How to Be Resilient
+ Will Your Status Affect Your Dream Vacation? +
Singer Jimbeau Hinson
H E A L T H + S P I R I T + C U L T U R E + L I F E
NEW YEAR, A NEW YOU
Everything you need to know to take control of your health
+ Sex on Campus Black colleges tackle HIV, but is it working?
Orphan to Oprah
The story of Hydeia Broadbent
SILVER Lining When Olympic champion Ji Wallace came out as positive this year, the Aussie showed millions that HIV doesn’t have to stop you from living your dreams
Photographed for HIV Plus by Fernando Barraza
january/february 2013
www.hivplusmag.com
in this issue
January+February 2013
healthy doses 8 HIV and your dream Vacation Some unlikely destinations have restrictions on travelers with HIV.
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9 paper dolls galore Activists collect 20,000 paper dolls in support of the female condom.
9 promising practice Accepting gay kids may make them less likely to get HIV.
mpowr 16 New Year, new You Everything you need to know right now to get healthier in 2013.
case studies 10 Meningitis scare in NYC Why middle-aged gay men are at risk.
11 News you can use All the latest news, studies, and more.
12 the problem with prison After they get out, many former convicts drop their HIV regimen, especially women.
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14 can a ring prevent hiv? New hope for women hoping to prevent HIV without solely relying on condoms.
15 doctor, doctor Peer mentoring between physicians could change the kind of care you get.
46 let’s get physical New moves you can do at home.
46 The exercise ratio Not too much, not too little.
47 hangover cures How to recover if you overdo it.
ALSO: 48 The LAST word After banning an ad for AIDS Walk Los Angeles, the city of Santa Monica courts controversy.
38 Reaching Higher Heights
From Olympic medalist to public HIV activist, Ji Wallace just wants to pay it forward.
26 Sex and Black Campuses
How historically black colleges are addressing HIV on campus.
30 Girl, Uninterrupted
Hydeia Broadbent went from an orphan with HIV to a national leader in the fight to educate people about HIV.
44 Boy on Fire
Country music crooner Jimbeau Henson is back with a new album and a new outlook on being bisexual and positive.
clock wise from top: fernando barraza; courtesy subjec t (2)
you2.0
Editor's Letter
M
Editor in chief
A
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Diane Anderson-Minshall
A
Z
I
N
evp, group publisher
E Joe Valentino
Broverman INTEGR ATED advertising MANAGEr Steven O’Brien Scott McPherson interactive art director Robert Hébert digital Editor Michelle Garcia senior managers, integrated marketing ASSOCIATE Editor Sunnivie Brydum Robbie Imes, Kevin Stec copy editor Trudy Ring senior manager, social media Shamila Siddiqui ASSOCIATE ART DIRECTOR Boo Jarchow INTEGR ATED MARKETING MANAGER Stephanie Block editorial interns Daniel Reynolds, Nazly Siadate senior director, client services Stewart Nacht managing Editor Neal
creative director
Peter Di Maso Dave Johnson director, digital media Scott Ragan senior online producer Christopher Harrity web production coordinator Joe Okonkwo
lead web architect & developer
creative director, digital media
circulation Director Jeff Lettiere
fulfillment manager Argus Galindo Production Manager John Lewis
Advertising Production Manager Heidi Medina
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Stephen P. Jarchow ceo Paul Colichman cfo Tony Shyngle eVP, GM, Bernard Rook evp, publishing Joe Landry vp, editorial director Matthew Breen chairman
Christin Dennis, John Mongiardo, Stephen Murray, Alex Paul, Josh Rosenzweig, Joe Valentino vice presidents Matthew Breen, Greg Brossia, Eric Bui, Steven Capone, Justin Garrett senior vice presidents
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KINA WILLIAMS
what’s your story? Do you have an interesting story about yourself or someone you know that you want to share? You might be a candidate for a profile in one of our departments or another section. We want to hear from you, and we want to know what you’ve been up to. So email us at mail@HIVPlusMag.com or write us at HIV Plus, 10990 Wilshire Blvd., Penthouse Suite, Los Angeles, CA 90024.
HIV Plus (ISSN 1522-3086) is published bimonthly by Here Publishing Inc., 10990 Wilshire Blvd., Penthouse Suite, Los Angeles, CA 90024. HIV Plus is a registered trademark of Here Media Inc. Entire contents © 2013 by Here Publishing Inc. All rights reserved. Printed in the USA.
Longtime Companion
I
may be like a lot of folks
when it comes to sports. I don't follow it much until the Olympics come around and then I'm glued to the TV for weeks. This year offered a special treat, when Australian Olympian Ji Wallace came out and told the world he had HIV. After that, Wallace didn't become a pariah, he became a sex symbol, and photos of him in little more than a Speedo went viral online. Thankfully, we pinned down the new activist for a one-onone with writer Daniel Reynolds to talk about sports, love, and becoming the new face of HIV. Since fitness is important to everyone, we also invited HIV-positive fitness expert Sam Page, a Los Angeles–based trainer, to join us. He'll show you one new easy exercise move each issue that you can incorporate into your daily routine without even leaving your home. And another athlete has ties to our biggest feature this month: Magic Johnson. We look at the work of his foundation and one of its activists, Hydeia Broadbent. She's known Johnson since she was 9 years old, when she told the world she was HIV-positive. I hope you're inspired too.
Diane Anderson-Minshall Editor in Chief
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healthy doses STATUS SYMBOLS Pyramid Hunting If you’re looking to visit pyramids, you might want to plan your vacation for Mexico or Peru, since Egypt is strict about deporting HIV-positive foreigners. But who knows? A new wave of tolerance could follow the recent democratization of the Egyptian government.
Can I Travel with HIV?
Going Down Under In Australia restrictions come into play primarily when HIV-positive people wish to stay in the country for longer than 90 days. HIV testing is required for anyone older than 15 applying for a permanent visa. Being HIV-positive does not usually disqualify an applicant, but government officials may take the cost of the applicant’s care or public health risks into consideration.
Some countries are tricky when it comes to visitors with HIV if you’re hiv-positive and looking to visit or work in another country anytime soon, you had better know whether your status will be a source of trouble. In some places, stories of travelers who ended up at the emergency room after an unexpected accident and then found themselves immediately deported for being HIV-positive aren’t uncommon. Forty-five countries, territories, and regions have some legal restrictions on foreigners known to have HIV, according to a 2012 study compiled by UNAIDS.
The Bustle of Asia A record 6 million travelers visited Taiwan in 2011, yet the country is anything but friendly to those with HIV. Foreigners planning on staying in the country longer than three months can be forced to take HIV tests or other medical examinations, according to the Tainan City Health Bureau, and are not allowed to stay in the country if they test positive.
Caribbean Paradise Turks and Caicos in the Caribbean are a sightseer’s paradise, but the islands bar HIV-positive people from working or residing there for even a short period. But if your hopes are set on escaping to the Caribbean, there are no laws on the books barring HIV-positive tourists from St. Lucia or Trinidad and Tobago, and, let’s face it, they probably have better beaches.
Headed to Zion Surprisingly, some of the places that have restrictions on HIV-positive travelers are known for social and political acceptance of LGBT people. For example, LGBT-friendly countries including Israel, Australia, and New Zealand have laws requiring HIV testing for foreign workers, and the United States barred HIV-positive visitors until fairly recently. Israel, the home of World Pride 2012, requires HIV testing for certain foreign workers, and the Ministry of Interior reserves the right to deny work permits to those who are HIV-positive. The law appears designed to largely to prevent people from countries with particularly high HIV rates, such as those in sub-Saharan Africa, from entering the country, but it can affect anyone with HIV, including Americans.
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New Zealand’s law is similar to Australia’s regarding the treatment of HIV-positive people: Tourists who are staying in the country less than 90 days do not have to declare their status upon arrival. However, people applying for work permits or residency must be tested for HIV and can be turned away if they are positive. Also, a New Zealand policy on accepting refugees from political persecution reserves 20 places for people with HIV.
The Rest of the Best Most countries, territories, and regions have no HIV-specific restrictions on entry, stay, and residence these days. The United States is now included in that list (as it only recently lifted its ban on HIV-positive foreign visitors), along with such major nations as the United Kingdom, Brazil, and Japan.
