhibitor medicines, including PREZCOBIX.™ ○ Changes in body fat can happen in people who take HIV-1 medicines. The exact cause and long-term health effects of these changes are not known. ○ Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. These are not all of the possible side effects of PREZCOBIX.™ For more information, ask your healthcare provider. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. Please see accompanying full Product Information for more details. Janssen Therapeutics, Division of Janssen Products, LP © Janssen Therapeutics, Division of Janssen Products, LP 2015 01/15 008417-140113

027409-150108

• PREZCOBIX™ is a prescription HIV-1 (Human Immunodeficiency Virus 1) medicine used with other antiretroviral medicines to treat HIV-1 infection in adults. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). PREZCOBIX™ contains the prescription medicines PREZISTA® (darunavir) and TYBOST® (cobicistat).

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Wisdom inspired by real people

DISCOVER YOUR WISDOM WITHIN

Visit PREZCOBIX.com to hear wisdom inspired by experts and people like you living with HIV. Ask your provider if Once-Daily* PREZCOBIX™ is right for you.

PREZCOBIX.com *PREZCOBIX™ is taken in combination with other HIV medications for the treatment of HIV-1 infection in adults.

IMPORTANT PATIENT INFORMATION PATIENT INFORMATION PREZCOBIX (prez-koe-bix) (darunavir and cobicistat) tablets Please read this information before you start taking PREZCOBIX and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment. What is the most important information I should know about PREZCOBIX? • PREZCOBIX may cause liver problems. Some people taking PREZCOBIX may develop liver problems which may be lifethreatening. Your healthcare provider should do blood tests before and during your treatment with PREZCOBIX. If you have chronic hepatitis B or C infection, your healthcare provider should check your blood tests more often because you have an increased chance of developing liver problems. Tell your healthcare provider if you have any of the below signs and symptoms of liver problems. • dark (tea colored) urine • yellowing of your skin or whites of your eyes • pale colored stools (bowel movements) • nausea • vomiting • pain or tenderness on your right side below your ribs • loss of appetite • PREZCOBIX may cause severe or life-threatening skin reactions or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. Call your healthcare provider right away if you develop a rash. Stop taking PREZCOBIX and call your healthcare provider right away if you develop any skin changes with symptoms below: • fever • tiredness • muscle or joint pain • blisters or skin lesions • mouth sores or ulcers • red or inflamed eyes, like “pink eye” (conjunctivitis) • PREZCOBIX when taken with certain other medicines can cause new or worse kidney problems, including kidney failure. Your healthcare provider should check your kidneys before you start and while you are taking PREZCOBIX. See “What are the possible side effects of PREZCOBIX?” for more information about side effects. What is PREZCOBIX? PREZCOBIX is a prescription HIV-1 (Human Immunodeficiency Virus 1) medicine used with other antiretroviral medicines to treat HIV-1 infection in adults. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). PREZCOBIX contains the prescription medicines PREZISTA (darunavir) and TYBOST (cobicistat). It is not known if PREZCOBIX is safe and effective in children under 18 years of age. When used with other antiretroviral medicines to treat HIV-1 infection, PREZCOBIX may help: • reduce the amount of HIV-1 in your blood. This is called “viral load”.

• i ncrease the number of CD4+ (T) cells in your blood that help fight off other infections. Reducing the amount of HIV-1 and increasing the CD4+ (T) cells in your blood may help improve your immune system. This may reduce your risk of death or getting infections that can happen when your immune system is weak (opportunistic infections). PREZCOBIX does not cure HIV-1 infection or AIDS. You must keep taking HIV-1 medicines to control HIV-1 infection and decrease HIV-related illnesses. Avoid doing things that can spread HIV-1 infection to others. • Do not share or re-use needles or other injection equipment. • Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades. • Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. Ask your healthcare provider if you have any questions on how to prevent passing HIV to other people. Who should not take PREZCOBIX? Do not take PREZCOBIX with any of the following medicines: • alfuzosin (Uroxatral®) • cisapride (Propulside®, Propulsid® Quicksolv) • colchicine (Colcrys®, Mitigare®), if you have liver or kidney problems • dronedarone (Multaq®) • ergot-containing medicines: • dihydroergotamine (D.H.E. 45®, Embolex®, Migranal®) • ergotamine tartrate (Cafergot®, Ergomar®, Ergostat®, Medihaler®, Migergot®, Wigraine®, Wigrettes®) • methylergonovine (Methergine®) • lovastatin or a product that contains lovastatin (Altoprev®, Advicor®, Mevacor®) • lurasidone (Latuda®) • midazolam (Versed®), when taken by mouth • pimozide (Orap®) • ranolazine (Ranexa®) • rifampin (Rifadin®, Rifater®, Rifamate®, Rimactane®) • sildenafil (Revatio®), when used for the treatment of pulmonary arterial hypertension (PAH) • simvastatin or a product that contains simvastatin (Simcor®, Vytorin®, Zocor®) • St. John’s Wort (Hypericum perforatum), or a product that contains St. John’s Wort • triazolam (Halcion®) Serious problems can happen if you take any of these medicines with PREZCOBIX. What should I tell my healthcare provider before taking PREZCOBIX? Before taking PREZCOBIX, tell your healthcare provider if you: • have liver problems, including hepatitis B or hepatitis C • have kidney problems • are allergic to sulfa (sulfonamide) • have diabetes • have hemophilia • have any other medical condition

IMPORTANT PATIENT INFORMATION • a re pregnant or plan to become pregnant. It is not known if PREZCOBIX will harm your unborn baby. Tell your healthcare provider if you become pregnant while taking PREZCOBIX. • Pregnancy Registry: There is a pregnancy registry for women who take antiretroviral medicines during pregnancy. The purpose of the registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry. • are breastfeeding or plan to breastfeed. Do not breastfeed if you take PREZCOBIX. • You should not breastfeed if you have HIV-1 because of the risk of passing HIV to your baby. • It is not known if PREZCOBIX can pass into your breast milk. • Talk to your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines interact with PREZCOBIX. Keep a list of your medicines to show your healthcare provider and pharmacist. • You can ask your healthcare provider or pharmacist for a list of medicines that interact with PREZCOBIX. • Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take PREZCOBIX with other medicines. How should I take PREZCOBIX? • Take PREZCOBIX exactly as your healthcare provider tells you. • Do not change your dose or stop taking PREZCOBIX without talking to your healthcare provider. • Take PREZCOBIX 1 time a day with food. • If you miss a dose of PREZCOBIX by less than 12 hours, take your missed dose of PREZCOBIX right away. Then take your next dose of PREZCOBIX at your regularly scheduled time. • If you miss a dose of PREZCOBIX by more than 12 hours, wait and then take the next dose of PREZCOBIX at your regularly scheduled time. • If a dose of PREZCOBIX is skipped, do not double the next dose. Do not take more or less than your prescribed dose of PREZCOBIX at any one time. • If you take too much PREZCOBIX, call your healthcare provider or go to the nearest hospital emergency room right away. What are the possible side effects of PREZCOBIX? PREZCOBIX may cause serious side effects including: • See “What is the most important information I should know about PREZCOBIX?” • Diabetes and high blood sugar (hyperglycemia). Some people who take protease inhibitors including PREZCOBIX can get high blood sugar, develop diabetes, or your diabetes can get worse. Tell your healthcare provider if you notice an increase in thirst or urinate often while taking PREZCOBIX. • Changes in body fat can happen in people who take HIV-1 medications. The changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the middle of your body (trunk). Loss of fat from the legs, arms, and face may also happen.

The exact cause and long-term health effects of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having new symptoms after starting your HIV-1 medicine. • Increased bleeding for hemophiliacs. Some people with hemophilia have increased bleeding with protease inhibitors including PREZCOBIX. The most common side effects of darunavir, one of the medicines in PREZCOBIX, include: • diarrhea • nausea • rash • headache • stomach area (abdominal) pain • vomiting Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of PREZCOBIX. For more information, ask your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. How should I store PREZCOBIX? • Store PREZCOBIX tablets at room temperature between 68°F to 77°F (20°C to 25°C). Keep PREZCOBIX and all medicines out of reach of children. General information about PREZCOBIX Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use PREZCOBIX for a condition for which it was not prescribed. Do not give PREZCOBIX to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about PREZCOBIX that is written for health professionals. For more information call 1-800-526-7736. What are the ingredients in PREZCOBIX? Active ingredients: darunavir and cobicistat Inactive ingredients: colloidal silicon dioxide, crospovidone, hypromellose, magnesium stearate, and silicified microcrystalline cellulose. The tablets are film-coated with a coating material containing iron oxide black, iron oxide red, polyethylene glycol, polyvinyl alcohol (partially hydrolyzed), talc, and titanium dioxide. Manufactured by: Janssen Ortho LLC, Gurabo, PR 00778 Manufactured for: Janssen Therapeutics, Division of Janssen Products, LP, Titusville NJ 08560 Issued: January 2015 © Janssen Pharmaceuticals, Inc. 2015 027415-150108

Switching Fears now people often fear the stigma more than they fear the virus

“What if they cough, will we all get infected?” Questions like these were far too common, as education and knowledge around the virus was just not there during the eighties and early nineties especially in the black community. A 1990 episode of A Different World touched on the lack of knowledge, when Tisha Campbell played an HIV-positive student. The school went into a panic and students asked questions similar to those listed above. In addition to the lack of knowledge around how you get it, knowledge around “who” can contract HIV was also rapidly evolving. HIV changed from a “white man’s disease,” to “a gay man’s” disease, to an “all man’s disease.” The virus knew no race, gender, sex, education, wealth, health, as it affected all communities. This fear from how rapid the virus was spreading created horrible myths, stigmatization, and helped perpetuate many of the beliefs around the virus that still exist today. Fast forward to 2015. Although the same stigmas and shames exist, fear of death has all but disappeared. It has almost become a case of cognitive dissonance. You know the virus exists. You know what steps you can take to help prevent it. Then subconsciously you know that sex feels better without the “complications” of a condom. You know that you can contract an STI or HIV, but you are also knowledgeable enough to know that all of these things can now be treated. Do you still put on the condom? This way of thinking has become one of the more frequent conversations I have when discussing barriers to prevention. Other barriers including bareback intercourse being preferred over protected intercourse. Trust in a partner being compromised if asked to use condoms. Lack of access to condoms, specifically lack of access to free “good condoms” (e.g., Magnums). We have created ways to validate choices that we know may have serious consequences. So where does this leave us?

This leaves us as HIV practitioners and advocates to have to find new ways to communicate the importance of not seroconverting. The addition of PrEP to prevention efforts is quickly becoming one of the better tools we have in fighting against the virus. Although the virus is manageable even much more than diabetes, it is still not something we want to continue to spread. The benefits of being HIV-negative still outweigh the effects of living with HIV. Yet the numbers still continue to rise in the more marginalized communities, in particular the Black LGBT community. For example, according to an amfAR February 2015 issue brief, “HIV and the Black Community: Do #Black(Gay) Lives Matter?” Black gay men represent only .2 percent of the U.S. population, yet they represent twenty-three percent of new infections in the U.S. We must continue to practice safer sex, and be more willing to have the conversations around HIV and disclosure. It is okay to ask and talk about HIV status with sexual partners. It is okay to take the time to put a condom on. HIV is much more than the stigmas of yesteryear, but until they have been eradicated there is no need to acquire that burden. George M. Johnson is an HIV advocate who works for Us Helping Us, People into Living located in Washington, D.C. He has written for Pride.com, Musedmagonline.com, Blavity.com, Rolereboot.org, and Ebony.com. Follow him on Twitter @IamGMJohnson. A&U • OCTOBER 2015

illustration by Timothy J. Haines

ith new treatments, and advancements, HIV has now become a manageable and treatable chronic condition. From thirty pills a day, to thirty different pills including some once-a-day doses, they were able to reverse the stigma of HIV being a death sentence. A community that was once hidden is now thriving as people who are HIV-positive are living longer lives. The effect has helped cause a situation where some people are more fearful of the potential stigma of living with HIV than they are from actually contracting HIV. It wasn’t always that way. During the eighties and the nineties the word “HIV” had become synonymous with the term “death sentence.” Contracting HIV had become people’s newest fear as the nation’s biggest epidemic had no cure in sight. Many people succumbed to their fears around the virus’s mortality rates, which created a first wave of stigma that is still felt today. Rather than communities learning how to live in a society with those who were HIV-positive, they shunned individuals living with HIV/AIDS and turned them into modern-day lepers. During that time, HIV prevention efforts and practices were at its peak. With Magic Johnson’s announcement that he was living with HIV, and several others’ influence and prominence in society, safer sex initiatives across the country were at an all-time high as a way to fight against the spread of the virus. Pharmaceutical companies continued to spend millions on research creating cocktails with the shortterm goal of staving off death and the long-term goal of creating a cure. Although the awareness and understanding of the virus was thorough, the stigma being built against those who had contracted the virus would ultimately prove to be the hardest thing to eradicate. Contracting HIV meant living the rest of your days in shame during those times. People were afraid to even be in the same room with a person who had the virus. “Can I catch if from kissing?” “Can I get it from sharing a water fountain?”

