HIV Plus Issue 104 January/February 2015 by Pride Media

JANUARY / FEBRUARY 2015

www.hivplusmag.com

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?

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

What are the other possible side effects of STRIBILD?

STRIBILD can cause serious side effects:

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.

• 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 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.

• 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.

What should I tell my healthcare provider before taking STRIBILD? • 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. • If you take hormone-based birth control (pills, patches, rings, shots, etc). • If you take antacids. Take antacids at least 2 hours before or after you take 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. • 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. What is 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. 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

• 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 Who should not take STRIBILD? 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 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. STBC0096 10/14

editor in chief DIANE ANDERSON-MINSHALL art director BONNIE BARRETT copy chief TRUDY RING contributing editors NEAL BROVERMAN, KATIE PEOPLES, MARK S. KING, SUNNIVIE BRYDUM, TODD HEYWOOD, MICHELLE GARCIA assistant editor DANIEL REYNOLDS wellness editor SAM PAGE mental health editor GARY MCCLAIN video correspondent JOSH ROBBINS creative director, digital media DAVE JOHNSON director, digital media SCOTT RAGAN interactive art director CHRISTOPHER HARRITY online photo and graphics producers YANNICK DELVA, MICHAEL LUONG manager, application development ALEX LIM SVP, group publisher JOE VALENTINO

SVP, marketing & brand strategy STEPHEN MURRAY VP, integrated marketing AMANDA JOHNSON senior manager, integrated marketing STEVEN O’BRIEN manager, integrated marketing LAUREN THOMAS coordinator, advertising PAIGE POPDAN coordinator, integrated marketing JOHN MCCOURT art director, integrated marketing CHARLIE FLAUMER senior director, media strategy STEWART NACHT circulation director JEFF LETTIERE fulfillment manager ARGUS GALINDO production services GVM MEDIA SOLUTIONS, LLC advertising production manager HEIDI MEDINA front end developer MAYRA URRUTIA traffic manager KEVIN BISSADA

HERE MEDIA chairman STEPHEN P. JARCHOW ceo PAUL COLICHMAN cfo/coo TONY SHYNGLE executive vice presidents BERNARD ROOK, JOE LANDRY VP, editorial director LUCAS GRINDLEY

senior vice presidents CHRISTIN DENNIS, JOHN MONGIARDO, STEPHEN MURRAY, JOE VALENTINO vice presidents GREG BROSSIA, ERIC BUI, STEVEN CAPONE, JUSTIN GARRETT, LUCAS GRINDLEY, AMANDA JOHNSON

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ADVERTISING & SUBSCRIPTIONS OFFICES 120 West 45th Street, Suite 3800, New York, New York 10036-4041 Phone (212) 242-8100 • Advertising Fax (212) 242-8338 Subscriptions (212) 209-5174 • Subscriptions Fax (212) 242-8338 EDITORIAL OFFICES 10990 Wilshire Blvd., Penthouse Suite, Los Angeles, California 90024 Phone (310) 806-4288 • Fax (310) 806-4268 • Email mail@HIVPlusMag.com DISTRIBUTE HIV PLUS FOR FREE AT YOUR OFFICE OR FACILITY HIV/AIDS service organizations, community-based groups, pharmacies, physicians’ offices, and other qualifying agencies can request bulk copies for free distribution at your office or facility. Log on to HIVPlusMag.com and select “organization copies” on the “subscribe” link at the top of the page to download a copy request form. There is a 10-copy minimum. FREE INDIVIDUAL SUBSCRIPTIONS HIV Plus magazine is now available FREE to individual subscribers. Subscribe and get a digital copy of each magazine delivered to the privacy of your computer six times per year. We require only your email address to initiate delivery. You may also share your copies with friends. To sign up, just log on to HIVPlusMag.com and select “digital edition” on the “subscribe” link at the top of the page. NEED SUBSCRIPTION HELP? If you have any questions or problems with your bulk or individual magazine delivery, 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 © 2015 by Here Publishing Inc. All rights reserved. Printed in the USA. just email our circulation department at Jeff.Lettiere@HereMedia.com. WHAT’S YOUR STORY? We want to hear from you: Email us at editor@HIVPlusMag.com or write us at HIV Plus, 10990 Wilshire Blvd., Penthouse Suite, Los Angeles, CA 90024.

jan /feb 2015

IN THIS ISSUE

JAN | FEB 2015

IN EVERY ISSUE

SPECIAL AFRICAN-AMERICAN ISSUE

7 Buzzworthy

12 Twenty Ways to Live to 100

Miracle yogurt, fossil virus, Alvin Ailey dancers, meth links, and more

Don’t fear: It’s actually easier than you think

17 Phoenix Rising

22 Daily Dose

When treatment as prevention gets personal

A former Christian-music star reinvents his career after his diagnosis

47 Barbershop Diaries

28 We Are Still Here: Black Gay Men

TREATMENT CHRONICLES

29 TOTALLY, TYSON!

This young Louisiana couple won’t fit your stereotypes

43 Ten Symptoms to Never Ignore

Plus: New drugs, early aging, and better sleep

43 Great News for Your Medicine Cabinet

Plus: Facial fillers, coming out, and a new single-dose treatment option

Helping each other battle HIV against the odds

The supermodel turned actor continues to wow us with his HIV activism, modeling, and acting, including the new films, Addicted and Chocolate City

36 Love, HIV, and Hip-Hop Meet music industry vet Maria Davis

29 36

ON THE COVER: TYSON BECKFORD: TAYLOR HILL THIS PAGE: TYSON: HM ANDREW H WALKER

EDITOR’S LETTER

and easier to read. It’s the fi rst of some big changes coming down the pike, so please let us know what you think. Th is is our annual African-American issue, and we couldn’t be happier to have supermodel Tyson Beckford grace the cover. Tyson is a fierce advocate for HIV and AIDS awareness as well as the rights of people who are HIV-positive or LGBT. He lost a family member to AIDS complications

early in the epidemic, and he began advocating for testing, treatment, and research even before he became famous. His focus now is amfAR’s Countdown to a Cure, an initiative that aims to find a cure by 2020. “I think it can be done,” Tyson told me. “We’re very, very close. You can almost feel it, you know? And it brings a smile to my face when I think about it.” (And wow, what a smile it is!) In the issue we also talk about HIV among black gay and bi men, an article partly inspired by several panels at the U.S. Conference on AIDS. Several HIV Plus contributors attended, including Jacob AndersonMinshall, who wrote the feature on page 28; Daniel Reynolds, who talked with Maria Davis about her life after her then-fiancé gave her HIV, for the article on page 36; and Katie Peoples, who was written numerous articles for us on trans women and HIV. We all had the good fortune to hang with Orange Is the New Black star Laverne Cox, who gave an amazing plenary speech on HIV and the marginalization of trans women in research. (Expect to see more on that in our pages soon.) I hope you like this jam-packed issue. Let us know what you think of the changes and look for even more great ones coming this year.

