A&U September 2014 by A&U: America's AIDS Magazine

SEPTEMBER 2014 • ISSUE 239 • AMERICA’S AIDS MA

alex NEWELL LENDS HIS POWERHOUSE VOICE TO THE FIGHT AGAINST AIDS

GOOD SPORTS

Amazin LeThi Flexes Her Activist Muscles • Jack Mackenroth Gears Up for Braking AIDS

MOBILIZING FOR CARE

MARIA DAVIS & PWN-USA SHINE A LIGHT ON WOMEN’S HEALTH WITH I DESIGN

What is STRIBILD? STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. It combines 4 medicines into 1 pill to be taken once a day with food. STRIBILD is a complete singletablet regimen and should not be used with other HIV-1 medicines. STRIBILD does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking STRIBILD. 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.

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

• Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking STRIBILD, your hepatitis may suddenly get worse. Do not stop taking STRIBILD without ﬁrst talking to your healthcare provider, as they will need to monitor your health. STRIBILD is not approved for the treatment of HBV.

• Take a medicine that contains: alfuzosin, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, pimozide, sildenaﬁl when used for lung problems (Revatio®), triazolam, oral midazolam, rifampin or the herb St. John’s wort. • For a list of brand names for these medicines, please see the Brief Summary on the following pages.

• If you take hormone-based birth control (pills, patches, rings, shots, etc).

• Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera®).

• If you take antacids. Take antacids at least 2 hours before or after you take STRIBILD.

What are the other possible side effects of STRIBILD?

• If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD.

Do not take STRIBILD if you:

Serious side effects of STRIBILD may also include:

• 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.

• New or worse kidney problems, including kidney failure. Your healthcare provider should do regular blood and urine tests to check your kidneys before and during treatment with STRIBILD. If you develop kidney problems, your healthcare provider may tell you to stop taking STRIBILD.

• You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking STRIBILD 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.

• All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD 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 STRIBILD without ﬁrst talking with your healthcare provider.

Who should not take STRIBILD?

STRIBILD can cause serious side effects:

• 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.

What should I tell my healthcare provider before taking STRIBILD?

• 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 STRIBILD. The most common side effects of STRIBILD include nausea and diarrhea. Tell your healthcare provider if you have any side effects that bother you or don’t go away.

• 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 STRIBILD 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.

STRIBILD is a prescription medicine used as a complete single-tablet regimen to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD does not cure HIV-1 or AIDS.

I started my personal revolution Talk to your healthcare provider about starting treatment. STRIBILD is a complete HIV-1 treatment in 1 pill, once a day. Ask if itâ&#x20AC;&#x2122;s right for you.

Patient Information STRIBILD® (STRY-bild) (elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 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.

• Do not stop taking STRIBILD without first talking to your healthcare provider • If you stop taking STRIBILD, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking STRIBILD

What is STRIBILD?

Who should not take STRIBILD?

• STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD is a complete regimen and should not be used with other HIV-1 medicines. • STRIBILD 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.

Do not take STRIBILD if you also take a medicine that contains: • adefovir (Hepsera®) • alfuzosin hydrochloride (Uroxatral®) • cisapride (Propulsid®, Propulsid Quicksolv®) • ergot-containing medicines, including: dihydroergotamine mesylate (D.H.E. 45®, Migranal®), ergotamine tartrate (Cafergot®, Migergot®, Ergostat®, Medihaler Ergotamine®, Wigraine®, Wigrettes®), and methylergonovine maleate (Ergotrate®, Methergine®) • lovastatin (Advicor®, Altoprev®, Mevacor®) • oral midazolam • pimozide (Orap®) • rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®) • sildenafil (Revatio®), when used for treating lung problems • simvastatin (Simcor®, Vytorin®, Zocor®) • triazolam (Halcion®) • the herb St. John’s wort Do not take STRIBILD if you also take any other HIV-1 medicines, including: • Other medicines that contain tenofovir (Atripla®, Complera®, Viread®, Truvada®) • Other medicines that contain emtricitabine, lamivudine, or ritonavir (Atripla®, Combivir®, Complera®, Emtriva®, Epivir® or Epivir-HBV®, Epzicom®, Kaletra®, Norvir®, Trizivir®, Truvada®) STRIBILD is not for use in people who are less than 18 years old.

What is the most important information I should know about STRIBILD? STRIBILD can cause serious side effects, including: 1. Build-up of lactic acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take STRIBILD 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 • have stomach pain with nausea or vomiting • feel cold, especially in your arms and legs • feel dizzy or lightheaded • have a fast or irregular heartbeat 2. Severe liver problems. Severe liver problems can happen in people who take STRIBILD. 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 STRIBILD for a long time. 3. Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take STRIBILD, your HBV may get worse (flare-up) if you stop taking STRIBILD. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. • Do not run out of STRIBILD. Refill your prescription or talk to your healthcare provider before your STRIBILD is all gone

What are the possible side effects of STRIBILD? STRIBILD may cause the following serious side effects: • See “What is the most important information I should know about STRIBILD?” • 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 STRIBILD. Your healthcare provider may tell you to stop taking STRIBILD if you develop new or worse kidney problems. • Bone problems can happen in some people who take STRIBILD. 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 who take HIV-1 medicine. These changes may include 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 any new symptoms after starting your HIV-1 medicine.

The most common side effects of STRIBILD include: • Nausea • Diarrhea 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 STRIBILD. For more information, ask your healthcare provider. • Call your healthcare provider 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 STRIBILD? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, bone, or liver problems, including hepatitis B infection • If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD. - 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 with 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 STRIBILD. - 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 STRIBILD can pass to your baby in your breast milk. It is not known if the other medicines in STRIBILD can pass into your breast milk. - Talk with your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements: • STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. • Be sure to tell your healthcare provider if you take any of the following medicines: - Hormone-based birth control (pills, patches, rings, shots, etc) - Antacid medicines that contain aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or after you take STRIBILD - Medicines to treat depression, organ transplant rejection, or high blood pressure - amiodarone (Cordarone®, Pacerone®) - atorvastatin (Lipitor®, Caduet®) - bepridil hydrochloride (Vascor®, Bepadin®) - bosentan (Tracleer®) - buspirone - carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®) - clarithromycin (Biaxin®, Prevpac®) - clonazepam (Klonopin®) - clorazepate (Gen-xene®, Tranxene®) - colchicine (Colcrys®) - medicines that contain dexamethasone - diazepam (Valium®)

- digoxin (Lanoxin®) - disopyramide (Norpace®) - estazolam - ethosuximide (Zarontin®) - flecainide (Tambocor®) - flurazepam - fluticasone (Flovent®, Flonase®, Flovent® Diskus®, Flovent® HFA, Veramyst®) - itraconazole (Sporanox®) - ketoconazole (Nizoral®) - lidocaine (Xylocaine®) - mexiletine - oxcarbazepine (Trileptal®) - perphenazine - phenobarbital (Luminal®) - phenytoin (Dilantin®, Phenytek®) - propafenone (Rythmol®) - quinidine (Neudexta®) - rifabutin (Mycobutin®) - rifapentine (Priftin®) - risperidone (Risperdal®, Risperdal Consta®) - salmeterol (Serevent®) or salmeterol when taken in combination with fluticasone (Advair Diskus®, Advair HFA®) - sildenafil (Viagra®), tadalafil (Cialis®) or vardenafil (Levitra®, Staxyn®), for the treatment of erectile dysfunction (ED). If you get dizzy or faint (low blood pressure), have vision changes or have an erection that last longer than 4 hours, call your healthcare provider or get medical help right away. - tadalafil (Adcirca®), for the treatment of pulmonary arterial hypertension - telithromycin (Ketek®) - thioridazine - voriconazole (Vfend®) - warfarin (Coumadin®, Jantoven®) - zolpidem (Ambien®, Edlular®, Intermezzo®, Zolpimist®) 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 STRIBILD without first talking with your healthcare provider. Keep STRIBILD and all medicines out of reach of children. This Brief Summary summarizes the most important information about STRIBILD. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about STRIBILD that is written for health professionals, or call 1-800-445-3235 or go to www.STRIBILD.com. Issued: October 2013

COMPLERA, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, the STRIBILD Logo, TRUVADA, and VIREAD 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. © 2014 Gilead Sciences, Inc. All rights reserved. STBC0076 03/14

c o n t e n t s September 2014

42 Cover Actor & Singer Alex Newell Talks to A&U’s Dann Dulin About Performing His Heart Out in the Name of AIDS Awareness & Being a Vibrant Voice for Those Who Have Not Yet Found Theirs

Departments

Features 24 Leader of the Pack Activist Jack Mackenroth Brakes for AIDS Awareness

Frontdesk

Mailbox

32 Gallery NYC in the 1980s Set the Stage for Artists to Respond to the Epidemic

Ruby’s Rap Andy Tendler

NewsBreak

36 Designing Woman Maria Davis Advocates for Women to Take Charge of Their Heath

viewfinder

38 A Man for All Reasons Adult Film Mogul & Documentary Filmmaker Michael Lucas Reimagines Safer Sex On and Off the Set 48 Raise Your Voice Amazin LeThi Destigmatizes HIV Through Empowering Communities 52 Power of Evidence Sex Worker Research Comes of Age cover by Ricky Middlesworth Photography; inside photo by JSquared Photography

19 28 30

Just*in Time Brave New World Poetry

lifeguide 54

Treatment Horizons

Hep Talk

The Culture of AIDS

Lifelines

Survival Guide

A&U Frontdesk

Reelin’ In the Years

ummer days have begun to fade (always signalled by an early frost in the Adirondack mountains of upstate New York) and I get a little nostalgic for the days of old, when I was first contacting writers (including the poets, John Ashbery, Mark Doty, Gwendolyn Brooks; the prose writers Lesléa Newman and David B. Feinberg; and the playwrights Eve Ensler and William M. Hoffman) for submissions to what was to become the first nationally distributed HIV/AIDS magazine. They all shared my wish: Hopefully people will dip deep into their well of compassion for those impacted by HIV/AIDS. Hopefully those impacted could live with dignity. Hopefully we all could pass this test of humanity. With a particular bent on the arts and literature—Art & Understanding magazine morphed into A&U, a four color glossy with a readership in all fifty states. Over the years, we’ve added profiles on advocates and community-based organizations, treatment and wellness articles, and columns penned by humorists and activists alike. But we’ve always kept culture at our core. So it is with great pride and humility that I’d like to announce the publication of Art & Understanding: Literature from the First Twenty Years of A&U (Black Lawrence Press), an anthology that represents some of the literary hightlights of the magazine. Although we’ve been publishing close to twenty-five years, there are so many gems of expression—poems, short stories, plays, essays—that were excluded due to lack of space. It’s hard to cram close to 240 issues of literary expression into one book, so we settled on the first 200 issues of the literary archive that is A&U. But I feel we have done a good job of representing the diversity of both the A&U writer as well as the A&U readership. Although many of these great writers have passed on, their work continues to be read. That was one of the foremost goals of Art & Understanding, Inc., the 501(c)(3) that publishes the magazine: to preserve and protect the early literary responses to the epidemic as well as continue to develop new voices—many of whom, because of the advent of protease

A M E R I C A’ S A I D S M A G A Z I N E issue 239 vol. 23 no. 9 September 2014 editorial offices: (518) 426-9010 fax: (518) 436-5354

inhibitors, are still alive and writing today. When A&U (formerly Art & Understanding) was first launched, nobody knew about Kindles and Nooks. Even underground ’zines were produced on paper; not for everyone to visit online. In a sense the revolution in media has made the world a more literate as well as affordable library of the spirit. With this issue, as with every issue, we are dedicated to multiplying the voices of advocacy so we can get to zero. First up, we spotlight Glee actor Alex Newell in our coverstory interview. In his short time since winning his TV role thanks to a reality competition show, Alex has appeared at AIDS event after AIDS event. A&U’s Dann Dulin learned why Alex has dedicated himself to the cause: “Many people don’t have a voice— they’re either unable or too frightened to speak out. The least I can do—the absolute least I can do—is give back and do it for all those other people who can’t, won’t, or just don’t.” On other fronts, the September issue features a Gallery that spotlights artists who came of age in the New York City of the 1980s; Project Runway alum Jack Mackenroth on why he’s putting pedal to the mettle for Braking AIDS, a Boston– New York bike ride; adult film star and director Michael Lucas on his considered decision to advocate for PrEP, a prevention tool that is rattling the toolbox; and Amazin LeThi, an actress and AIDS advocate who is determined to raise awareness among Asian communities around the globe. Hopefully the next bound installment of the best of A&U will represent the literary works talking about AIDS in the past tense. How wonderful the cure is. How a vaccine was discovered that put an end to the misery of millions around the world. How the AIDS pandemic helped us solve other diseases, like poverty and oppression. But it’s up to us to write the next chapter.

DAVID WAGGONER

Editor in Chief & Publisher David Waggoner Managing Editor: Michael Needle Senior Editor: Dann Dulin Editors at Large: Chip Alfred, Sean Black 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, Annie Buckley, Larry Buhl, Ruby Comer, Nancy Ellegate, Diane Goettel, Sally Hessney, Angela Leroux-Lindsey, Sherri Lewis, Alina Oswald, Mark Rebernik, Dale Reynolds, Elizabeth Rodgers, David Rosenberg, Corey Saucier, Mariel Selbovitz, Justin B. Terry-Smith, Patricia Nell Warren, Chuck Willman, Jeannie Wraight 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, Stephen Churchill Downes, Greg Gorman, Francis Hills, Renée Jacobs, 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. ©2014 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

Printed in USA • Visit our Web site at www.aumag.org

A&U Mailbox

“Quoting from David Mixner, Michael Urie cites the famed civil rights advocate when he says, ‘We lost a generation of storytellers.’ Urie goes on to say that ‘many seventeen-year-olds don’t know about AIDS, because the stories are not being told. It’s partially our fault as a society for not seeking out those who were there and listening to their stories.’”