Spontaneous Human Combustion

think I am going to burn myself out of existence. There is a thing called Spontaneous Human Combustion: Where a person is fine one moment— gentle, wholesome, and kind, with life moving along as it should, and the next they are covered in raging livid flames; burning yellow and red at temperatures somewhere in the upper Fahrenheits. This, of course, is a rare phenomenon; but a phenomenon nonetheless. And I am about to self-combust. The California summer has been uncharacteristically grueling the last few months, and I’m sure the heat is getting to me. It has to be the sun baking down on the concrete, the fact that I don’t have an air conditioner in my little oven of an apartment, or perhaps some mild dehydration that is making me make such strange choices lately....There is also a drug called crystal meth. Spontaneous human combustion happens all over the world to all types of people and the reasons are often mysterious and unclear: As if the person caught in a whirling pyre of their own making could not have done anything to prevent this awful act of God from happening to their poor sweet selves. I like the way that sounds…. Through no fault of my own I am beginning to burn alive. This is what I tell my doctor when she asks me how I have lost forty pounds since my last visit. This is what I say when I admit to missing a few doses of my HIV meds this month (something I haven’t done in more than eight years), and this is what I say when she touches my shirt, while asking me to

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and other random things to look out for

breathe, and remarks that it is completely soaked through…. “I think it’s the heat.” I say. “I think it’s the heat.” I say. “I think it’s the heat.” I say. And I begin to laugh quietly because it sounds so silly and hollow coming out of my mouth, like a two-year-old with his hand in the cookie jar repeatedly professing that the dog made him do it. It has indeed been really hot this summer, and I have indeed been listless and fatigued by the sun, but who the hell looses forty pounds because they don’t have air conditioning? Do you know how many people would stop using their air conditioner if they thought it would help them lose forty pounds? So then I tell her the truth; I tell her about this thing called Spontaneous Human Combustion, and how one day you can be living your life, struggling as best you can to make things come together for your good: To pay your rent, to fall in love, to keep food in your belly, and then all of a sudden something happens, and you are fully engulfed in flames— running in circles trying to put the fire out, and wondering how this could have happened to you…. And I told her about this drug called crystal meth.

Without even flinching she gave me a crisp white card with a name and number on it. I put it neatly in my wallet behind my ATM card and in front of my powder-blue Tiffany & Co.’s card, and went back out into the blistering summer heat. I will call the number in the morning. I am not naïve. I’ve known about Spontaneous Human Combustion for years….I’ve heard stories of it destroying people’s lives, my mother used to warn me about it when I was a child, and of course, I always try to stay cool in the summer. But this summer has been crazy. And I think I’ve been a little overwhelmed. Things get hard sometimes; and sometimes you lose yourself. And though Spontaneous Human Combustion is a rare phenomenon, it is a phenomenon nonetheless. And everyone knows that one of the side effects of having HIV is that it makes you more susceptible to rare phenomenon. I’ve just got to be more careful that I don’t catch myself on fire, because right now it seems way too easy for me to burn. Corey Saucier is an artist and writer living in Los Angeles. He is a Lambda Literary Fellow in Fiction and Non-Fiction and is currently penning his first novel. His musings and wanderings on Love, Life, and Nonsense can be found at www. justwords.tumblr.com. A&U • OCTOBER 2015

DARE

LOOK

CAPTURING FACES OF AIDS, PHOTOGRAPHER J. TOMÁS LÓPEZ DARES PEOPLE TO LOOK THE PANDEMIC IN THE EYE

by Alina Oswald

t all started with an Agfa 35mm German photo camera that J. Tomás López received from his father, an amateur photographer, back in 1961. Growing up in Long Island, New York, López would often travel to Myrtle Beach, South Carolina, where his father rented a cottage for the family, and where, as a child, the nowprofessor of photography at the University of Miami would use the camera and have fun taking many pictures.

But then it came time for López to go to college, to study psychology and philosophy. “I didn’t think about taking pictures,” he tells me over the phone, “and then I got drafted into the Army.” He did an internship at Bellevue Hospital, in New York City. From there, he was assigned to Moncrief General Hospital, Fort Jackson, South Carolina, where he was to treat returning Vietnam war veterans, who were still in the military but had hard drug addictions. “They all came back with cameras, Nikons and Minoltas that were very inexpensive at the PX in Vietnam,” López recalls, “and what I noticed was that they would talk only about the pictures that [they’d taken

while in Vietnam, developing their film in a darkroom on the base].” Some of the Vietnam vets had had experiences so horrifying that they thought they’d lost their souls, and so their photographs became the only way through which they could communicate. “And I realized that photography [for them] became this amazing cathartic narrative,” López adds. Kevin (detail), 1990-1991, silver gelatin print, 15 by 15 inches. “Kevin, we took this shot just a few days before he passed. He was the only one I photographed twice. The first time was in drag as Sugar Kane, his stage name. But he knew time was short and wished to leave a more poignant image and he asked me to photograph him naked, for all to see he had nothing to hide.” A&U • OCTOBER 2015

A&U Gallery Chuck, 1990-1991, silver gelatin print, 15 by 15 inches. “Chuck was my assigned PWA—person with AIDS; we came up with the concept of the infrared film and close up on the eyes together.” After leaving the Army, in South Carolina, López enrolled in an interdisciplinary program for film, video and photography, and received an MMA from the University of South Carolina. He then studied with Ansel Adams for two years, between 1976 and 1977, and in 1983 received an MFA from the University of South Florida in Photography and Modernist Studies. “I started teaching in ’77, and I’ve been teaching ever since,” he says. “My interest in photography is how it functions in the world, in terms of creating history, being a visual diary following the rule of art, and [in terms of ] the people who believe that media is our modern storytelling...that’s what I teach my students, to use photography to tell their own stories.” He also encourages his students to photograph what they feel passionate about. The rest will fall into place. Over the years López has followed his own photography passions, using his camera to document various causes, traveling the world, to Mexico, South America and other places, to capture wars, displaced and marginalized people, or life in the subway, be that in New York City, London, Paris, Rome, Barcelona, or Madrid. In the summer of 1990, López received a phone call from the then-director of the Art in Public Places, Art Keeble, who wanted to recruit twelve to fourteen artists to work with as many people living with HIV/AIDS, to create a collaborative project later called Faces of AIDS. The project was to be organized by the Art in Public Places together with NAPWA and TAN, or Tampa AIDS Network. López was living in Tampa, and he remembers the initial meeting taking place in a hot room, at TAN, in July or August of that year. And then, as other artists were being selected to contribute to this project, López ended up being the only photographer. At the time he didn’t know much OCTOBER 2015 • A&U

about HIV/AIDS. Robert Mapplethorpe had just died of the disease. People were still not sure how it was being transmitted. “It was really the early days,” López recalls. When mentioning that he was going to work on Faces of AIDS, some friends would tell him, “You’re crazy, you are going to get AIDS,” to which he would respond that if the disease were that contagious, then everybody would get it. “I got a lot of grief from people at first,” he says, “for getting involved in this project.” But he got involved

anyway. And he didn’t want only to photograph his subjects, but also to really get, understand, what his subjects were really going through, living with HIV/AIDS. To start work on Faces of AIDS, López was teamed up with one of his would-be subjects, a man called Chuck, and then he met Chuck’s partner, Jerry. Also, for about four months, López got to spend a lot of time at TAN, attending weekly meetings, every Thursday, speaking with the doctor and participants. López remembers “a gentleman by the name of Dennis,” a social worker who was HIV-positive. He had been a heroin addict, but had cleaned himself up and put himself through school. From chatting with him, López began to get a sense of the repercussions of having HIV/AIDS, to understand that the virus did not deprive individuals only of their health, but also of every social aspect of daily life. He learned the socio-economical implications of the disease, the stigma,

John StA.,1990-1991, silver gelatin print, 15 by 15 inches. “John StA. was a member of ACT UP; he was an attorney and Canadian. His articulation of the isolation effect AIDS has on the soul of those infected was that it was ten times worse than knowing you were going to die. The effect was the isolation from your friends and family once word got out.”

Glenda, 1990-1991, silver gelatin print, 15 by 15 inches. “Glenda was eleven months-old when we made this photo. I remember having her mom, Jennifer, prop her up in the chair in my studio because she was too young to sit upright. She was born with AIDS; her parents were IV drug users.”

loneliness and rejection that often (still) Chuck had shingles on his face. So the come with an HIV diagnosis. photographer used infrared film to make López recalls Dennis explaining that the shingles disappear in the photobasically everybody diagnosed with HIV/ graph. And when the other participants AIDS was going to die. And, in general, saw Chuck’s portrait, they wanted to be when individuals would announce that photographed in the they had HIV or AIDS, people would avoid same way. “Everyone looking them in the eye. “Back when I looked translucent was a child, when people had cancer, it and beautiful,” López was very similar,” López says. “Cancer was says. Around that considered a punishment from God or time, another phosomething rather than just bad luck.” tographer, Nicholas The photographer also learned that Nixon, came out with the only treatment available at the time a photography book, was AZT, and that the government would People With AIDS, not help patients pay for their medication featuring terrifying unless they spent all their money, to the portraits of people very last cent, first. For example, Chuck’s who were dying of partner, Jerry, had been very wealthy, but AIDS. But López they had to spend all their savings before wanted to make his the government began to cover their AZT. subjects look beauAs López started to become more imtiful, in spite of the mersed into the project, he and Jennifer, 1990-1991, silver gelatin his wife, who’s also an artist, became friends with Chuck and print, 15 by 15 inches. “Jennifer was Glenda’s mom. She told me his partner, having them over the story of how shocked she was for dinner on a regular basis. to hear at eight months of being When it came time for with child that she had AIDS and López to photograph him for it was too late to abort.” the project, it so happened that

disease, to show that AIDS was not God’s punishment, and that anybody could get it. So after photographing Chuck, López then captured the portraits of Kevin, Glenda, Dennis and John, among others. They all looked beautiful. And they all had a story to tell—Chuck had been a plumber and his partner an insurance agent; John became a member of ACT UP in Florida; Glenda was an elevenmonth-old baby, born to heroin-addicted parents. They all had a story of social rejection that was more heartbreaking for them than the illness itself. In the exhibit López calls them only by their first name, because they didn’t want to have any links to their families. Each portrait is haunting in its own way. Each print is larger than life, daring viewers to look the particular face of AIDS in the eye. John’s portrait is a diptych—in one image he’s smiling, in the other one he’s not. His hands are posed as if in prayer. Glenda’s portrait has been shown in several museums, in relation to December 1, World AIDS Day. The photographer remembers the eleven-month-old child

A&U • OCTOBER 2015

A&U Gallery Dennis, 1990-1991, silver gelatin print, 15 by 15 inches. “Dennis was an MSW social worker at TAN, Tampa AIDS Network. He was the organizer of the dinners and presentations by doctors, psychologists and other PWAs at the weekly support meetings.” not being able to stand on her own, and drooling. And he couldn’t really touch her to clean her up, because at the time there were still so many questions surrounding the ways HIV could be transmitted. So, they called Glenda’s mother to come to the studio, to clean up the baby the best she could. Glenda’s portrait is in particular haunting. “I think it’s probably the most shocking,” López says, “because we don’t expect an eleven-month-old girl to be dying.” After a pause, he adds, “She looks like a ghost. The infrared is part of the invisible spectrum [and gives] that waxy look. [Her face is] so smooth, [it has] sort of a haunting look.” And then there is Kevin’s portrait, maybe one of the most powerful images. He was from Michigan, and he was a drag performer in Tampa. López had photographed him in persona. Later on, when Kevin got sick, the photographer visited him in the hospital. When it became clear that there was nothing else that they could do, doctors sent him home. He had a gay plague, but because when a person a shunt put in, and had his medication is perceived as dying, others are reticent to distributed that way. One day he showed look them in the eye.” up at the photographer’s studio, because J. Tomás López dares viewers to look he wanted his portrait Faces of AIDS taken—naked, showin the eye. The ing the shunt. Kevin portraits included knew that his death in the project are was imminent, and close-ups, and was not afraid to tell large. “You must the truth about living look into their with the disease. “I eyes. [There’s] no don’t want to hide averting your gaze; anything anymore,” no value judgment López recalls Kevin about an Old Tessaying. The photogratament punishing pher took twenty-four God. They are just shots. The one showlike us. They are ing Kevin with his us,” he says. hands over his eyes Today, those was chosen by an exfaces of AIDS are hibition that traveled Jerry, 1990-1991, silver gelatin print, 15 by still relevant. To around the world. 15 inches. “Jerry was Chuck’s partner; he López it’s not so López worked shaved his head for the photograph for much a matter on Faces of AIDS for dramatic effect.” of then and now, about one year and a when it comes to half, but was involved the history—the in the project for several years. “So many photographic history in this case—of the people that I spoke to referred to the alienAIDS pandemic, but of “us” and “them.” ating nature of this virus,” López writes in For him, “the issue of HIV/AIDS is not an the artist statement. “Not just because it is isolated issue. It’s an issue of fear and igcontagious nor because it is thought of as OCTOBER 2015 • A&U

norance magnified to the point of making those who have [the disease] feel different. It’s like the difference, in linguistics, between ‘it’ and ‘thou.’ “And so, if I think of you as ‘thou’ then I respect you. But if I transmutate you into an ‘it,’ [it is as if ] you have no soul.” He further relates this divide to the principles that stand at the base of slavery or the marginalization of women. It’s reducing other people to not meaning the same or as much as others. “That’s why I think that the early days of AIDS are so important,” he says. “Because for those who fought, and lots of people did, it’s like the early days of gay rights or feminism.” He pauses, and then adds, “For me, Faces of AIDS is of its time. [It] traveled the world until 1995–1996. It’s up to my students now to take it to the next step.” The entire collection is at the Ft. Lauderdale Museum of Art. López’s last solo exhibition of the photographs showed them at 40 by 40 inches in carbon pigment Inkjet prints. Alina Oswald is Arts Editor of A&U.