For more on places where it’s OK to travel (or not) visit UNAIDS.org. —Charles Hicks
20,000 Paper Dolls Hung as message boards at last summer’s AIDS conference and now traveling the world, this long chain of paper dolls—each with notes written by celebs, politicos, activists, and everyday women around the globe—was an attempt to break the Guinness World Record. The effort, by Universal Access to Female Condoms, may have failed, but the message was heard loud and clear. Want to sign on? Go to Sign4FemaleCondoms.org. —Diane Anderson-Minshall
opposite page: photos.com (7); this page from top: brian jones, courtesy aid for aids, photos.com
e is Tipsy Rose Le at er n in w ed crow n g a Dr Show the Best in es. The in Los Angel ut y ea satirical b d in el h t, n a e pag ed over is a r , er b o Oc t r Aid fo 0 $300,00 . AIDS r fo
A wall of 20,000 paper dolls at the XIX AIDS Conference in July
Accepting Families Can Reduce HIV in Gay Kids The Family Acceptance Project, a San Francisco program aimed at reducing familial rejection of transgender, bisexual, lesbian, and gay youth, was named a “Promising Practice” at an October conference sponsored by the Center for Reducing Health Disparities at the University of California, Davis, School of Medicine, and the Latino Mental Health Concilio. Researchers found, essentially, that supportive and accepting family members can help reduce health disparities, including HIV risk, among LGBT Latino youth and young adults. For more information on the Family Acceptance Project’s work, visit FamilyProject.SFSU.edu. —Sunnivie Brydum
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case studies
Thwarting a Deadly Menace
Source: photos.com
A disease typically affecting young people is targeting gay men who are HIV-positive
M
eningitis is usually a disease that can act as a harsh, if not fatal, blow to teenagers. That’s why so many colleges require incoming firstyear students to be vaccinated against it. Normally, about 30 to 50 teenagers and young adults in New York City contract bacterial meningitis each year, with a 10% rate of death. However, meningitis is now a new threat to the city’s HIVpositive gay men. Since August 2010, Neisseria meningitidis, the bacteria that causes this form of meningitis, has hit about 13 gay New York men whose ages average in the early 30s. Eight of those men had HIV, and four of the 13 10
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(33%) have died of meningitis. Three of the deceased had HIV. Because of this, the New York City Department of Health is particularly urging meningitis vaccinations for HIVpositive men who have had sexual contact in the last two months with men they met through a party, mobile dating app, or another casual setting. Meningitis infects the membranes surrounding the brain and spinal cord, and this can lead to serious neurological damage. It can be caused by either a bacteria or a virus, but the bacterial form is far more serious. The disease is transmitted by prolonged close contact—such as kissing or sex—as well as by sharing eating utensils, a drinking glass, or a cigarette with an infected person. Health experts note that meningitis is not spread by simply breathing the same air as someone with the disease. The most common signs of a meningitis infection include high fever, severe headaches, stiff neck, headache-induced vomiting or nausea, confusion or difficulty concentrating, seizures, fatigue, sensitivity to light, a rash, and the inability to eat. People with HIV do have a greater risk of acquiring invasive meningococcal disease, as bacterial meningitis is also known, and it can be fatal if not properly treated. Even people who received a vaccine for college, the health department warns, may need a booster shot, especially since there is not enough information to know how long the vaccine lasts in people with HIV. It usually takes seven to 10 days after getting the shot for the vaccine to become effective, but not everyone who is vaccinated will develop protective levels of antibodies. HIV-positive people who receive a type of vaccine known as the meningococcal conjugate vaccine are being advised to receive a second shot about eight weeks after the first. Even as the city recovers from the devastating effects of Hurricane Sandy and the subsequent snowstorms that have battered the city, vaccinations are available to people across the five boroughs in most public health clinics. For more information on where to find a vaccine, visit NYC.gov/DOH. —Michelle Garcia
News You Can Use
photos.com
✚ Got Milk? Cows’ milk may become another tool in defending humans against HIV. In a new study from Melbourne, Australia, researchers vaccinated pregnant cows, which cannot contract the virus, with an HIV protein and studied the first milk produced by the cow after birth. When the scientists analyzed the first milk, known as colostrum, they found it had a high count of antibodies that could inhibit
HIV from infecting cells. “The antibodies bind to the surface of the virus and block the protein, which needs to be freed to get in contact with human cells—like a key and lock system,” lead researcher Marit Kramski of the University of Melbourne told Australia’s Herald Sun. The researchers now hope to develop an inexpensive preventive cream for women to use topically to protect themselves against HIV, though such
Studies show that almost half of HIVers are outed, while scientists look to cows’ milk and nanotech to treat and test for HIV. —Nazly Siadate and Michelle Garcia
a product is unlikely to be available for a decade. ✚ Not Doctor Feelgood A woman from New York City’s Harlem neighborhood is suing a physician who administered an HIV test without her consent, according to the New York Daily News. The woman, who is not identified in the suit, went to Lifex Medical Care in Brooklyn’s Sheepshead Bay area in September 2011 for treatment of a vitamin B-12 deficiency after gastric-bypass surgery. The woman says she declined to be tested for HIV, but she alleges that physician Pavel Yutsis did the test anyway, returned with a positive diagnosis, and neglected to offer her statemandated post-diagnosis counseling. The lawsuit, filed in Brooklyn Supreme Court, also claims that Yutsis violated confidentiality laws by sharing the woman’s test results with staff. “When he told me I was positive and threw the papers at me, I just went numb,” the woman told the Daily News. “I would have wanted to hear it in a better environment, from someone that I trusted. I never felt comfortable in that place.” ✚ Nanotech to the Rescue Scientists at Imperial College in London have conducted and published a new study that uses nanotechnology to produce an HIV test that is “ten times more sensitive and a
fraction of the cost of existing methods,” Reuters reports. The test easily analyzes saliva and detects HIV early on. Lead researcher Molly Stevens is hopeful this cheaper form of testing will benefit parts of the world where resources are scarce. ✚ HIV’s Outing A report form La Trobe University in Melbourne, Australia, says that over half of all people with HIV have had their status revealed by other people, usually friends and colleagues. Doctors and health care staff are accountable for 7% of the disclosures, the report found. Brent Allan, executive officer of Australian HIV/AIDS organization Living Positive Victoria, says unauthorized disclosure is harmful to selfesteem, and the risk deters people from getting tested. ✚ FDA Stalls Crofelemer New Drug Application Crofelemer, a new drug that assists in symptomatic relief of noninfectious diarrhea in people with HIV, is still under review by the Food and Drug Administration. The FDA is working collaboratively with drugmaker Salix Pharmaceuticals to ensure proper production and control of crofelemer’s active ingredient, a compound made from tree sap, which is the first botanical product the FDA has considered for oral use. The FDA is expected to take action early in 2013.
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STATUSstudies SYMBOLS case
“A country’s sociopolitical response to a disease is the most important factor in determining the course of an epidemic.”
After Incarceration fter hiv-positive prisoners have done their time and reentered society, their new lives often don’t include HIV care, according to a new study. And this alarming trend may be more pronounced among women. Researchers at Yale University tracked the post-prison HIV care of nearly 900 former inmates in 10 different U.S. cities, defining “maintaining care” as keeping one medical appointment every three months in which viral load or CD4 count was measured. They found that 34% of former inmates had no HIV care in the six months after release from prison. Only 38% kept two regularly scheduled appoint-
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ments, while 19% made it to their first visit but missed their second, and 8% attended their second after missing their first. Those skipping appointments could be risking their health by allowing their regimens to lapse, and those not adhering to their meds are also putting their sex partners at risk, since regularly taking antiretrovirals drastically cuts one’s chance of infecting others. Rather surprisingly, heroin users were nearly 50% more likely to stay in care than other former prisoners. But perhaps the most interesting finding to emerge was that men were twice as likely as women to retain care. “There are data to support that women fare less well than men, including from a
study that we are about to publish,” says lead researcher Frederick Altice. “One reason is that HIV-positive women, compared to HIV-positive men, often have more competing medical and social comorbidities—higher rates of mental illness, substance use disorders, and other medical conditions, not to mention [they] return to less stable circumstances, such as abusive relationships, are caring for children, and [are often] breadwinners for the family.” Altice’s research shows that prisoners who kept up with their care before they went to prison were 67% more likely to retain care after their release. Apparently, even good habits die hard. —Neal Broverman
photos.com
A
Many find it difficult to stay on the straight and narrow with their HIV care once they get out of prison
HEALTH + SPIRIT + CULTURE + LIFE
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WORLD AIDS DAY 2011
It Takes a Village
Six people who are changing the world together
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10 Great Discoveries in 2011
A YEAR OF PROGRESS IN HIV
Seeing one doctor for your HIV and a primary care physician for everything else is becoming a relic of the past—what you need to know about treatment in the 21st century
To subscribe, go to: www.hivplusmag.com/subscribe
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BL EBLM>GBG@ The Grammy Award–winning singer and activist reflects on her commitment to fighting AIDS
LA FAMILIA BONITA
Latino families deal with HIV together
STATUSstudies SYMBOLS case
With This Ring A new tool for preventing HIV in women is filled with a lifesaving drug, and possibilities
Researchers see the ring, expected to be tested on humans in 2013, as an alternative to Truvada, a combination pill that includes tenofovir and emtricitabine that was approved by the Food and Drug Administration last year for pre-exposure prophylaxis (PrEP), or prevention therapy for those considered high-risk for HIV (which could include anyone in a relationship with an HIVpositive partner as well as sex workers).
There are concerns—namely, with possible discomfort. Pills are obviously easier to take, and a topical gel can be applied when a woman knows she’s going to have sex. But the researchers see possibilities with combining their ring with contraceptives, therefore creating a powerful tool that can prevent HIV transmission and unwanted pregnancies at the same time. —Neal Broverman
The ring in the center is filled with tenofovir. The other two rings are commercially available contraceptives: Estring (left) and NuvaRing (right).
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from top: photos.com; Judit Fabian, Universit y of Utah
at a conference this fall in Chicago, doctors and scientists were wowed by a new product aimed at preventing HIV transmission: an intravaginal ring filled with the antiretroviral drug tenofovir. This new HIV weapon was introduced by researchers at the University of Utah and Eastern Virginia Medical School, who describe the plastic ring, which holds the tenofovir gel and releases it inside the vaginal canal, as simple and cheap to produce. The ring’s plastic tubing is novel in that it allows water-soluble drugs such as tenofovir to be absorbed into the body. “This ring is a breakthrough design because it is highly adaptable to almost any drug,” lead researcher Patrick Kiser said in a statement. “The amount of drug delivered each day is the same and the release rate can be modified easily if needed.” While some studies have shown a tenofovir topical gel to be effective in bringing down transmission rates, success is tied to regular usage. The university researchers believe the ring will increase adherence. One ring releases up to 10 milligrams of tenofovir each day for at least 90 days.