DIANE ANDERSON-MINSHALL EDITOR IN CHIEF | EDITOR@HIVPLUSMAG.COM

A season of great HIV Plus moments (clockwise from left): Hanging with me at the U.S. Conference on AIDS (from left) were contributing editor Katie Peoples, writer Jacob Anderson-Minshall, and OITNB star Laverne Cox, who gave a fantastic speech; editorial assistant Daniel Reynolds talking to Jay-Z and Puffy’s old promoter, Maria Davis, about living with HIV (read his interview on page 36). Plus (bottom) I joined a dozen other HIV experts and gay-dating-app bigwigs (some with HIV-positive founders) in talks at the San Francisco AIDS Foundation to brainstorm ways to promote HIV testing, education, and prevention via our sites and apps.

jan /feb 2015

BRADFORD ROGNE (TOP)

ecause we create the fi rst issue of the year in November, it always gives us a good chance to look back at the year and see what we did right, what we did wrong, and what we just need to do more of. So this year we’re doing a little retooling, thanks to our new art director, Bonnie Barrett. I was thrilled to be reunited with Bonnie, who I fi rst hired in 1998, I think, to work on one of the four magazines we’ve collaborated on. We were practically just kids then (and she was an art geek fresh from the set of the David Letterman show). So this issue is Bonnie’s fi rst step in updating the magazine to be fun, engaging,

BUZZWORTH Y personalized, seminaked selfies for donations over $250. He would tag the name, business, website, or social media handle of any major donor and post it on all of his social media outlets, which have a reach of over 500,000 followers. It worked—donations rolled in. After each selfie was posted on Instagram, even more donors responded. He laughs about how much hard work went into it: “I think there are some people who have permanently blocked my number. I did a lot of direct asking to virtually everyone I know. I hounded people.” Martone Cycling Co. donated bikes, and the gay dating app Scruff paid for the team jerseys. “The Braking AIDS Ride was life-changing in so many ways,” he says. “You create amazing bonds with people when you conquer seemingly insurmountable challenges together. The ride was only 10 days ago and I could barely walk for two days after the ride, but I can’t wait to do it again.” Thankfully, he—and you, if you dare—have nine months to prepare this time.

WOULD YOU RATHER EAT YOGURT OR HAVE A COLONOSCOPY? Yes, it may soon come down to that choice. Massachusetts Institute of Technology bioengineer Sangeeta Bhatia and her research team have engineered a yogurt that is capable of testing for colorectal cancer, Bhatia told MIT Technology Review. Basically a bacteria in the yogurt is modified to interact with tumors and produce nanoparticles that carry biomarkers of cancer. You eat the yogurt, and the nanoparticles are excreted in urine and can be detected using a paper-based antibody test. Injections of the nanoparticles have worked in mice so far, identifying both colorectal cancer and blood clots, but the yogurt is an easier way to get them into the body.

THINKSTOCK (YOGURT)

ONE ACTIVIST GETS CHEEKY AND BREAKS FUNDRAISING RECORDS Athlete, model, and HIV activist Jack Mackenroth broke individual fundraising records in last fall’s Braking AIDS Ride (BrakingAIDSride.org), a three-day, 300-mile bike ride from Boston to New York. Mackenroth raised $47,455, while his 19-person team, dubbed #TheMackPack, raised $128,300 for Housing Works, whose mission is to end the dual crises of homelessness and AIDS through relentless advocacy and the provision of lifesaving services. Mackenroth says, “I made the mistake of speaking before doing my research and I just announced that I was going to raise $50,000 in just seven weeks. I figured that with my massive social media reach I could just put out a few occasional callouts and the donations would come rolling in. Wrong.” After his initial request for funding produced few donations, he began “selling” hivplusmag.com

B UZZWORTHY

“FOSSIL VIRUS” COULD UNEARTH AN HIV CURE Is the key to curing HIV hidden inside our own DNA?

AGE IS NOT A CONDOM The physicians behind HIV-Age.org want your doctors to understand that sex doesn’t end at 50, and neither do sexually transmitted infections. The group cites Centers for Disease Control and Prevention reports that STI diagnoses in people age 65 and older are increasing along the same lines as in the 20-24-year-old age group. Another study showed that among HIV-positive New Yorkers who are 50 or older, nearly 20 percent engage in condomless sex. This is a problem for people with HIV especially, the group notes, because doctors often “do not believe that older adults, and especially older adults with HIV, are sexually active. This failure to engage the older adult, and particularly the older adult living with HIV, in a conversation about sexual health and the need for safe sex practices has consequences, which include the spread of HIV.” HIV-Age.org notes that a landmark 2007 study found that 73 percent of people age 57-64 reported having sex in the previous year, as did 53 percent of those age 64-75 and 26 percent of those age 75-85. It’s one reason HIV-Age.org is supporting “Age Is Not a Condom,” a new social media campaign created by the AIDS Community Research Initiative of America. by Katie Peoples, Trudy Ring, and Diane Anderson-Minshall

FACTOID!

The “Age Is Not a Condom” concept was created by the designer Andy Chen when he was a Fulbright Scholar at the Helen Hamlyn Centre for Design at the Royal College of Art in London, as part of his design project “Imaging Intimacy.”

jan /feb 2015

A team of researchers led by Douglas Nixon, MD, has discovered an antibody that can detect a “fossil virus,” or genetic material that humans no longer use, which resembles HIV-1, the most common strain of HIV. One of the biggest challenges to stopping HIV is its ability to mutate and replicate rapidly. Under normal circumstances, the human body’s immune system can’t keep up with these changes in order to effectively detect, fight, and eliminate HIV from the body. Antiviral vaccines and treatments may boost the immune system but have also failed due to this reason. But a study recently published by Nixon and his team shows there may be a way to get around this difficulty. Their research, supported in part by the Bill and Melinda Gates Foundation, found that T cells formed to target the fossil virus can also simultaneously attack HIV. The fossil virus is called HERV, or human endogenous retrovirus, and the scientists reported that an anti-HERV antibody has the ability to bind to an HIV-infected cell and eliminate the virus. “What we’ve found is an antibody that recognizes these fossil viruses within all our genomes, which can neutralize HIV-1 in a way that has never been seen before,” says Nixon, who chairs the department of microbiology, immunology, and tropical medicine at the George Washington University School of Medicine and Health Sciences. “We have found in vitro, in the test tube, that you can actually have an antibody work against HIV-1, which is not directed against the HIV-1 virus itself.” Since the fossil virus’s envelope, or shape, does not change as quickly as that of the deadly retrovirus, the antibodies also do not have to modify as rapidly to keep up. Scientists believe that HERV’s ability to maintain its outer shell could make it invaluable to developing a new vaccine or therapy Nixon’s team was made up of researchers from several institutions, including George Washington University, the University of California, San Francisco, Oregon Health & Science University, and the University of Rochester. The results were published July 14, 2014 in an article titled “An Antibody Recognizing Ancestral Endogenous Virus Glycoproteins Mediates Antibody Dependent Cellular Cytotoxicity on HIV-1 Infected Cells” in The Journal of Immunology. Their work was funded by the National Institutes of Health, the Bill and Melinda Gates Foundation, the Peter and Shelagh Godsoe Family Foundation, the District of Columbia Developmental Center for AIDS Research, and amfAR, the Foundation for AIDS Research. —Daniel Reynolds

BUZZWORTH Y

COULD MONKEYS LEAD TO A VACCINE? Researchers have discovered a vaccine that blocked simian immunodeficiency virus (HIV’s primate cousin, if you will) among rhesus macaque monkeys. Equally good: It also quickly resuppressed the viral loads of monkeys who already had SIV, according to a report in Frontiers in Immunology. What does it mean for you? Two human safety trials are being developed now, along the way to seeing if the vaccine could have the same impact on humans.