It’s nice to see a person like Michael Urie making his way in the acting business with so many credits under his belt [cover story, “Stepping Back,” by Dann Dulin, July 2014]. I like what he made reference to in his comments: Quoting from David Mixner [A&U, July 2002], Urie cites the famed civil rights advocate when he says, “We lost a generation of storytellers.” Urie goes on to say that “many seventeen-year-olds don’t know about AIDS, because the stories are not being told. It’s partially our fault as a society for not seeking out those who were there and listening to their stories. Of course, the sad truth is that a lot of them are gone....And some of them don’t want to talk about it because they don’t want to relive it. I understand. So it’s our responsibility to carry it on.” I agree wholeheartedly. —Walter Baggot Santa Monica, California Ugly Betty. I just can’t say enough about that show. Michael Urie was so good as the character Marc St. James. It’s very good that Michael is committed to the AIDS cause. Michael has worked with so many great organizations. I always support Broadway Cares as one of my charities.

And I did not know that Michael was in the show Angels in America. This is one of the shows that people should see, like The Normal Heart. Anyway it’s very impressive what Michael has accomplished in his career. I wish him good luck in the future. —Solange Ettinger Patterson, New Jersey

Condom Free? I am very disturbed by the messages I am reading about. I was very upset by Corey Saucier and what he seemed to say, that PrEP is now the magic bullet and you can just about throw away your use of condoms [Brave New World, July 2014]. I really believe that this is a big mistake. Every person should use a condom when having sex. The message going out is that people can stop using condoms, but I consider their useto be one of the pillars of the safe sex message. I would say that, to be safe, please use a condom and use PrEP with it. That’s what I have to say on the subject. —George Pagalo Phoenix, Arizona

The Evidence Is In

facts related to the history of AIDS [Gallery, July 2014]. So much of our history in America has been lost over the generations. What artists and other people have produced over the past thirty-five years since the onset of AIDS is preserving our political, social, and cultural history. It is one of the saddest stories: all the artists who have died from AIDS. We have lost a lot of creative people, many of them were really fascinating. These were meaningful people; who knows what they would have produced. I was really moved by the “Ephemera as Evidence” show at the La MaMa La Galleria show. —Evelyn Sand New York, New York 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.

It is so very important to save the artiA&U • SEPTEMBER 2014

photo by Annie Tritt

Neverending Story

ADAM TENDLER

ruby illustration by Davidd Batalon; photo by Greg Parkinson

arlier this year, the pianist Adam Tendler preformed here in Los Angeles. Before the concert, I learned that he was a finalist for the 2012 American Pianist Association Classical Fellowship Award and the 2013 American Prize. Adam is an AIDS and LGBT activist, and when he performs his piece, “Night Thoughts” (“a meditative recital program of modern American piano music”), he donates his profits to one or more local organizations. “Night Thoughts,” a concert he performed at Rothko Chapel in Texas, can be viewed on Adam’s website. The virtuoso was raised in Montpelier, Vermont, not far from The Trapp Family Lodge (of The Sound of Music fame), one of my favorite havens. The “maverick pianist” (The New Yorker) founded a nightly jazz series in New York and serves on the faculty of Third Street Music School Settlement. On the personal front, he has a beau of nearly five years. Adam and I met up at UCLA one afternoon near the performing arts center, and sat on the grass amid the lively outdoor sculptures. Ruby Comer: I want to be completely clear…please explain exactly what you do professionally. Adam Tendler: I perform modern music, which ranges from pieces composed this morning to a hundred years ago. I usually perform and study other people’s music, but sometimes I compose my own works. For instance, I recently premiered a protest piece in memory of Matthew Shepard called “HATE SPEECH,” for piano and audience cell phones. I also have a teaching studio and so the piano becomes a platform for education. And then of course I write about music and my life in the field, which

SEPTEMBER 2014 • A&U

inevitably involves the piano. You’re cuttin’ a new rug, piano man! You entertain and educate through the piano. Whom did you listen to growing up in Vermont? I grew up on Madonna, Prince,

Beethoven, Chopin, and everyone in between. I have two older sisters who exposed me to everything from pop to metal to gangsta rap, and at the same time I took piano lessons and was raised with classical music around me all the time. Everyone in my family played the piano,

and my grandfather was a piano teacher. But I suppose my heroes changed over time. As I grew to appreciate classical music as a vessel for my own self-expression, I started to find heroes in composers and performers who seemed to speak a language that resonated with me, and even this has been a kaleidoscope of different people over the years. Adam, you are a one-man band. The AIDS epidemic…[he cuts me off and asserts] …is the holocaust our community suffered in the eighties and nineties— and the indifference of those in positions of power who could have helped save lives. This gets me angry.

In what way? Well, my first major relationship was with someone who was positive. We were together for two years. I virtually went from the closet straight into this relationship. He was ten years older and twenty years positive, so I guess you could say it was kind of zero-to-sixty! It was a true adventure, though. We had a blast. Did you encounter any challenges? I think both of us wondered, at our own times and for our own reasons, if

Indeed. But then, Ruby, I also think of how that widespread ignorance and fear actually galvanized our community, and how we found unity and courage and power through the crisis. There’s still so much to do: A cure. A vaccine. An end to stigma. When did you first learn about the epidemic? I’m not sure about specifics, but, growing up in Vermont, my first knowledge of AIDS probably came via the entertainment industry and its response, from MTV promos to magazine articles to celebrities wearing red ribbons. [He pulls out some sheet music from his backpack to shield his eyes from the bright sun.] I also remember watching and re-watching the movie version of And The Band Played On when it first came out in 1993. I was eleven and HBO played it all the time back then. But I definitely already knew about AIDS before watching that film. Probably Madonna told me about it.

an audiobook format on iTunes and Amazon. It can also be streamed on Spotify. I know you often perform at New York’s GMHC, too. What sparks you to volunteer your time and talent? I saw Larry Kramer’s The Normal Heart on Broadway, twice, and it inspired me to do something for GMHC. [Larry co-founded GMHC in 1982.] You know, Ruby [he clears his throat], I think of volunteering as a privilege and a responsibility. We have to look out for each other, and it’s so easy to lose motivation when we’re at our computers trying to outwit each other on social media. Oh, drats. Don’t get me started on that horrid FaceBook, Twitter, and the rest of the muck, Adam. Call me an old fogey, but I think we’ve lost the intimacy. [He smiles, smirks, and squints.] Whom do you consider a hero in the AIDS epidemic? Larry Kramer. Fearless, selfless, and incredibly talented as an artist, we owe so much to the fires he lit, from founding Gay Men’s Health Crisis and ACT UP, to his brilliant body of work. I’m so happy to see more people recognizing his role in history and coming to his work, with the recent revival of The Normal Heart in New York and the HBO movie version of the play, as well as his prophetic and scathing book, Faggots, which I think more people are reading these days. I must tell you, when I met my boyfriend on the Christopher Street pier in New York, that’s the book he was reading. I was like, “Hey, I just bought that, too. Want my number?” [His eyes beam and Adam shrugs with a grin.]

[I chuckle.] How has the AIDS epidemic affected you? I lost a friend and a musical colleague a couple of years ago. Overwhelmingly, though, my positive friends live tremendously healthy and empowered lives, and they affect my life every day in the best possible way.

we were really right for the other person—and our different statuses probably played a part in that. Looking back, we were just projecting our insecurities onto each other. All things considered, I think we navigated the dynamic remarkably well, especially considering we were both a little nuts. We’re still friends. And we’re still nuts. I read your recently published memoir, 88x50 (Kirkus Indie Book of the Month). I thoroughly enjoyed joining you vicariously on your adventures driving in a Hyundai around the United States to perform free recitals on the eighty-eights to underprivileged communities. Where can others read your tome? It’s available on all digital formats— Kindle, Nook, and iBooks—as well as in

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 • SEPTEMBER 2014

photo by Scion Fullana

“The piano is the garden in which I plant my creative life.”

NEWSBREAK Road Warriors & Heavy Hearts On Monday, August 11, after a twelve-day motorcycle journey from Milwaukee to New York City, a band of not-so-weary travellers revved their engines onto a ferry bound for Governor’s Island, New York City. Concluding the 5th Annual LifeRide event sponsored by Kiehl’s Since 1851, the philanthrophic warriors blazed a trail for press and public alike to The AIDS Memorial Quilt, adorning the rolling green lawn of the 172 acre island/national monument. The first of a two-day public display, featuring 260 12-foot-by-12foot sections of this Clockwise from top: Kevin Robert Frost, internationally celebratamfAR’s CEO; Chris Salgardo, Kiehl’s ed, handmade tapestry President; rugby player and StandUp included an unfolding Foundation founder Ben Cohen; actors ceremony, new panel Milissa Sears and Teddy Sears dedication and a Reading of the Names. Presenting speakers included Julie Rhoad, The NAMES Project Foundation CEO; Dr. Howard A. Zucker, Acting NY State Health Commissioner, Kevin Robert Frost, amfAR CEO; Chris Salgardo, President, Kiehl’s USA; and Ousman Laast, U.S. Senator Kirsten Gillibrand’s NYC Regional Assistant and representative for LGBT outreach. “Wherever it is displayed the Quilt provides balm for the painful wounds of grief, pours oil into waters made turbulent by controversy, opens eyes that refuse to see and enlists every person who experiences it in the fight to end AIDS,” shared Julie Rhoad, The NAMES Project Foundation CEO. “It is difficult to walk away from this Quilt unchanged.” Notable guests in attendance, many repeat riders of this annual event (reading names as well) included: Tyson Beckford, model; Gilles Marini, actor; Jay Ellis (Masters of Sex), actor; Teddy and Milissa Sears, actors; Grant Reynolds, TV host, former Marine Sniper; Conrad Leach, artist; Katee Sackhoff (Battlestar

A&U • SEPTEMBER 2014

Bringing hearts together since 1998

P zMatch.c m

NewsBreak

Galactica), actor; Scott Niemeyer, producer; Vanessa Marcil, actor. Many of the caring riders expressed grief over the loss of so many friends and loved ones. “It’s not right that people are still dying, it’s just not right,” voices Katee Sackhoff with partner Scott Niemeyer at her side. About amfAR, The Foundation for AIDS Research (www.amfar.or): amfAR, The Foundation for AIDS Research, is one of the world’s leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested more than $388 million in its programs and has awarded more than 3,300 grants to research teams worldwide. In 1996 Kiehl’s (www.kiehls.com)made HIV/AIDS a key philanthropy. Over the past two decades, the fervent support of HIV/AIDS organizations has been at the heart of Kiehl’s efforts, leading to partnerships with organizations such as amfAR, The Magic Johnson Foundation for AIDS and Youth AIDS. Since 2001, Kiehl’s has raised approximately $3,000,000 for HIV/AIDS organizations and continues to do so. About The NAMES Project Foundation (www.aidsquilt.org): Established in 1987, The NAMES Project Foundation is the non-profit organization that is the caretaker of The AIDS Memorial Quilt. The agency’s mission is to preserve, care for, and use the ever-growing AIDS Memorial Quilt to foster healing, heighten awareness and inspire action in the age of AIDS and beyond. —Reporting and photos by Sean Black

Newly Single The FDA recently approved a new single-pill regimen for the treatment of HIV-1 infection from ViiV Healthcare: Triumeq (abacavir, dolutegravir and lamivudine). Triumeq is ViiV Healthcare’s first fixed-dose combination using the company’s dolutegravir, an integrase strand transfer inhibitor (INSTI) called dolutregravir (brand name: Tivicay). While abacavir and lamivudine, as NRTIs, are from a long-established class, dolutegravir was only approved in the U.S. in 2013. Together, the drugs inhibit two enzymes—reverse transcriptase and integrase—necessary for the virus to replicate and continue infection. Approval was based primarily on the results from two clinical trials. One of the trials, a Phase III trial (called SINGLE) enrolled treatment-naive adults, and compared dolutegravir and abacavir/lamivudine (as separate pills) with the most commonly used single-pill regimen: efavirenz, emtricitabine and tenofovir, or Atripla. More patients were undetectable in the Triumeq arm (eighty percent at ninety-six weeks) compared to Atripla (seventy-two percent over the same time period). For treatment-naive subjects taking Triumeq, the most commonly reported adverse reactions of at least moderate intensity were insomnia (three percent), headache (two percent), and fatigue (two percent). Patients with hepatitis B or C should be monitored for hepatoxicity if taking Triumeq. For more information and a full set of warnings and recommendations, log on to: www.viivhealthcare.com.

With dynamic choreography and soul-stirring messages, Dance for Life wowed audience members once again with performances from top-notch dance companies in the Chicago area. On August 16, thousands of attendees gathered for a gala reception at Hilton Chicago’s Grand Ballroom and then packed the Auditorium Theatre of Roosevelt University. Each year, organizers, dancers, choreographers, and audience members build momentum in the fight to get to zero and to make a positive difference in the lives of individuals affected by HIV/AIDS. Performances by Giordano Dance Chicago, Hubbard Street Dance Chicago, Joffrey Ballet, River North Dance Chicago, Ensemble Español Spanish Dance Theater and Visceral Dance Chicago, along with world premieres by Randy Duncan, and Harrison McEldowney and Jeremy Plummer, captivated the audience with an array of styles. Proceeds from the evening benefit AIDS Foundation of Chicago, The Dancers’ Fund, Making A Daily Effort, and Agape Missions Inc. For this year’s effort, Dance for Life has so far raised $175,000 and counting. For more information, log on to: www.danceforlife.org.