WHEN DO Fred Says Founder Dr. Robert Garofalo Teams Up with Photographer Jesse Freidin and Writer Zach Stafford to Share Portraits & Stories of People Living with HIV/ AIDS and the Furry Friends that Saved Them by Alina Oswald

hey sniff and lick our toes. They drag us out of bed every morning. They bring us joy and show us the true meaning of friendship, compassion, and unconditional love. They are our dogs, and we cannot imagine life without them. Dr. Robert Garofalo certainly can’t. Doctor Rob, how his patients tend to call him, is Division Head of Adolescent Medicine and the Director of the Center for Gender and Sexuality and HIV Prevention at Ann & Robert H. Lurie Children’s Hospital of Chicago. He has worked in the HIV field for many years, but receiving his own HIV diagnosis in 2010 left him isolated and lonely, and unsure of where his life was taking him. And so, though he had never had a dog in his life, he decided to get one. “And I remember that my best friend told me that it was one of the most selfish decisions that I would ever make,” he says, “because I couldn’t take care of myself at the time, so how was I going to take care of a dog?” But it turned out that a Yorkie named Fred changed his life in a most miraculous way. “I wasn’t sure that my life would ever have peace or joy back in it,” he explains, his voice breaking up with emotion. “And this little...creature brought it all back,” he adds talking about his dog. “This giant ball of positive energy needed me when he was a puppy, but I needed him more.” In 2012 Doctor Rob started a charity, Fred Says, to help others who are living with HIV. Today Fred Says has almost 50,000 Facebook followers who often

share stories about their own dogs. A couple of years later, in 2014, during an event, he remembers looking at pictures of his dog, when a man sitting next to him commented on the pictures, and that he should meet his son, an award-winning pet photographer living in San Francisco. And as the doctor was planning to visit San Francisco only a couple of weeks later, he met, and then became friends with the photographer, Jesse Freidin. One day, they were sitting in Freidin’s studio, in L.A., making plans for Fred Says, when they came up with the idea of a new charity, When Dogs Heal, to capture the healing power of dogs, in this case, over people living with HIV. And so, they started to put the idea into action. They began by recruiting HIV-positive individuals from every demographic group of HIV, from all across the spectrum, Joseph and Pancakes and country. And they travelled from San

Francisco and L.A. to Chicago, New York, and, most recently, Atlanta. “Each city has its own flavor and feel for some reason,” Doctor Rob says. “In L.A. we’ve got a number of African-American women who told their stories of healing. But San Francisco really stood

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OGS HEAL out. [There] we were getting a narrative of the epidemic.” He explains that so many people in San Francisco had been infected some thirty years ago. They didn’t think they would be alive today to tell their stories. And, so, their dogs became symbols of hope for them. The stories are rather amazing, and they run the gamut, speaking of overcoming loneliness, feeling marginalized and alienated after an HIV diagnosis, addiction, violence, and also of dogs playing roles in companionship and helping people overcome addiction. There’s the story of a San Franciscan meth dealer, whose best friend was also a meth dealer. The best friend had a dog. When police raided the friend’s apartment,

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the friend went to jail, and the dog got injured. He decided to save the dog, and ended up saving himself. He has lived his life sober ever since. In Chicago a man had just been diagnosed with HIV. He was sitting on the street, devastated, when a stray dog came up and sat next to him, and then followed him home. And he’s had the dog ever since. “So, there are stories of hope and healing, addiction and learning what unconditional love was supposed to be about, because so many people that get HIV feel that they are not lovable anymore,” Doctor Rob says. While working on the project— photo shoots started in 2014, in Chicago, and continued this year in other cities—he

has also formed strong connections with all those who have volunteered to be part of the project. “I was really taken back by how motivated these people were to tell their stories and help [others]. I talked to them all about their individual stories and their dogs, and there’s a bond between us all, because we’ve all been there,” he adds. “They are quite amazing! I feel really indebted to these wonderful people, and their pets.” Those participating in the When Dogs Heal project are as diverse as their stories, and also as their dogs, which, in turn, range from pure to mixed breeds, and also rescue dogs. “The dogs were very well behaved. Jesse [Freidin] is a pro,” Doctor Rob says, when I inquire about the actual

Tremaine with Sir Rockee Balboa and Madam Russia

Felicia with Simon and Gypsy Rose photo shoots. As they travel from city to city, Jesse Freidin is in charge of the ipant, and writes short stories that would, photography, and then Zach Stafford, the then, accompany the photographs. “When Dogs Heal feels like a very natwriter on the team, interviews each partic-

ural continuation of my photography investigating the healing nature of the dog/ human bond,” photographer Jesse Freidin says, talking about the project. “Because Rob had commissioned me years ago to create portraits of his own dog, Fred, I was already personally invested in his beautiful story, which makes this collaboration so important. At a moment when HIV awareness is beginning to shift, When Dogs Heal is such an exciting opportunity to make a difference, incite positive change, and bring the focus back to the epidemic. As an artist, there is nothing that inspires me more.” Zach Stafford adds, “When Dogs Heal is a really special project to me as both a writer, and a person who has been personally affected by HIV/AIDS. When we first came up with the idea, I had just released a book called Boys, An Anthology, which explored the lives of gay and queer men all around the world. I loved doing that book so much because I think stories are not only life saving, but also freeing—especially the stories that go untold. When we, as a group, came up with the idea for this project that perfectly meshed a lot of our collective talents and lives, I was selfishly thrilled. I have lost a few family members to HIV/AIDS over the years—probably most notably my grandmother—and to be able to work on something that allowed me to meet so many people that survived something that so many people I love didn’t was truly hum-

Sharon and Dulk

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bling. And to meet the dogs that helped them do this is simply inspiring. “I always tell friends that When Dogs Heal is a lot of things, but most importantly it’s evidence of the power of love and how love can be the thing that can save us all. And as a writer I am really honored to be able to hopefully help show that with these stories.” When Dogs Heal–People Living with HIV and the Dogs that Saved Them comes from the collaborative work of three very passionate individuals who put together this amazing charity. “We did it together,” the doctor says. “I don’t think I’ve ever worked on a project that was more collaborative in this sense. It was really...these three guys in a studio in L.A. sitting over coffee, coming up with this crazy idea, and then putting it into action. Zach [Stafford] is a writer. Jesse [Freidin] is a photographer. I was the guy with the backstory. It was really about tapping into each other’s strengths, and trying to produce a project that was different.” There’s also a fourth member of the incredible When Dogs Heal team, and that’s Dr. Garofalo’s niece, Christina Garofalo, who handles the social media and writes the blog. She explains that, “After receiving their diagnoses, some of [the participants] struggled with the will to take their medication—medication that’s expensive and can have harsh side effects—and others with the emotional effect of the stigma of being positive. But nearly all of them said that knowing they had their dog depending on them gave them the will to take care of themselves. It’s incredible how having to put someone else’s needs first, you end up—in a way—putting yourself, your life, first. For these people, their dogs taught them to find the purpose and value in their own lives again.” When Dogs Heal connects dogs to the mission. “[It also] allows us to be a little creative,” Doctor Rob explains. He has noticed that things have gotten a little stale, when it comes to finding fresh ways in which to address HIV and AIDS nowadays. “Medications have become so much more effective,” he says, “but I don’t think there is an energy, at least in this country, in the sense of talking about HIV the way we used to. I don’t think you read news stories about HIV anymore in the mainstream media. Hopefully that’s because people aren’t dying anymore, and that’s a great thing. When Dogs Heal–People Living with HIV and the Dogs that Saved Them focuses on living. That’s a big change. It’s really about the dogs rescuing people.” When I ask if he and Fred are part of the OCTOBER 2015 • A&U

Sister Lotti Da and Shiner project, he replies, “That’s a big question. Everybody knows my story already, and I’d rather focus on other people, but I think my picture with Fred will be [on the website, but] it’s [not] going to be the focus.” When he first started the Fred Says charity, he did not include his own HIV story. “I was very stingy about my own environment,” Doctor Rob explains. “I would just say, ‘Fred helped me through a difficult time in my life,’ but I would never tell anybody what [that] was.” But then he realized that he had to tell his own HIV story, in order to help others. “It took me a while to be honest about my own story, as part of this charitable work, and that speaks to the hidden nature of HIV and the stigma that still lives on. Hopefully, a project like this will help break down some of that stigma, and make it a little easier for people out there living with HIV.” When Dogs Heal’s website launches October 1. Three art exhibits are to open

simultaneously on World AIDS Day, as part of the When Dogs Heal Project—at the LGBT Center in New York City; in Chicago; and in San Francisco, at the San Francisco AIDS Foundation. Plans are to promote each as a “story of the week” on the blog, and also to take the exhibit on the road, in the upcoming year, to universities, schools and communities, especially in cities that are the hotspots of new HIV infections. “Hopefully I’ll continue to do what I do, to make the world a better place for all sorts of people, but certainly people living with HIV and AIDS,” Doctor Rob says, speaking about his own plans. “I hope that this message of the [healing] power of pets, specifically dogs in this case, will continue.” Learn more about When Dogs Heal at www. wdhproject.org. Read what Fred Says at http:// fredsays.org. Contact award-winning pet photographer Jesse Freidin at http://jessefreidin.com. Alina Oswald is Arts Editor of A&U.

FRENCH KISS

Parlaying a modeling career onto the big screen after serving his French homeland in the esteemed Paris Fire Brigade where he witnessed the horrors of AIDS firsthand in its earliest days, actor Gilles Marini redoubles his commitment to the audience he credits for helping to make him a star. Text & Photos by Sean Black

laying it in his latest role as serial killer Sebastien Dussault on Lifetime’s Devious Maids, Gilles Marini, thirty-nine, isn’t too fazed about his character’s uncertain survival. The Hollywood heartthrob has proven his staying power as an actor and his international fanbase anticipates his character’s hopeful return.