DOES SEATTLE REPRESENT A SEA CHANGE IN HIV CRIMINALIZATION LAWS?

THINKSTOCK (ALL)

In a majority of U.S. states, sex while HIV-positive can result in felony charges, regardless of condom use, type of sex, or viral load Consensual sex can be a felony in a majority of U.S. states—at least for people with HIV. Despite advances in treatment and even HIV-blocking preexposure prophylactic medications, having HIV can still lead to decades in prison even for spitting on a person. But criminalization has created a public health risk, as laws making it a crime to have sex when you know you have HIV have decreased testing rates and increased public misperception of HIV’s risks and methods of transmission. Seattle public health officials went a different route last fall, seeking court-ordered treatment for an HIV-positive man, known only as “AO.” AO is thought to have potentially transmitted HIV to as many as eight sex partners, but he wasn’t prosecuted under a Washington law that makes intentionally infecting someone with HIV a class A felony assault. Intent is hard to prove. Most HIV transmissions occur shortly after the positive partner has acquired the virus and doesn’t even know he or she has it, says Catherine Hanssens, executive director of the Center for HIV Law and Policy. Even in extreme outlying cases like that of AO, who public health officials say knew his positive status, it is difficult to prove whether or not someone disclosed their status before engaging in behaviors that could transmit HIV. Most criminal statutes are based not on actual transmission but on disclosure of status, says Sean Strub, executive director of HIV

advocacy organization Sero Project. That makes it hard for HIVpositive people to defend themselves—it’s their word against the accuser’s. “Some of these people being prosecuted did everything right: They got tested and treated, they used a condom,” says Strub, who is HIV-positive, adding, “What I often say is we’re all one disgruntled ex-partner away from finding ourselves in a courtroom.” For Mark Hunter, it was two disgruntled exes. Born with hemophilia, Hunter acquired HIV through a blood transfusion as a child. Hunter says he told his ex-fiancé about his HIV status when he proposed. When the relationship ended, he briefly dated another woman who he says knew his status from the start. But in 2008, Hunter was arrested while living in Arkansas during grad school, as his ex-girlfriend filed charges five years after their breakup. Neither of his exes contracted HIV. Hunter spent two and a half years in prison under Arkansas’s law that makes “exposing another person to human immunodeficiency virus” a class A felony. Now free, he is pained that he must register as a sex offender, like rapists and child molesters.

“When government wants to cut our funding, HIV is called ‘a manageable illness.’ But when it comes to [criminalization], HIV turns into a ‘deadly disease.’” — Naimah O’Neal, AIDS Taskforce of Greater Cleveland Even if one of Hunter’s former partners had tested HIVpositive, it would be difficult for the state to prove exactly where she had acquired it. “When you hear reports that allege someone infected seven or eight people, well, the science is just not there to track that,” Hanssens says. She is relieved to see some policies, as in Seattle, move away from criminalization and toward public health solutions. In June the Justice Department advised states to limit the use of HIVspecific criminal statutes, and Congresswoman Barbara Lee has sought, although unsuccessfully, to repeal them. Strub, however, sees increased stigma of HIV-positive people. With medications allowing them to live long, healthy lives, “people with HIV started to be seen as an inherent threat to society, as viral vectors and potential infectors, because we were going to be around longer,” he says. “Most people with HIV think the stigma now is worse than it’s ever been,” he adds. “We haven’t spent much effort on combating stigma. You can increase awareness of the epidemic and increase stigma and fear at the same time.” —Mary Emily O’Hara hivplusmag.com

BUZZWORTHY

THE LINK BETWEEN METH AND HIV

Alysia and her father

EDITOR’S PICK: COOLEST NEW WEBSITE

ALVIN AILEY, MARRIAGE EQUALITY, AND WORLD AIDS DAY World AIDS Day 2014, December 1, marks the 25th anniversary of the great choreographer Alvin Ailey’s death from complications of the disease. December is notable for other reasons, though, as the troupe he founded, the Alvin Ailey American Dance Theater, will begin its New York City Center season December 3 and feature the company’s first married gay couple—dancers Antonio and Kirven Douthit-Boyd, who wed in July 2013. The December 18 performance benefits Dancers Responding to AIDS. After the New York season ends January 4, from February through May, the dance troupe will be on an 18-city U.S. tour; visit AlvinAiley.org to find a venue near you. President Obama has recognized Alvin Ailey’s contributions to dance and civil rights by posthumously awarding him the Presidential Medal of Freedom, the nation’s highest civilian honor. The company’s artistic director, Robert Battle, accepted the medal at a White House ceremony November 24.

ANDREW ECCLES (DANCERS), ELLYXANDRIA FERGUSON (WEDDING); ALYSSA, COURTESY ALYSSA ABBOT

Whitney Joiner, the senior features editor at Marie Claire magazine, and Alysia Abbott, the author of Fairyland, A Memoir of My Father, are great friends and, with their publishing cred, the epitome of New York cool girls. They have something else in common: They both lost their fathers to AIDS in 1992. Abbott’s father was an out gay man, living in San Francisco; Joiner’s dad was closeted in suburban Kentucky. “Until meeting each other, we didn’t really know anyone else who could understand and relate to our experience,” the women write on their new website, TheRecollectors.com. “But considering that 650,000 people have died of AIDS in the U.S. since the advent of the crisis, we knew we couldn’t be the only ones.” The Recollectors is a storytelling site and community for the kids who have lost their parents to AIDS. Because of the stigma around the disease, many have never shared their stories before. Silent no more: The Recollectors brings these (now adult) kids together to share in a modern mash-up of memoir and history, like a wonderfully evocative narrative version of the AIDS Memorial Quilt.

A new Australian study draws a possible link between methamphetamine use and rising HIV infection rates among gay men. According to a report by Tammy Mills at The Age, physician Beng Eu at Melbourne’s Prahran Market Clinic surveyed 211 of its gay male patients and found that 31 percent had HIV, and of those, 84 percent had used meth in the past month and believed their drug use contributed to their diagnosis. Eu believes his study shows that more research must be done on the link between meth use and HIV infection rates, which are at a 20-year-high in Australia, and points out that in addition to increased HIV rates, the incidence of syphilis and deaths caused by hepatitis C have also gone up, which Eu speculates could be linked to a larger problem of risky sexual behavior due to meth use, though no studies have been conducted yet.