Top to bottom: River North Dance Chicago performance, “Excerpts from Eva”; Hubbard Street Dance Chicago performance, “Excerpts from One Thousand Pieces”

photos by Julia Nash

Dance for Life

A&U • SEPTEMBER 2014

Justin B. Terry-Smith 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. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.

Hey Brother! XOXO

I have a couple of questions I hope you can answer about the American legal system as it relates to screening and treatment when it comes to living with HIV. A friend/past dalliance of mine who is living with HIV is in Washington in jail. Word got out he is there, since April, on charges that were reportedly a set-up. However, that is not proven yet. But it seems the story was released here to damage his business and reputation, by people who don’t like him. It was a well-kept secret; even the government and consular officials did not know. So now the cat is out of the bag, and I can ask questions. Q: I hear he is getting his meds, but what are the consequences in prison for people with HIV, in the Washington area? XOXOX Canadian IML Brother I’m so glad to hear from you and I hope all is well. Let me start off by saying that it is really hard to tell someone how prisoners and/detainees are being treated because each state is very different, but I’m glad you asked about just one, and I’m guessing you are asking about Washington state since you are very close to it. As far as I know there are no consequences for inmates who are living with HIV in prison, but there are challenges. The Centers SEPTEMBER 2014 • A&U

for Disease Control and Prevention (CDC) (2014) states that inmates in jails and prisons across the United States are disproportionately affected by multiple health problems, including HIV as well as other sexually transmitted infections (STIs), tuberculosis (TB), and viral hepatitis. Treatment: I looked up treatment as far as the Washington State Prisons system and HIV treatment is concerned and I found some information from the U.S. Department of Health and Human Services (HHS) (2014). According to HHS, correctional facilities have two main methodologies for dispensing medications to those who are on ART. The first method is called directly observed therapy, or DOT. This is where the inmate or prisoner goes to the medical unit or pharmacy for all HIV medication doses; dosing is observed by staff members. The second method is called keep-on-person or KOP. KOP lets prisoners/inmates to keep their medications in their cells and take them independently. Monthly supplies are obtained at the medical unit or pharmacy. Which method is better? In 2001 Dr. Margaret Fischl et al conducted a study correlating DOT vs. KOP inmates, and found out that a higher percentage of DOT patients achieved undetect-

able viral loads compared with the KOP patients (eighty-five vs. fifty percent) over a forty-eightweek period. Basics: According to the CDC (2011), before September 2007, the Washington State Department of Corrections (WADOC) only provided HIV testing to inmates on request. In September 2007, WADOC began routine HIV opt-in screening in which inmates were notified that HIV screening would be performed during the prison intake medical evaluation if they consented. In March 2010, WADOC switched to a routine optout HIV screening model in which inmates are notified that HIV screening will be performed unless they decline. In my opinion I believe that all HIV-positive people, whether in prison or jail, deserve the respect of being able to get proper healthcare. I know a lot of people are asking, “Well, Justin, how do we pay for that?” I honestly don’t know. But I know if I were falsely or legally imprisoned (and since I’m a black male I believe that has a greater chance than happening to me than my white counterparts), it would be unfair for someone to deny me my HIV medication. There is nothing more wretched than watching someone die and having the means to stop it. ◊

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 in only 1 pill a day. Ask your healthcare provider if COMPLERA may be the one for you.

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 (EpivirHBV), carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, 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: • 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. •

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 regimen and should not be used with other HIV-1 medicines. HIV-1 is the virus that causes AIDS. When used properly, COMPLERA may reduce the amount of HIV-1 virus in your blood and increase the amount of CD4 T-cells, which 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. • 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 tenofovir (ATRIPLA, STRIBILD, TRUVADA, VIREAD) • Other medicines that contain emtricitabine or lamivudine (ATRIPLA, Combivir, EMTRIVA, Epivir, Epzicom, STRIBILD, Trizivir, TRUVADA) • 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?” • 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 healthcare provider 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 nonprescription 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. How should I take COMPLERA? • Stay under the care of your healthcare provider during treatment with COMPLERA. • Take COMPLERA exactly as your healthcare provider tells you to take it. • Always take COMPLERA with food. Taking COMPLERA with food is important to help get the right amount of medicine in your body. A protein drink is not a substitute for food. If your healthcare provider decides to stop COMPLERA and you are switched to new medicines to treat HIV-1 that includes rilpivirine tablets, the rilpivirine tablets should be taken only with a meal. 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. Issued: June 2014

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. ©2014 Gilead Sciences, Inc. All rights reserved. CPAC0115 08/14

LEADER of the PACK

Using the Power of Social Media, AIDS Activist Jack Mackenroth Assembles a Team for Braking AIDS & Beyond

ith one click, Jack Mackenroth has turned selfies into an act of selflessness. For a donation to his Braking AIDS Ride fundraising campaign, he will snap himself with your name or handle scrawled across He’s also ongoingly recruiting a team for the Ride and future events dubbed The Mack Pack (#TheMackPack in social-media-land). Jack’s goal with The Mack Pack is to “gather a group of social media savvy [individuals] who want to be

his hubba-hubba physique and post it on his social media channels: Twitter: @ jackmackenroth has 107,000 followers; Instagram: @jackmackenroth has 17,000; and FaceBook: www.facebook.com/jackmackenrothfanpage and four others on the same site boast 250,000 combined.

part of a socially conscious ‘club’ where we choose events and causes—primarily HIV-centric—to be a part of and put our energy behind,” he explains. The Braking AIDS Ride is the Pack’s first event and, so others can share in the journey, he

is documenting the training process on social media, as they gear up for the 285mile Boston-to-New York bicycle ride on September 12–14, 2014. He will continue documenting as they make the triumphant trek. A&U • SEPTEMBER 2014

photo by Tyler Cheevers Gomes/TCGFOTOGRAPHY.COMWW

by Chael Needle

AUGUST 2014 • A&U

two wheels in working order. Chael Needle: In your video, you mention that you have never ridden seriously. What does your training involve and how is the training going so far? Jack Mackenroth: Ha! Well I purchased a pretty good bike which helps a lot and I clip into the pedals which helps use all my leg muscles. I try to ride at least ten miles every day—around the city and to the gym. I take spinning classes and on the weekends we do at least one long ride. My boyfriend has done several rides before and he is extremely helpful. We did seventy-two miles last Saturday. Regardless, it’s gonna hurt my taint no matter how hard I train. [Smiles.] It does help that I’ve been an athlete my whole life but the AIDS Ride welcomes all skill levels. It’s not a race. Do you have any tips for beginners who may want to train for next year’s event? Sure! Invest in a good bike—nothing crazy—like $1,200. It makes a world of difference. And just have fun. It doesn’t matter if you are fast or slow—it’s all about the camaraderie and the experience. We all support and push each other. Also—start early in the year. I had a job that prevented me from committing until July so I had only two months to train and fundraise. And don’t forget to eat and hydrate. A lot. How did you come up with the idea for personalized selfies? Well, since I didn’t have much time to fundraise I tried to draw on the resources I do have. My social media network is pretty massive for someone who is not a real celebrity so I wanted to figure out a way to mobilize and monetize it. Everyone likes a shout-out on social media and my semi-naked photos get a lot of retweeets so it’s a win-win. Sex sells and what better cause than charity—especially HIV/AIDS? For $250 or more I will tag your handle on my chest or arms and for $1,000 or more I will write your social media handle on my big billboard of a butt. Are you pleased with the response you received so far in The Mack Pack’s efforts to marshal a social media army in your quest for Braking AIDS? How many have now joined the Pack? Yes! Ecstatic! We currently have fourteen riders—that’s pretty astounding since I only formed the team in July and the Braking AIDS ride is one of the smaller Boston-toNew York rides—only about 150 people total. What are you most concerned about right now when you think of the progress we’ve yet to

make in fighting AIDS? Hmm...many things. I think Truvada as PrEP is vastly under-prescribed. If I was a young, gay HIV-negative man I would take it in a heartbeat. I think people should all be getting tested every three months. Early detection is better. And if you are undetectable on treatment it is virtually impossible for you to transmit HIV. I don’t think you should ever ask someone’s HIV status. The information is useless unless they tell you they are positive. Just assume they are positive and proceed accordingly. That’s just my opinion. Also, I honestly think there will be a cure in my lifetime. There are so many great technological advances happening. And HIV should never be criminalized. It stops people from getting tested. People like to blame others for their own responsibilities. Shame. Lastly, the stigma is grippingly oppressive. Stop with the judgments. I didn’t get HIV by doing anything almost everyone reading this has also done. So it could be you. Have some compassion. You work tirelessly for AIDS advocacy, you design clothes, you swim competively. How do you save yourself from burning out? Well, I work best when I have a lot on my plate. I don’t design much these days. I can’t do everything and do it well. So HIV-related stuff is the most important to me now. The other stuff in my life takes work. I set aside time to cultivate my relationship, friendships, swim, train, and all that good stuff! To make a donation: visit: http://bit.ly/jackmack. For more information about Braking AIDS and Housing Works, log on to: www.brakingaidsride. org and www.housingworks.org. Chael Needle is Managing Editor of A&U. A&U • SEPTEMBER 2014

photos courtesy Jack Mackenroth

Jack has set a personal goal of $50,000, the individual fundraising record (to follow his and the team’s progress or to make a donation, log on to http://bit.ly/jackmack). Braking AIDS proceeds go to Housing Works, a New York City-based organization tackling the interrelated crises of homelessness and HIV. Funds will help provide lifesaving services to nearly 4,000 individuals living with or affected by HIV/AIDS. With his leading-man looks and sincere dedication to the cause, it’s easy to see why he gets speedometers racing and blood pumping back to the heart. Since his stint on Project Runway a few seasons back and participation in a plethora of AIDS awareness campaigns, some of which he helped create, Jack has assembled an army for good. Donations from followers are coming in (around $15,000 so far for Jack alone), and others, like Martone Cycling Co. and Scruff, have shown their mettle in response to Jack’s inspired leadership by offering special incentives. Why does he ride? “Well, I truly believe that we should all try to leave this world a better place than when we came into it,” says Jack. “HIV is obviously a very personal cause for me since I’ve been living with HIV for twenty-five years. I’m lucky but there are a lot of people who are really struggling with their health. They need our help. I have great health so I feel obligated to pay it forward.” He’s riding to honor the memory of his partner, Greg Beutler, who died in 1996, and others he has lost. He’s riding to support Housing Works because he believes in its mission and he remembers how important organizations like it were to him when he was diagnosed as positive at age twenty. He’s riding because there’s more miles to go in the fight against AIDS. A&U caught up with the spokes-person to ask him about the motivation behind keeping

Milestones

’m the kind of girl that likes to celebrate milestones: First kisses, first times holding hands, 2nd Annual Elderly Queer Film Festivals, first times crying in front of each other, first times farting in front of each other, Third Annual Trans Pride Parades, and International Donut Days are all justifiable reasons to take a moment and celebrate! Besides, who balks at an opportunity to wear cute outfits and get flowers from a handsome gentleman caller?! It was going to be our fourth month together, and soon to be our fourth time having sex (which I was really excited about), and to mark the momentous occasion, we were going away for a four-day weekend! I’m the kind of girl who never knows what to pack. Should I be “sexy and sassy” with bright pink hoochie shorts and a lime green crop top, or “elegant and refined” in a church hat and my grandma’s pearls? There are just so many options…. But after our last sexual situation that resulted in a panicked PEP treatment for the boyfriend, there are definitely a few things that ARE going in the suitcase: Condoms. My boyfriend is not a Truvada whore (at least not yet anyway), but I am definitely a Reyataz slut. That is the terminology being thrown around these days right? People who get regularly tested by their doctors—who negotiate with insurance companies and HIV prevention agencies to take a regimen of highly effective medications; who after much thought and soul searching decide to mitigate their damages and make mature choices that could protect themselves and their monogamous partners—we

are calling these people whores and sluts now right?! As if taking a pill and letting strangers use you dirty have anything to do with one another…. I am NOT that kind of girl! I take my pills every single day so that I don’t die of AIDS—end of story. And I kind of wish my HIV-negative boyfriend could do the same thing. But

like “Abstinence Only” programs for high school kids in Mississippi (that obviously don’t work), the powers that be are still pushing “Condoms Only” for grown-up gay men. So for our romantic weekend getaway to the beautiful private Lake Arrowhead community, instead of packing four little blue Truvada pills we are packing: cute underwear, a few sexy toys, some lube, a big bag of gummy bears, some Viagra, and lots and lots of condoms. Let the vacation begin! The drive down was amazing. He drove and I navigated. We talked the whole way down, because the best thing about us is the way we talk. We talked about how lovely it was to reach a FourMonth-A-Versary, about how much we

love each other, about how from that altitude the silver mists of clouds covering the city below made the golden skyline look like heaven—which made us talk of God and divinity, and destiny, and whether it was possible for two souls to find each other so late in life…. And then we talked about all the dirty unspeakable things we were going to do to each other once we reached the cabin. Because when I am in a relationship I am so that kind of girl! And when we got there we grilled steaks for dinner. We sun-bathed and did boat tours on the sparkling water in the day; and at night he and I were whores and sluts. We did wonderful, loving, raunchy, wet things to each other all night for hours! Things that made me blush at breakfast the next morning and things that would make him giggle non-stop at random times throughout the day. We smiled and kissed and took lots of silly pictures that weekend; but we technically did not have sex…. We just could not get the condoms to do what they say they are supposed to do; and at our age we were tired of pretending that we could. So in a heap of sweat, after our fifteenth attempt, we finally said it out loud. “I don’t want to love someone that I have to use condoms with,” he said. “Me neither,” I said, “it doesn’t feel good.” “I’m just going to have to get over the fear,” he said, more to himself than me. “Yes, you are.” And I heard a bell knell somewhere deep inside of us, because I knew we had drawn a line in the sand. This was a milestone: Our first time facing the truth. 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 Non-sense can be found at www. justwords.tumblr.com. A&U • SEPTEMBER 2014

illustration by Timothy J. Haines

sexual escapades, bright pink hoochie shorts, and the moments in between

AIDS Walk Los Angeles is coming up! Sunday, Oct. 12 West Hollywood SIGN UP TODAY! aidswalk.net 213.201.WALK Download our free mobile app! Search “AIDS Walk” in your app store