STATUS SYMBOLS
Meeting the Demand
W
A new program pairs HIV specialists with your hometown primary care doctor Fonseca, training and workforce manager for HealthHIV, which is based in Washington, D.C. The mentoring program allows them to expand that knowledge on a flexible schedule. After an initial face-to-face meeting with their mentor, they can then easily contact the mentor by phone, email, or videoconference when they have a question regarding treatment, how to talk to patients about HIV, or even how to overcome their own skittishness about discussing the issue. Primary care providers need HIV expertise more than ever, Fonseca points out. It’s estimated that when the Affordable Care Act is fully implemented in 2014, about a half million newly insured HIV-positive Americans will seek treatment, mainly in primary care settings, such as community health clinics. The fact that effective drugs have made HIV a chronic, manage-
able condition for many people in the U.S. means that HIV treatment needs to be part of a patient’s general health care. And most doctors specializing in HIV began practicing more than 20 years ago, and half are expected to retire in the next five to 10 years. Since January 2012, HealthHIV has matched more than two dozen doctors with mentors, with each mentor taking on multiple relationships. Many of the primary care doctors being served so far are in urban settings, but there’s also a focus on getting mentors to providers in underserved rural areas, particularly in the South. In order to maximize the benefits, the project seeks to match mentors and primary care physicians by background and interest, Fonseca says. “What really is key is the relationship that they have with their mentor,” he says. —Trudy Ring
photos.com
ith an increasing demand for HIV care and a decreasing number of doctors specializing in this area, HIV-positive patients could have difficulty finding a knowledgeable physician. But a new project called the HIV Workforce Capacity Building Initiative is trying to do something about that. The initiative, an effort of the group HealthHIV (with funding from a BristolMyers Squibb Positive Charge grant), connects primary care physicians with HIV specialists who serve as mentors. The idea is for the two physicians to develop an ongoing relationship in which the mentor provides guidance regarding HIV care. “What we’re finding is folks interested in expanding HIV knowledge are very busy, with a high volume of patients,” says Julio
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TESTS
YOU NEED
TESTS NOW YOU NEED
NOW It’s a newByyear and aBrydum new you. Your Sunnivie best resolution might be to get the annual tests and immunizations every HIV-positive person needs. It’s the strongest commitment you can make to your health. Frank Spinelli, a New York City physician who specializes in treating patients with HIV, helped navigate what tests you need, when you need them, and why it’s worth your trouble. 16 plus • J A N U A R Y/ F E B R U A R Y 2 0 1 3 hiv
It’s a new year and a new you. Your best resolution might be to get the annual tests and immunizations every HIV-positive person needs. It’s the strongest commitment you can make to your health. Frank Spinelli, a New York City physician who specializes in treating patients with HIV, helps navigate what tests you need, when you need them, and why it’s worth your trouble.
PHOTOS.COM
MPOWER
EVERY
TO
Blood Pressure What it measures: The pressure of the circulating blood on the walls of your blood vessels. What that means: Because blood pressure is closely related to the strength and rate of your heartbeat as well as the diameter and elasticity of the arterial walls, it is a useful diagnostic tool for a variety of conditions. Why you need it: Elevated blood pressure is associated with a substantially greater risk of heart attack among HIV-positive people, according to a 2012 report by the Veterans Health Administration.
Cardiovascular Disease What it measures: Cholesterol and triglyceride levels, and irregularities in arterial walls or cardiac ventricles. What that means: An assortment of tests, ranging from a simple blood draw to a chest X-ray to various types of ultrasounds, can help your doctor determine how effectively your heart is pumping blood and spot any rhythmic irregularities. Why you need it: HIV infection can double the risk of heart attack, according to a 2011 study from the University of Pittsburgh’s School of Medicine. Additional conditions like diabetes, smoking, and even antiretroviral treatment can also increase your risk for heart attack.
Look Out for
Diabetes What it measures: The amount of glucose in your blood, also known as blood sugar. What that means: While there are several different types of tests for diabetes, most function by looking at the amount of glucose in the blood that has attached to red blood cells as they move through the bloodstream. The more glucose in the blood, the higher the potential for damage to your large and small blood vessels. Why you need it: HIV-positive people are at an increased risk for diabetes, especially if they have additional risk factors such as a family history of diabetes, increased waist circumference, physical inactivity, and African-American or Latino heritage. Because some HIV treatments can affect glucose uptake levels, it’s also important to be screened for diabetes before starting HAART or any nucleoside reverse transcriptase inhibitor drugs, according to Diabetes Spectrum. 18
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As men and women with HIV grow older, it is crucial that doctors routinely screen them for anal, cervical, and colon cancer, as all of these cancers have a higher incidence in those who are HIV-positive. Spinelli recommends an annual colonoscopy in all HIV-positive patients older than 50. Similarly, men over age 50 should be regularly screened for prostate cancer, and women should get annual mammograms after age 50. Women should also get other screenings for breast and gynecological cancers as soon as they are diagnosed with HIV.
MPOWER
Only of Americans living with HIV have their viral load under control and at low levels.
Cholesterol (Lipids) Test What it measures: The EVERY amount of fat carried through the blood as triglycerides, phospholipids, and cholesterol. What that means: Lipids include both the “good” cholesterol (HDL) and “bad” cholesterol (LDL), and both HAART and protease inhibitors can affect Months lipid levels. Why you need it: As HIV progresses, there is a trend of decreasing cholesterol and increasing triglycerides, which can lead to increased risk of heart disease and heart attack, stroke, pancreatitis, and blood clots. Receiving regular lipids tests can help your doctor determine if you should go on cholesterol-lowering drugs or change your diet to minimize this risk. Smoking also increases the risk of elevated lipid levels.
3
Lymphocyte Subset What it measures: Number of healthy CD4 cells (a.k.a. T cells), B cells, and natural killer (NK) cells. What that means: A lymphocyte subset determines the number or proportion of certain types of white blood cells, which are important in the formation of antibodies that help your immune system. Why you need it: This test can tell you how healthy your immune system really is, which can help doctors monitor your HIV care and make sure you’re getting the best type of treatment.
PHOTOS.COM (3)
HIV Viral Load What it measures: The amount of active HIV in your blood. What that means: HIV cells replicate at varying rates, and the rate determines your viral load. The goal is to have as few copies as possible in your blood, known as an “undetectable viral load,” generally considered to be less than 20 HIV RNA copies per milliliter, or less than 75 HIV copies per milliliter, depending on the type of test. Why you need it: Your doctor can assess the state of your HIV infection and how well your medication regimen is working based on the number of HIV copies in your cells. The fewer copies, the better. A viral load of more than 200 copies per milliliter usually means you need to change your antiretroviral therapy.
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Complete Blood Count (CBC) What it measures: The number of white and red blood cells, the number EVERY of platelets, the amount of oxygencarrying protein in the blood, and the proportion of blood composed of red blood cells. What that means: White blood cells regulate the body’s ability to fight infection and are often compromised by immune-system disorders such as HIV. Red blood cells carry oxygen into the bloodstream, and an excessively high count can indicate lung disease, which is more common in people who have HIV and people who smoke. Platelets are essential for effective blood clotting and can be lowered by HIV. Why you need it: A CBC is a standard, informative test that can be used to diagnose opportunistic infections, detect blood clotting problems and anemia, and measure cell production and destruction, which is affected by HIV.
Comprehensive Metabolic Panel What it measures: Liver and kidney function, in addition to assessing the levels of glucose, proteins, and electrolytes in your blood. What that means: A comprehensive metabolic panel tells doctors how well your kidneys and liver are filtering waste produced by your body. It also measures your blood sugar levels and how well your cells are producing calcium, sodium, carbon dioxide, bicarbonate (which maintains the body’s pH balance), and other electrolytes needed for healthy organ function. Why you need it: HIV medication frequently affects liver and kidney function, which is why it’s important to monitor blood urea nitrogen and creatinine, both of which determine how well your kidneys are filtering waste out of your blood.
A NN U A L LY
of Americans living with HIV are taking medications regularly.
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What it measures: Amount of thyroid hormone, which regulates the body’s metabolism. What that means: Your metabolism controls how quickly and effectively your body processes nutrients and can be affected by a number of factors, including HIV itself, HAART, and other medical conditions that you may have along with your HIV. Why you need it: HIV-positive patients being treated with HAART are at an increased risk for hypothyroidism (often called underactive thyroid), which causes an abnormally low level of secretion of thyroid hormone. It will also test for thyroiditis, an inflammation of the thyroid gland that can be triggered by HIV.
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PHOTOS.COM (3w); pill: gilead sciences
Thyroid Stimulating Hormone
MPOWER
Testosterone (for men) What it measures: Levels of the male hormone created and secreted by the genitals. What that means: Low testosterone levels, also known as hypogonadism, result from deficient natural production of the hormone. There is some evidence that AIDS-based wasting may be affected, in part, by hypogonadism. Why you need it: Low testosterone is connected to low sex drive and erectile dysfunction, which some studies suggest upward of 60% of HIV-positive men experience. Low testosterone production has also been linked to anemia, osteoporosis, muscle loss, and depression. For some patients, hormone replacement therapy may be a viable option to counter some of the effects of hypogonadism.