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Antonio Douthit-Boyd (left) and Kirven Douthit-Boyd on and off the stage

BUZZWORTH Y

FIVE WAYS TO SURVIVE GRIEF

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When Jamie Turndorf, Ph.D., known to millions of radio and TV fans as “Dr. Love,” lost her husband, the author of Kiss Your Fights Good-bye turned to the spirit world to find him. She details the process in her new book, Love Never Dies: How to Reconnect and Make Peace with the Deceased (Hay House). Here are a few tips we picked up about dealing with a loss.

Learn to be grateful. We cannot appreciate the light if we never see the darkness. Similarly, how can we know joy except by contrast? When we suffer, we’re being taught to appreciate the simple gratitude that comes when the pain stops. Remember, we can’t appreciate light without living in the dark.

Know you’ll get what you need. We aren’t supposed to whiteknuckle our way through life. When we have a hard time, we’re supposed to open our hearts, eyes, and ears and decipher what this hard time is teaching us. We are given exactly what we need in order to complete our spiritual development.

Don’t drown your sorrows. Many people try to defuse their anxieties by becoming workaholics, shopaholics, and/or alcoholics. Millions more resort to unhealthy or excessive sex, eating, drug use, gambling, and even hobbies. While these sorts of activities may permit us to temporarily escape unpleasant feelings, their long-term effects can be debilitating if not disastrous. More to the point, they block receptivity.

Surrender control. When we’re smacked by the tsunamis of life, we’re being asked to bow to forces greater than ourselves. Physical and emotional suffering, including grief, serve to break down our defenses. When sorrowful things happen, we can either become bitter and petulant or view these trials as the gift that brings us closer to God and the spirit realm. It is said that the heart must be broken again and again in order to finally be opened.

Take your emotional muscles to the gym. Flex your emotional muscles and train yourself to tolerate all your feelings—positive and negative alike. Approach it like training at the gym. When you first start a new regimen, your muscles are weak and you can’t bear a lot of weight. But with time and practice, your muscles develop. You become stronger and can bear more and more weight. The psyche works in much the same way. ✜ hivplusmag.com

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An HIV diagnosis was once a death sentence, but that is no longer the case for those who stay healthy. In fact, the average HIV-positive person today is expected to live to be nearly 80, roughly on par with the general population. As more and more people reach the century mark, here’s a list of the best things you can do— besides adhering to your medication regimen—that’ll help you have a long, healthy, happy life.

Michelle Garcia and Diane Anderson-Minshall 1. Get married…or at least partnered

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2. Beat Back the Blues Even when things don’t seem like they’re going your way, looking at things with a positive attitude may be enough to help you get through a tough situation, and even live longer. One study indicated that people in their 20s who used mostly positive, affirmative words to describe themselves were more likely to live into their 80s than those with negative outlooks. Additionally, people with a more positive view of life tend to have fewer strokes, coronary problems, injuries, and colds, and positive-thinking women have healthier pregnancies.

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OK, singletons, don’t hate us for saying this, but a good marriage will extend your life (a bad marriage, one with violence or emotional upheaval, will not, of course, so it has to be a good, solid relationship). A widely reported Harvard University study found that married women were 20 percent less likely than single women to die of stress-related health problems, including cirrhosis of the liver, suicide, and heart disease. And married men were 100 to 200 percent less likely than unmarried men to do so. If that doesn’t convince you, researchers Corinne Reczek and Hui Liu, of the University of Cincinnati and Michigan State University, respectively, analyzed national health data for nearly 200,000 people over a seven-year span and found that the rate of mortality among men in cohabiting relationships dropped by 80 percent, while the rate dropped 59 percent for women. According to Karen Sherman, author of Marriage Magic! Find It, Keep It, & Make It Last, when a happily married person undergoes heart bypass surgery, he or she is three times more likely than a single person to still be alive 15 years later. She told Utah’s Deseret News that additional studies have indicated that married couples experience lower levels of heart disease, cancers, flu, Alzheimer’s, depression, and stress.

5. Listen to Your Inner Music

Loss of brain function is often a difficult side effect of both HIV and aging. Galina Mindlin, MD, coauthor of Your Playlist Can Change Your Life, has created Brain Music Therapy, a method of converting a person’s brain waves into music to help them concentrate, sleep, and deal with stress or depression. But, says Mindlin, your medulla oblongata doesn’t need to be the next Mozart to benefit from music. Any song from your playlist that calms you, be it Kanye West, Ozzy Osbourne, or Native American flute solos, can help you rewire your brain and change your behavior in as little as two weeks if you play it twice a day for five minutes.

6. Keep Getting in the Action 3. Nurture Your Gut The lymphoid tissues in a person’s stomach are filled with T cells. Because HIV affects T cells, many people with HIV have gastrointestinal problems, but a healthy GI tract is crucial to proper absorption of antiretroviral medication. Some HIV meds need to be taken with food to assure this absorption and avoid potential side effects such as diarrhea. Many HIV-positive folks could also benefit from probiotics and a high-fiber diet, says Brian Risley, the manager for treatment education at AIDS Project Los Angeles.

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4. Shake Your Groove Thing

Exercise helps control your weight, fights cardiovascular disease, and lets you look fantastic in an old pair of jeans, but it can also help boost your T cells. APLA’s Risley says some studies have shown that moderate activity, even in short bursts, spurs an uptick in T-cell counts, even when it doesn’t have a serious effect on viral load. Exercise can also help you feel better between your ears. Says psychotherapist Melissa Lopez: “Exercise is beneficial because we produce hormones that help calm us down when we exercise.” According to the Mayo Clinic, most people should aim for at least 30 minutes of physical activity each day. “Walk, go to the gym, dance around your house,” Lopez adds. “Anything is good, as long as it makes you feel good.”

Orgasms can be wonder drugs in themselves: They help you sleep, boost your immunoglobulin levels (which fight infections), and reduce stress and depression. So get it on once or twice a week, just don’t forget to play safe.

7. Break Up With Facebook— and Your Phone, or at least give them a time out once a week

Smartphones can be lifesavers, and with most of us glued to ours, it’s not easy to imagine leaving it off for a whole day. The same for social media. But experts argue that when you see work-related emails on your phone during off hours, it causes higher levels of stress. Moreover, in a MeQuilibrium study, over 60 percent of those surveyed reported feeling jealous, depressed, or even annoyed after checking social media updates, and three out of five people admitted to spending more of their free time

9. Kick the Habit for Good

It’s common knowledge that cigarettes are bad for everyone, but an estimated 60 percent of deaths among people with HIV are associated with smoking. ‘“In the beginning, when people had an AIDS diagnosis and they were given eight to 16 months to live, we overlooked their smoking habit,” Risley says. As people are living longer, it’s important to remember that smoking may cause mitochondrial infections; mitochondria are an energy-producing feature of human cells. Also, some people with HIV have a heightened susceptibility to cardiovascular disease, and smoking compounds that risk. Plus, of course, there’s smoking’s association with lung cancer.