After literally going up in flames in the Season Three finale, the smoldering actor is reenergizing at his hilltop home where, upon my arrival, he greets me in cutoff sweats and a sleeveless tee emblazoned with the American flag. Marini became a permanent citizen of the United States back in June of 2012. It is a dream he admits that took him nearly ten years to achieve. Having just washed and waxed his sixteen-year-old

son George’s muscle-car, a Dodge Challenger, he hefts aside the buffing towel and extends a taut arm. Handshake, bro hug. This guy’s the real deal. I first met Gilles last summer while crossing the New York Harbor on a motorcylce-laden ferry to Governor’s Island reflecting on the bittersweet skyline views of Lower Manhattan where the iconic Twin Towers of the original World Trade Center once stood tall. Governor’s Island was the last stop of Kiehl’s Fifth Annual LifeRide, and Gilles had made the twelve-day, 1,600 mile motorcycle trek from Milwaukee to New York City to raise funds and awareness for amfAR. Banding together with the pack of celebrity riders along with dedicated amfAR staffers and press, they were led by crusader and motorcycle enthusiast Chris Salgardo, President of Kiehl’s USA. Kiehl’s, the premium skin and hair care apothecary line heralding “Since 1851” from its New York City East Village origins, has raised over $400,000 from its LifeRide events and specially created products to help fund research to find a cure for AIDS. Riding up to moving, meticulously hand-crafted panels from the AIDS Memorial Quilt that were laid across the sprawling green lawns of the Island’s former A&U • OCTOBER 2015

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as long as AIDS exists, LifeRide will exist and Chris will make sure of that,” Marini confidently assures. Gilles’ humanity and rigorous work ethic stems from his upbringing as the son of humble bakers. His mother Francine is Greek and his late father Georges, for whom Gilles’ son is named, was Italian. Gilles is the middle child of three, with an

“

172-acre military base offered a reminder of why these individuals make this draining yet rewarding journey. Staff of The NAMES Project Foundation were also on hand. The NAMES Project Foundation was founded in 1987 and is the non-profit organization charged with taking care of The AIDS Memorial Quilt. The agency’s mission is to preserve, care for and to use the ever-growing AIDS Memorial Quilt to foster healing, heighten awareness and inspire action in the age of AIDS and beyond. “I love being a part of LifeRide. I learn so much about the disease,” shares Marini. He also just completed LifeRide 6. “It makes me a better man,” he says with pride. “Chris Salgardo says after eight to ten hours of riding it becomes dangerous. The ride can be very hard and Chris has geared it that way to remind us what we are riding for—the ups and downs, the dangers.” His thoughtful analogy references the bumps in the road of life. “Making this LifeRide [which he thinks is beautifully named] a difficult ride reminds each of us, every day, that we are riding for a purpose and that we have to be alert, we need to be conscious, we need to be good to ourselves and to others, and to survive that day. It isn’t a victory until we end this disease. So

school graduation baking up pastries. “I was pretty good at making anything from eclairs, to milles-feuilles, and even strawberry shortcakes,” he shares as he remembers his dear father. “The nicest dude you’d ever want to meet,” he quickly notes. “People would call my father ‘tonton,’ or uncle, because when kids were thrown out of their homes for right or wrong reasons, [the bakery] was the place they would come. It was warm in the winter and at night and my father was always there. He worked from 10 p.m. to 2 p.m.—you heard me right 10 p.m. to 2 p.m.! He wanted me there with him at the bakery at a very early age because he wanted me to see [his commitment] what he was doing each night. By exposing me to this [dedication] he knew it would help me later on in life and he was absolutely right.” Upon graduation from high school Marini left his parent’s bakery to join the French army, where he served as a fireman for the famous Paris Fire Brigade (Brigade des Sapeurs-Pompiers de Paris), which serves as the primary fire and rescue service for Paris and surrounding sites of national strategic importance. With 8,550 firemen, it is the largest fire brigade in Europe and the third-largest urban fire

My neighborhood was filled with IV drug users, as heroin was huge in the late eighties and early nineties, and out of nowhere [it seemed] every single young person who was abusing heroin in the neighborhood came down with AIDS and died.

older sister and a younger brother. He was born in Grasse, a small city on the French Riviera known for perfume manufacturing as well as the birthplace of Jean-Honoré Fragonard, the nineteenth-century Rococo genre painter of French aristocracy. Instilled with a dedication to working long hours, Marini helped in his father’s bakery from the age of eight to his high-

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service in the world, after Tokyo and New York City. “I had a great physicality,” admits Gilles. “I was very gifted in sports, too, in general.” He still keeps fit by playing soccer regularly and practicing MMA (mixed martial arts). “Back in those days military service was an obligation—I think they should have kept it that way. Youth these days are lazy and have no respect.” He laughs at his brief rant, signature of a caring father. Rather than merely passing his time in the military, Gilles instead embraced his country’s call. “If I have to do this—then I want to learn a skill,” he thought. “There were a couple of Special Forces and one of them was the Fire Brigade in Paris. I was told I would never get in because I was from the south and it was too difficult but I didn’t listen to anyone and I got in.” Shortly after enrolling in 1994, death tolls from AIDS were still mounting. Pre-antiretrovirals, AIDS was at its peak. OCTOBER 2015 • A&U

“It was very much in the forefront of society’s mind. It affected mainly the gay community and they were looked upon as if they were carrying the Black Plague. It was very difficult for many of them to seek out or ask for help at that time. I cannot even imagine what so many must have experienced and gone through,” he compassionately reflects. “I heard a number of stories from my fellow firefighters at the time about when they would arrive at an accident with an injured person [with AIDS] and that person would admit to feeling ashamed and worry that the firefighters wouldn’t attend to their injuries. It was absolutely heartbreaking. We knew so little back then.” Growing up in Grasse, Gilles had already been exposed to seeing people suffering with HIV and dying from AIDS. “My neighborhood was filled with IV drug users, as heroin was huge in the late eighties and early nineties, and out of nowhere [it seemed] every single young person who

was abusing heroin in the neighborhood came down with AIDS and died.” Gilles recalls one specific harrowing tale when he was around ten-years-old that left a mark and has stayed with him. “One memory that I have is of this guy, I think his name was Kevin. He came into the bakery and my father gave him some bread because we knew he was a drug addict and he was broke. When he bit and pulled the bread from his mouth most of his teeth fell out onto the ground. I remember my heart went ‘boom’ inside of me and I remember thinking that I would never use drugs in my life, ever. I was in shock without realizing it at that moment.” The early days of the pandemic filled people with irrational fears that science was trying to right in the media. People were afraid to shake hands or to sit next to a person with HIV or AIDS. “There was so much misinformation out there at the time. It was insane,” he recalls. Finally, people from the medical industry started to

know a little bit more about the transmission of the virus and correct information was getting out into the mainstream via newspapers, radio and TV. One of the leading French actresses in France at that time, Clémentine Célarié, went on television and she kissed a man with HIV on the mouth. “French kiss!—tongue!—on national television—you

know France is edgier. She made a point that said—‘Stop saying all this bullshit—this is not how you contract HIV’—because a lot of people were getting hurt.” The event Gilles recounts occurred on April 7, 1994, when major French channels united to broadcast a unique and critical program at the time, which soon

became the political action group known as Sidaction. (The French word for “AIDS” is “SIDA.”) During its inception and first nationally televised gathering, Célarié’s bold symbolic gesture showed viewers and the world that HIV is not transmitted through kissing let alone a handshake. The impact of the broadcast was considerable, A&U • OCTOBER 2015

attracting 23 million viewers and raising 45 million euro. Key allegiances were forming around the globe among health workers, journalists, activists, celebrities like Elizabeth Taylor [A&U, February 2003] and Morgan Fairchild [A&U, December 1997], and researchers like Dr. Mathilde Krim [A&U, December 2001], the foundOCTOBER 2015 • A&U

ing chairman of amfAR. And, of course, France made a vital contribution to AIDS research when Luc Montagnier and his team at the Pasteur Institute, including Françoise Barré-Sinoussi and Jean-Claude Chermann, published findings about their isolating of HIV, a first-ever accomplishment which helped determine HIV as the virus that caused AIDS. Celebrating its twentieth anniversary in 2014, Sidaction continues to be a major public event in raising awareness and funds for HIV/AIDS charities, research institutions, and the medical care for those suffering with HIV/AIDS. Sidaction formed from members of The Association of Artists Against AIDS, ACT UP-Paris, AIDS Federation, Arcat-AIDS, along with a number of other researchers and activists. Twenty years later, reminiscing about this high point of television, Clémentine Célarié humorously confirmed in an interview that she is healthy and never seroconverted. “The first thing is that I’m still not HIV-positive,” she shared with the French media. Latest data from a 2011 report estimates that 160,000 people are living with HIV/ AIDS in France of today’s 37 million worldwide. France has the second highest number of new diagnoses in Western and Central Europe followed by Italy. Evidence shows increasing rates of HIV transmission in a number of European countries, particularly among men who have sex with men (MSM) as in other regions of the globe. It’s no surprise then, considering France’s past commitment to the fight against AIDS and his own experiences as firefighter, that Gilles formed a deep appreciation for the struggles of individuals living with HIV or AIDS, and others made vulnerable by social stigma and discrimination. It’s an appreciation that he imported to the United States, when, thanks to an impressive portfolio of images by Paris-based photographer Fred Goudon, he was able to embark on a modeling career soon after

fulfilling his military duties. Gilles first met Goudon while living and serving in Paris, and was introduced to modeling by the photographer (probably most famous on our shores for his Dieux du Stade rugby-hunk charity calendars). “Fred Goudon, one of my dearest friends, helped me understand what it is to be a gay man in this world and that the love men share is the same without differences in terms of love. In simple words, Fred helped me to understand that we all feel the same way. Perhaps a problem with homophobia is that people don’t understand because they don’t have friends who are gay. There aren’t any good reasons in life for disliking another person without knowing them first.” Moving to the United States to learn English while finding his footing as a model, Gilles soon found work. One of his first modeling jobs was a television commercial for Bud Light beer. Other commercials quickly followed and in 2005 Marini made his movie-acting debut in the provocatively titled horror flick Screech of the Decapitated. In addition to his most recent role as Dussault on Devious Maids, Marini is known for playing Angelo Sorrento on ABC Family’s hit series Switched at Birth, Nicolas on CBS’s 2 Broke Girls, Luc Laurent on ABC’s Brothers & Sisters and the steamy neighbor Dante in Sex and the City: The Movie, his breakout cameo au naturel (that’s French for “edgier,” as Gilles might say). He finished second place by less than one percent of the votes on Season Eight Dancing With the Stars and was ushered back for its first ever All-Stars edition after viewers voted him the “Best All-Time DWTS Contestant.” Gilles lives with his wife Carole, his son Georges and his nine-year-old daughter Juliana. He is especially proud to raise his children in this country. “I want the very best for the United States and look forward to getting more involved in politics and education. We need smart children for a better world with parents who are involved in the lives of their children. Acceptance, compassion, and respect must be instilled in our kids as a part of their way of living. This we must do.” For more information about Gilles, log on to: www.GillesMarini.com. to find out more about the AIDS-related work of the organizations mentioned in this article, log on to: www.sidaction. org and www.amfar.org/liferide. Post -production (Digital Styling): Eve Harlowe Art & Photography; www.EveHarlowe.com. Sean Black, Senior Editor, photographed Dr. Rachael Ross for the October issue.

Over 40, On PrEP

What’s It Like to Be Out, Proud, Over 40, and on PrEP? In a Revealing Roundtable Discussion, Eight Gay Men Bare Their Souls About a Blue Pill That’s Changing Their Lives

t happened on Fourth of July weekend in Philadelphia. Gay people from all over the world flocked to the City of Brotherly Love to celebrate the fiftieth anniversary of our movement and our marriage equality victory. After all the festivities, I went home and did something I never thought I would do. I took my first dose of Truvada for PrEP. Having worked for this magazine for seven years and in HIV healthcare for two, I’ve been aware of PrEP since the clinical trials. I just thought of it as a pill for young gay men who were engaging in high-risk behavior. That wasn’t me. Now I realize PrEP may be a viable option for anyone. Once I started taking the pill, I wanted to connect with other gay men

on Truvada as at FIGHT’s I entered this Jonathan Lax HIV Treatnew chapter ment Center, in my life. adds, “Anytime Naturally, this turn of events one of our inspired me HIV-positive to write this patients tells us that their partner article. “We’re seeing is negative, we talk a landslide of to them about PrEP. D interest in PrEP,” says For a lot of people, CHIP ALFRE PrEP is a really great Helen Koenig, MD, Medical Director of Philadelphia way to talk about their status because they feel like they have someFIGHT’s PrEP Progam, which initially targeted young MSM of color but is now thing to offer their partner. Now they can expanding its outreach efforts to include say, ‘I’m HIV-positive, I really care about everyone. Koenig, who is also a physician you, and there’s this thing called PrEP.’”