Hepatitis B and C What it measures: The presence of hepatitis B or hepatitis C virus, an infection of the liver and a common coinfection among HIV-positive people, due to the similar modes of transmission. What that means: According to the Centers for Disease Control and Prevention, as many as one third of HIV-positive patients are also infected with hepatitis. Liver disease, which is often related to hepatitis infection, has become the leading cause of non-AIDS-related death among the HIV-positive population. Why you need it: Since HIV-positive patients are already at increased risk of liver disease, it is critical to regularly screen for the virus. Spinelli also recommends vaccinations against hepatitis A and hepatitis B for all HIV-positive patients.
Vitamin D What it measures: Levels of vitamin D, a fat-soluble vitamin found in only a few food sources or through exposure to sunlight. What that means: Vitamin D deficiency has been connected to bone demineralization in aging HIV patients. Why you need it: Vitamin D deficiency is common in people with HIV, because you use more vitamin D for regular bodily functions than someone who is HIV-negative. Additionally, some studies have found that HIV patients on nonnucleoside reverse transcriptase inhibitors have an increased incidence of vitamin D deficiency.
Annual Exam
The
It sounds like something for kids going to camp or college, but the annual physical exam is a must for HIV-positive folks. It should include comprehensive health screenings, with a rectal exam, breast and gynecological exams for women, and a look at waist circumference, which is a simple tool to assess abnormal accumulations of deep abdominal fat, or visceral adipose tissue, caused by HIV and highly active antiretroviral therapy.
Anal or Cervical Pap Smear What it measures: The existence of certain strains of human papillomavirus, which is responsible for most types of cervical and anal cancers as well as genital warts. What that means: Women should regularly receive a cervical Pap smear, and women who have cervical HPV or participate in anal sex, as well as HIV-positive men, should all receive anal Pap smears yearly. Why you need it: Cervical cancer (which is almost always caused by HPV) in women and anal cancer in both men and women occur more frequently in conjunction with HIV infection. In addition, according to the CDC, HPV can cause cancers of the vulva, vagina, penis, and throat. It can also lead to infertility in women or be transferred to children during delivery. Regular screening is an important proactive step, and there is evidence that HPV vaccinations can help protect against the development of anal and cervical cancer. Remember, this information is intended as a recommendation and should not take the place of your primary care physicianâ&#x20AC;&#x2122;s guidance. It is intended to supplement your individual treatment plan and offer you a starting place to take control of your health care.
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How America’s historically black colleges and universities are trying to stop the spread of HIV on campus
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photos.com
By Michelle Garcia
uch as the seven sisters colleges
educated throngs of women before they were even granted the right to vote, America’s historically black colleges and universities offered higher education to African-Americans long before the civil rights era. The term “historically black colleges and universities,” often shortened to the acronym HBCUs, generally refers to schools that have had a particular mission to educate blacks and existed before 1964. Pennsylvania’s Cheyney University, founded as the Institute for Colored Youth in 1837, is the oldest existing HBCU. Today, there are 103 HBCUs, which still grant 22% of the bachelor’s degrees earned by African-Americans, reports The Network Journal. “Among blacks, 40% of all congressmen, 12.5% of CEOs, 40% of engineers, 50% of professors at non-HBCUs, 50% of lawyers, and 80% of judges are HBCU graduates,” the publication notes. That means these institutions serve as an educational bedrock for many black Americans—and are a great place to conduct HIV prevention efforts targeting African-American youth and young adults, a group with some of the fastest-growing infection rates. Unfortunately, by the time kids get to college, it might be too late, says Howard University professor Goulda Downer. “When the students come to campus, many believe, I’m free for the first time, and I can do whatever I want,” Downer says. Downer runs Howard’s HIV/AIDS Consortium, an initiative established two years ago to merge all of the campus’s HIV-related prevention efforts, research, professional education, and student-driven projects and groups. As is the case at many other colleges, freshman orientation at Howard includes in-depth sexual education. And students have multiple options when it comes to testing; on-campus residents can even get an HIV test in their dorm rooms. But that doesn’t mean students are protecting themselves from the virus. Downer says part of the real issue is peer pressure. “Sometimes the upperclassmen will try to entice the younger girls, and some of them don’t know how to negotiate safe sex,” she says. “Women and men. A lot of them don’t know how. When we look at these kids, none of [their] parents talk to their kids about sex. The only thing kids are being taught is abstinence, and that doesn’t always work.”
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Downer counsels numerous students, many with HIV, as well as their partners. In addition to her one-on-one sessions, Howard University offers a screening program, behavioral and biological research on HIV, and a substance abuse outreach program. Howard is not the only HBCU with an innovative initiative. Administrators at many of these schools understand that their students have already heard the condoms-or-abstinence song and dance. A 2006 College Student Journal study on HIV knowledge at HBCUs found that students didn’t perceive themselves to be at great risk of infection. The same study indicated that many students were undereducated about HIV (young men slightly more so than young women). As Downer suggests, the real lessons that these educated young people will grasp can’t be taught by a stodgy professor lecturing on the harm of sexually transmitted infections. Instead, the most effective lessons about HIV prevention occur at the peer level. Mississippi’s Jackson State University has a “popular opinion leaders” program in which young men on campus engage their peers in natural, organic conversations about HIV prevention. Freshmen at Southern University in Baton Rouge, La., get HIV education as part of a required introductory health course, which hammers home the basic information such as proper condom use and STI prevention facts, and the class can be rehashed to student organizations or in low-stakes environments like residence halls. In another example of peer counseling, Georgia’s Fort Valley State University has instituted gender-specific campaigns that convey positive examples of sexual responsibility. North Carolina Central University in Durham has a social media effort that delivers HIV prevention advice to students through Twitter. Norfolk State University in Virginia promoted its gender-specific HIV prevention and awareness program by offering $20 Visa gift cards to students who attend. At the beginning of the 2011-2012 school year, Hampton University in Virginia earned an $85,000 grant for its Peers in Prevention program, in which a cross-section of the student body is 28
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These institutions serve as an educational bedrock for many black Americans—and are a great place to conduct HIV prevention efforts targeting AfricanAmerican youth.
Below: Grant Colfax, director of the White House Office of National AIDS policy; Opposite page: Panelists at the White House’s LGBT Conference on HIV/AIDS at Morehouse School of Medicine in Georgia
clock wise from top: photos.com; courtesy morehouse college (2)
trained on HIV prevention education and expected to relay that information to other students. That initiative smartly targets incoming freshmen, students who, experts say, need a sexual health primer as soon as they set foot on campus. “Our desire is to create a campus community that is aware of how these issues adversely affect minority college students,” says Darylnet Lyttle, Hampton student health center administrator, “and how they can decrease their risk of being affected by them.” Morehouse, a prominent all-male college based in Atlanta, hosted a multicampus event in 2012, bringing together alumni, representatives of local AIDS service organizations, and students for a panel discussion on HIV, masculinity, and homophobia—something that the university was previously criticized for not taking on. Clark-Atlanta University and Spelman College students joined in the event as well. The campus also was the site of the White House’s LGBT Conference on HIV/AIDS, which brought the issue to campus in a major way. The
conference was aimed at health professionals, but that sort of exposure could be the kind of encouragement that college students planning to enter the medical field may need. Meharry Medical College in Nashville not only educates African-American medical students but also aims to address the medical needs of people of color, who are disproportionately affected by HIV. A campus initiative called Project SAVED! allows HBCU medical students, faith leaders, and health care providers to work together to reduce HIV among AfricanAmericans through biological and behavioral research. The goal of the four-yearold program, a joint project of Meharry’s Center for AIDS Health Disparities Research and the Centers for Disease Control and Prevention, is to empower medical students to become effective doctors for HIV-positive patients. Training includes guidance on administering HIV tests and ways to reduce stigma in a hospital setting. Donald Alcendor, an assistant professor at Meharry who is deeply involved
in the program, is trying to lead the way among HBCUs with programs to not only teach future doctors about HIV but encourage more research about people of color and the virus. “I have developed an HIV 101 for people in line to be physicians and dentists,” Alcendor says. “We talk to them about HIV on a higher level, to get them familiar with what [health professionals] do. We can get something done with HBCUs that have teaching hospitals like Meharry.” Alcendor believes that creating “onestop shops” in communities of color based around HBCUs will encourage engagement among young medical professionals while providing HIV care and preventive services to those in need. And since HBCUs have produced some of the country’s most prominent African-American leaders—including Oprah Winfrey (Tennessee State), W.E.B. Du Bois (Fisk University), Martin Luther King Jr. (Morehouse), and Alice Walker (Spelman)—the answer to ending HIV may be sitting in a lecture hall in Atlanta. ✜
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GirlUninterrupted Hydeia Broadbent has dedicated her entire life to raising awareness about HIV/AIDS By Sunnivie Brydum
T
wenty years ago, a little girl with HIV captured the hearts of a country grappling with an epidemic when she appeared on a Nickelodeon special and tearfully told basketball legend Magic Johnson that she “just wanted people to know that we’re normal people.” Despite dire medical predictions that she wouldn’t survive childhood, today that little girl is all grown up and still speaking out. Hydeia Broadbent, now 28, travels the country speaking on behalf of the Magic Johnson Foundation, with AIDS activist organizations, and as part of her own continued efforts (HydeiaBroadbent.com) to raise awareness around HIV and AIDS. As a child with congenital HIV in the late 1980s, Broadbent faced discrimination on a regular basis, and she uses those experiences to educate her audiences. “When I was a little girl in kindergarten, there was a teacher who was very apprehensive about me being in her class,” Broadbent recalls. Despite Broadbent’s adoptive parents reaching out to the teacher, principal, and faculty, Broadbent still faced an uphill battle. “I sneezed and I cleaned it up and washed my hands. But then the teacher was so freaked out that she actually sprayed me with bleach because she thought HIV/AIDS might be airborne. Which it’s not.” Despite progress in medical treatment, Broadbent says there’s still a massive stigma surrounding HIV and AIDS. “I think we need
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to stop looking at HIV/AIDS as a moral disease,” Broadbent says. “Because when you see someone who has lung cancer, you don’t say, ‘That’s what they get for smoking all those cigarettes.’ And when it comes to HIV/AIDS, we need to be less judgmental.” That’s a message Broadbent’s parents instilled in her. Patricia and Loren Broadbent have always encouraged their daughter to “speak out and speak up,” unashamed and unafraid. That’s been their mantra since the Broadbents adopted an abandoned 6-week-old infant in Las 32
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Vegas in 1984, knowing only that the girl’s mother had been addicted to drugs. Three years later, when Broadbent’s birth mother had another child who was HIV-positive, the infant’s social worker encouraged the Broadbents to have Hydeia tested. The doctors returned with a grim prognosis:
The girl was HIV-positive and not expected to live past age 5. More than 20 years later, Broadbent has done more than just survive. By the time she was a teenager, Broadbent had appeared on Oprah, 20/20, and Good Morning America and had been featured
courtesy subjec t (2); Robert John Kley
Life in the spotlight (clockwise from top left): A young Broadbent appears on national television; onstage at last year’s ERASE HIV Youth Summit; with community notables at the ERASE summit; in her room as a child.