8. Make Friends — Not Just the Online Kind

Having strong relationships with other people can be a matter of life or death. A review by Brigham Young University of existing research on the topic found that people with weak social connections were 50 percent more likely to die in the research’s follow-up period (an average of 7.5 years) than their peers with strong social bonds. To fight feelings of loneliness, Lopez encourages joining support groups for people with HIV or finding friends or family members you can depend on to let you vent to every once in a while. “Do not isolate yourself, and don’t make [HIV] a secret,” she says. “I always think that clients, no matter how long they’ve been living with HIV, should find other people to talk to.”

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10. Take Your Vitamins and Minerals, Especially Zinc

Many doctors recommend their patients take a general multivitamin to supplement their diet, but people with HIV can also benefit from supplements like zinc, a mineral that can get used up and lost in the urine if a person has chronic infections or inflammation. Jacob Teitelbaum, author of The Fatigue and Fibromyalgia Solution, says zinc deficiency is often so severe in people with AIDS that it can “account for many, if not most, of the immune dysfunction seen early in the illness.” Other helpful supplements include selenium, which has been shown to boost immunity in people with HIV while suppressing the level of virus in the body, vitamin D and calcium for bone health, and iron to fight anemia, especially for menstruating women. Still, those with HIV should also be wary of some supplements that might have adverse interactions with antiretroviral treatment. Risley notes that Saint-John’s-wort, for example, does not mix well with antiretrovirals or some other drugs, like statins, which lower one’s cholesterol. Talk with your doctor, then take your Flintstones.

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on their computers than with their significant others. But if you turn that all off, you’re excising that external stress from your life, at least for the day. If that’s not incentive enough, some doctors still argue that carrying your mobile near your body raises your risk of some cancers because of the radiation it emits (limited studies have found some association, but more research is needed, according to the National Cancer Institute). “Most of us have no idea that cell phones are small microwave radios that should not be kept directly on the body,” epidemiologist Devra Davis wrote in a commentary piece for the Environmental Health Trust’s website. She further noted, “The iPhone 4 manual, for example, says that if the phone is kept in the pocket, ‘FCC guidelines for safe exposure can be exceeded,’ and that ‘users are responsible for protecting themselves.’ ” For safe usage, carry your phone off your person, especially in the case of pregnant women or young children, and use a speaker or wireless handset for calls.

host of Travel Channel’s American Grilled and chef-owner of Bayou Bakery, a New Orleans-inspired bakery and café in downtown Arlington, Va., and Lauren Mauro, hematologist and oncologist at GW, gave a good intro to a neutropenic diet with some guidelines. Download their cookbook, aimed in part at people with HIV here: http://bit.ly/105AugM.

13. Hose Down Your Food First

11. Get Testy

Even if thinking about all the hands that have touched your produce from the farm to your table doesn’t give you the willies, Risley suggests using a fruit- and vegetable-specific spray to clean raw produce. Even better, you can make your own veggie wash, one part vinegar to three parts water. Guas advises that you wash fruits and veggies in cold, clean tap water—what could be simpler? Don’t forget Guas’s other tip: Chilling meat on ice while preparing your meal can deter unwanted bacterial growth.

People tend to experience a drop in testosterone levels once they advance past the age of 50, but HIV can also lead to a sharper drop in the hormone. Constant fatigue can be an indication that the virus is affecting your testosterone. While some doctors may write you off as just being tired from having the virus, Risley says both men and women should insist on being tested for chronic testosterone loss if fatigue is a persistent problem. If your levels are low, you and your doctor may want to consider testosterone replacement therapy to help you stay alert.

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12. Skip the Sushi

When your T-cell count goes below 200, you become more susceptible to bacterial infections. Risley suggests avoiding raw foods like sushi or oysters, which may contain fungi or bacteria. You should also avoid soft cheeses made from unpasteurized milk (Brie, Camembert) and any with mold (Roquefort or other blue cheeses). All meats should be well cooked, and leftovers should be refrigerated immediately or tossed out. Risley also suggests the same cooking method for those who use medicinal marijuana. ‘‘I’ve heard a few doctors who tell their patients who smoke marijuana to nuke it in the microwave for 30 seconds,’’ he says. ‘‘That kills a lot of the trace bacteria or fungus that may remain on the plant.’’ You can even consider a neutropenic diet, often prescribed to anyone with a weakened immune system to help reduce the risk of infection by protecting you from bacteria and other harmful organisms found in some food and drinks. Epicure With the Chef MDs, the award-winning Web series hosted by former Food Network star Marc Silverstein, pairs Washington, D.C.’s famous chefs with specialists and physicians from the George Wa s h i n g t o n Medical Faculty Associates to create simple, healthy recipes. In a recent episode, David Guas,

14. Build Your Own Dream Team

Not everyone can afford a team of celebrity doctors, personal chefs, and expensive therapists, but most folks with HIV have access to qualified professionals at local HIV clinics and organizations. Consider talking to a nutritionist to find out which foods are right for your needs as well as seeing a qualified counselor to determine a plan to strengthen your mental health. While professionals at private practices may be unaffordable for some people, many offer a sliding fee scale, with the fee based on what you can afford to pay. Don’t be afraid to ask.

15. Consider Personalized Meds

One of the burgeoning trends in the medical field is personalized medicine for a patient based on their demographic information and genes. ‘‘We’re going to have a lot more genetic tests for people to specifically tailor medication,’’ Risley says. ‘‘We just assume that if you take this one particular medication, your body will absorb it, but not everyone has the same absorption capabilities.’’ While genetically tailored treatment is not widespread, it may be soon. Talk to your doctor about developments regarding ailments such as depression, colorectal cancer, and chronic obstructive pulmonary disease. hivplusmag.com

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at a time when you may feel especially lonely, and it comes in a furry package of unconditional love. According to Labdoor, one study showed that patients experienced a 37 percent reduction in anxiety if they spent time with animals before having medical procedures, so consider cuddling up with Fido before your next trip to the doc.

19. Have a Glass of Wine

Depression, stress, and anxiety are tough for people to overcome, but these conditions can also harm your immune system. Lopez works with her HIV-positive patients to develop a plan once their moods start to sour. ‘‘When you’re already working with a compromised immune system, pre-depression or anxiety can bring on a lack of motivation,’’ she says, which can lead to people slacking off on their meds. Lopez suggests finding a professional counselor, especially when you’re first diagnosed with HIV, to form a plan to deal with anxiety, depression, or other negative feelings. “Know the symptoms of depression, know the symptoms of anxiety, so you know what’s happening to you,’’ she says. ‘‘You have to be proactive to prevent another, deeper cycle of depression.’’ Lopez also suggests doing some research to assure that a potential therapist has some understanding of HIV and AIDS, and any community or culture that you may also identify with, like Asian, African-American, Latino, or LGBT.

17. Have a Little Faith

No matter if you worship in a cathedral, a temple, a teepee, or on the sofa, most physicians believe that some form of spirituality can help people better cope with their health problems. Religion can also help you build their social circle and feel generally more positive. Don’t believe in a higher power?