30th ANNUAL

AIDS WALK

LOS ANGELES OCT. 12, 2014

Benefiting

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

A Special Thank You to

A&U Magazine #AIDSWalkLA AIDSWalkLA

AUGUST 2014 • A&U

Created and produced by MZA Events. AIDS Walk Founder/Senior Organizer: Craig R. Miller. © MZA Events, 2014

AIDSWalkLA

poetry

It’s Like DNA Memory returns to me our last encirclement, bones of Mikel’s back beneath my hands. Did I scream all the way to the airport Alan Martinez, as you drove with virtuosic madness, and the top down, the old Fiat, corkscrewed roads leading to the ludicrous interstate and the blue-edged runway where machines roar as they’re forced to defy, again and again, gravity? In my hands, the book Mikel gave me, my inheritance he said, Kenneth Patchen. He’d read me a few lines before handing it over: we shall not be there when death reaches out his sparkling hands, there are so many little dyings that it doesn’t matter which of them is death. The book was used, some of the pages worn through like moth wings when they’ve been handled. It’s in their DNA to elude handling, and in our DNA to handle them anyway. You’ll forget my voice, Mikel said, but it coils through me still, like that year we worked in the bedspring factory, our hands constellated with puncture wounds from the sharp ends of the copper wire as we fastened spiral after spiral to cold metal bedframes where someday mattresses would be flung for cheap deathbeds. After Mikel died, his face lesioned royal purple, I dreamed a spiral staircase made of the white-blue stuff of stars, the whole thing spinning at an even pace as if automated, not so much a staircase as a coiled ladder, and on each rung a soul, miniscule, giving off a dull glow like a lit cigarette far down the street during a power outage. —Diane Seuss Diane Seuss’s third collection of poetry, Four-Legged Girl, is forthcoming from Graywolf Press. Her second book, Wolf Lake, White Gown Blown Open, won the Juniper Prize for Poetry and was published by the University of Massachusetts Press in 2010. Seuss has published widely in literary magazines; her work has won a Pushcart Prize and has been included in Best American Poetry 2014. She is Writer in Residence at Kalamazoo College.

A&U • SEPTEMBER 2014

Brian had his HIV under control with medication. But smoking with HIV caused him to have serious health problems, including a stroke, a blood clot in his lungs and surgery on an artery in his neck. Smoking makes living with HIV much worse. You can quit.

Call 1-800-QUIT-NOW.

#CDCTips

HIV alone didnâ&#x20AC;&#x2122;t cause the clogged artery in my neck. Smoking with HIV did. Brian, age 45, California

ALL NEW YORK

IS A STAGE

An Exhibition & Book Explores 1980s New York as Theater, When Artists Grappled with New Media, New Fame, and the First Wave of the AIDS Epidemic by John Eimicke

he art of the 1980s made drastic jumps from the previous eras. The tempest of social change was a perfect storm for artists of the time and the new exhibition and book put together by Michael Auping, chief curator of the Modern Art Museum of Fort Worth, aims to illustrate this point. (The release of Urban Theater: New York Art in the 1980s, out in October from Skira Rizzoli, coincides with the exhibition of the same name on which it is based. The show runs from September 21, 2014, to January 4, 2015, at the Modern Art Museum of Fort Worth, Fort Worth, Texas.)

Essays by Auping (“High Performance: Theatricality and the Art of the ’80s”), and the museum’s curator, Andrea Karnes (“Personality Complex”), and assistant curator, Alison Hearst (“Keeping It Real: The Impure Abstractions of Ross Bleckner, Troy Brauntuch, Peter Halley, Donald Sultan, Philip Taaffe, and Christopher Wool”), run alongside the 208-page book’s 120 illustrations and touch on the era’s interest in media culture, consumerism, cartoons, and street art. The book and show also illustrate the camaraderie and relationships shared by many of the artists, who mostly lived and worked on New York’s Lower East Side, as exegeses of the 1980s as theater. As Auping so eloquently puts it in the

book’s Introduction: “...New York art in the ‘80s was bigger, brighter, more glamorous, and in some ways darker than anything Americans had ever experienced…With a generation raised on Hollywood films and television, and sophisticated in the power and rhetoric of media, the ’80s produced large, artistic personalities that helped support the content of their art or became the art itself. Andy Warhol had predicted that in the future everyone would be famous for fifteen minutes. There is the sense that this generation took that prediction to heart, although many of them have experienced far more than fifteen minutes of fame.” The authors’ aim plods along like

most other art books covering the main biographical and bibliographical points of the infamous artists of the time; Haring, Rothko, Basquiat are briefly touched upon, as well as the significance of so many creative people dwelling together, dating one another, sharing each other’s ups and downs, results of which led to the coming of age of so many influential artists in the eighties in New York City and engendered a wealth of work so diverse as to be unlike any previous school of art. From the gender-identifying artwork of Barbra Kruger to the social criticisms of Jeff Koons—the full gamut of 1980s art superstars is appreciated. The book also covers some more A&U • SEPTEMBER 2014

SEPTEMBER 2014 • A&U

Left: Barbara Kruger, Untitled (I Shop therefore I Am), 1987, photographic silkscreen on vinyl, 111 by 113 inches. Courtesy: Glenstone. Photo: Tim Nighswander © Barbara Kruger Bottom: Keith Haring, Red, 1982–84, Gouache and ink on paper, 106 3/4 by 274 inches. Courtesy Gladstone Gallery, New York and Brussels © Haring Foundation

A&U • SEPTEMBER 2014

A&U Gallery

Right: Jeff Koons, New Hoover Convertibles, Green, Red, Brown, New Hoover Deluxe Shampoo Polishers, Yellow, Brown Doubledecker, 1981-87, three vacuum cleaners, two shampoo polishers, and fluorescent lights in Plexiglas casing, overall 82 5/8 by 54 by 28 inches. Courtesy: Glenstone. Photo: Tim Nighswander © Jeff Koons Bottom: Robert Longo, Untitled (Men in Cities series), 1981, charcoal, graphite, and dye on paper, 98 by 48 inches. Courtesy of the artist and Metro Pictures © 2014 Robert Longo / Artists Rights Society (ARS), New York

less-exposed or rather forgotten figures of the time. A considerable section is devoted to the late Lou Reed’s wife, Laurie Anderson, and some of her contemporaries of the performance art scene of that time. Robert Longo and Basquiat’s band Grey also helped to develop this image of 1980s art as theater. Anderson’s “O Superman” to this day pops up on tenacious collegiate artists’ playlists and Longo’s “Men in the Cities” drawings, which are a literal

SEPTEMBER 2014 • A&U

marriage of performance and graphic visual art, are iconic images of the eighties, only preempted by the artist’s eventual foray into video art ballads like Killing Angels: Marble Fog. In fact Longo is quoted in the book as saying, “At a certain point in the ’80s, it seemed like all roads led to performance, whether you were a painter, sculptor, or a video artist.” And many artists at the time were performing art or in bands alongside creating conventional art, thus synthesizing the book’s point of the period as a theater. And the time was a very theatrical one. The twenty-four-hour lights of Times Square were the accent lighting on this stage, with no curtain call in sight, especially for the artists living and working at this time in New York City. For the first time artists attempted to use their real lives as subject matter and expressions of art, none more than those artists whose lives had been touched and affected by the AIDS epidemic that dominated the minds of all New Yorkers. Artists like Robert Mappelthorpe, who unflinchingly publicized their sexual journeys, as in his photos of himself and friends clad in leather, blackand-white close-ups of cod pieces, and the people and appurtenances of the underground gay bar scene, expressed and described their lives through their work. And most likely it’s because of this outpouring of emotions and the humanization of the AIDS epidemic that the disease no longer carries the kind of stigma it once did during the artists’ time, when AIDS was being labeled as a “gay cancer” and fear was the prevalent prescription. Artist Keith Haring and his “Ignorance=Fear, Silence=Death” posters certain-

ly accomplished this: While simplified and featureless characters danced in harmony to cryptic proclamations, the homogenous nature of the illustrations helped to identify the millions affected by the crises. On the other hand artists like Nan Goldin took a different approach. Along with its subsequent book, her show, “The Ballad of Sexual Dependency,” was an autobiographical snapshot of so many friends’ lives that were lost to AIDS. The informal photos depicting the dysfunction and basic human dependency are only amplified by Goldin’s comments years later in a 1996 reprint: “The pictures in the Ballad haven’t changed. But Cookie is dead, Kenny is dead, Mark is dead, Max is dead, Vittorio is dead. So for me, the book is now a volume of loss, while still a ballad of love.” Different artists experiencing the epidemic from different viewpoints registered and conveyed the same message of humanity. And though the book and show do not focus on the era’s advances in AIDS activism, and the book only mentions how the pandemic played such a key role in the creation of so much of this era’s art, the 1980s’ art as urban theater was definitely innovated by AIDS and its unfortunate sacrifices. For more information about the exhibition, log on to: www.themodern.org. John Eimicke is an artist living in New York with his dog, Arya. He holds a BFA from Fashion Institute of Technology.

DESIGNING

WOMAN Music Promoter Maria Davis and Positive Women’s Network-USA Join Merck’s I Design HIV Education Campaign

aria Davis has lived a lot of life. She recorded on Jay Z’s first album. As a model, she appeared in publications like Ebony and Essence. A mother of two, she’s been an ambassador for amfAR. And she’s been living with HIV for nearly twenty years. Now she’s embarking on a new venture as I Design commemorates its second anniversary, joining team members Mondo Guerra [A&U, January 2013], fashion designer and Project Runway All Stars winner, and Duane Cramer [A&U, May 2013], HIV activist and award-winning photographer. Davis will serve as a spokesperson for the campaign, motivating HIV-positive women to be advocates for their

own individual treatment and care plans. “It’s been a long time since women living with HIV have been represented in the media,” says PWN-USA Executive Director Naina Khanna, pleased that her organization will play a role in I Design’s focus on women. “The care continuum for women is not really very good,” Khanna tells A&U. “Only about four in ten women diagnosed with HIV have the virus under control.” There are an estimated 275,000 women living with HIV in the U.S., of which a disproportionate number are African-American. Davis says, “As an African-American woman living with HIV, it is critical for me to make sure my voice is heard in discussions with my

healthcare team and I want to encourage other women living with HIV to do the same.” She predicts that, in partnership with PWN-USA, “we’re going to lead a powerful movement across the country.” “Community leaders like Maria Davis who understand the nuances of our lives can help women by serving as role models, helping to amplify our own voices,” Khanna comments, emphasizing that women’s perspectives need to be lifted up higher in the broader conversation. “There’s nothing like another woman with HIV telling you what she’s gone through to be inspiring and to really start to break down some of the internalized stigma that women with HIV feel.” She adds that we can’t ignore the systemic A&U • SEPTEMBER 2014

photos courtesy Merck & Co

by Chip Alfred

barriers limiting access to care. Lack of financial resources is a major obstacle many women living with HIV face. “If you have a doctor and you’re going to get your medication paid for but you can’t afford the bus fare to get across town, how are you going to get to your appointment? We as a community really need to focus on understanding HIV as a human rights crisis.” Davis, fifty-four, contracted HIV unknowingly from a man she planned to marry. She was diagnosed in 1995 when she had to take an HIV test to apply for a routine life insurance policy. “Of course I didn’t think I was going to get HIV because at that time there wasn’t much information. We all thought it was a gay white man’s disease,” she recalls. “I thought I was going to die. I didn’t really have anybody to talk to and I’m in the music industry. The I Design campaign is so important because it’s not about what somebody else tells you. It’s about you asking those important questions to your healthcare providers.” One of New York’s premier music industry insiders who produces and directs showcases for signed and unsigned artists, Davis has leveraged her position in the entertainment industry to educate the community about HIV by partnering with organizations such as Lifebeat–Music Fights HIV/AIDS, and BET Rap it Up Community Service. Her new mission is to make sure that everybody—especially the young women she encounters in the music business—speaks up for themselves and knows their status. She served as a keynote speaker for the National Black Leadership Commission on AIDS, and is a leader in the HIV ministry at the First Corinthian Baptist Church in Harlem. Davis says her diagnosis has helped her strengthen her religious and spiritual connections. “When you have challenges in life, you realize sometimes you don’t have anywhere

to turn to but your faith.” “This is a sexual disease, but the stigma is greater for women,” Davis notes, referencing the gender inequity that exists for people living with HIV. “I have had people ask me if I was a prostitute. That really blew my mind! They don’t ask men that question.” Another key difference between HIV-positive men and women is that women are primarily

munication is the cornerstone of the relationship between the patient and the physician. It’s got to be a give and take. It’s got to take the patient’s wishes into account. Each patient is an individual, and no two patients are alike.” The ProjectIDesign website features a broad spectrum of innovative tools to help you take control of your own health and well-being. On the site you can

. “When you have challenges in life, you

realize sometimes you don’t have anywhere to turn to but your faith.”