After a social worker encouraged her parents to have Hydeia tested, the doctors returned with a grim prognosis: The girl was HIV-positive and not expected to live past age 5. More than 20 years later, she’s done more than just survive. in The New York Times, People, Essence, National Geographic, and more. Ever the overachiever, Broadbent stole the spotlight at the 1996 Republican National Convention, where she read an original poem. “I am the future, and I have AIDS,” Hydeia proclaimed before thousands of delegates and millions of TV viewers. “I can do anything I put my mind to. I am the next doctor. I am the next lawyer. I am the next Maya Angelou. I might even be the first woman president.… You can’t crush my dream. I am the future, and I have AIDS.” These days Broadbent travels the country speaking to audiences about abstinence, safe sex practices, and the importance of knowing your status. In September, Broadbent was a featured speaker at the Magic Johnson Foundation and California African American Museum’s ERASE HIV Youth Summit (ERASE stands for Empowering and Reinforcing Awareness of Students Through Education), which engages high school students in open, accessible dialogue about the facts, risks, myths, and stigma associated with HIV. Broadbent enjoys speaking to young people but doesn’t pull any punches about the reality of living with HIV. While advances in medical treatments have allowed Broadbent to live a full and largely healthy life, she
wants young people to understand that living with HIV is not as simple as taking one daily pill, which she says is a common misconception. “I always explain to youth that even though I was born with HIV, if they don’t make wise choices, they can contract it,” Broadbent says. “I talk about the fact that I almost died, being an inpatient, and how much medication I have to take.” Educating young people is especially important to Broadbent, who worries that as the AIDS epidemic has evolved, educators have become complacent. “I think that we’ve forgotten to really put the fear in HIV/ AIDS awareness, so many just act like it isn’t a big deal anymore,” she says. “People think that maybe their education or how much money they make can prevent them from contracting HIV, and I try to say, it can happen to anyone if you’re not wise about your body, and if you don’t talk to your sexual partners about HIV.” While Broadbent has a penchant for speaking with youth, she has a critical message for parents: “Please talk to young people about HIV/AIDS because there’s so many kids who don’t even really know what it is. They don’t even know they’re at risk. I just want people to realize that this is a people’s disease, and it can happen to anyone, anytime.” ✜
Practical Magic A 20-year-old foundation brings education, resources, and a touch of magic to communities that need it most
O
n November 7, 1991, 6-foot 9-inch Los Angeles Lakers point guard Earvin “Magic” Johnson (above with Hydeia Broadbent) rocked the sports world with his announcement that he was HIV-positive. The NBA All-Star and three-time Most Valuable Player defied the odds by becoming a long-term survivor, and his charitable organization, the Magic Johnson Foundation, launched that same year, has also endured. It’s an inspiring journey that is chronicled in the recent ESPN documentary The Announcement, now available on Netflix. Today, the foundation seeks to “address the educational, health, and social needs of ethnically diverse urban communities” by advocating for community-based HIV/ AIDS education, testing, and awareness as well as pushing for college access and digital literacy among ethnically diverse, socioeconomically challenged young people. The foundation goes about this work by hosting events such as the ERASE HIV Youth Summit, held in high schools in Los Angeles, New York, Atlanta, and Miami, meant to give students current, relatable information and resources about HIV and help them sort through the facts, myths, and stigma about HIV and AIDS. Among the Magic Johnson Foundation’s more notable achievements in the last 20 years: it’s provided direct services to over 250,000 students in 16 urban areas; awarded over $3 million in grants; provided free HIV testing to more than 38,000 Americans in 16 major cities; and educated nearly 280,000 people about HIV. In addition, the organization observes an annual Point Forward Day on the anniversary of Johnson’s announcement, November 7 (and named for the position that Johnson played for the Lakers and the popular do-good phrase “pay it forward”). The day is another opportunity for the foundation to promote testing and education around HIV. —S.B.
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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 single-tablet 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? STRIBILD can cause serious side effects: t 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. t 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. t 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.
t 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. Who should not take STRIBILD? Do not take STRIBILD if you: t 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. t For a list of brand names for these medicines, please see the Brief Summary on the following pages. t Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera®). What are the other possible side effects of STRIBILD? Serious side effects of STRIBILD may also include: t 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. t 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. t Changes in body fat can happen in people taking HIV-1 medicines. t 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.
What should I tell my healthcare provider before taking STRIBILD? t 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. t 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. t If you take hormone-based contraceptives (birth control pills and patches). t If you take antacids. Take antacids at least 2 hours before or after you take STRIBILD. t 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. t 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. NEW STRIBILD is a complete HIV-1 treatment in 1 pill, once a day.
Ask if itâ&#x20AC;&#x2122;s right for you.