18. Adopt a Dog

They’re cute and cuddly and cost a lot less than having a baby with only two legs. Even better, people who have pets have been shown to have less stress and anxiety, lower blood pressure and cortisol levels, fewer sick days, and longer lives. For people disabled by HIV, dogs (and cats—really, any pet, though we have a soft spot for dogs) can help you feel less alone in the world,

20. Find a Way to Laugh More

Go to comedy clubs, watch TV sitcoms, pop in a funny movie— any of it helps manage your stress and improves your health, according to research studies. One such study indicated that people who had watched a funny movie had lower levels of the salivary endocrinological stress marker chromogranin A (CgA). Researchers Masahiro Toda and Hiroe Ichikawa report that salivary CgA measurement is becoming an established means of evaluating stress: “Since fibers of the parasympathetic nervous system also innervate the salivary glands and stimulate salivary flow rates, it has also been suggested that salivary flow rates may reflect stress reactions.” The subjects in their study also reported a “feeling of being uplifted and fulfilled.” What’s it all mean? According to spit science, if you have a good laugh, you will have less stress and possibly be fulfilled and uplifted. ✜

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16. Keep Your Head in the Game

Yes, drinking to excess is bad for you, and if you have substance issues, by all means, don’t pick up that bottle. But for the rest of us, drinking one glass of red wine each day has a health benefit that can indeed help you live longer. ( Just ask the family of Jeanne Calment, once on record as the oldest living woman— she died at age 122. Turns out, ol’ Jeanne drank exactly one glass of wine daily all her adult life.) How does it help? Red wine contains polyphenols, antioxidants that also help maintain the elasticity of your artery walls, making for a healthier heart.

LIKE A PHOENIX RISING By Diane Anderson-Minshall

For nearly a decade, Byron Keith was a star in the contemporary Christian music scene—during the industry’s heyday in Nashville—with tens of thousands of fans in the U.S. and abroad. He toured the world, released eight albums, got married, had children, and then came a public divorce and outing as a gay man. He disappeared in 2005, but to the excitement of his die-hard fans, he reappeared in 2012 with new music—this time in the Americana folk fusion genre—and a new moniker, Byron Rice. We chat with Rice about his life, his new album (out early this year), and being a poz performer.

Tell me about going on hiatus. My wife and I had been working through the process of [divorce] and my obligations as a Christian country artist. Unfortunately, my accountability pastor decided to spread the word, and so it was a hard last year between us. So, between being told I wasn’t a man of God anymore, and that I wasn’t welcome at a lot of churches because I’d gotten divorced—they didn’t even know I was also dealing with the fact that I was gay, and we were trying to deal with that issue as well—it was definitely a hard time. I just basically didn’t have anything relevant to say anymore, because I’d been beaten down by so many people. That must have been tough for your wife as well. Yeah. We spent two years really going through the process of making sure that was what we wanted. We have two daughters, so we wanted to make sure that they were of the appropriate age too, for us to separate—so that they could understand what was going on. She and I are good friends, so that helps the process a lot. You acted while on hiatus, but, ironically, when you did the musical Rent, which is about HIV and AIDS, a costar found out you were HIV-positive and had some objections to touching you.

Correct. That kind of put me back in a spiral. I felt basically, right back in the same place I was when I left the Christian music industry. I felt I didn’t have a place to fit now in the acting community. Through that, I kind of started to write a lot more. And then I met my best friend, good friend, Kevin Garrett, who also is my manager. He had a studio and wanted to start putting an album together. I had already written a few songs, so we started putting some songs together and it wound up becoming an album. You’ve been working through Kevin’s label and now you’re signing with a major label, Warner Nashville, to re-release Lost in the Woods. Does the title allude to how you felt? For me, Lost in the Woods is about [when] I had to go and find my space, my spiritual space, and my own personal space. My friend had invited me out to an event in the woods here in Tennessee with a group of very loving hippies. And through that experience and sharing music and all of that, it was the beginning steps of me starting to come back to realizing that I had a lot more to say. That I was relevant and that I did have something that was about my life experience that would help other people. Continued on page 48 hivplusmag.com

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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

DAILY DOSE

FREE AT LAST One HIV-positive man finds something deeply profound and very personal about the findings of two recent treatment studies

recent years, two remarkable studies have emerged that provide real solutions for people living with HIV who want to avoid passing the virus on to others. In 2011 findings from the HIV Prevention Trials Network’s 052 study provided evidence that when someone living with HIV takes their medications every day, it drastically decreases the chance of infecting someone else. In the trial, researchers found that the risk of transmission was reduced by 96 percent or possibly even more when the HIV-positive partner had a level of HIV in their blood that was “undetectable”—or so low that it can’t easily be measured. However, HPTN 052 focused almost exclusively on heterosexual couples, so it was momentous when earlier this year the PARTNER study in Europe announced similarly optimistic preliminary results for gay men. In that study so far, no new infections occurred in gay couples where the HIV- positive partner had an undetectable viral load. Having grappled with my own HIV diagnosis over the past seven years and my fears of giving the virus to someone else, there has been something deeply profound and very personal about the findings of both studies. Ever since the HPTN 052 results were released, I’ve often pondered if my transition into living life with HIV might have been less traumatic had I known that treatment would help me avoid passing HIV on to my sexual partners.

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When, like far too many gay men, I tested positive for HIV in 2008, I found myself deeply concerned about how it might hinder my ability to connect to others both physically and emotionally. In many ways, I suddenly saw myself as a vector of disease, and I wondered if the fear and stigma around my HIV would leave me isolated and alone. While I soon found that sex was still possible and that many gay men had found a way to make peace with the virus, the stigma and my uncertainties about the risk of transmission ensured that negotiating sex was always fraught with fear and worry. Although I consistently disclosed my HIV status to men I had sex with, I could never be certain how the person across from me might react. Too many times, disclosure of my HIV status was met with unexpected and deeply painful verbal abuse. Actually having sex presented even more challenges. Although I desperately did not want to pass the virus on, I found it as difficult as ever to negotiate condom use. In retrospect, I suppose it makes sense; condoms had been a tremendous challenge prior to my diagnosis, so expecting perfect adherence afterward seems almost silly. Still, the struggle tore me apart, and I found myself frequently in an ethically challenging space where my sexual partners knew I had HIV but decided to not use condoms as long as we minimized risk by having me as the bottom. Although all condomless sex was completely consensual, I found myself filled with shame and guilt after each experience—unsure what my responsibilities were as an