SEPTEMBER 2014 • A&U

the caregivers in their families. “Over seventy percent of women with HIV have a child under eighteen. Sometimes we’re caregivers for elders in our families or extended families,” says Khanna. According to Davis, for these women, the challenge is often putting their needs first. “We put everybody else’s business in front of ours—kids, husbands, significant others.” Khanna emphasizes the need for more women like Davis to become leaders fighting for their rights and improving the lives of women living with HIV. “Our response must be led by the communities that are impacted.” Dr. Michael Gottlieb, a renowned HIV physician, reinforces the importance of vocalizing in conversations with your doctor how you’re doing with your treatment plan. “Com-

download a conversation checklist, which offers tips on how to engage in a candid dialogue with your doctor; design a digital textile illustrating your approach to managing HIV; take a quiz about women and HIV; and view videos, photos and more. There are two mobile and desktop apps to help you track and manage your health, My Health Matters and My Positive Agenda. These user-friendly programs can help you document your symptoms, set up reminders when to take your medications, and keep a record of when you’ve taken them. All of this can be helpful when formulating your key discussion points for your next appointment with your healthcare provider. Davis believes the most important things to remember are not allowing HIV to define you, and bolstering your support system as well as your immune system. “We’re not just HIV. There is so much more to us. People think you have to be infected to be affected and you don’t. We all need to be educated. This fight is for all of us—not just people living with HIV,” she reminds us. “It doesn’t matter who you are or what color you are, HIV shouldn’t be a thorn in your side. If you learn how to advocate for yourself, you will be connected to a whole new world so you don’t have to be alone.” For more information about I Design, visit www.ProjectIDesign.com. To learn about Positive Women’s Network-USA, go to www.pwn-usa.org. Chip Alfred is an A&U Editor at Large based in Philadelphia. He wrote about Positive Women’s Network-USA for the March 2014 issue.

A MAN FOR ALL REASONS Outspoken, Eclectic Entrepreneur Michael Lucas Sounds Off Fervently About HIV Prevention by Dann Dulin photos by Christopher Logan

aised in Russia and a U.S. citizen since 2004, Michael has quite a résumé: lawyer, adult film actor, male escort, writer, documentary filmmaker, political activist, and public speaker. His film company, Lucas Entertainment, produced the first adult film in Israel, Men of Israel. Michael’s constant course and challenge in life is to reinvent himself. Compassionate and committed to social issues, he’s against drug abuse, child exploitation, anti-Semitism, and unsafe sex. He’s done print PSAs promoting safer sex and the importance of getting tested and he supports AIDS causes, including New York’s GMHC. This past May he participated in the city’s AIDS Walk and raised enough money to be a Star Walker (those who make over $1,000. Michael brought in $3,200.) Recently divorced after an eight-year relationship, Michael, who is negative, is currently dating an HIV-positive guy. Always an open book, last year Michael announced that he was taking Truvada as PrEP (pre-exposure prophylaxis), a therapy of one pill taken daily that can reduce the risk of HIV infection by as much as ninety percent. A hot-button issue, the use of PrEP has attracted many health professionals who are avidly against it but also many who are seeing the benefits. Michael says it changed his sex life, but he’s quick to admit that it can be risky, with potentially serious side effects. Although he once opposed barebacking, Michael now stands up for SEPTEMBER 2014 • A&U

condom-free adult films in light of PrEP. After contacting Dr. Robert Grant of the University of California, San Francisco, who conducted a major PrEP study, Michael was committed to trying the drug regimen. At an AIDS conference last year, Dr. Grant announced that, “No one in iPrEX [the study] acquired HIV infection with a drug level that would have been expected with daily dosing….We have not seen anyone become infected that indicated daily use.” The study included high-risk participants such as men who had unprotected sex and negative men who had sex with positive men. Explaining about his serodiscordant relationship, Michael says: “We have made a joint decision not to use condoms because he is on medication (and undetectable) and I am on PrEP.” Because of Russia’s increasing homophobia and anti-Semitism, Michael renounced his Russian citizenship several years ago and decided, five years after his American naturalization, to also become an Israeli citizen. Since then, he has resettled his parents and other family members in the U.S. His passion for Israel is evidenced in his first documentary, Undressing Israel, an entertaining and illuminating film. His latest documentary, The Campaign of Hate: Russia and Gay Propaganda, is deeply disturbing and available on DVD and on iTunes, as well. Michael’s weapon is his voice—and he urges others to speak up, as well. He lays a heavy burden on public forums of discussion and debate to resolve burning topics. Having resided in Munich and Paris, Michael now calls Manhattan’s Hell’s Kitchen home. He also has a house on Fire Island and spends one month each year in Tel Aviv. At forty-two, Michael does have one regret though: his decision to legally change his birth name. Dann Dulin: So what made you choose the name “Michael Lucas”? Michael Lucas: I didn’t choose that name, it was chosen for me by

A&U • AUGUST 2014

[an adult film] studio that I was working for in 1997. I would like to have kept my real name, Andrey Treyvas. Name one myth about being a porn actor. There are no fluffers and it’s a business. Also, the majority of porn stars are not doing drugs. When did you begin taking Truvada as PrEP? I began taking Truvada in June 2013 when very few people were talking about using the drug as a course of prevention. It wasn’t gaining traction as a new form of prevention and people needed to start talking about it. I think it is the most effective form of protection. For years you advocated condoms, now you’ve changed your position... I am still advocating safe sex. I would never advocate anything else. But there are a few points to be made here. First of all, the CDC changed their language regarding safe sex. Now, when they refer to sex without condoms, they refer to it as “condomless sex.” Why? Because there are new ways to have safe sex. Safe sex, in my opinion, starts with a conversation with one’s partner, understanding their status and knowing if they are on a medical regimen. Someone being treated for HIV who complies with their medical regimen [and suppresses the virus to undetectable levels] is far less likely to transmit the virus. There is also, of course, PrEP, which I am on, and it has been approved by the FDA as an effective form of prevention. And, yes, there will always be condoms, but the truth is that people do not use condoms as often as they should. I feel strongly that we should explore every form of protection, including Treatment as Prevention and PrEP. How did you first hear about the epidemic? I remember hearing about it on Russian TV when I was fourteen years old. Was it discussed in school? They, of course, told us about it, but it was referred to as something that was happening in the West. You have to remember that when the epidemic began, everyone was just learning about it. No one really knew what was going on. Prevention wasn’t discussed until the early nineties. This disease has killed over thirty million people worldwide. It used to scare me. The thought of getting it worried me for half of my life. I remember witnessing the devastation it caused in the eighties. How often do you get tested? Before I was on PrEP, I would get tested about three times a year. But now that I am on SEPTEMBER 2014 • A&U

PrEP, I am required to get tested every three months. That’s another advantage of PrEP. People are encouraged to get tested regularly and to continue a healthy level of care. I think anyone who enters a relationship should know his and their partner’s status. Of course, if the relationship becomes committed, then I would hope that they get tested and discuss what level of care is appropriate for them. Has anyone close to you died from this disease? Yes, a friend of mine died, a brilliant ballet dancer from Russia. We traveled together. I remember on a trip to Turkey he got very sick. He passed away two months later. It was so very sad. I remember being shocked because it was the first time this disease hit close to home.

Israel today? The situation is tragic, but on a basic level the Israelis are defending their right to exist against a radical group who want them to cease to exist. Israel is a liberal democracy pitted against violent religious fundamentalists. I am disappointed that so many people on the left are quick to criticize Israel but accept their enemies’ repression of women, gays, and religious minorities.

What do you consider the most pressing issue for the HIV/AIDS community? The most disturbing thing to me is the stigma that surrounds HIV/AIDS. For so long, heterosexuals discriminated against those with HIV. In recent years, the gay community has begun to shame those who are HIV-positive. Fighting the stigma is key to fighting the disease. You frequent universities, educating students about HIV. What drives your activism? I think we have a responsibility to help our community be a better place. We are all passionate about something, so I have attempted to use my public platform to help bring awareness to issues I care about. Which individual has inspired you the most? The Italian journalist Oriana Fallaci [a passionate war and political correspondent who interviewed many world leaders] for being brave, honest, and forward thinking. What’s your take on the current affairs in Russia and of Putin? It’s the same as any decent person would have. I condemn violence against the LGBT community and the military aggression against Ukraine. Your film, Undressing Israel, is a love letter to the country. Can you expound on your affinity toward this place? Israel is my country; my birthright! Growing up in Russia, I was forced to repress my Jewish identity. I was given my mother’s maiden name at birth, specifically because Treyvas sounded less Jewish than my father’s surname, Bregma. The core of my worldview is my Jewish identity. What’s your take on the current conflict in

To borrow a Proust question: What’s your current state of mind? I am very content with what I have going on right now. My company is doing extremely well, I have an amazing new boyfriend and I’m looking forward to an exciting fall. One last question: Whom do you consider a hero in the epidemic? I would be remiss if I didn’t mention my boyfriend, Tyler Helms. He took his diagnosis and used it to create change— publicly disclosing his status in 2009 and raising thousands of dollars for AIDS related causes. Tyler’s also on the board of directors for GMHC. But there are so many people who have passionately joined the fight to end the AIDS epidemic over the last thirty plus years. They are all heroes in my opinion. For more information, log on to Michael’s website at: www.michaellucas.com. Dann Dulin is Senior Editor of A&U.

A&U • AUGUST 2014

RISING ABOVE

Alex Newell Shines in His Efforts to Bring Global Consciousness About HIV to His Generation and Beyond by Dann Dulin photos by Ricky Middlesworth Photography

AUGUST 2014 â&#x20AC;˘ A&U

What a Force!

tanding in the warm, shimmering sunlight on this late summer morning, Alex Newell waits patiently as I open the security door of my West Los Angeles apartment building. He cuts a commanding figure, not only in my presence, but on television, portraying the transgender character, Unique, on the popular series Glee. I was instantly taken by his gentle aura, his openness, and evolved sensibility.

His gracious soft-spoken mother, Brenda, a cross between Loretta Devine and Gloria Gaynor, accompanies him. Her eyes sparkle pride for her only child and there’s no doubt that Alex was raised in a loving supportive home, despite the loss of Alex’s father to cancer when he was just six years-old. At twenty-two, Alex has been so dynamic in raising public awareness of HIV/AIDS, even the most seasoned activist would be impressed. In a capsule, he’s been involved with GMHC, S.T.A.G.E. (a benefit for APLA), AIDS Action Committee of Massachusetts, and Divas Simply Singing. He’s also reached out to other causes as well, including the Human Rights Campaign and the LGBT community. He’s been the Grand Marshall of several Gay Prides. For World AIDS Day 2012, Alex was the New York host of a Planned Parenthood webcast that originated from Johannesburg, South Africa. Young people from around the world posed questions to HIV/AIDS activists. “That’s how we’re going to fight HIV/AIDS,” Alex explained to CNN, “by engaging and empowering young people to help themselves and their peers stay HIV-free.” In the opening ceremonies of AIDS Walks in San Francisco, Los Angeles, and New York, Alex serenaded the attendees with the right-to-your-gut “I Know Where I’ve Been,” from the musical, Hairspray. “I had to say ‘No’ to one AIDS Walk because I was literally going from coast to coast,” says Alex, with a twinge of guilt, now seated across from me in my living room. “Those people at the AIDS Walk are my heroes.” Alex cuts a robust, full figure, yet he carries himself like a dancer, light and lofty. Clad in black stretchy jeans and a soft-white untucked dress shirt that mostly covers a T-shirt (with the inscription “Live To Thrill”), Alex has painted alabaster-colored nails and wears contemporary brown pointy shoes. He’s not only a clotheshorse, but has a shoe obsession, as well. His designer of choice is Christian Louboutin. “I worked so hard to get on the show,” he recounts, his hand toying with the bottom of his shirttail. “It was three years of grueling hard work that finally paid off.” Alex won a two-episode story-arc on Glee’s third season. His character instantly connected with viewers and he became a series regular in the fourth season. It is not yet certain that he will be part of the sixth and final season of Glee. He appeared in the film Geography Club, now available on VOD and DVD. In June he released a single, “Nobody To Love,” and he’s currently in the studio laying tracks for a full album. (Beyoncé is his absolute favorite singer, and he adores Whitney, too. “If I ever met Beyoncé,” he bursts with buzz-exaltation, “I think I’d be on the ground…crying!” He then adds, “If I’m reincarnated, I want to be Beyoncé! Just let me be Beyoncé!”)