Patient Information STRIBILDTM (STRY-bild) (elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/ tenofovir disoproxil fumarate 300 mg) tablets #SJFG TVNNBSZ PG GVMM 1SFTDSJCJOH *OGPSNBUJPO 'PS NPSF JOGPSNBUJPO QMFBTF TFF UIF GVMM 1SFTDSJCJOH *OGPSNBUJPO JODMVEJOH 1BUJFOU *OGPSNBUJPO What is STRIBILD? t STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. 453*#*-% JT B DPNQMFUF SFHJNFO BOE TIPVME OPU CF VTFE XJUI PUIFS )*7 NFEJDJOFT t STRIBILD does not cure HIV-1 or AIDS. :PV NVTU TUBZ PO DPOUJOVPVT )*7 UIFSBQZ UP DPOUSPM )*7 JOGFDUJPO BOE EFDSFBTF )*7 SFMBUFE JMMOFTTFT t Ask your healthcare provider about how to prevent passing HIV-1 to others. %P OPU TIBSF PS SFVTF OFFEMFT JOKFDUJPO FRVJQNFOU PS QFSTPOBM JUFNT UIBU DBO IBWF CMPPE PS CPEZ þ VJET PO UIFN %P OPU IBWF TFY XJUIPVU QSPUFDUJPO "MXBZT QSBDUJDF TBGFS TFY CZ VTJOH B MBUFY PS QPMZVSFUIBOF DPOEPN UP MPXFS UIF DIBODF PG TFYVBM DPOUBDU XJUI TFNFO WBHJOBM TFDSFUJPOT PS CMPPE 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). -BDUJD BDJEPTJT DBO IBQQFO JO TPNF QFPQMF XIP UBLF 453*#*-% PS TJNJMBS OVDMFPTJEF BOBMPHT NFEJDJOFT -BDUJD BDJEPTJT JT B TFSJPVT NFEJDBM FNFSHFODZ UIBU DBO MFBE UP EFBUI -BDUJD BDJEPTJT DBO CF IBSE UP JEFOUJGZ FBSMZ CFDBVTF UIF TZNQUPNT DPVME TFFN MJLF TZNQUPNT PG PUIFS IFBMUI QSPCMFNT Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: t GFFM WFSZ XFBL PS UJSFE t IBWF VOVTVBM OPU OPSNBM NVTDMF QBJO t IBWF USPVCMF CSFBUIJOH t IBWF TUPNBDI QBJO XJUI OBVTFB PS WPNJUJOH t GFFM DPME FTQFDJBMMZ JO ZPVS BSNT BOE MFHT t GFFM EJ[[Z PS MJHIUIFBEFE t IBWF B GBTU PS JSSFHVMBS IFBSUCFBU 2. Severe liver problems. 4FWFSF MJWFS QSPCMFNT DBO IBQQFO JO QFPQMF XIP UBLF 453*#*-% *O TPNF DBTFT UIFTF MJWFS QSPCMFNT DBO MFBE UP EFBUI :PVS MJWFS NBZ CFDPNF MBSHF IFQBUPNFHBMZ BOE ZPV NBZ EFWFMPQ GBU JO ZPVS MJWFS TUFBUPTJT Call your healthcare provider right away if you get any of the following symptoms of liver problems: t ZPVS TLJO PS UIF XIJUF QBSU PG ZPVS FZFT UVSOT ZFMMPX KBVOEJDF
t EBSL iUFB DPMPSFEw VSJOF t MJHIU DPMPSFE CPXFM NPWFNFOUT TUPPMT t MPTT PG BQQFUJUF GPS TFWFSBM EBZT PS MPOHFS t OBVTFB t TUPNBDI QBJO 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. *G ZPV IBWF IFQBUJUJT # WJSVT )#7 JOGFDUJPO BOE UBLF 453*#*-% ZPVS )#7 NBZ HFU XPSTF þ BSF VQ JG ZPV TUPQ UBLJOH 453*#*-% " iþ BSF VQw JT XIFO ZPVS )#7 JOGFDUJPO TVEEFOMZ SFUVSOT JO B XPSTF XBZ UIBO CFGPSF t %P OPU SVO PVU PG 453*#*-% 3Fý MM ZPVS QSFTDSJQUJPO PS UBML UP ZPVS IFBMUIDBSF QSPWJEFS CFGPSF ZPVS 453*#*-% JT BMM HPOF
t %P OPU TUPQ UBLJOH 453*#*-% XJUIPVU ý STU UBMLJOH UP ZPVS IFBMUIDBSF QSPWJEFS t *G ZPV TUPQ UBLJOH 453*#*-% ZPVS IFBMUIDBSF QSPWJEFS XJMM OFFE UP DIFDL ZPVS IFBMUI PGUFO BOE EP CMPPE UFTUT SFHVMBSMZ GPS TFWFSBM NPOUIT UP DIFDL ZPVS )#7 JOGFDUJPO 5FMM ZPVS IFBMUIDBSF QSPWJEFS BCPVU BOZ OFX PS VOVTVBM TZNQUPNT ZPV NBZ IBWF BGUFS ZPV TUPQ UBLJOH 453*#*-% Who should not take STRIBILD? Do not take STRIBILD if you also take a medicine that contains: t BEFGPWJS )FQTFSB®
t BMGV[PTJO IZESPDIMPSJEF 6SPYBUSBM®
t DJTBQSJEF 1SPQVMTJE® 1SPQVMTJE 2VJDLTPMW®
t FSHPU DPOUBJOJOH NFEJDJOFT JODMVEJOH EJIZESPFSHPUBNJOF NFTZMBUF % ) & ® .JHSBOBM® FSHPUBNJOF UBSUSBUF $BGFSHPU® .JHFSHPU® &SHPTUBU® .FEJIBMFS &SHPUBNJOF® 8JHSBJOF® 8JHSFUUFT® BOE NFUIZMFSHPOPWJOF NBMFBUF &SHPUSBUF® .FUIFSHJOF®
t MPWBTUBUJO "EWJDPS® "MUPQSFW® .FWBDPS®
t PSBM NJEB[PMBN t QJNP[JEF 0SBQ®
t SJGBNQJO 3JGBEJO® 3JGBNBUF® 3JGBUFS® 3JNBDUBOF®
t TJMEFOBý M 3FWBUJP® XIFO VTFE GPS USFBUJOH MVOH QSPCMFNT t TJNWBTUBUJO 4JNDPS® 7ZUPSJO® ;PDPS®
t USJB[PMBN )BMDJPO®
t UIF IFSC 4U +PIO T XPSU Do not take STRIBILD if you also take any other HIV-1 medicines, including: t 0UIFS NFEJDJOFT UIBU DPOUBJO UFOPGPWJS "USJQMB® $PNQMFSB® 7JSFBE® 5SVWBEB®
t 0UIFS NFEJDJOFT UIBU DPOUBJO FNUSJDJUBCJOF MBNJWVEJOF PS SJUPOBWJS $PNCJWJS® &NUSJWB® &QJWJS® PS &QJWJS )#7® &Q[JDPN® ,BMFUSB® /PSWJS® 5SJ[JWJS®
STRIBILD is not for use in people who are less than 18 years old. What are the possible side effects of STRIBILD? STRIBILD may cause the following serious side effects: t 4FF i8IBU JT UIF NPTU JNQPSUBOU JOGPSNBUJPO * TIPVME LOPX about STRIBILD?” t /FX PS XPSTF LJEOFZ QSPCMFNT JODMVEJOH LJEOFZ GBJMVSF :PVS IFBMUIDBSF QSPWJEFS TIPVME EP CMPPE BOE VSJOF UFTUT UP DIFDL ZPVS LJEOFZT CFGPSF ZPV TUBSU BOE XIJMF ZPV BSF UBLJOH 453*#*-% :PVS IFBMUIDBSF QSPWJEFS NBZ UFMM ZPV UP TUPQ UBLJOH 453*#*-% JG ZPV EFWFMPQ OFX PS XPSTF LJEOFZ QSPCMFNT t #POF QSPCMFNT DBO IBQQFO JO TPNF QFPQMF XIP UBLF 453*#*-% #POF QSPCMFNT JODMVEF CPOF QBJO TPGUFOJOH PS UIJOOJOH XIJDI NBZ MFBE UP GSBDUVSFT :PVS IFBMUIDBSF QSPWJEFS NBZ OFFE UP EP UFTUT UP DIFDL ZPVS CPOFT t Changes in body fat DBO IBQQFO JO QFPQMF XIP UBLF )*7 NFEJDJOF 5IFTF DIBOHFT NBZ JODMVEF JODSFBTFE BNPVOU PG GBU JO UIF VQQFS CBDL BOE OFDL iCVGGBMP IVNQw CSFBTU BOE BSPVOE UIF NJEEMF PG ZPVS CPEZ USVOL -PTT PG GBU GSPN UIF MFHT BSNT BOE GBDF NBZ BMTP IBQQFO 5IF FYBDU DBVTF BOE MPOH UFSN IFBMUI FGGFDUT PG UIFTF DPOEJUJPOT BSF OPU LOPXO t Changes in your immune system *NNVOF 3FDPOTUJUVUJPO 4ZOESPNF DBO IBQQFO XIFO ZPV TUBSU UBLJOH )*7 NFEJDJOFT :PVS JNNVOF TZTUFN NBZ HFU TUSPOHFS BOE CFHJO UP ý HIU JOGFDUJPOT UIBU IBWF CFFO IJEEFO JO ZPVS CPEZ GPS B MPOH UJNF 5FMM ZPVS IFBMUIDBSF QSPWJEFS SJHIU BXBZ JG ZPV TUBSU IBWJOH BOZ OFX TZNQUPNT BGUFS TUBSUJOH ZPVS )*7 NFEJDJOF
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. NEW STRIBILD is a complete HIV-1 treatment in 1 pill, once a day.
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Photography, st yling and grooming by Fernando Barraza w w w.fernandobarraza.com; Backstage FiX video by Pauly Maybury; clothing (OPPOSITE page): Ji Wears Jensen check shirt & Armour+Homme leather harness
ReachinG
HIGHER One of the stars of the 2000 Olympic Games, Australian gymnast Ji Wallace just came out to the world about his positive status. It made him only the third Olympian to do so and turned him into just the kind of activist the world really needs.
HEIGHTS
Story by Daniel Reynolds Photography by Fernando Barraza
j a n u a r y/ f e b r u a r y 2 0 1 3 â&#x20AC;˘
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Ji Wallace, who won second place in trampoline in the 2000 Sydney Olympics, points out that a thin exterior plating is the only physical difference between the gold and silver medals. “So really, everybody comes second, don’t they?” the Australian Olympian jokes. “It’s just a pretty paint job.” In conversation, Wallace laughs often. He pokes fun at his shortcomings, while remaining modest about his remarkable athletic achievements. In addition to his Olympic silver medal, Wallace won gold at the 1996 Trampoline World Championships and set a world record for the double mini trampoline in 1998. Since coming out as a gay man in 2005, Wallace has been an activist, role model, and—after a photograph of him in a Speedo went viral—a sex symbol. He has served as Australia’s first Gay Games ambassador and was a guest of honor at the London Pride House during the 2012 Summer Olympics. It was there that he watched a television broadcast with Greg Louganis, a former Olympic diver who is HIV-positive. “I happened to catch a Piers Morgan
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shoot with Ji Wallace and photographer Fernando Barraza, visit HIVPlusMag.com
Ji wears AN Armour+Homme leather harness, G Star jeans, Diesel under wear, & A Burberry watch
gold Olympic medal is 93% silver.