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photo of C. Alfred by Holly Clark Photography; all other photos courtesy interviewees

by Chip Alfred

She also their stories. points out that Within about more people an hour, eight over thirty-five men respondare coming to ed to my post. FIGHT asking Here is some about PrEP. “Peobackground on ple who are older the men who E ES have a better sense in participated, along ROGER KLOR general of their own risk. with a snapshot of their They have their life together PrEP experiences. more. They are likely to have a job, be Damon L. Jacobs, 44, Brooklyn, NY educated, and are more likely to be adRelationship status: Single herent to the PrEP regimen.” How long on PrEP? Four years Andrew Goodman, MD, Assistant Medical Director at Philadelphia’s MazKevan Walsh, 51, Melbourne, zoni LGBT Health Center, says most of Australia the new PrEP prescriptions he writes are Relationship Status: Partnered for patients specifically requesting it— How long on PrEP? Three weeks and many of these guys are over forty. “Most of my starts are coming to me Rich Reese, 43, Fort Plain, NY for their first appointment, after asking Relationship Status: Single their regular provider who didn’t know How long on PrEP? Six months anything about PrEP,” he explains. “A lot of gay men are saying they’ve talked with Kurt Douglass, 52, Morrisville, PA friends about it, or they saw something Relationship Status: Single on-line about PrEP. It’s a part of our How long on PrEP? Two months culture now.” And this cultural shift includes a Jody Wheeler, 46, Los Angeles, CA proliferation of PrEP websites, blogs Relationship status: Single and social media pages, which is where How long on PrEP? One year I began my research. I was seeking information and support, and Alan Turner, 58, Winnipeg, what I discovered was a Canada movement. I found Relationship Status: a Facebook group It’s complicated called “PrEP How long on Facts: RethinkPrEP? Thirteen ing HIV Premonths vention and Sex,” with Roger 7,500 memKlorese, 59, bers! I put up Seattle, WA a post there Relationthat I was ship Status: looking for Married people to share How long on

PrEP? Three years Philip Tan, 40, Brooklyn, NY Relationship status: Single How long on PrEP? Eleven months What made you decide to go on PrEP? Kurt: I participated in clinical research for an HIV vaccine and more

RICH REESE recently the injectable PrEP. My experience through both clinical studies gave me this sense of “super power” (even though I was fully aware that I could be receiving a placebo). Today, I find the use of PrEP one more added advantage to making safe sex safer. Roger: My husband is HIV-positive, and he was when we met. We had some increasing reticence about the risk of sex, even with condoms. In addition, we are open, in sex both inside and outside the relationship. Rich: I thought about going on PrEP because more guys I was meeting were positive. I felt it was not a question of if I would convert, but when. I felt sooner

SS LA G U KURT DO

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or later luck would put me on PrEP. run out. Damon: AfHas being on ter the breakup PrEP changed of a long-term your life? relationship, Roger: I I was getting feel the back into the burden dating/cruisof loss ing world. For and the first time in fear liftmy life, I was no ed. I can longer insisting my honor and partners use conmiss those S OB doms to top me. The dear people D A M ON J A C sensational and wonderful I’ve lost without experiences were accompafeeling that I would nied by such fear and terror. All sexual inevitably join them or that sex encounters had been accompanied with was intrinsically dangerous. the nagging thought, “Is this going to be Rich: I am much more educatthe time I have to pay for it?” I was tired ed about HIV now. I find myself of living in fear of HIV. PrEP gave me an talking to everyone about PrEP alternative to getting HIV while allowing and educating them on what it’s me to have the kind of pleasure I wanted all about so they know this exists to have. as an option. Philip: I was having unproDamon: Quite tected anal sex often unexpectedly, enough (once every PrEP drasticaltwo months) that ly changed my life. I’d have to get an I always used to HIV test. As you rely on someone can imagine, else wearing that got very a condom inconvenient. and making I thought, “If sure it didn’t I seroconvert break or fall in the age of off in order PrEP, I would to stay HIV never be able to negative. With forgive myself.” PrEP, I am fully My gay doctor in control of my was hesitant to HIV status for put me on it, even the first time in my SH KEVAN WAL asking me, “What if you adult life. That sense of have side effects in twenty control over my destiny then years?” I asked him back, “What if gave me the agency to start writing I seroconvert in twenty years?” He finally about PrEP, talking to media about

PrEP, and starting an education group about PrEP on Facebook (PrEP Facts). Jody: Both my emotional and my sex life have gotten much better. I’m enjoying sex a hell of a lot more and am no longer afraid of HIV. What’s more, I’m

LER JODY WHEE

getting seen by a doctor far more often (four times a year), which helps keep me healthy in many other ways. Philip: I don’t ever use condoms anymore, plus I do not serosort my partners. I find myself chatting with and being more open to poz guys than I was in the past. How about your sex life? Kevan: It’s early on but I feel that I will be able to “let go” and enjoy the moment more with PrEP. Damon: PrEP has liberated my sexual expression in a way that allows me to focus on pleasure, fun, connection, and intimacy with multiple partners. Alan: Before PrEP one of my main strategies for remaining HIV-negative was to be the top for all condomless

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fucking. That has now changed and this old confirmed top has become much more versatile. Rich: I no longer have anxiety about HIV. I am much more relaxed and have enjoyed sex more than ever in my lifetime. Kurt: It may be too soon to tell, but I think PrEP adds an element to initiating the HIV-status conversation.

PrEP becomes clearer. I am certain that, if we had it available in the 1980s, nobody would have shamed it.

seat of your own health,” remarks Caitlin Conyngham, Director of PrEP Programs at Philadelphia FIGHT. “It gives you power to make a decision about your sexual health in a way that’s never been on the table.” “It’s a wonderful thing because we’re using PrEP as a tool to help people be more open and honest with themselves What do you and their partners,” says Dr. Koenig. The look forward to future of PrEP, she asserts, must include in the future? increased awareness among primary Alan: With care clinicians. “People need a provider the advent of PrEP, PHILIP TAN who knows about PrEP, who knows a world without any how to fill out application forms for stigma associated with HIV patients who are uninsured, status. A world where help people who are uneveryone gay, straight and all other shades of derinsured, and sign What advice would you give to other guys sexual orientation or people up for copay kink can enjoy life thinking about starting PrEP? assistance cards.” and sex without Damon: If you are at risk for HIV, “There needs fear of disease consider using it. For those who can’t to be barrior shame. decide, ask yourself: “If I was a woman, er-free access Jody: I now would I take birth control pills?” “If and competent think living there was a vaccine for HIV, would I ask informato see a time my doctor for it?” If the answer to these tion readily where new questions is “Yes,” then PrEP may be available to HIV infections right for you. everyone,” says are virtually Roger: Don’t take judgment and Conyngham. “I zero is pretty moralizing for an answer. You’re taking hope that PrEP damn possible. the agency in making a strong choice for can bring pleasure Philip: I am your own protection. And don’t let the back into the prohopeful that I can be hurdles of our broken insurance system ER ALAN TURN vider’s office, and back on Truvada, that I can deter you. There are folks who can help meet a sex-positive partner into the conversations we you navigate that. regardless of his HIV status who I have with each other. We should can love and cherish. What do you say to critics of Truvada? be encouraging fulfilling sexual lives at Rich: I just want to keep going, keep Kevan: PrEP is a prevention option. any age.” Why would you deny anyone using what- living an active, productive, sexy life. Damon: I want to continue to expeever tools they had available to them to For more information, log on to these webrience the work I love, the sex I crave, prevent seroconversion? sites: www.facebook.com/groups/PrEPFacts; the partners I desire, while being Kurt: Life is a personal journey. People www.fight.org; and www.mazzonicenter.org. proactive, responsible, and empowered should be permitted to enjoy the pleaabout my pleasure. sures of life. Criticism is better served as Chip Alfred, A&U’s Editor at Large, is the valued education—not judgment. Director of Development and Communications “PrEP really puts you in the driver’s Roger: Every day, the evidence for at Philadelphia FIGHT.

OCTOBER 2015 • A&U

Christopher Hewitt

Awards 2015 W

hen we founded the Christopher Hewitt Awards in 2013, I didn’t know who Christopher Hewitt was. What I knew was that I had recently taken on a role as Literary Editor for A&U, and one of my main goals was to seek new creative work about HIV/AIDS from diverse writers, for diverse readers. An annual award seemed like an ideal way to attract and recognize exciting new literature. It seemed logical to name the award for Christopher Hewitt, who had been A&U’s first Literary Editor. It was only after doing a little research that I learned that he had been a successful writer in his own right, with poems and translations in publications including The New Yorker, The American Poetry Review, and the anthology Queer Crips: Disabled Gay Men Tell Their Stories. At the time of his death in 2004 at the age of fifty-eight, he had been working on a memoir titled Brittle Bones, in part about living with osteogenesis imperfecta. Still later, I came across Hewitt’s photo in his obituary in the San Francisco Chronicle, and I realized that I had briefly met him in 1993. I was sixteen, freshly out of the closet (when having a closet to come out of was still a given), and I’d sneak into a gay club in Berkeley called the Mix. Hewitt was there most Friday nights in his electric wheelchair, whirring around the dancefloor to ABBA and

Erasure, and we would exchange hellos. In the years that followed, I would spot him across the room at cafes and writers events, each of us with a pen and rumpled spiral notebook at the ready. Calling this the Christopher Hewitt Award was a logical choice—and an emotional one too, for A&U’s Managing Editor, Chael Needle, and Editor-in-Chief and Publisher, David Waggoner, who had both worked closely with Hewitt. But for me, connecting the name with the face and the memory made it all the more fitting on a heart level that the award—meant to encourage emerging writers as much as acknowledge established ones— should be named for him. This is all a long way of saying that we at A&U are very excited to congratulate the winners of the third annual Christopher Hewitt Awards in Fiction, Poetry, and Creative Nonfiction. The quality of work submitted in all categories was outstanding, which made the work for our judges more challenging…and will make the rewards for our readers, we hope, that much sweeter. —Brent Calderwood Brent Calderwood is the author of The God of Longing (Sibling Rivalry Press, 2014) and Literary Editor for A&U. His website is brentcalderwood.com.

A&U • OCTOBER 2015

fiction

Drowned River by Dale Corvino

“G

ood morning, papi, happy Friday,” I greet the bakery owner, a big, hairy Syrian, and he laughs and gives me a bag of mini-muffins from yesterday. When I make a left by the big Post Office I see Mr. Terry. He’s sweet but always a little stiff around me. Mr. Terry is from Elliot Houses, like me. He’s been working the Post Office retail window for years. It’s almost time to take his pension, “if they don’t steal it from me first,” he says every time it comes up lately. I’m feeling cute in this yellow chevron top, color of butter. Tenté taught me about the dedication that runs across the main Post Office on the 8th Avenue side, above the big staircase: Neither snow, nor rain, nor heat, nor gloom of night stays these couriers from the swift completion of their appointed rounds. The words of an ancient Greek, telling his people about the Persian mail system, but of course these gringos think it’s about the Pony Express or some shit. I see Mr. Terry a lot when he’s on breaks. He runs all the way around to the loading docks on 33rd to smoke. His daughter, who I came up with, has been begging him to quit. I’d never tell her, and he knows this, but he still blushes a little when he sees me, cute. Some nights I catch him outside the Elliot Houses, too, and he just smiles. I say hi to all the post office workers on break, the smokers. I light them up, too. I don’t pay any special attention to Mr. Terry. “Hi Chiqui, look at you all sunshine today,” says the lady from Chinatown. “Mira, you changed your hair, I love it! Super fanci.” A man I don’t know makes a sexual innuendo towards me, more for the benefit of his friends. He can’t help himself, I know. I have the curves and the ass he wants in a little package. Then I catch him clocking my jawline. I haven’t done my contouring yet, the bathroom was busy. I bought yellow leggings to match this top, they fit so good, with sequins on the back. He wants my cutlets, but has to make it a OCTOBER 2015 • A&U

joke in front of his friends. They laugh, but not Mr. Terry. “Mira tu paquetico, mister postman,” and I shake my ass at him. They laugh more at my joke than his. I’ve conquered another man. I run my hand up through my curls and bounce them, a victory shake. I have to fix my headband, which I made from the hem of the top. Yes I am crafty that way. The curls are my own, they all have kinky hair on my mom’s side, but they straighten. I put in this new color, Nice ’n Easy Natural Medium Golden Neutral Blonde, that shit is Nice ’n Nasty going on. My clutch is leather in light gray, it elevates the whole outfit. I love a coordinated look. My lids are painted with Lemon Drop for a complete effect, it’s making my eyes sparkle, linda. Someone always has a cigarette for me, and today it’s the papi cabron who tried to shade me. I share the mini-muffins because I earned them with my sunshine, and the sun shines on all. We go back a long way, me and Mr. Terry. He still can’t say my name, that bruto. I guess he knows me as Jaime Manriquez since I was born, and it’s funny to see him stop in the middle of calling me “Jaimito,” then mumble like his mouth ran out of batteries. Mr. Terry’s daughter is about the same age as me, we used to play together. I liked her and she liked me, until she got her titties, then she worried about what the boys would think. I was always feminine, and I presented as a girl back then too, and all the other Puerto Rican kids called me La Chiquita. The other Puerto Rican kids from Elliot were mostly good to me, they protected me, but whenever I left Elliot I got harassed. Mr. Terry’s stepson gave me a blade to carry, it has a pearl handle, and I still have it, and he showed me how to sharpen and polish it. I took the name Chiqui when I transitioned because it took their shade and made it chic. Music is coming from a truck, so I launch into a little number. I used to do shows at Escuelita before I transitioned. I strike a pose, pointing to the bow on my head, I’ve still got the lip sync down. This