Alex’s role on Glee was challenging, but never intimidating. “It was hard,” he tells me in his most polite Sandra Dee voice. “For ten hours we’d rehearse one number over and over and over and over again—all day! I got bored actually. I was dead by the end of the day.” He gingerly tilts his head. “It was therapeutic to play Unique. She’s such a breath of fresh air, jubilance, and youth. I really have fun with her.” Raised in Lynn, Massachusetts, thirty miles north of Boston, Alex lived in a diverse neighborhood, which inspired his interest in global issues. His focus in the HIV/AIDS community is youth. He hopes to create dialogue among his peers and to keep them educated on the vital facts of the pandemic. (Forty percent of new infections worldwide come from the younger generation and a recent CDC report found that half of the U.S. infections are in the thirteen to twenty-four age group. Most don’t even know that they’re infected.) “There is strength in community and to win this battle we must all come together,” Alex asserts, shifting his posture and becoming more erect. “My generation can be very hardheaded,” he admits. “I also have stubborn moments. People are reckless. They can be so uncaring and unfiltered. But you just have to keep yelling and screaming,” he emphasizes. “Remind everyone to protect themselves, go get tested, so they can live a healthy vibrant life.” His own friends discuss HIV openly and get tested. Alex was tested for the first time last year and he was negative. “I was so happy,” he notes. “I was out on the street one day and came across this mobile station. They asked me, ‘Wanna get tested?’ I thought, ‘I’m not doing anything, might as well.’ Those units are so convenient. Everyone should take advantage of them.” At one point, OraQuick, the HIV rapid test A&U • SEPTEMBER 2014

company, asked Alex to be its face, but he declined due to scheduling conflicts with his work on Glee. He murmurs to himself, affirming, “Hmmm, I can do it now. I need to reach out to them again....” If one of Alex’s friends contemplated engaging in unprotected sex, Alex says he would scream at him! “If you don’t speak up, you’re not just hurting that one person, you’re hurting the partner, too. That person, in turn, will hurt someone and it just spirals out of control.” “None of us want to get sick,” he snaps, crossing one leg over the other. “We want to live healthy lives for our own children, so they can grow up with two parents.” Though Alex is not currently involved in a relationship, he aspires to have a husband and children. Several of his friends are HIV-positive but they live very full lives. “Even if we contract the virus you can still live a positive life….You can!” he assures, his voice an octave higher. One of those friends is much older and Alex looks to him for advice. “He educates me and all of my friends. He’s a driving force behind us.” Alex never knew a world without HIV/ AIDS. Awareness came early for him. “It might be because I am African-American and it’s giant in our community and secondly, because I am gay and it’s a part of our community.” Although he was born a Baptist, Alex attended an all-white Catholic high school. “So I could wear a cute yellow uniform,” blurts Alex, with a sly glance. “…And sex was never discussed! We didn’t even talk about Planned Parenthood. If you got pregnant they kicked you outta school, but no one ever got pregnant.” He ponders a moment then concludes, arching one eyebrow, “Catholic school was a doozy.” “I never made school a priority, which was terrible, but I knew what I was going to do with the rest of my life. I mean, when I’m singing on stage, am I going to be pulling out a protractor?!” Alex treated high school like a red carpet event. A self-described Fashion Diva, he attended every prom starting with his freshman year. “Prom was my thing. I loved it. I escorted girls who couldn’t get a date—and I made the perfect date.” Admittedly, he likes people and enjoys attention—and he certainly got attention in high school. But Alex’s education didn’t begin that way. “God help us all,” he replies laboriously when I ask about elementary school. For the first few grades, he attended a Christian school. On Fridays the students would be issued a square rug-mat to sit on the gymnasium floor and sing “Kumbaya,” accompanied by a strumming guitar. Next, they prayed. “I was not having it!” jovially declares Alex. “I can’t be around all of this. I grew up in a black Southern Baptist church where there’s shouting and singing.” SEPTEMBER 2014 • A&U

A&U • AUGUST 2014

UNIQUE PERSPECTIVE He transferred to public school and then to a charter school. “That Where do you go for downtime? was…the….worst…time…of….my… Home. life,” he laments with slow and heavy precision. His mother speaks up Have you ever been starstruck? from across the room. (His dour pubI get starstruck when I meet iconic licist is seated next to her, preoccupeople like Tyra Banks, Kristin Chepied with her cell phone throughout noweth, Loretta Devine, and Sheryl the entire interview.) “I thought you Lee Ralph. said it was so good?” inquires Brenda with a concerned tone. “No, no. It What individual has inspired and/or was awful.” He shakes his head. impressed you the most? “Those years were terr-i-ble…,” attests Kristin Chenoweth. The girl’s been Alex, stretching out the syllables, exthrough a lot. She’s the most positive plaining, “…because we went for ten person... hours a day and teachers had their favorites. I wasn’t one of them and it Whom are you dying to meet? was awkward.” Beyoncé! [He howls then adds]…and The school concentrated on sports, Chaka Khan, too. rather than Glee-type activities, which was Alex’s passion. “I felt like an Share your favorite beauty tip. outcast. As a kid you are well aware I have to keep the car frigid when I’m of how people feel about you,” he going to an event, keeping the air conremarks with old soul insight. “They ditioner on full blast so my face doesn’t always treated me differently from get oily. everybody else and I don’t know why.” Alex recalls an incident in the sevWho was your first celebrity crush? enth grade when he had not done his Awwww…. [He whispers eagerly] homework because he was performTony Danza! ing in regional theater. The teacher Alex performs at AIDS Walk San Francisco in 2013. was angry with him and told him to What pisses you off? Photo by Donna F. Aceto leave the show. “We were opening the Everything! [He shouts.] No. I just get annoyed so easy nowadays. I don’t know what it is. next day and I told her I couldn’t do I think I’m just getting old and set in my ways. Incompetence annoys me. Incessantness too. that.” The teacher countered, “I can get you to do it. I’m your vice princiComplete this sentence: What bothers me most about fame is… pal.” Alex replied, “Yeah, but you’re Always having to be ready, always being “on,” always having to smile even on my worst not my mother.” He pauses to take a day. I’m human. I have terrible days. meaningful breath. “She was always very stern with me. I don’t think that If you could star in one movie which film would it be? she cared.” [One of the three female singers in] Dreamgirls. “Yet, if I had not gone through those experiences in middle school I What do you believe happens after we die? would not be the person I am today, [He instantaneously answers in a lifted voice] We all turn into unicorns and frolic through and I definitely would not have been the lands….[trailing off ]. I’m kidding. I believe there’s a God, obviously, and that there’s a the person I was in high school. When heaven. I don’t want to think there’s a hell because they certainly don’t serve margaritas, and I got to high school,” he stops for it’s going to be a little too hot not to have a margarita. effect, “I knew who I was!” “You can thank her,” I say to Alex. A thoughtful expression sweeps his words. “I’m like that. If someone says I thing his mother taught him, “If you just across his face. He flips his hand can’t do something, I want to prove I can.” clench your fist and never give anything theatrically above his neatly styled twoHis teacher has not responded. out, you never get anything back.” tone pompadour afro and offers, “I did, A few days after our interview, Alex As he prepares to depart for another in a backhanded sort of way. I wrote her a is off to a fundraiser in San Francisco. media activity I ask, “When you sing at very nice e-mail two weeks ago. I told her What motivates him to care? Straight away these AIDS Walks, do you walk afterthat this wasn’t a hateful e-mail and that he replies in a low innocent tone, “Why wards?” “Child, no!” Alex quickly reI wasn’t trying to make her wrong,” he shouldn’t I? I can’t think of a reason why exclaims slowly. “I did want to tell her how sponds. “That’s why I wear my heels, so awful she had been to me and that she was I shouldn’t. Many people don’t have a they can’t ask. That’s a looong walk.” He voice—they’re either unable or too frightnot a good teacher, but I just told her that takes a beat and whispers, “I’ll golf-cart it ened to speak out. The least I can do—the if she had not been my teacher, I wouldn’t though…!” absolute least I can do—is give back and be where I am today. I always wanted to do it for all those other people who can’t, prove her wrong!” he announces intensely, Dann Dulin interviewed Michael Urie for the July tapping the side of the chair to underscore won’t, or just don’t.” He remembers somecover story. MAY 2014 • A&U SEPTEMBER 2014 • A&U

Raise Your

Voice

Author, fitness guru & Athlete Ally Ambassador Amazin LeThi uses the universal language of sports to change the attitudes about HIV/AIDS in the Asian community and around the world Text & Photos by Alina Oswald

“YOU

gotta give them hope,” Harvey Milk once said. His words have inspired generations, and resonated with many individuals over the decades. One of these individuals is Athlete Ally Ambassador and Vietnam Relief Services Ambassador Amazin LeThi, a Vietnamese fitness guru, author, and actor. She appeared in movies like Bridget Jones Diary 2, and TV shows like The Closer. LeThi (spelled Lê Thi in Vietnamese) is also the founder of the Amazin LeThi Foundation, a charity through which she helps raise awareness about the devastations caused by the

A&U • SEPTEMBER 2014

AUGUST 2014 • A&U

AIDS pandemic in the Asian community and shows people how they can help. I caught up with LeThi in New York City, prior to her trip to Washington, D.C., where she was to attend the first ever White House Forum on Global LGBT Human Rights. Chaired by Ambassador Susan Rice, the event brought together activists like Stuart Milk, Harvey Milk’s nephew and the co-founder of Harvey Milk Foundation. Milk is also a collaborative partner of LeThi’s foundation, and he invited her to accompany him, to further engage her in supporting LGBT rights in Vietnam. “It’s an incredible opportunity,” she comments on the event. “I would have loved to meet Harvey Milk,” she adds, “but I’ve met Stuart. Through Stuart Milk you see the spirit of Harvey Milk. And Stuart said, you got to think globally in any advocacy work. And you must remember the us-es, because you can amplify their voices.” And LeThi takes his advice to heart, maybe because there was a time when she was one of the “us-es,” desperately needing the hope that Harvey Milk talked about. A Vietnam War orphan, LeThi grew up in Australia with her adoptive parents, and then started traveling the world, as a young adult. She was one of the few lucky orphans who had their original documents. She knows the name of her biological mother, and hopes that, one day, she will find her biological family. She tries to think that they would have heard about her, as she is well known within the Vietnamese community, just not realize that she’s their daughter. Being a trans-racial adoptee brought up in a white community, LeThi was bullied a lot in school, especially during her teenage years. She never fit anywhere, and, growing up, couldn’t find any Asian role model to look up to. Therefore, she became determined to create her own possibilities, and define her own space. Soon, she realized that she could achieve her goal through sports. Amazin LeThi started bodybuilding at the age of six. Her mother would drop her off at the gym, and, in time, the gym became her babysitter. While others at the gym thought

she was only a kid killing time, she got to try out different sports, and became obsessed with bodybuilding while flipping through fitness magazines. Bodybuilding gave her the edge she needed to define her space, stand up to her bullies, and even plant the seeds for a future career path. It also offered her the role model she’d been seeking for so long. “Arnold Schwarzenegger, however silly, became this role model for me,” LeThi says. “Because he was this person from a little village in Austria, with a strange accent and a name that people couldn’t pronounce, and he [made it in] America.” Today, LeThi is the first bodybuilder who has crossed over into the entertainment industry, internationally. It was during her work in the entertainment industry that she came

face to face with AIDS. She recalls attending a meeting, when she found out that a person in that meeting had HIV. She had heard about HIV as a teenager, but didn’t really know anything about it. “I was ignorant,” she confesses. “I knew I didn’t want to meet anyone who had it, because I might catch it.” So, at the meeting, she tried to sit as far away from the HIV-positive person as she could, but ended up sitting right next to him. “And I just remember, as I sat down, and I’m so ashamed thinking about it now, but I got my chair and moved it right across,” LeThi explains, turning her body to demonstrate the move. “He came to me and said ‘Hi.’ I said ‘Hi,’ and from that point on I pretended he did not exist.” Her eyes widen as she continues. “He didn’t flinch. And I

thought he must get this all the time. He’s not even bothered by the mere fact that I discriminated against him....That stuck in my mind when I started to do charity work.” LeThi has always wanted to give back to the community, not just the Vietnamese, but the Asian, community, too. “I wanted to make an impact, but I didn’t know what that meant then,” she comments. “But I’ve always thought that sport was going to be a part of it.” She was working with Starlight Foundation for a hepatitis C campaign, when she was made aware that there were no Asian celebrities or public figures to represent the Asian community. That got her thinking about launching a charity and becoming the

voice the Asian community needed. The idea of an AIDS foundation came only after her meeting a Vietnamese woman at the UN Volunteer Office in Hanoi, Vietnam. Pham Thi Hue had contracted HIV while in her early twenties, from her husband who was a drug user. She found out about her status only after giving birth to her child. In the hospital, because of her diagnosis, doctors put her in quarantine. After returning home to Haiphong, she and her family were shunned from their community and lost their jobs. When things hit rock bottom, Pham Thi Hue bought poison...but ended up not using it. Instead, she joined an HIV support group to learn more about the disease and went pubA&U • SEPTEMBER 2014

lic with her story, to help people understand that anyone can get infected with HIV, not only sex workers and drug users, but also a tailor like herself. Today, she is the founder of Red Flamboyant Group, a Vietnamese AIDS group helping people living with HIV/AIDS, and the 2004 recipient of Time magazine’s Asian Hero of the Year. “I’ll always remember the moment she grabbed my hand and said, ‘Will you come

defined by shame...and also risk stereotypes like IV drug use and “dirty” needles, lack of doctor-patient confidentiality laws, and unwillingness (for various reasons) of getting tested. Nobody speaks about the virus from fear of losing their families, being kicked out of their homes, communities, schools or jobs. When people look at Asia, they usually see countries like Japan or China, not the poor Asian countries. They may not be aware

back and help the three hundred Vietnamese children [living with HIV] that I’m working with?’” LeThi says, and shakes her head. “I [couldn’t] say no to that. [So] this is my life’s commitment, to raise my voice about how HIV impacts the Asian community.” In the Asian community, as in many communities, HIV/AIDS is more than a medical condition. HIV/AIDS is a social disease,

that Asia has over two million orphans or that poor families often have to choose between sending their children to school and feeding them, and more often than not, they choose the latter. “No mother should be [put] in a position to make that kind of basic human rights choice,” LeThi comments, visibly shaken. So, LeThi decided to change the AIDS conversation in the Asian community, and