interview with Greg Louganis on CNN,” Wallace says. “And when I was writing a thank-you letter to Piers Morgan—for just interviewing Greg as a person, not Greg the HIV diver—these words were ringing in my head: ‘There is value in being seen and heard.’ ” CNN anchor Anderson Cooper used words similar to these last summer in his coming-out letter to blogger Andrew Sullivan. The message about the power of visibility hit home with Wallace. Just months before the London Olympics, he tested positive for HIV, leaving him feeling alone, angry, and frustrated. Nonetheless, he was motivated to effect change. “From that very first day, I wanted to scream at the world, ‘Know your status! Get yourself tested and know your status!’ Because a lot of people wouldn’t be in the situation that I was in if everybody knew their status. So right from the getgo, I wanted to do something about it.” He wrote a letter to Morgan that revealed his HIV. He also sent a copy to the Sydney Star Observer. “I felt inspired to write,” he penned. “I too am an Olympic medal winner living with HIV.” The newspaper staff replied within 20 minutes. They wanted to run the story. And in August the news about Wallace was out, during the London games. Wallace draws his resilience from the sport that launched him to fame: trampolining, which he has practiced since his youth. In Australia a trampoline is a common backyard apparatus for families. Wallace’s household was no exception. (Due to a string of highly publicized injuries to children, the device is less common in the United States.) “I was a bit of a raucous kid that had a lot of energy and needed a bit of controlling,” Wallace says. “My parents bought me a trampoline hoping that would entertain me for a little while, but it only encouraged me to do bigger and crazier things.” In search of larger trampolines and higher heights, Wallace and some neighborhood friends joined the PCYC, a local gym For a behind-the-scenes video from our cover
and youth center. What began as a hobby and social activity quickly escalated into a career sport, with Wallace as its rising star. “We went to local competitions, and the coach saw us from there,” he explains, on being discovered for a national team. “She invited me over to her club, which was about 25 miles away. And my parents took me over there for about 10 years, about four times a week, until the magic day happened [and] trampoline got included in the Olympics.” The 2000 Sydney Olympic Games marked the first time trampoline was included as an Olympic sport. That’s where Wallace won his silver medal. But the fight for inclusion is still a 42
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pressing issue at the Olympic games. Each time the games are held, only a handful of athletes are open about being gay or bisexual. Transgender athletes are practically forbidden. With more than 10,000 competitors at the London Olympics, only about two dozen were openly gay or bisexual. The pool of Olympic athletes who are forthcoming about being HIV-positive is infinitely smaller. Apart from Wallace, only Greg Louganis and Magic Johnson have stepped forward for the cause. “I only have a tiny, small voice,” Wallace says. “And if it can reach some people that don’t see the light or feel they have nowhere to turn in a vulnerable situation like returning an HIV-positive test, then
I feel like I’ve ‘gayed it forward.’ I’ve given back to people who have supported me for such a long time.” After hearing of Wallace’s story, Louganis reached out to his fellow Olympian, offering his blessing and support. Inspired by his hero, Wallace plans to run with the Team to End AIDS (T2), a marathon training team that raises funds for AIDS Project Los Angeles, in the 2013 L.A. Marathon in March. But even for an Olympic champion, the prospect of a 26.2-mile run can be daunting. “I’m actually kind of freaking out,” Wallace admits. “It’s going to take eight or nine hours. My trampoline event at the Olympics went for 30 seconds. It really is the flip side of what I’ve ever done before.”
ge t t y images (3)
Full of energy, Wallace competes and wins the silver medal at the 2000 Olympic Games in Sydney.
“I only have a small voice. if it can reach people that feel they have nowhere to turn in a vulnerable situation like returning an hivpositive test, then...i’ve given back to people who supported me for such a long time.”
“I’m actually kind of freaking out,” Wallace admits. “It’s going to take eight or nine hours. My trampoline event at the Olympics went for 30 seconds. It really is the flip side of what I’ve ever done before.” But Wallace is no stranger to arduous training. In 2008 he broke his right ankle during his brief career as a performer in Cirque du Soleil’s Zaia show in Macau, China. He spent nearly two years learning to walk again and has undergone four surgeries to repair the damage. After rehabilitation, he accepted a coaching position at the Cirque du Soleil headquarters in Montreal. Training and teaching others turned out to be ideal preparation for Wallace’s
next pursuit. Since learning of his positive status, Wallace has jumped headlong into activism. Before the 2014 International AIDS Conference in Melbourne, he plans to establish the Silver Lining Foundation, which will work internationally to provide education about HIV and how to prevent it. It will also promote physical and emotional well-being for those who are positive. To this end, Wallace will lead HIV-positive hikers on a sevenday trek on the Kodoka Track in Papua New Guinea. He hopes this journey will inspire others while also raising awareness of the AIDS crisis in that nation. In addition, Wallace plans to create a marathon cycle event, partner with other campaigns to address stigma and dis-
crimination among athletes, and produce a documentary about his journey. It is a lot for one man to handle—but Wallace can rely on the support of his parents and his boyfriend, Shaun, as he navigates the road ahead. “We caught on like a house on fire,” says Wallace, who was open about his status with Shaun from the first day they met at the beach. “[Shaun] shrugged his shoulders and said, ‘That’s not a problem for me. I like you. Do you want to have dinner?’ We are still together and living an amazing life. I really am proof that honesty with yourself and others around you makes for open dialogue and great outcomes.” “We’re really looking forward to making a change in people’s lives,” he adds. Through activism and his foundation, the Olympian will show the world that there is hope in every hardship. “Because every cloud does have a silver lining. Every life moment, you can turn a chorus of tragedy into one of comedy. Look for the silver lining. It just so happens that silver hangs around my neck.” At a recent photo shoot for a sponsoring trampoline company, Wallace’s silver medal snapped off the cloth lanyard. He will send his prize back to the mint for repairs and polishing. “That poor medal’s gone through trauma in its life. It’s been lost for five years. It’s damaged. It’s fallen. It’s actually broken. It’s in two pieces. It’s been through some tough times, and so have I. But trust me,” Wallace assures us, laughing, “it will come back looking better than ever.” ✜ j a n u a r y/ f e b r u a r y 2 0 1 3 •
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ask+tell STATUS SYMBOLS
Musical Therapy jimbeau hinson found success in Nashville in the 1990s, writing songs for artists such as Patty Loveless and the Oak Ridge Boys. But at the height of his career in the mid ’90s, Hinson’s HIV, which he was keeping secret, caught up with him and he fell into a coma. His status both an HIV-positive man and a bisexual one was revealed to the country music industry. But instead of turning their backs on him, Hinson’s peers embraced him, and the songwriter’s health slowly improved. Hinson, who’s been with his wife, Brenda, for nearly 30 years, recently released his debut album, Strong Medicine, which chronicles his relationship not just with his wife but also with HIV. —Neal Broverman Why was this a good time to release your first album? I started writing a book about my life about around 18 years ago. I was living with the secret of my infection for about 12 years and figured if I could just write it down on paper, it could be good therapy. I was in L.A. visiting a friend who’s a guitar player for Lyle Lovett, and after dinner one night, I pulled out my computer and read her a portion of my book. We laughed and laughed. She used to be a literary agent and said this was the
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greatest thing she’s read since Catcher in the Rye or Confederacy of Dunces. She encouraged me to work on the book more, so I spent the next couple years getting it in some form. I had a rough draft and read it to a friend, Sandy Knox, and we sat down, passed a box of Kleenex around, and laughed and cried. She called six or seven months later and said, “I want to start a record label. I want to put your story out. I want to do an album centered around your story. I think the world needs to
hear this.” It all came about from my little therapy project 18 years ago. Does the title have a double meaning? I’ve known Sandy for 20, almost 30 years. She’s one of the few that knew of my infection and she wanted to go back and dig up songs from the past. Much of those songs I wrote back in the 1980s when I was dealing privately with my infection. The song “Not You Again” is definitely about my infection. The album is a collection of things that
were thinly veiled. They’re songs of inspiration and fortitude and not giving up and forgiveness and monogamy— all the lessons I’ve learned through this journey. Your peers in the music industry were encouraging when you came out about your status in the ’90s. Has it gotten even more tolerant of people with HIV? What about LGBT folks like yourself? The music business had always had a lot of gay people in it. [In the ’80s] there were a lot of gay people in the industry, they just weren’t out. Being LGBT or HIVpositive, it wasn’t like a curse or an unacceptable thing in country music, but to the audience it was quite taboo. They had to walk that line. I remember a meeting in the ’80s for a committee and someone asked if we should support an AIDS benefit for kids and everyone said, “No, no. We don’t want our name associated with that.” That told me a lot. I thought, Maybe I should keep this a secret. There was definitely that element of fear going on in the ’80s. Nowadays I
think the whole nation has opened up a lot more, not just the music business. Hallelujah. So it wouldn’t be hard to stage an AIDS benefit in Nashville now? It’s come full circle. Now the younger generation doesn’t think it’s anything to be gay at all. They don’t see anything wrong with it. They also don’t think it’s anything to be HIV-positive, because they think it’s simply a chronic disease. No one’s talking about how you have to change your entire lifestyle around pills. It’s not that hard to prevent yourself from catching it and you should prevent yourself from catching it. That’s one of the main reasons I wanted to do this project—I wanted to talk about the things nobody’s talking about. My doctor was recently awarded an honor, and [at the ceremony] 20-year-olds were getting up and talking about their recent infection. I was floored. You’re a bisexual man married to a woman. Do you field a lot of questions about that? Most people don’t
talk about bisexuality, so I do get questions. They’re mostly polite questions, no one’s rude about it. I’m just a married man now. I had three male lovers, three female live-ins, and I married a woman and have been married to her for 33 years. I grew up and found someone I love to be with. I’m 61, I don’t want to be out there, like some of my friends, chasing 20-yearolds. I love my life. I love my wife. If I was with a man, I’d be the same way and settle down with one person. Have you worked out all the kinks that go along with being in a serodiscordant relationship? My wife’s healthy and always has been. You just have to stay on top of it and be careful. Condoms and Clorox are cheaper than these pills I have to take. I personally work out three or four days a week and eat real food, not overprocessed stuff. And I keep positive people around me. Having a positive frame of mind is one of the most important ways to deal with life, period. I mean, at 61, I’ve outlived a lot of people who thought they’d outlive me. ✜
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you 2.0 Coconut oil may stave off thrush.