THINKSTOCK

By Jeremiah Johnson

DAILY DOSE

HIV-positive man having sex, unsure of what the real risks were for my sexual partners, and very unsure that I could ever find a way to make condoms work. Coming from this dark and confusing space, I can say that the emergence of these recent studies and the removal of uncertainties around my risk of infecting others has been nothing short of miraculous for my mental health. Having maintained an undetectable viral load since 2009, I can finally say with confidence that I have most likely never passed the virus to anybody else. I am also able to more freely connect with other gay men, regardless of HIV status, and leave my fears behind. My hope is that other gay men, whether positive or negative, will also find a way to escape their HIV-related fears, and that communities that have found themselves divided by HIV status may finally find healing. However, hopeful as they are, these studies have also led to their own share of controversy, and many have debated if doctors should advise HIV-positive individuals to begin treatment earlier in light of these findings. So-called treatment as prevention, or TasP, strategies have emerged to try to get far more people living with HIV on treatment as soon as possible in order to protect their sexual and drug-using partners. Such tactics have been both heralded as hope for finally ending the AIDS epidemic and denounced as pushing people on to early treatment when it might not be necessary or beneficial for their health. TasP may be hopeful for many people living with HIV, much as it has been for me. I imagine that many, but not all, HIV-positive individuals will choose TasP and early treatment as a way to protect others if they are given the option. However, as I see the drive for increased treatment pressing forward, I am reminded of how

â&#x20AC;&#x153;Living life with HIV might have been less traumatic had I known that treatment would help me avoid passing HIV on to my sexual partners.â&#x20AC;?

difficult it was for me to start medications and how important it was that the decision to begin treatment was entirely my own. Hearing public health officials and fellow advocates debate the merits of TasP and early treatment, I find myself praying that the policies we build and the messages we create will construct a more hopeful reality for others living with the virus, where they can finally have the peace of mind that TasP brings without ever feeling forced to take medications before they are ready. It has been a long journey to feel so free and so safe as a gay man living with HIV. I sincerely hope others are now able to find a shorter path to happiness. â&#x153;&#x153; Jeremiah Johnson is the HIV prevention research and policy coordinator for Treatment Action Group, an independent research and policy think tank fighting for better treatment, a vaccine, and a cure for AIDS. hivplusmag.com

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MARC BAPTISTE

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Tyson Beckford

was 12 years old when he straddled his first motorcycle. Little did he know that a couple decades later he’d be riding a hog across the country, raising money and awareness for an HIV cure. Growing up in Harlem by way of Jamaica, the multiracial Beckford later made fashion history in the 1990s as the first black male supermodel. (The Source magazine found him; Ralph Lauren brought him to fame.) Growing up he was teased for the uniquely good looks he inherited from his father, Lloyd Beckford, a Jamaican of Panamanian descent, and his mother, Hillary Dixon Hall, who was Chinese Jamaican, but like Naomi Campbell (who is also black and Chinese), he proved those childhood bullies were way off base. Now the 43-year-old model, activist, and TV personality—he was cohost of Bravo’s Make Me a Supermodel, among other gigs—is turning heads as an actor. He costarred in the indie hit Addicted and has a slew of other movies on their way to theaters. Most anticipated—the black strip-club film Chocolate City, from which leaked test shots have been making the Internet rounds since October, reminding everyone that the man who has made lists including VH1’s 40 Hottest Hotties of the ’90s and People’s Most Beautiful has never looked better. Not bad for a guy old enough to have a son, Jordan, who appears on his own reality show, Candy Girls. You’ve done the Kiehl’s LifeRide for amfAR several times. What’s that event like for you? It’s not so much an event. It’s more like hanging out with your family and riding a motorcycle. It’s fun. And then the last day, it’s so, so emotional. You know what I mean? It’s more draining than the ride itself, because it’s the day that you go and read the names,

and that’s the date you’re getting ready to say goodbye to all of the other riders. You’re reading the names of people who’ve died of AIDS complications? Yes. That’s the most emotional part of the whole ride. Have you ever lost anybody in your life? Oh, yeah. I lost my cousin. She was a nurse. She was taking care of someone with HIV, and as they were cleaning up the sheets she got pricked by a needle. That was it for her. It was very rapid—within six months. Was that before they had PEP? Yeah, long before they had PEP and before they even knew what they were dealing with. The black community is among the hardest hit by HIV and AIDS. These diseases, they don’t pick a color. They just impact whoever they want, you know? It’s just sad. Let’s face it. You’re sexy as hell. You’re a supermodel and your personal brand is about ﬁtness and vitality. Has anyone ever cautioned you against aligning yourself with a cause like HIV? No, never. Long before I was known to the world as anybody, I always was a strong believer in the gay community and a big supporter of finding a cure for HIV and breast cancer. I just do things that I think are morally right. I don’t really pay any attention to anyone saying any negative stuff. And they wouldn’t, because they see how passionate I am for it. hivplusmag.com

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AmfAR’s goal is to cure HIV by 2020. Do you think this is possible? Yes. There are some cases of people being cured already. They don’t want to make a big deal out of it yet, ’cause you still got to monitor and see if it really is working. I think it can be done. We’re very, very close. You can almost feel it, you know? And it brings a smile to my face when I think about it. I just came from the U.S. Conference on AIDS, and there were a lot of people talking about how misinformation is increasing the HIV rate in the South. I was just telling my girlfriend about how bad it is in Atlanta. It’s gotten really bad there. We definitely got to learn to be safe and to just keep pushing to find this cure. It’s sad to say, we’re going to lose some people on the way to this. But we can’t stop what we’re doing to raise awareness and funds for the cure, because we’re really close. What was your ﬁrst HIV test like? Were you nervous? I wouldn’t say it was scary. You want to know, you know? [And after it was over] it was like, OK, that’s it? There’s all this anxiety and then you’re like, it’s just a blood test. Yeah, exactly. So it’s good to go and know. It was painless. I mean, besides the little prick. That was it. You’re in the fashion industry, which is fast, stressful, and not always healthy. How do you stay healthy? I work out. I take my time and do what I do. I don’t let that industry control who I am. I see a lot of times where people have gotten caught up in the industry and gotten themselves into trouble drinking, taking drugs, partying too hard. I don’t. I choose when I want to go out, and I choose if I want to drink or not. You just can’t let yourself get caught up in it, because you do have to look good. You’re not looking good if you’ve been out drinking all the time. Does the men’s fashion industry deal with the same kind of body dysmorphia and body image issues as women’s fashion? No, not as far as the men going to the bathroom and throwing up and stuff like that. We don’t do that. We just go to the gym. A man’s body gets in top shape quicker than women do. It’s hard for us to really not be in shape for something. That kind of makes me hate you. [Laughs] No, I mean we have more muscle mass. So when we go running or play basketball or do something active—skateboarding, cycling—it drops off quicker. So for me, I’m always maybe a few days or one week away from being as shredded as I want to be. If I know I got something coming up, like a naked shoot, I know how much time