SEPTEMBER 2014 • A&U

use the universal language of sports, to create this change. She believes that storytelling has an important role in capturing a more...whole story of AIDS, as told by different people, from different parts of the world. She starts with Asia, and her country of Vietnam. LeThi also strongly believes that companies have a responsibility to give back to the community. Her partner, Minor Hotel Groups, based in Thailand, has taken on this responsibility, in order to create that much needed change. She also admires the work of Kenneth Cole [A&U, November 2011], who uses fashion to design unique HIV awareness campaigns, and also TOMS Shoes, which matches every pair of shoes purchased with a new pair of shoes donated to a child in need, giving the phrase “walking in someone else’s shoes” a brand new meaning. After all, not being able to afford shoes or clothes, having to walk barefoot, represents a health concern, which is often worsened by an HIV diagnosis. LeThi has long-term future plans for her foundation, and also for those she helps through the Amazin LeThi Foundation— that is, children living with HIV/AIDS and homeless LGBTQI youth. That’s because she looks at the young children she helps today, and sees the successful adults they will become one day, in part because of her foundation, whose mission is to offer them “career development opportunities through sports, and create educational programs, while raising awareness to end social stigma and discrimination.” Also, LeThi always thinks of ways to give back to the community. In 2015, her charity will be launching the first Vietnamese sports camp for children living with HIV/AIDS. The camp would offer HIV-positive and negative children, ages eight to fifteen, a space where they can play together, have fun, learn new sports, and, with that, new life skills. And while HIV is a very heavy conversation topic, she hopes to engage the help of professional athletes to jumpstart the AIDS conversation using sports. It is important to get involved in the conversation about AIDS, and necessary to change the attitude toward the pandemic. Storytelling helps. “It [shows children] that it can be better,” LeThi says. “It gives them hope, and hope is important....I look at it, and this is what I would have wanted.” Visit Amazin LeThi at www.amazinlethi.com. Learn more about Amazin LeThi Foundation by visiting www.amazinlethifoundation.org. Alina Oswald is a writer, photographer, and the author of Journeys Through Darkness: A Biography of AIDS. Contact her at www.alinaoswald.com.

Power of Evidence A movement to decriminalize sex work gets a boost from a multi-nation study by Larry Buhl

A&U • SEPTEMBER 2014

photo by International AIDS Society/Steve Forrest

“They fall prey to abusive johns and nization (WHO) report that urges governresentations at a session on HIV police. They face an increasing risk of ments to decriminalize behaviors to better prevention strategies for sex violence, and due to fear of arrest they are address the spread of HIV: workers, which took place at the less likely to insist on limits and safeIn the report summary, the WHO said; XX International AIDS Conference guards, including condom use. Imagine if “Countries should work toward decriminaltwo months ago in Melbourne, you are a sex worker on the streets trying ization of behaviours such as drug use/inAustralia, showed that decriminalization of to escape the police, you’re going to work jecting, sex work, same-sex activity and nonsex work could significantly decrease global in more remote environments where you conforming gender identities, and toward HIV infections among female sex workers. can’t be found, and that leaves you prey to elimination of the unjust application of The study was part of a series of papers by The Lancet that underscores the need to address one of the highest risk groups of HIV—sex workers— to impact the HIV epidemic. Researchers who studied HIV among female sex workers in Canada, India, and Kenya concluded that structural changes, like decriminalizing sex work, give sex workers greater control over their environment. That control makes it safer for them and their clients. Anna-Louise Crago, a doctoral candidate at the University of Toronto, was an editor of the Lancet series. As a former sex worker, Crago has a firsthand understanding of the challenges faced by this population. Crago says that sex workers reported that perpetrators At the XX International AIDS Conference, Richard Horton from The Lancet holds up knew that they could not access the journal’s special-theme issue on HIV and sex work. police protection. “The antagonistic relationship with police that criminalization creates and the abuse by police that abuse by clients.” civil law and regulations against people criminalization fuels across many contexts The controversial policy of condoms as who use/inject drugs, sex workers, men creates a climate of impunity for violence evidence—police “proving” that suspects who have sex with men and transgender against sex workers, by police and by their are engaging in sex work by finding conpeople.” clients.” doms on their persons—is just one example The WHO says that sex workers are Because sex work is a crime almost of the system working against the health fourteen times as likely to have HIV as everywhere in the world, men and transand safety of sex workers. other women, and transgender women fare gender people who trade sex are driven “Police may think they are doing a good the worst: they’re almost fifty times as likely underground and face unsafe situations, thing by taking condoms away, and may not to have HIV as other adults. according to Steffanie Strathdee, Associrealize in fact they are not going to prevent Megan McLemore, a senior researcher ate Dean of Global Health Sciences at the this person from having sex,” Strathdee in the Health and Human Rights Division University of California San Diego School continues. “They are just going to have of Human Rights Watch, points out that of Medicine and one of the leaders of the unprotected sex or reuse condoms and that some individuals belong to more than one Lancet series. In talking with A&U, she isn’t going to help anyone.” of these high-risk groups and that transgenpointed out how laws against sex work The Lancet series on sex work and HIV der sex workers face dire conditions. and the environments sex workers face comes on the heels of a World Health Orga“Transgender people are highly suscepenhance an already perilous situation.

infographic courtesy The Lancet

tible to HIV because the environment of risk disproportionately affects trans people,” McLemore says. “When you combine employment discrimination, getting kicked out of houses, you have a lot of people who have to engage in sex work for survival.” McLemore says what unites these groups is that their activities are either illegal or heavily stigmatized in many parts of the world. That means that they are unlikely to seek out medical help or advice simply because they don’t want to be arrested for being gay or having sex for money. McLemore and other decriminalization advocates say the proclamations from the WHO and the Lancet series have significant implications for HIV prevention because they take the onus of protection off the individual and castigate legal systems that make it difficult, if not impossible, to prevent the spread of HIV among the sex work population. A few parts of the world have attempted to address the dangers to sex workers by changing their laws. New South Wales, Australia, decriminalized sex work in 2009. So far New Zealand has not experienced any repercussions from decriminalization, although sex worker advocates agree that not a lot of research has been done since 2009 and that the rate of HIV and other STDS in that country were low to begin with. In December, Canada’s nine Supreme Court justices unanimously struck down laws targeting sex work. The Court proclaimed that Canada’s laws caused unreasonable harm to sex workers’ safety and health. But the battle isn’t over yet. The Court gave the government twelve months to respond and the legislature has introduced legislation to re-criminalize sex work. Because conservatives have a majority in the parliament there is a good chance they will succeed in reversing the Court’s ruling. “We have a very right-wing government here and the Prime Minister is close to his evangelical base and is an evangelical,” Crago said. “Sex workers SEPTEMBER 2014 • A&U

may have to go back to court if it is re-criminalized, and show that the laws are unconstitutional.” Short of complete decriminalization, or even legalization, it is possible that changing some police policies could have a positive impact on the health and safety of sex workers. One of these policies is condoms as evidence. Not surprisingly, this policy often keeps sex workers from carrying protection. Human Rights Watch released a 2012 report on the condoms-as-evidence policy in four cities, Washington, D.C., New York, San Francisco, and Los Angeles, and since then has had success in changing policies, McLemore tells A&U. “In San Francisco the prosecutor has agreed not to use condoms as evidence in misdemeanor [investigations] and police have agreed not to confiscate condoms. In New York City, a bill has not yet passed, but prosecutors in four of five boroughs have agreed to not use condoms as evidence. In D.C., while not admitting they had done it in the first place, the police reassured the community by issuing cards saying they would not confiscate [condoms] and a number with a complaint line for any abuse by metro police.” In part of Nevada, sex work is tolerated, and some areas around the world have permissive attitudes like red light districts where police turn a blind eye. But McLemore and Strathadee agree that complete decriminalization will have the biggest impact on the health of sex workers and that it needs to happen on a multi-country level.” With the WHO declaration and the Lancet study, the movement to de-criminalize sex work has gotten a boost. But Crago admits there is still a lot of work to do. “The discussions around sex work often happen in very sensationalistic and moralistic terms that devalue or silence sex workers’ voices. Hopefully we are moving to the point where their voices are heard and respected. I think many people regardless of how they feel about sex work understand the value of evidence, and I think the evidence is clear and convincing that criminalizing sex work has a devastating effect on sex workers’ health.” Larry Buhl writes the monthly Hep Talk column for A&U.

lifeguide

Nuclear Waste

A New Season for Nukes: ATC and the Legacy of Accelerating ARVs NRTIs have always been the backbone of the drug combinations used in cART. Currently available NRTIs are hampered by problems of drug resistance and in some cases, particularly with the early ones, long-term toxicity, so regimens depend on a handful of well-tolerated NRTIs. Rising levels of drug resistance, including cross-resistance, are leaving an increasing number of patients with little to no treatment options. Apricitabine (ATC) is a Phase III deoxycytidine analogue NRTI with significant antiviral activity and good tolerability in treatment-experienced patients failing regimens containing 3TC and in those with the M184V mutation, thymidine analogue mutations (TAMs), nucleoside-associated mutations such as the L74V and certain mutations at codon 69. Resistance to ATC has been shown to be slow to develop and there’s little evidence of resistance in clinical use, including in patients on ATC up to forty-eight weeks. The profile of ATC suggests there is little potential for cross-resistance with currently available NRTIs; in combination with its antiviral

activity in the presence of the M184V mutation, ATC confers high level resistance to 3TC and FTC, making it a highly viable treatment option for patients who have failed regimens containing these NRTIs. The drug is eliminated by the kidneys, meaning there is a low potential for drug interactions with those eliminated by the liver. Reviewing the Data on Old Nukes In “Modifying Therapy in Treatment-Experienced Patients: When Should It Be Done?”, Joe Eron, MD, presented on switching from a threedrug regimen to a two-drug regimen, including to ritonavir-boosted protease inhibitors (PI/r) plus 3TC. However, many HIV patients are resistant to 3TC. During the session “Antiretroviral Therapy: Not All Strategies are Created Equal,” Eric Le Fevre reported on forty-eight-week data from the MODERN study, which compared maraviroc + darunavir/ritonavir to TDF/ FTC + darunavir in treatment-naive HIV patients. The study found that the regimen containing two NRTIs was more effective than the PI-based regimen, with 86.8 percent of patients achieving viral suppression versus 77.3

percent. Jim Dearmast reported that in the dolutegravir SAILING study less people experienced virologic faulure on NRTI-based regimens than those on PI and other background regimens. No patients receiving NNRTIs with dolutegravir, regardless of how many were active, experienced virologic failure, including patients with the M184V mutation on 3TC/FTC with another NRTI. It was reported at AIDS 2014 that the prevalence of ARV drug resistance in treatment-naive patients in Western Kenya was highest for NNRTIs at 8.3 percent and second highest for NRTIs at 2.1 percent. The same pattern has been found globally, indicating the need for new NNRTIs and NRTIs for drug resistant patients, both treatment-experienced and treatment-naive. This has important implications for the clinical management of HIV patients, as the risk of first-line treatment failure is increased. Additional data from Kenya found that, in HIV-infected children on cART, 78.8 percent had drug resistance mutations to NRTIs, 86.1 percent to NNRTIs and 77.4 percent had resistance mutations to both. Another study from AIDS 2014 found that drug resistant mutations persist in HIV provirusA&U • SEPTEMBER 2014

he summer of AIDS 2014 this July in Melbourne saw the community move beyond the wave of incidental, failed attempts at a cure and back to the discovery of optimal antiretroviral therapy, but are treatment-experienced patients invited to the party? While combination antiretroviral therapy (cART) has significantly contributed to virologic suppression, improved immune function, and quality of life in people living with HIV, issues at AIDS 2014, including drug-drug interactions and cross-resistance, still pose significant barriers to long-term successful treatment and began to take center stage again. Presenters including Paul Sax and Joe Eron presented the need for newer anti-HIV drugs with increased potency and improved pharmacokinetic profiles either in existing classes or new classes of drugs with different targets.

how to get overwhelmed by the data on new nukes, old nukes & lots of different classes of ART at AIDS 2014

Boston to new York September 12–14, 2014

I didn’t know what to expect from my first Ride other than my knees would probably hurt at the end. “What I found was a happening, a gathering, a civil rights movement on two wheels, comprised of so much honesty and optimism that I remain today, sitting at my desk back at work, teary-eyed and numb from the experience. “Yes, the Crew and organizers do a wonderful job and make the Ride far easier than anyone can know until they’ve done it. “But my favorite part was listening to Riders’ stories after dinner — people’s lives, their struggles, their thanks, their commitment. I was very moved.