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fitness
Staying in Shape One Day at a Time
Everything in Moderation Could working out too much be giving you the blues?
or putting in 20 minutes on a treadmill not only does wonders for the heart and muscles, it makes most people Now there’s no excuse to not get fit feel energized, cheerful, and more relaxed. But there can be too much of a good thing. ne of the biggest obstacles to exercising for anyone is the A new study from Columbia University found that 2.5 to 7.5 hours of exercise per belief that you need a gym membership, lots of spare time, and week improves mental health by easing special equipment. Not true, says Los Angeles–based fitness anxiety and depression, but working out more coach Sam Page—who trains rock star Florence Welch of Florthan that could have the opposite effect. ence + the Machine and the top talent of the ABC reality show Extreme Among the 7,600 people studied, those who exercised more than 7.5 hours a week Makeover: Home Edition. Page, a former model and actor who is also HIVhad greater symptoms of depression positive, will show you a new move or two each issue this year that you can and anxiety than those who worked out do in your home when you have five minutes to spare. less—regardless of age, gender, or general physical condition. The study is believed to Kettlebell Shoulder Swing. 1. Squat holding a kettlebell in both hands be the first to show a connection between between your legs with your arms straight. 2. Thrust your hips forward and swing too much exercise and poor mental health. the kettlebell out and up to just above shoulder height with your arms It’s unclear if people are getting straight. Allow the kettlebell to fall forward and guide it back down sad and stressed because they along the same path. Do 12-15 reps. work out too much or if people who already feel that way are Sun Salute Push-up. 1. Support your body on your toes and hands exercising excessively to try to with your arms straight. Lower into push-up position. 2. Push up to deal with emotional problems. The takeaway: Don’t stop a straight-arm position, then raise one hand to the ceiling while rotatexercising, but if it’s getting in the ing your body to the same side and look up at your hand, with gratitude. The idea l way of other activities and you’re Complete with 10-15 reps on each side. number of working out for hours on end to hours of simply get through your day, talk ex ercise pe Trainer to the stars Sam Page can be found at SamPageFitness.com or on r w eek to your doctor. —Neal Broverman hitting a spin class
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his mobile fitness app, PocketSAM (Pocket-Sam.com).
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Photography by BRADFORD ROGNE
health
Recovering From the Holidays
Four easy ways to feel great after a night of overindulging unless you’re an alcohol virgin (and congrats if you are), you’ve probably endured a post-party hangover. The famed one-too-many syndrome that typifies New Year’s Eve, St. Patrick’s Day celebrations, and every party you attended in your 20s happens when your overburdened liver tries to clear out the toxins and chemicals left by the alcohol. Headaches, dehydration, nausea, head spins, lowered blood sugar, and fatigue all kick in the morning after you’ve indulged— responses that are even worse for folks with HIV. Every culture swears by its own hangover treatments (Bloody Marys, menudo, olive oil, Tiger Balm, sleeping 18 hours), but we found five natural remedies that might ease your pain.
Opposite page: photos.com; this page: photos.com; courtesy subjec t
Sexercise: Physical activity is one of the best treatments for a hangover. Exercise increases sweat, releases endorphins, and helps moves booze-laden blood through the liver and kidneys more quickly. Yoga guru Tara Stiles offers a Hangover Yoga routine on Blip.tv, which includes headstands and a stretching, twisting pose that literally wrings your liver like a sponge. Even better if you’re not a yoga nut: Sex counts as exercise, so if you didn’t do it while you were drunk, now’s the time to get your game on in the name of good health. Don’t forget to keep it safe, though! Blowfish: No, not the cute little fish that blimps up when frightened, this hangover cure is a new FDA-regulated over-the-counter medication that comes with a money-back guarantee. The recommended dose of Blowfish (two tablets) contains 120 milligrams of caffeine (about the same as a cup of coffee), 1,000 milligrams of aspirin, and
an antacid—a combo that, taken when you wake up, is said to cure a hangover in as little as 15 minutes. “The magic of the effervescent tablet,” says Blowfish creator Brenna Haysom, “is that it hits your system much faster than getting a cup of coffee, taking an antacid, and taking some aspirin separately.” The folks behind Blowfish are so sure of their product, they’ll even send you the first sample free. ($2 shipping, ForHangovers.com)
Wasabi: Yes, this time we do mean to conjure sushi images. The Wasabi Hangover Bath Treatment from Body Systems offers the path of least resistance. Get into a hot tub, pour in the treatment, relax, and detox. The Wasabi Treatment contains organic ginger to ease nausea, fever, and indigestion; organic mustard to increase circulation, stimulate sweat glands, and open pores; Epsom salts for internal rebalancing and relieving muscle aches; and a specific blend of essential oils to loosen phlegm, soothe nerves, and jump-start pain relief. Even better: It’s great not just for holiday hangovers but also jet lag and overindulgence of other sorts. ($5, Body-Systems.net) Bytox: For some celebrants it’s all about ease, and the specially formulated Bytox hangover remedy patch lets you slap one on before, during, or after your night of boozing and then helps reduce the physical side effects of alcohol consumption. It works by replenishing the nutrients and vitamins (like B1) your body loses whenever you imbibe. It’s best to put it on 45 minutes before you start drinking and wear it for eight hours after your last drink, but it’s safe, natural, and caloriefree, and there’s no chance you’ll overdose. ($14.99 for a fivepack, Bytox.com) —Diane Anderson-Minshall
A Mobile App That Could Help Women Worldwide App: The Well Project For: Apple iOS (iPhone, iPad) & Android Cost: Free Where: iTunes.Apple.com (iPhone, iPad); Play.Google.com (Android) The Well Project, a nonprofit aimed at dealing with HIV/ AIDS pandemic by focusing on women, has launched their first mobile app. It’s part of the project’s effort to better serve its audience (70% of whom live outside the U.S.) and many of whom increasingly rely on their mobile phones or tablets for information gathering. With the Well Project App, women in even the hardest-to-reach areas will be able to find treatment information and support in their own language as well as share their experiences with other women living with HIV. One such example of new information accessed through the App is the availability of preventive drugs for women at high risk of contracting HIV. The U.S. Food and Drug Administration approved HIV medication Truvada for preventive use in July, making it the first drug OK’d as a preventive measure. “In developing our mobile application, we are working to dramatically increase our reach, especially to women who may not have access to traditional computers but instead rely on mobile technology to access the Internet,” says Dawn Averitt Bridge, founder and chair of the board of the Well Project. “Our ultimate goal is to be able to offer every woman looking for information about HIV/AIDS on the Internet the culturally relevant information she needs to survive and thrive in her own native language.” —Nazly Siadate
the last word
No Room on the Bus AIDS Walk Los Angeles finds its ads are not welcome on Santa Monica’s Big Blue Bus
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speech is too hazardous of a practice,” says Craig Miller, founder and senior organizer of AIDS Walk Los Angeles and a longtime Santa Monica resident. “Our position is that their position is totally absurd.” Miller and his colleagues tried to persuade city officials to lift the ban on noncommercial ads, but after the City Council voted not to do so, Miller and his company, MZA Events, which produces the AIDS walk, filed suit in September, seeking to have the policy changed. Two AIDS walk volunteers are plaintiffs as well, and the suit is pending in federal court. Santa Monica officials did not respond to requests for comment for this story, but Mayor Richard Bloom had previously said he feared the buses could play host to “counterproductive speech.” A Los Angeles Times article reported that Bloom mentioned an August incident in San Francisco in which a political group, the American Freedom Defense Initiative, placed an ad on city buses that called Israel “the civi-
A Big Blue Bus in Santa Monica
lized man” and its adversaries “the savage.” San Francisco’s transit agency subsequently condemned the ad’s language and initiated a review of its advertising policy. Miller is skeptical about talk of “counterproductive speech.” “Isn’t that any speech we disagree with?” he says. He adds that there is a need for some limits on speech, but Americans always “have been careful to make sure any limits are a reaction to a clear and present danger.” There is no such danger in the AIDS walk ads, which had generated no complaints, he says, and the walk’s organizers have never had problems with any other advertising venue. While the suit remains
pending, Miller thinks there might be a change in the policy with the reconfiguration of the City Council after November’s election. Two members who favored letting the AIDS walk advertise were reelected, and one who was opposed did not seek reelection. Nor did Mayor Bloom. The council will choose a new mayor from among its seven members, as is the practice in Santa Monica. “We have a very optimistic sense of our ability to put together four votes for a commonsense resolution,” Miller says. Then, he says, the Big Blue Bus will again be “a vehicle not only for those seeking to sell goods, but those seeking to do good.” —Trudy Ring courtesy aids walk los angeles; courtesy subjec t
anta monica, Calif., is a famously liberal community, to the point that some call it the “People’s Republic,” either as compliment or insult. So it’s a bit unexpected that the Los Angeles suburb is embroiled in a controversy involving its rejection of an AIDS fundraiser advertisement. AIDS Walk Los Angeles had been placing ads for the fund-raising event on Santa Monica’s Big Blue Buses for six years, paid for at full price, so the walk’s operators were surprised when city officials turned down a bus ad for the 2012 walk, held in October. The city cited a policy against running noncommercial advertising— a policy that had been on the books for several years but had not been enforced. The reason for the policy: If the city accepted ads from one group, it would have to accept them from all, under the First Amendment, and some of them might prove controversial. “Their position is that free
The AIDS Walk Los Angeles’s banned advertisement 48
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WORLD AIDS DAY 2011
It Takes a Village
Six people who are changing the world together
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10 Great Discoveries in 2011
A YEAR OF PROGRESS IN HIV
Seeing one doctor for your HIV and a primary care physician for everything else is becoming a relic of the past—what you need to know about treatment in the 21st century
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BL EBLM>GBG@ The Grammy Award–winning singer and activist reflects on her commitment to fighting AIDS
LA FAMILIA BONITA
Latino families deal with HIV together