butter chevron top looks so good against my thin brown arms. The smokers lift their heads and brighten one at a time like sunflowers as I do a salsa slide through them. “Devora-me otra vez, devora-me otra vez,” I sing along. They didn’t know I can sing for real. “She says ‘eat me up again,’” I translate for the gringuito, and give him my seduction look, but he’s mute and looks down. I’m bringing it home when I hear this shriek in the sky. Everyone laughs, even Mr. Terry. It’s this giant bird, looks like a seagull but that can’t be right, why is he shading me? “Mira cabron, no me atormentes,” I say to the bird. That means, “Ugh, don’t mess with me, asshole.” He glides down in a spiral and lands on a “No Parking” sign so close to me. He looks my way and I lock eyes with him, then take in his full white breast, his gray wings, and his yellow beak. He’s coordinated with my look today. This bird is giving me life. “Where did you come from, are you lost?” I throw him a mini-muffin and he moves so fast to take it in his beak, and flies off. The gringuito opens his mouth: “We’re just a few hundred feet away from the Hudson, and along here, it’s a mix of seawater and fresh. The Lower Hudson is actually considered a drowned river—a river overrun with salt water. That’s why we get seabirds, like that ring-billed gull.” “Okay, professor,” I smile in reply to his lesson. The maintenance guys know all about them, they’ve been nesting on the roof,” adds Mr. Terry. “They’re a nuisance.” Time to say goodbye to the smokers crew, and be on my way. I give them my signature exit, throwing my hand up with a flourish and waving my little fingers in front of my mug. I pass the West Side Yard, where the Long Island Rail Road keeps its trains after bringing all the suburban papis to their office jobs. A construction crew is laying a big deck across the whole yard, and building some more office towers for them. I’m feeling myself, but I rein it in to get past the construction crew. Not soon enough though, because one of

these cabrones in a hard hat and a safety vest spooks me. I catch him eye-rolling and frowning at me, I clock all his disapproval in the way he holds his big body. I hurry past him in my gorgeous Italian cork-heeled wedge sandals. Past the Yard is this ugly ’70s office building with sloping sides that used to have an ice skating rink on the roof. It looks like the headquarters of a dark empire. This is where GMHC moved a while back. I’m a client, I go for counseling with my social worker. On my way to my morning appointment is when I pass the Post Office smokers. Then I stay for hot lunch. I see some other clients standing in front of the building entrance, and stop to catch some gossip. Tenté is there. I hug him all over, he’s so big next to me, and we have a loud kiki for everyone coming in and out of the building to overhear. Tenté is my best friend, from the Canary Islands. He’s a handsome queen, a dancer. He works at the cafe on Christopher Street during the week, but on Sunday nights he gets up in drag and hosts a talent show. His drag is more experimental, more art school confidential, while mine was more old-school pageant. “Loca, this construction worker cabron spooked me, but now I’m with my people and unbothered!” I do a hair flip for Tenté. Next I tell him about the big gull that almost ruined my number. “Oh, yes, I’ve seen them around here,” he says. “It reminds me of Tenerife. Once I watched one at Los Cristianos beach swoop down and carry off half a sandwich from this kid’s hand, and another pluck a catch right off a fishing line.” “Gaviota! Gaviota! Maldita seas,” I sing for Tenté. “You’re more pigeon than seagull, loca,” he reads me. Tenté is on point—I’m a city bird, except I’m not common, even if I came up in the projects. I’ll have to ask that professor about pigeons. Tenté lives close to the big Post Office. He’s in and around the station all the time, sending packages to his mom—fabrics she likes, sometimes underwear. He had a tough time making friends there at first, but once he got past the workers’ gruff fronts, he found their humanity. He rents a small room on the cheap from an older queen who supports his artistry. Tenté likes to stare out his window at the office building on the corner, a regular plaid of bricks and glass, lights on this floor, lights off the next. He keeps his room dark except for a candle. He can even see the river between the buildings and beyond, just a

little segment. After hot lunch, we go back to Tenté’s. His roommate is out, I can beat my face in peace, with Tenté’s good brushes and his magnifying mirror. Tenté can be depressive, and here he goes staring out the window like an aged-out novela star. “What that postman said is the Hudson is a body half riverine and half marine. Trans, like us. Transformista, between two islands,” he says, pointing to his reflection in the window. “Trans woman, also between two islands,” he continues, now pointing at me. “Yes, loca, tell it.” Tenté is an artist in his heart. “I am a vagrant gull,” he over-pronounces the words, as if for his ESL teacher. I go back to the dark empire HQ, leaving Tenté to his melancholy. GMHC does hot dinners on Fridays, they have turkey tonight, it’s okay. Turkey for a pigeon, hey. After dinner, I take 10th Avenue home. It’s that summer night when the sunset lines up with the buildings, and the sun is a disk burning at every intersection, over the pink New Jersey sky. I’m skirting the trucks pulling out of the loading docks at 29th Street when I clock him. (Back in his dark little room, Tenté ponders the uncanny dislocation of hearing the gulls around the Post Office, while carrying a package for his mother. It takes him back to those languid days at Los Cristianos, and even further back, to time spent playing around the Port in Tenerife, picking over littered remains of crabs left by flyovers, getting into a staring match with one menacing gull roosting on a rock, and the rough dock worker who gave him attention. It takes him back to a secret boat trip with that rough man, gulls trailing the boat in a broken echelon, taking advantage of the craft’s upwash, while keeping black eyes peeled for food.) My chest heaves and I’m breathing so hard, now that I’m sure he’s following me. Not this shit again. I have phantom pangs from the last beating, those two Irish boys who broke my lip and pushed me into the street. I crawled under a truck to dodge their kicks; they wore work boots. I hear him pant, and laugh, a snide little laugh. I dig the blade out of my clutch, and once it’s in my hand, I run like a bitch on fire. This cabron starts chasing me, I’m not that far from home. I take a quick look behind me, he’s an ugly chulo in a leather jacket too big for him. Do I even know him? (Tenté wonders about the future of the gulls around him. There’s plenty of open sky around here, but not for much longer. The Post Office is being converted into a

train station—another transformista.) That’s when I stumble in my damn wedge heels, and the cabron takes advantage. He grabs my clutch, so I pop my blade. I’m trying to get my clutch back, it’s got cash and my pills and some good makeup in there. He catches me by the hair. “Aie! Déjame!” He’s jerking me around hard, and for once, I wish it were a wig. The cabron laughs when I show him my blade, I think he’s high. He jerks me again sharply, forcing me this way and that. He pulls me down so hard I almost fall on my back, and takes advantage of the moment to feel my breasts. He squeezes them hard, trying to prove they’re implants, but they’re mine. I break out of my wedges so I can get my balance back and face him. (They’re raising up commercial buildings, floor by floor, over the West Side Yard. That contractor who shaded Chiqui was working on a pair of towers that taper away from each other, like two awkward strangers forced to crowd in on a subway car. That’s what it looks like in the illustration they plastered all over the site enclosure. “The sky turns solid all around me,” Tenté laments.) I’ve been jerked around enough by this cabron, my roots are burning from his abuse. I take a desperate step: I cut off my hair, as close to his hand as I can get. I don’t want to lose too much length. I try to do it in one clean slice, but it takes a second, not so clean. He screams a little and tries to hit me, but I’ve cut myself free. I’ll be safe if I can get to 27th Street. (Tenté marvels at how their pitchy calls block out every siren, every car horn, every downshifting truck. He finds himself surrounded by the vast Atlantic of his childhood on West 34th Street. The sea of his youth is a flat, soft vastness of blue reflections. The city outside is hard, patterned, vertical ruptures made of minerals and ores re-formed, like stalagmites dripping from hubris. The gulls have this auditory power to take him back, faster than a jet, more reliably than a carefully labeled package from his mother.) That’s when I see Mr. Terry on the corner. He must have been enjoying his last cigarette of the day, and now he’s rushing towards me. Mr. Terry yells out “Hey!” and the cabron freezes. I make it to Mr. Terry and turn around. The cabron is just standing there with my hair in his hand, my broken shoes at his feet, looking stupid. That’s symbolic of something. I must have cut into his fleshy palm because blood is running into my hair, and there’s splatter on my expensive leather clutch. A&U • OCTOBER 2015

creative nonfiction

Long-Term Survivor by Victoria Noe

It’s ruined, and now I’m really ready to go back and slice this cabron, but Mr. Terry holds me back. (Tenté will always be oriented to the sea, he tells himself. It’s guided his life choices, his own migrations. Staring morosely at his sliver of the river, he internalizes the tidal pull. He floats above himself walking along the river while smoking marijuana. In his sativa reverie, he passes the hulking coffin of the Convention Center, then takes in the assault of pulsing noise and aviation fumes that is the heliport.) The cabron is yelling insults. Mr. Terry takes me by the shoulders and makes me look in his eyes, to knock me into the moment. He can’t see my pain, can he? “Are you hurt?” he asks, and I nod. (Tente’s phone rings, taking him out of his trance. Hardly anyone calls him. He says hello, but it’s immediately clear he’s been pocket dialed. He listens for voices over the rustling of fabric against the speakers, then a dramatic scene, screaming, jostling. He’s yelling into the phone but no one hears him.) My chest burns, I can’t stop panting, and I lose my shit when Mr. Terry embraces me. I’m just going to lean on this good man and cry, this is what it’s like. Mr. Terry rubs my shoulders like no man ever. “He’s getting away, should we…?” and I interrupt him, “Just let him go.” Mr. Terry then holds me tight to him, and exhales: “Oh Chiqui.” It’s the first time he’s ever used my name. All the fear rushes out of my shaking body, all the love I carry rushes to my skin, blushing it pink like the New Jersey sky. I am protected, respected, alive. Then I hear a tiny voice in my pocket, and it’s Tenté screaming into my phone. “Chiqui! Chi! Qui! Are you all right, my pigeon?” “Yes, loca.” Dale Corvino found his confessional voice at “Dean Johnson’s Reading for Filth,” recounting his youthful exploits as a kept boy. Under a pseudonym, he’s blogged advice for rentboy.com, appeared in Savage Love, contributed to Prose & Lore, and to the anthology Johns, Marks, Tricks & Chickenhawks. Under his government name, he’s published a reminiscence of his family relationship to Marilyn Monroe in Salon, an appreciation of Blondie in ImageOutWrite, and a short story in Jonathan. Dale lives near New York City’s main post office, which is now transforming into a train station.

OCTOBER 2015 • A&U

t’s only the past few years that that designation has become widely used. Hell, no one expected it would ever be possible. There was a time when my only prayer was to get through a week without reading the obituary of someone I knew or admired from afar. Since many who have reached that milestone are also baby boomers like me, I’ve taken a special interest in their challenges. During a visit to New York, I attended a listening session at Gay Men’s Health Crisis and was profoundly moved by stories of isolation and loneliness, especially from straight men and women who felt a unique stigma. But I was an observer, not a participant. A few months ago, when Jeff Berry at Test Positive Aware Network (TPAN) announced The Reunion Project in Chicago, I told him I’d like to attend, though I wasn’t a long-term survivor. “Yes, you are,” he insisted. “But I’m not positive,” I insisted right back. “But you were there.” I still don’t identify as a long-term survivor, but he was right: I was there. I’ve been in and out of the community since about 1983. I started out volunteering and then became a fundraiser. The deaths of people I knew, mostly but not exclusively men, piled up during those early years. If I lost touch with a gay friend, I assumed it was because he was dying or already dead. I talked about my work with few people outside the community. To be a straight woman working for an AIDS organization in the late ’80s/early ’90s was as isolating as it gets. I know: Elizabeth Taylor and Princess Diana, prominent public faces of straight women involved in the community. But most of us weren’t in the public eye. We were caregivers and social workers and advocates. We raised money, delivered meals and found emergency housing for those kicked out by their families. Our social lives consisted of work, fundraising events and memorial services. We did good work and had good intentions, but we were naïve: naïve about the emotional toll of our involvement. Inside the AIDS community we weren’t always welcome, to put it mildly. We were told to our faces that we didn’t belong, called “breeders” and much worse. We were looked at with suspicion, as if our goal was to attain sainthood for working with modern-day lepers. After years of working in theater with gay men, I was shocked to be treated with contempt. We became pariahs in the outside community. “You’ll never get a date now” was my ex-boyfriend’s sneer when I told him I took my first staff position at an AIDS service organization. Turned out the asshole was right. Because in 1989, if I told a straight guy I worked for an ASO, that was pretty much the end of the conversation. I went to my friends’ weddings and baby showers, but didn’t discuss my work. Their attitude was always the same: “Why do you want to do that? It’s not about you.” They were right. I was HIV-negative then and now. I wasn’t at risk. But I wanted to help so I kept at it: cranking out grant proposals, organizing fundraisers, showing up at memorial services. By the time I was married with a baby in 1994, though, I was cynical and angry and exhausted. I backed off. For the next seventeen years, I kept up with the medical miracles and observed World AIDS Day. Other than that, I was careful to keep my distance. After a concussion ended my sales career in 2009, I embarked on something very different: writing. I began work on what became a series of small books about grieving the death of a friend. I assumed AIDS would be one of the topics, but gave it little thought until 2011, when Tracy Baim asked me to contribute an article about my experiences to Windy City Times’ “AIDS @ 30” series. I remember sitting down at the computer, not sure I could remember much. I didn’t realize how much I’d deliberately suppressed. But before long my fingers

could barely keep up. The anger surged so quickly and so dramatically that it scared the hell out of me. People and events, places and conversations popped into my head. But what was most troubling to me— and still is—was the isolation. I was not on the inside of the community, not on the outside: somewhere in between, unable to identify completely with either side. The extent of that isolation was slow to reveal itself. I reconnected with a woman who’d been a volunteer in the same organization where I was the development director. It was soon apparent that our experiences were eerily similar, but until that day— over twenty years later—we had never shared them. In early 2013, I sent my mother a copy of my book. Now, my parents were always quite liberal with regard to the LGBT community. A gay man was my father’s best friend. My nephew is gay. Acceptance was always there and they never questioned my work. So her initial reaction was not what I expected. “You never told us. I had no idea you went through any of this.” As it turned out, she wasn’t the only one. People I’d known for 20 years didn’t know I’d ever had any involvement in the AIDS community. Time and again I saw shocked looks on their faces, and heard it in their voices, because I never, ever talked about it. And that’s when I realized the true cost of isolation. If it was this bad for me, how must it be for those who have lived with the virus for decades, unable to disengage from it for even a minute? I kept to myself because I didn’t think anyone cared about all the people I knew who were dying. I didn’t think anyone cared that I was afraid to check on friends I’d lost touch with because too often I found out they were already dead. I didn’t think anyone cared that I would come home from work and sit on the couch in the dark, staring at nothing, forcing myself to not feel. So I wasn’t prepared for people to thank me now, thirty years later, for what I did. I wasn’t prepared for people to seek me out for information or advice. I wasn’t prepared to jump back into the community, this time as a writer and member of ACT UP New York. There are days when I don’t have a fucking clue why I’m back. I don’t know what I thought I’d be doing at this age, but it’s not this. Thirty years ago I hoped all this shit would be over, but it’s not. At the closing of the 2015 U.S. Conference on AIDS, one of the ministers said something that raised goosebumps all over my body: “Sometimes we choose our calling, and sometimes our calling chooses us.” I still feel frustrated, I still feel angry. But I don’t envision walking away again any time soon. Because this time, for the first time, I don’t feel alone.