where the

RIBBON meets the ROAD brakingaidsride.org 866-858-6877

“The Ride for me began as a means to challenge myself to ride a long distance, but it became clear very early on that the Ride was about much more than my bike or my knees. It was about struggle and love. Thank you all for making it happen. It was an honor and joy to be a part of BRAKING AIDS® Ride. I can’t wait to come back next year.” — Leon, Rider #162 Benefiting

lifeguide

And Then There Were Two: Another New NNRTI on the Horizon NNRTIs are part of almost every durable HIV regimen; however the options are extremely limited with efavirenz being the dominant drug in this category and the serious adverse events (SAEs) make it intolerable for many patients. There is a need for new NNRTIs that are more efficacious and have better toxicity profiles. VM-1500 is an NNRTI currently in Phase I/II development by a small biotechnology company, Viriom, that fits this unmet need in HIV treatment. VM-1500 is a bioavailable potent inhibitor of wild-type HIV and broadly active against strains carrying mutations associated with resistance to other NNRTIs, including the K103N, Y181C, L100I, K103N, G190A and V106A. In preclinical testing, VM1500 inhibited ninety-two percent of HIV viruses in a panel of fifty viruses derived from NNRTI-treated patients, compared to zero percent with efavirenz and sixty-two percent with TMC-125. VM-1500 was not associated with any significant pathological or clinical findings. At AIDS 2014 data on VM1500 from an open label Phase I clinical trial studying doses of 10 mg, 20 mg, 40 mg and 80 mg of VM-1500 in twenty-four healthy volunteers, the drug was found to be well tolerated and safe, with no SAEs reported. Significant plasma concentrations remained at the last sampling point of forty-eight hours, indicating the drug can be developed as a long-acting ARV. VM-1500 was rapidly and efficiently converted to the active substance and reached steady-state levels in plasma after six days. In a Phase Ib/IIa, placebo-controlled randomized study of the safety and pharmacokinetics in healthy volunteers and safety, tolerability and antiviral activity of VM-1500 in HIV infected patients, 12 healthy volunteers were randomized to receive a single oral dose of 20 mg or 40 mg

of VM-1500 or placebo with a 3:1 drug/placebo ratio. VM-1500 was well-tolerated and again no SAEs were reported. In part two of the study, a total of sixteen HIV-infected, treatment-naive subjects were randomized to receive 20 mg or 40 mg of VM-1500 or placebo QD for seven days. The 20 mg dose was safe and well-tolerated with no SAEs reported. The pharmacokinetics analyses confirmed rapid and efficient conversion of the prodrug to the active substance. All seven HIV-infected subjects from the 20 mg cohort achieved strong virologic response with median HIV RNA reduction of 1.73 log10 IU/ml after seven days of treatment. To date, the clinical studies have demonstrated that VM-1500 is a well-tolerated, safe and efficacious NNRTI that can be developed as a long-acting ARV. Thus far, the data indicates VM-1500 is superior to efavirenz, the dominant NNRTI in today’s ART regimens. While the ACTG is focused on evaluating a number of HIV drugs, there is a plethora of HIV therapies intended to treat the virus still waiting to move forward into mature stages of clinical research. Future studies could be developed to measure the response of treatment-experienced, drug-resistant patients with regimens based on ATC, cenicriviroc, and VM-1500, with emerging therapies such as Sangamo, PRO140, and therapeutic vaccines from Inovio, Theravectys, Biosantech and Profectus.

The clinical data on new drugs at AIDS 2014 was encouraging for improving the long-term success of HIV treatment in drug-resistant treatment-experienced patients. ATC has antiviral activity and potent viral suppression comparable to 3TC against strains resistant to other NRTIs, good tolerability, a low proneness for the development of drug resistance, a favorable toxicity profile, including a low chance for mitochondrial toxicity, and a low potential for drug interactions. VM1500 is active against NNRTI-resistant strains, has superior antiviral activity and superior tolerability and toxicity profiles and available data indicates it can be developed as a long-acting ARV. BIT225, a VPU inhibitor from Biotron, and other therapies in development give us some hesitant reason for hope for new treatments to construct viable regimens in drug resistant treatment-experienced patients. Clinical trials of ATC and VM-1500 may meet the urgent need of an increasing number of HIV patients and should be high on the priority list of the ACTG leadership and community advocates. Mariel Selbovitz, MPH, serves as the Chair of the Cornell ACTG Community Advisory Board and has authored over thirty abstracts and articles. A former member of ACT UP NY, David Miller is an AIDS treatment activist and current member of the Cornell ACTG CAB. A&U • SEPTEMBER 2014

es for more than twelve years despite durable viral suppression, indicating that new treatments targeting the drug-resistant provirus may be necessary to achieve viral eradication.

AIDSWALKATLANTA.COM

TWEET @AIDSWalkAtlanta And Tell Us How You Are HOPE #AWA5K

#IAMHOPE

Featuring Hydeia Broadbent, 2014 Ambassador

HCV Behind Bars part two: how one state grapples with hepatitis c in the correctional system

Larry Buhl: With a limited Department of Corrections budget, only a few inmates with HCV are able to be treated with DAAs, in any state. Can you describe the protocol that sets up criteria for who is eligible for treatment in Washington? Lara Strick: We are in the midst of changing our protocol, but basically we have a hep C care review committee that discusses each case to determine eligibility for treatment. All of these cases tend to be fairly complicated. If the committee votes to treat the patient based on criteria mainly on medical necessity then the patient is treated. There are some higher levels of approval, particularly for some of the more controversial regimens. But the system is somewhat flexible. The issue of prioritization isn’t limited to corrections. We know cost is a driving factor. As we get better and better regimens with fewer side effects, the other barriers to treatment disappear. At that point the biggest barrier is cost. You have to figure how to prioritize treatment. Without going into individual cases, can you explain how some decisions might be made in who is treated with Sofosbuvir?

Whether you’re in prison or in the community, prioritization is based on medical necessity, whether that has to do with the degree of fibrosis of the liver, other clinical consequences of the disease, or other factors. It gets complicated fast. For some patients, even though they may have advanced disease, there are several newer regimens around the corner that may be better for them. If they can wait, based on certain criteria, they may be better off waiting. It’s hard to put a blanket statement on who must be treated now, who doesn’t need to be treated now or who would be better waiting until better therapies are available. Cost is not the only factor. Not only are they more effective, but they will be interferon-free. Most of the regimens now still include interferon. But by the end of the year there will be additional interferon-free regimens available that might be a better option to wait for. Until prices on the new meds come down, is it possible that lawmakers at the state level will make hepatitis treatment a bigger budget priority? State Medicaids foot the bill for a large percentage of the hep C-positive population in the community as well. So in the end it winds up being state dollars whether behind bars or in the free world. Specifically trying to get funding for the incarcerated, if you look at the cost of hepatocellular carcinoma and the clinical consequences of end-stage liver disease for correctional systems, and the fact that they are growing, you may be able to convince legislators that it is to everyone’s advantage to fund treatment now rather than waiting for the long term consequences of the disease. Both education and risk reduction programs are important. The cost is not cheap but when you compare it to a treatment course being $100,000, risk reduction and education are a bargain. Promoting both is the most effective

thing long term, but it doesn’t deal with the people who are already infected. What else would you like readers to know about how hepatitis C is treated in correctional systems? With the newer medications becoming approved in the next three years, the end of the epidemic is within sight. But to impact the epidemic, corrections needs to be included. The hope is that as the cost goes down this is a disease we treat more like HIV. With HIV, we treat everyone, not just those with a higher degree of damage or a greater progression of 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&U • SEPTEMBER 2014

photo courtesy Lara Strick

n the August issue’s Hep Talk I covered the issues facing state correctional facilities who face the dilemma of who gets treatment for HCV. With the population of incarcerated individuals with HCV estimated at seventeen percent, it is impossible for state departments of correction to treat everyone in their care that carries the virus, even if they can negotiate a lower price, as some educational institutions can. And there are no national protocols for whom to treat, when to treat, and how. Only three states have full-time infectious disease experts who oversee patient care: Oregon, Washington, and New Mexico. Dr. Lara Strick is a University of Washington clinical assistant professor of infectious diseases and an infectious disease consultant to the Washington State Department of Corrections. I spoke with her about the challenges of treating and managing care for HCV-infected inmates on a limited DOC budget.

E R U T CUL S THE

AID OF

MALE

SEX WORK

BOOKS

AND SOCIETY

Male Sex Work and Society Edited by Victor Minichiello and John Scott Harrington Park Press

his book is a wide-ranging, scholarly consideration of male sex work. The volume editors and their contributors have set themselves a difficult task indeed: Male sex work does not have that much of a written record, never having excited the concern of politicians, reformers, or even artists as has sex work by women. Of course, male sex work has been similarly stigmatized and is mostly illegal, so workers have been understandably circumspect. An added difficulty for today’s researcher is that sex work is increasingly arranged over the Internet, not in red light districts or other public spaces, lessening its visibility. The contributors to this volume, many academic researchers in fields such as psychology, anthropology, and public health, are scupulous in backing up assertions with reference to the established literature or through their own fieldwork. The book discusses historical contexts, business aspects, social issues, and male sex work in various societies around the world. In a number of chapters, the authors relay the first-hand comments of sex workers themselves, giving readers a unique view of their experiences and perspectives. Historically, and today, male sex work occurs overwhelmingly between men, so this book should be of interest to those concerned with HIV transmission between men who have sex with men. There is no one section on HIV, but this subject does come up in a chapter on public health and in a number of the other chapters, mainly in discussions of condom use. Safer sex practices emerge as the norm, but reasons workers may choose not to

E D I T E D BY

V I C TO R M I N I C H I E L LO

AND

JOHN SCOTT

follow them are discussed as well. The book’s editors and contributors have, happily, written in a very readable style without academic jargon or forays into theory. Thus, Male Sex Work and Society is accessible to any who might be interested in the topic. This book is a valuable resource on an elusive topic. —Nancy Ellegate

FILM

AIDS: Living in the Shadows Senior Executive Producer: Beth Mendelson; Host: Musician Elton John Voice of America (VOA)

t is hard to avoid hyperbole when talking about the tremendous strides made in the prevention and treatment of HIV/AIDS. It is equally difficult to tamp down the upsurge of hope one feels at the prospect of a medical breakthrough in AIDS research leading to a cure. Notwithstanding these auspicious developments, a Voice of America documentary titled AIDS: Living in the Shadows, which premiered at the XX International AIDS Conference in Melbourne, Australia, illustrates that the stigma associated with the disease is one of the biggest impediments to bringing about an end

to the global AIDS pandemic. Shame keeps people from getting tested and from seeking antiretroviral therapy. It stands in the way of safe-sex practices and the elimination of mother-to-child transmission of HIV. It prevents people from receiving the counseling, care, and support they need. Hosted by musician and AIDS activist Elton John, the documentary presents the powerful stories of individuals from around the world. The people in the documentary face abuse, humiliation, and ostracism as a result of testing positive for HIV. They are the victims of discrimination and hate crimes. A young Haitian woman named Venise Louis recounts how she ended up in an orphanage after being shunned by her family. Uch Navy, a Cambodian woman who contracted HIV from her late husband, talks about resisting the urge to commit suicide. Nigerian activist Ifeanyi Orazulike runs the risk of imprisonment for delivering health information to sexual minorities. The documentary explains how American evangelicals have spread hatred, fear, and disinformation in sub-Saharan Africa, promoting the criminalization of homosexuality in countries where anti-gay legislation makes it difficult for vulnerable people to access treatment for fear of persecution. All of the individuals in the documentary persevere in spite of the personal and political obstacles they face. Most of them are not only surviving, they’re thriving—serving as activists, advocates, role models, and mentors in their communities. They make it abundantly clear that the stigma associated with HIV/AIDS undercuts all of the recent advances made in medical science and must be eradicated. AIDS: Living in the Shadows can be viewed at the Voice of America (VOA) website (www.voanews.com/media/ video/1962292.html). —Sally Hessney Nancy Ellegate is a sometime book reviewer for A&U. Sally Hessney is an editor at a television listings company in Queensbury, NY. A&U • SEPTEMBER 2014

A Calendar of Events

t a private estate in the Las Palmas area of Palm Springs, California, the annual Jeannette Rockefeller Angel Program Kickoff Party benefiting AIDS Assistance Program (AAP) will offer an evening of camaraderie, compassion, and cocktails and hors d’oeuvres. Entertainment for the evening will be provided by contemporary jazz saxophonist Darren Motamedy, whose eleven albums and exciting shows have garnered praise and a legion of fans. As the unofficial start of the desert’s season of giving and a way to thank loyal supporters, the event also seeks to welcome new supporters to learn more about AAP and join the cause. AAP currently provides wholesome and nutritious food twice each month to more than 500 clients. More clients are on a waiting list, so funds are much needed to meet the demand. AAP enhances the lives of low-income men, women, and children living with HIV/AIDS without receiving any federal or state funding. The event bears the name of cofounder Jeannette Rockefeller, a philanthropist and activist who, along with Gloria Greene and Joanna Jakway, decided to make a positive difference in the

world by starting an oasis in the desert in 1991. Funds generated through the Angel Program directly support AAP’s food voucher program, contributing to the $50,000 needed each month to continue those vital services. Donations to AIDS Assistance Program’s Annual Giving will be matched by Wells Fargo Foundation through December 1. Date: October 12; 6–8 p.m.; location: supplied upon RSVP confirmation of attendance; tickets: no fee but attendance indicates a willingness to participate in AAP’s Annual Giving Program. For more information, contact the organization by phone at (760) 325-8481 or visit aidsassistance.org.

A&U • SEPTEMBER 2014

SEPTEMBER 2014 • A&U

Survival Guide

[a portrait by sean black]

Jeremiah Johnson New York, NY

[

HIV Prevention Research & Policy Coordinator at Treatment Action Group where he combats laws and policies that fuel the ongoing HIV crisis in the U.S. “I’m so grateful to be able to work on improving HIV prevention systems that failed me as a young gay man. No one should have to survive in a system that fails to meet—not only their HIV prevention needs—but all of their health and wellness needs.” Sean Black is an Editor at Large of A&U.

64 64

A&U • SEPTEMBER 2014

WE KNOW

HIV/AIDS MEDICATION THERAPY But we also know you won’t skip your workout for anything. Welcome to a pharmacy that gets to know you, not just your diagnosis. We’re not just treating HIV patients, we’re getting to know individuals. So no matter the level of support, guidance and confidentiality you prefer, we’re here for you. To learn more, visit HIV.Walgreens.com.

13CS0059-0114