poetry

by Noah Stetzer

New New Colossus

“AIDS began…in or near a small southeastern wedge of interior Africa, around 1908.”

The same way you might look at the Statue of Liberty— stare up at her copper face, time-travel back to when ancestors arrived at her feet, react as if shared genetics was all you needed to be so touched by that green symbol: the verdigris stain that took four years to completely cover her was found to be an unexpected protection that softened all the outlines and made her beautiful— you can stare down through Google earth at the Sangha River and for a moment consider what you may share with a muddy tributary that leads from Cameroon out to the world.

After recovering from Pneumocystis jirovecii pneumonia five years ago, Noah Stetzer went back to school and last summer completed an MFA in poetry. He has been selected as a poetry fellow for the Lambda Literary Retreat for Emerging LGBTQ Writers, and has also been awarded a scholarship to the Bread Loaf Writers’ Conference.

Victoria Noe is a Chicago-based writer and speaker, as well as a member of ACT UP/NY. Sales of the second book in her series about grieving friends, Friend Grief and AIDS: Thirty Years of Burying Our Friends, benefit Broadway Cares/Equity Fights AIDS. She has just begun work on a new book, Fag Hags, Divas and Moms: The Legacy of Straight Women in the AIDS Community, to be released in 2017. Her website is victorianoe.com.

A&U • OCTOBER 2015

poetry

by Sean Patrick Mulroy

At the LGBT History Museum in San Francisco, lights come up, and reveal the blood-stained suit of Harvey Milk, how madness paints itself through bullet holes that whistled through a man who begged us to be brave. A tape recording: To be played on the occasion of my death from political assassination— Look, how once our voices bled their windswept ribbons through the sky, despite what whistled through the air to quiet us— religion, gunfire, our own boundless want— every beaten face, a violent cumshot. every hospital, an arc of luscious wound, another comma in an endless litany of names. A tape recording: Should a bullet enter my brain then let it shatter every closet door— a few weeks, less, and it was over, only windows shattered in the white night while someone gathered up this suit of clothes and kept it, wet with blood—our blood, so soon to be an ugly stain on everything. For thirty years, we trembled in our ruined shirts. Outside of the museum, furious and brave the light of Castro hillside bathed in sun is blinding like the history of everything that dared to love before its time and died. I squint. A handsome man comes into focus, whistles as he passes, and it is a day to be alive, again. To kiss him, as I do, right there, in daylight street becomes a kind of offering, a drop of sweat poured on the sidewalk for our dead. I press my lips to his because he’s beautiful.

I put my tongue between his teeth because I can.

Born and raised in Southern Virginia, the house where Sean Patrick Mulroy grew up was built in 1801 and was commandeered by the Union Army during the Civil War to serve as a makeshift hospital. As a boy, Sean loved to peel back the carpets to show where the blood from hasty surgeries on wounded soldiers had stained the wooden floorboards. Now he writes poems. Sean is a candidate in the MFA program at UW Madison, a 2013 Lambda Literary Fellow, and an eight-time competitor at the National Poetry Slam.

OCTOBER 2015 • A&U

New Yardstick the who releases recommendations early to meet prevention & treatment goals

them. One key recommendation involves the initiation of antiretroviral therapy (ART). The other key recommendation involves the use of pre-exposure prophylaxis (PrEP). Recommendation #1: When to Start ART The first key set of recommendations covers the initiation of antiretroviral therapy (ART) across different age groups and patient poulations. One new guideline recommends that ART should be initiated among HIV-positive adults (nineteen and older) irrespective of progress of the disease and at any CD4 cell count, with priority given to those patients with severe to advanced HIV disease and those with a CD4 cell count below 350 cells/mm3. This was cited as a strong recommendation, based on moderate-quality evidence. A second new guideline for adolescents (ten to nineteen years of age) living with HIV reiterates the same recommendation for adults—initiation of ART irrespective of disease progression or CD4 cell count. This was cited as a conditional recommendation based on low-quality evidence. The recommendation, however, changes to strong when considering those patients at severe or advanced stages of the disease and those with cell counts lower than 350 cells/mm3. A third new guideline recommends that all children (one year old to less than ten) should be started on ART irrespective of disease progression or CD4 cell count. This recommendation includes infants diagnosed in the first year of life, as well. The same treatment prioritizations mentioned in the other recommendations apply here as well, though with slightly different CD4 cell count cut-offs. One updated guideline recommends that antiretroviral therapy should be started in all pregnant and breastfeeding women living with HIV, irrespective of disease progression and CD4 cell count, and continued for her lifetime. This was

cited as a strong recommendation, based on moderate-quality evidence. Recommendation #2: PrEP The second key recommendation covers the use of oral pre-exposure prophylaxis to prevent HIV transmission. TDF-containing oral PrEP should become one of the options offered as part of an array of HIV prevention approaches for those indivudals considered at substantial risk for contracting HIV (“some groups of men who have sex with men, transgender women in many settings, and heterosexual men and women who have sexual partners with undiagnosed or untreated HIV infection”). A review of clinical data suggests that adherence is strongly correlated with the level of protection. And that level of protection did not differ across mode of sexual transmission nor age, gender, or regimen (TDF vs. FTC plus TDF). The authors noted that PrEP may only be needed for periods of risk rather than for life, as well as the fact that severe long-term toxicity is rare. There is no evidence that PrEP leads to decreased condom use or an increase of sexual partners. This was cited as a strong recommendation, based on high-quality evidence. To read the full report, log on to: http://bit.ly/1Vx2jKd. Chael Needle wrote about ending disparities in HIV healthcare in the September issue. A&U • OCTOBER 2015

illustration by Timothy J. Haines

he World Health Organization (WHO) published its “Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV” last month to provide two key recommendations about the prevention and treatment of HIV to health sector advocates and professionals, especially those who shape policy for the nations in which they work. Reports like these are useful for those working on a community-based level, as well, because they rely on solid reviews of evidence-based data and practices and may be used as a yardstick for measuring one’s own national AIDS strategy. The WHO-convened Clinical Guideline Development Group reviewed and summarized available data up to June 2015. WHO published these early-released guidelines ahead of the full update in 2016 to revise its 2013 guidelines sooner rather than later, in an effort to improve the health outcomes of individuals at substantial risk for contracting HIV and individuals living with HIV or AIDS in an impactful way. The report framed its recommendations within the UNAIDS Fast-Track 2020 goals, which have been set to significantly reduce mortality related to HIV and prevent new infections, and with an eye on the 2030 target date, when AIDS could potentially no longer be a major public health threat thanks to our actions now. Three questions, quoted in full below, formed the core of the review: • In adults, adolescents and children with HIV, is ART initiated at a threshold above CD4 500 cells/mm3 compared with less than 500 cells/mm3 more harmful? • Should pregnant and breastfeeding women with HIV started on triple ARV drugs continue on lifelong ART regardless of eligibility criteria? • Should oral PrEP containing TDF [tenofovir disoproxil fumarate] be offered as an additional prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches? All the recommendations were graded according to how confident the reviewers felt about the data supporting

lifeguide

Affairs of the Heart

t is well known that people with hepatitis C virus (HCV) are at risk for liver damage, but the results of two new studies suggest that chronic HCV infection could lead to heart problems as well. Researchers of one of those studies, conducted out of Johns Hopkins University and published online July 27 in The Journal of Infectious Diseases, offer big caveats. Their study sample was small and was cross-sectional, looking at one point in time. However the result adds to a growing pool of evidence suggesting that HCV does damage to the body beyond destroying the liver. The Johns Hopkins researchers previously studied 1,000 people with HIV and found that virus to be associated with artery-clogging plaque, the main driver of heart attack and stroke risk. The study involved 994 men between forty and seventy years-old across several medical institutions in Baltimore, Washington, D.C., Pittsburgh, Los Angeles, and Chicago. Of that group, 613 were infected with HIV, seventy were infected with both HIV and hepatitis C, and seventeen were only infected with hepatitis C. Cardiac CT scans were conducted on those who had either HCV, HIV, or both viruses to measure the amount of fat and calcium deposits inside the vessels of their hearts. Those infected with hep C, regardless of HIV status, had thirty percent more calcified plaque in their arteries. People infected with either HIV or hepatitis C, on average, had forty-two percent more non-calcified fatty buildup, a type of plaque that’s thought to present the greatest risk of heart conditions. In addition, those who had higher levels of circulating hepatitis C virus in their blood were fifty percent more likely to have clogged arteries, compared with men without hepatitis C. “Some studies say there is a strong HIV/HCV synergy, but in this study we were surprised to find that the plaque associated with HCV was not influenced by having HIV, and vice versa,” said the study’s principal investigator Eric Seaberg, PhD, assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

Seaberg and colleagues also found that the potential heart risk of having HCV was stratified by viral load. Those with a hepatitis viral load greater than 2 million had a much higher level of calcified and non-calcified plaque. Non-calcified plaque, Seaberg points out, is actually more dangerous because of its instability and likelihood to move around the arteries. Another recent study revealed at the International Liver Congress in April, also showed that chronic hepatitis C virus (HCV) infection is associated with a higher risk of developing cardiovascular diseases and significantly increases cost of care and length of time in hospital. In this larger retrospective analysis, Howard University professors Dr. Firew Wubiee and Dr. Charles Howell and their team analyzed more than 200,000 inpatients with and without HCV infection at discharge using data obtained from the 2011 Nationwide Inpatient Sample, an all-payer inpatient care database containing information on more than 7 million hospital stays in the U.S. They found that those with HCV were twenty-nine percent more likely to have had an acute myocardial infarction (heart attack), ninety-eight percent more likely to have experienced a cerebral vascular “accident” (such as a stroke or cerebral hemmorhage) and eighty-eight percent times more likely to have coronary artery disease. There was also an eight percent increased risk for heart failure. Based on these results, study investigators conclude that chronic HCV infection should be considered a risk factor for the development of cardiovascular diseases.

Seaberg tells A&U that, because the Johns Hopkins cross-sectional study was so small, he is hesitant to make a pronouncement on causation, but he says the findings could mean that higher levels of HCV drive inflammation throughout the body. And inflammation can accelerate blood vessel damage that may contribute to heart disease. Seaberg adds that more information on the HCV/heart risk may come after he finishes a longitudinal study to see the progression of heart disease of men with hepatitis C over the course of three years. Subsequent studies are also needed to help doctors understand is whether the new class of HCV meds might stop the formation of plaque and reduce cardiac risk for their patients who have the virus. The Johns Hopkins researchers say that, until more studies are done, it would be prudent for patients with hepatitis C to have an annual cardiac evaluation, which should include cholesterol and glucose testing, a blood pressure check and a thorough assessment of lifestyle habits that could lead to or exacerbate heart problems. Larry Buhl is a radio news reporter, screenwriter, and novelist living in Los Angeles. His podcast on employment issues, “Labor Pains,” can be found at www.laborpainspodcast.com. A&U • OCTOBER 2015

illustration by Timothy J. Haines

studies show hcv infection could increase heart risk

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lifeguide

Talking “Cure”

obel Prize Laureate and world renowned HIV researcher Françoise Barré-Sinoussi recently made the statement that she does not believe an HIV cure is possible. As a co-discoverer of HIV, this statement carriers a lot of weight. So, I sat down with Dr. Harold Smith, PhD, a professor at the University of Rochester and faculty member for twenty-nine years, to pose the question “Is an HIV cure possible?” in light of Barré-Sinoussi’s statement. In part I of this two-part interview, Dr. Smith discusses his research on ABOBEC3G and his new HIV therapies/ eradication strategies, and the problems he’s faced in moving a potential cure for HIV forward. Early in his career, Dr. Smith became known as one of the leaders in the field of APOBEC; indeed, he was one of the youngest of this field at that time and he continues to make significant contributions. In part II, to be featured in an upcoming issue, Dr. Smith explores the idea of whether or not a cure is possible and whether or not, by looking at cure the same way that we look at treatment, in terms of what is acceptable, we may be setting the bar too high and setting ourselves up for failure.

Jeannie Wraight: Can you tell us about ABOBEC3G, Vif, and your research on them? Dr. Harold Smith: ABOBEC proteins have a curious quality to them. They are involved in many different functions in the cells. One that really caught my attention was ABOBEC3G. Vif (viral infectivity factor), is an HIV protein. It’s been studied for about twenty-five years and had various functions ascribed to it but nothing with great certainty. It was discovered that the purpose of Vif was to find and destroy ABOBEC3G. I realized this was a problem that my lab could contribute to. Thirty years ago I began switching my lab, over time, from cardiovascular disease to where it’s now, one hundred-percent-focused on HIV. What was needed was to try to apply this science toward developing new drugs since

Vif seemed to have such an important role in killing our host defense. The APOBEC host defenses, left alone, would completely devastate the coding sequence of HIV, mutating HIV and wiping it out. Without Vif we could defend ourselves against HIV, in which case it’s very important to validate this hypothesis. I now do academic research in my lab at the University of Rochester which is very fundamental to how molecules and enzymes like ABOBEC3G work. I also have a company full of scientists at OyaGen dedicated to finding out what are the best druglike chemistries to enable anti-viral activity through APOBEC3G and determine their safety. I formed OyaGen to develop new drugs that would bind to Vif and prevent it from destroying our defense mechanisms in order to stop HIV. OyaGen is probably, conservatively speaking, three years away from entering phase I clinical trial with the first drugs that prevent Vif from destroying ABOBEC3G. This is a totally new drug target on HIV, a genetic hit that HIV cannot survive because our lead compound prevents it from coding for its own proteins. So if not a mechanism for eradicating HIV, then it certainly is going to be a very important mechanism for blunting any kind of infection and preventing the expression of infectious virus from viral reservoirs. How have the dynamics surrounding the search for a cure affected your research moving forward? We were recognized early on, about five, six years ago, by the pharmaceutical industry as having the most advanced Vif drug development program. OyaGen has been working on small molecule drug development since 2010, though the company started in 2003. We were constantly told by the Pharma industry that we should move further along: “There’s an interesting experiment we would like to see you do. We know it’s going to cost a lot of money, we know you don’t have the money, but we’d like you to do it anyway and we welcome you to come back once

you’ve accomplished it.” And as we accomplished these requests each time; two men pick up the goalpost and walk ten yards further along and ask us to achieve another $100,000 and $300,000 experiment. The real issues are perceived as being “too early,” which is a term used by Pharma and investing firms to say at the discovery and development phase their money is at too much risk. I have to conclude that they are very satisfied with what they have and are doing therapeutically and there’s no urgency to evaluate new targets that may be curative. Pharma has a lot of money invested in current ART and good patent protection. Why spoil this with something that’s curative? I’ve raised this issue and I’ve been told “No, no, no, everyone’s very interested in cure.” I would imagine being at the board meeting where the lab director comes in and says, “Here’s the story— Vif dimerization antagonism is absolutely curative, no doubt about it. You give this to patients for a few months, there’s no living virus, everything is replication incompetent, you’re functionally cured.” Now there’s the reality that they may be free of ART. What would they do in contemplating the financial impact on what was a sure stream of revenue from ART and drugging familiar HIV targets? Cure is a disruptive technology for this industry. A&U • OCTOBER 2015

photo courtesy H. Smith

what are the barriers we face in the search for a cure?

Some say that the current funding systems aren’t set up for cure research and that it’s slowing the progression of potential cure agents and strategies. Has that been your experience? As I said I’m new to the HIV field. When I first started writing grants for my HIV research involving ABOBEC3G and Vif, I was coached by experts in the field to be careful how to phrase goals in research, new mechanisms, or developing a new drug target. They told me to not have a goal of eradicating the virus and not to use the words “kill” or “stop” the virus, [but] rather have more modest goals of inhibiting replication or reducing the spread of infection. Definitely [I was told that] a hypothesis for what might be curative should not be proposed because that would come across as ungrounded in the reality that cure had not been achieved despite decades of “research.” It was extremely taboo. In a grant, I lead with a hypothesis. For example, my hypothesis is [that] when I treat HIV with a drug that prevents Vif from destroying ABOBEC3G, 3G will cause devastating mutations to HIV and in a few cycles of replication the virus will be dead.

The argument is that this has the potential of being curative. From there I write my specific aims that outline the research approach and milestones. Previously, if you could not hypothesize curative approaches, you proposed therapy in the grant and hoped for more. The culture of peer review and grant writing encouraged scientists to limit their expectations. The sentiment expressed in the media is that now is the time for a cure, as perceptions have changed and, where we once did not dare imagine [a] cure, now we are seeking new approaches. If this is true, then although decades of science have led to success in extending the lives of people who have HIV, this period also reflects massive effort that failed to find a cure. I would argue that the statement is not entirely accurate. While responsible researchers limit their hypotheses in grant proposals to what can be tested, as no one knows what will be curative, even though “cure” was the word that could not be said, there remained every possibility that something or combinations of approaches could prove to be curative. So the grant structure was not geared towards cure research? Not at all. Then all of a sudden, there

were several claims and talk of “cures.” Even though NIH didn’t produce a clear understanding of the definition of cure or what constituted cure research, $100 million was appropriated by President Obama for cure initiatives. The system wasn’t set up to address cure in hypothesis-driven and mechanistic-type research. A new Research Funding Announcement (RFA) was released for cure research and when I asked the program officer in charge about our efforts in evaluating Vif, his response was, “No, that is not the kind of target we are considering for cure.” How did NIH know what drug targets were appropriate for cure? Do you see this changing? Much will have to change in the peer review system at NIH in order for innovation to have a chance to prove or disprove itself. Jeannie Wraight is the former editor-in-chief and co-founder of HIV and HCV Haven (www.hivhaven.com) and a blogger and writer for TheBody. com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in New York City.

A&U • OCTOBER 2015

E R U CULT S THE

AID OF

Longtime Companion

A film that made AIDS personal turns twenty-five by Larry Buhl

illustration by Timothy J. Haines

ere’s the premise Longtime Companion, which opened in theaters a quarter century ago: a group of gay friends in New York are changed over time as they confront deaths from AIDS. Who would want to see a movie about that? Lots of people as it turned out, though the studio didn’t think so at the time. Writer Craig Lucas [A&U, November 1998] and director Norman René have recounted the hell and high water they crossed to get it made. Almost a decade into the crisis only three other full-length films had dealt with the topic: the 1985 TV movie An Early Frost and little-seen indie films Buddies and Parting Glances (with a very young Steve Buscemi as a rock musician with AIDS). But none of those approached AIDS in such a visceral way, nor did they provide a punch to the gut that Longtime Companion delivered over and over. Longtime Companion was the first wide-release fictional work to deal with AIDS. Its structure and interlocking storylines and character arcs made the crisis real and personal for those who considered AIDS to be an abstract concept. It was a retrospective treatment, starting in the party scene of Fire Island in 1981 when someone noticing the short New York Times piece about “gay cancer” and ending with a beach scene in 1989 where survivors muse on what it will be like when AIDS is cured. It would be “like the end of World War II,” one character concludes. OCTOBER 2015 • A&U

Between those bookmarks we follow a small group of gay men—and a straight sister—as they are picked off like a sniper’s victim (Dermot Mulroney’s character, the first to fall ill), or degrade over time as their friends and doting partners suffer survivor guilt, anguish, terror, and exhaustion—sometimes all at the same time. By the time you reach the “let go” death scene between Bruce Davison’s character David and at the bedside of the panting, panicking partner, you may be whispering through tears with him as he gently urges the love of his life to move on: yes, let go. Scenes like the let go climax made critic Dave Kehr in the Chicago Tribune dismiss the film as melodramatic,

though even he recognized its importance as the “first mainstream fiction to openly solicit an emotional response to the AIDS crisis.” Some criticism has been hurled at it, mainly due to focusing on upper middle-class urban gay white men. And though it garnered several awards, including a Golden Globe for co-star Bruce Davison, Longtime Companion is inexplicably hard to find. The DVD is out of print and it’s not available for streaming. If you can find it, watch it not only for its historical significance but for its performances, fine writing, and stunning moments. Moments like watching Fire Island partiers gasp when a new

untouchable, a lesion-covered man, approaches their beach house with begging eyes and the heart-wrenching beach coda where the dead come back to life. There are bits of unexpected humor too, even gallows humor like the time Mary-Louise Parker [A&U, October 1999] ridicules a surprising piece of apparel in the closet of a recently fallen friend. And the activism of surviving characters, once their shellshock has worn off, leavens the narratives’ sadness. The end of the AIDS crisis may not be like VJ day, but there is a détente for those able to access lifesaving new meds. The title of Longtime Companion was both a reference to the obituary term for surviving same-sex partners of the disease in the eighties and also an allusion that the disease had already been around for a long time and would stay around, as it has, for a long time. It’s not just an elegy for those killed in early days of AIDS, but a fine work of drama that can be seen as more than a milestone in the history of art spawned by the disease. Larry Buhl is a radio news reporter, screenwriter, and novelist living in Los Angeles. His podcast on employment issues, “Labor Pains,” can be found at www.laborpainspodcast.com.

A Calendar of Events

he 14th annual An Enduring Vision Benefit Gala, an event created by the Elton John AIDS Foundation (EJAF), will honor leaders in HIV/ AIDS and human rights work. CNN anchor Anderson Cooper, returning for his eighth year as host, will oversee the black-tie festivities at Cipriani Wall Street in New York. Ford Foundation President Darren Walker is the featured speaker. KC and the Sunshine Band have been tapped to shake, shake, shake the crowd up. Attendees will have a chance to bid on exciting auction items and enjoy cocktails and dinner. The Enduring Vision Award honorees include M. Michele Burns, a corporate and philanthropic leader who has been an integral part of EJAF, from its inception to its current status

as a substantial AIDS grantmaker and AIDS advocacy juggernaut; Robert J. Coury, whose leadership at Mylan has helped the company expand and fulfill goals in improving global health and helping to end the AIDS pandemic; and Tracey Emin, a steadfast advocate for human rights causes and renowned artist. Sir Elton John and David Furnish serve as honorary chairs of the event. Over the past two decades, EJAF in the U.S. and in the U.K. has raised more than $321 million to combat stigma, prevent infections, provide treatment and services, and motivate governments to end AIDS. Date: November 2; time: 7 p.m. (cocktails, 8 p.m. (dinner and auction); location: Cipriani Wall Street, 55 Wall Street, New York, New York. For ticket information, contact Andreas Schwarz at the Elton John AIDS Foundation, by phone at (212) 219-0670 or by e-mail at andreas.schwarz@ejaf.org. Visit www.ejaf.org for more information about the foundationâ&#x20AC;&#x2122;s work.

A&U â&#x20AC;˘ OCTOBER 2015

OCTOBER 2015 • A&U

Survival Guide

[a portrait by sean black]

Doc Duhon Palm Springs, California “I try to pursue a heart path in life and relationships. The most significant accomplishment I can achieve is to live so authentically that it empowers others to do the same.”

A long-time member of the leather community and recently featured in the documentary, Desert Migration, Doc made peace with his unconventional nature during early recovery from drug addiction more than twenty-seven years ago. In his first years of recovery, he tested HIV-positive, subsequently receiving an AIDS diagnosis. He now mentors other nonconventional recovering addicts, most of whom also deal with HIV/AIDS. His message is that HIV is a virus, not a punishment based on alternative sexual or relationship choices. Sean Black is a Senior Editor of A&U. 64

A&U • OCTOBER 2015

YOU CAN LIVE A HEALTHY LIFE WITH HIV. TREATMENT HELPS MAKE IT POSSIBLE.

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To learn more, visit HIV.Walgreens.com. * Vaccines subject to availability. Not all vaccines available in all locations. State-, age- and health-related restrictions may apply.

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