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2011 Kiehl’s LifeRide for amfAR finale I need to get right for that shoot. Once you know the formula for your body and how it works, it’s so easy to jump right back in it. But I imagine you never really let yourself go. Yeah, that’s true. You never really let yourself go. You’ve got a couple of ﬁlm projects coming up. Yeah, Addicted is out now. I just got the numbers for that. We made $16.5 million as of Monday. And then we have Chocolate City getting ready to come out soon. We might enter it into Sundance, so we hope it gets in. And then there’s another film, called No Black Girls, Please. That was the working title, but I think the title now is Supermodel. And that’s another one that was being filmed to go to the Sundance Film Festival this year. So I might have two films in Sundance this year, which is almost unheard of at this point. Which of those was your favorite to ﬁlm? I enjoyed filming Chocolate City more than I enjoyed filming for No Black Girls, Please, because Chocolate City was a dancing movie, and I’ve never done anything like that before. And as we speak now, I hear they’re writing part 2. Last week they had a screening and the fans went crazy for it. Tell me a little bit about your role in that. I play this aging stripper who’s upset—he’s the head guy at that strip club, and he’s been the breadwinner there for many years, and this new kid comes in, a younger guy [Robert Ri’chard from Coach Carter], and he starts to steal his shine. My character doesn’t like it. He gets jealous, and he starts to become the mean asshole of the strip club, and everybody hates him. He’s a great actor, Robert. Yeah, he left Hollywood for a while. He said he was done with it, but then a great film like this brought him back into the business. It’s good to see him back again. When this movie comes out, are they going to start calling it the black Magic Mike? I hate when people use that reference, because it’s totally about a different kind of experience. Black strip clubs and white strip clubs are totally different. There’s more performance, more energy in a black strip club than there is a white one because the bodies are a little bit more ripped, and the girls have bigger, you know, it’s more so about the butt in black strip clubs than it is about the top, for women. It’s about how big they are down there: how they shake, how they move, how they gyrate. It’s a different experience. I don’t want to say it’s more rhythm-driven, but it is a

LARRY BUSACCA/GE T T Y IMAGES FOR MONTBLANC; CINDY ORD/GE T T Y IMAGES

With Rosario Dawson at Montblanc Celebrates 90 Years

With Laverne Cox at the amfAR Inspiration Gala little bit more rhythm-driven. There’s a lot more acrobatic stuff in a black strip club.… They allow you more to touch in black strip clubs. There was a underground lesbian strip club in L.A. that a woman spent several years making a documentary about. Yeah, you’re talking about…ah, been there a few times. Yes, Shakedown. They only let in a certain amount of men. I was there in the heyday of it. You’ve made so many lists, like VH1’s 40 Hottest Hotties of the ’90s or People’s Most Beautiful list. What does that kind of thing mean to you nowadays? It’s cool, and it brings people who don’t know about you to know about you. It also links back to some of the things you stand up for: amfAR, breast cancer, all the different things. It brings awareness to that when they give you those things. When you’re in People magazine’s Most Beautiful, or one year I was the most beautiful bearded man of whatever year that was, that was cool. People then tend to say, “OK, let me see what this person is about.” It brings you more fans, so it’s cool.

DIMITRIOS KAMBOURIS/GE T T Y IMAGES; ANDREW H. WALKER/GE T T Y IMAGES FOR H&M

How important have your gay fans been throughout your career? They’ve been very supportive of everything that I do, because they know that I support them. So they definitely supported me all the way through fashion. We brought in some gays and lesbians into the filming of Chocolate City because strip clubs have all different audiences. They don’t separate. We allow everyone to come to strip clubs, so that was very important that we had a table full of guys, a table full of girls. We wanted to show equality when we were making that movie. If you go into these clubs, you see all different kinds of people. It’s not just for women. It’s not just for men. You’ve done a number of HIV fundraisers, like LifeRide and Move Against AIDS, and you’re an ambassador for Kick4Life. Why are these causes important to you, as opposed to the millions of others you could be involved with? I try to do things that reflect me and are close to me and something that I also get out of it. I get the experience of meeting new people. And Kick4Life is a soccer organization [for kids], so it’s a lot of fun for me, because I love to play soccer. I try to do as many as I can that I feel connect with me. What’s the most important thing you hope to achieve with your activism? The most important thing that we’re trying to achieve is raising awareness. If it’s AIDS, HIV, breast cancer, cancer in and of itself, I’m always trying to push to raise awareness and to help find a cure. ✜ At the Alexander Wang X H&M launch at New York Fashion Week in October

is profoundly alienating,” says Charles Stephens in front of a packed audience. The founder of the Counter Narrative Project was at the 18th Annual United States Conference on AIDS and once again trying to explain what it’s truly like—as opposed to how the media portrays it—to be black and gay and HIV-positive. Later, Stephens elaborates, telling HIV Plus, “As black gay men, more often than not, we are denied a history, denied a culture, and often represented in the most narrow and simplistic forms. We are robbed of our lovely complexity far too often in mainstream culture, and that is in itself a form of violence. To strip someone of their complexity is to strip them of their humanity.” While LGBT folks celebrate the newfound acceptance they feel

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with the progress of marriage equality, others aren’t experiencing the same euphoria. Several of the remaining anti–marriage equality holdouts are states in the Deep South, where many black LGBT people still find themselves ostracized by both their spiritual communities and biological families. Even when they couldn’t rely on the government or society as a whole, black folks had always been able to count on their churches and their families. Leo Moore, MD, an internal medicine resident at the Yale University School of Medicine, spoke at the conference about the pain black gay men experience when “our families—our biological families—abandon us.” Then there’s the broader LGBT population: “Imagine being a black gay man and coming ‘home’ into a place where you assume that you will be accepted,” Stephens says, and instead, you’re left

VSTOCK LLC/THINKSTOCK

“The black gay male experience

“enduring deliberate marginalization, silencing, and dismissal. We think about these spaces—Castro, Chelsea, Midtown Atlanta—as being revolutionary and almost utopian. But we forget, for many black gay men, particularly in the ’70s and early ’80s, the racism they experienced, being denied entry into clubs and bars, for example, [and] the minimization of black gay art and literature.” Although things have gotten better through the years, Stephens acknowledges, “I’m also very aware of the racism that exists today within LGBT institutions. It’s a conversation we must be courageous enough to keep having.” The alienation many black gay men feel after being rejected by multiple communities often leaves them with only each other to rely on—especially if they also have HIV. Keith Green, a well-known spoken word artist, HIV activist, and former director of federal affairs for the AIDS Foundation of Chicago, echoes that sentiment: “This is who we are. These are our own lives we are saving.” That oft-repeated phrase—“saving ourselves”—is used by black gay men involved in HIV work as well as part of a new annual Tennessee-based symposium dedicated to bringing leaders in various disciplines together to address the health and wellness of black LGBT people living in the South. It is both this need for self-reliance and the feeling of running out of time that leads activists like Stephens to talk about the importance of gay black men remembering “our legacy” around HIV and AIDS. “Our stories matter,” Stephens explains. “We can’t just leave it up to white gay men to tell the story of the ’80s, we must put forth our own narratives. One of the worst things AIDS took from us, as black gay men, has been our stories. Which is why we must keep telling them and keep remembering them. Where there is memory there is resilience.” Stephens calls passing down that history to young gay black men critical “proof we existed,” and he sees it as necessary for them to “know that they not only have a community behind them, but a culture and a history.” Green puts it succinctly: “We are racing against time and AIDS to avoid becoming a people that once were.” Aquarius Gilmer of the National Black Leadership Commission on AIDS and Stephens agree that black gay organizations—and those who work in them at any level—need to do succession planning now. “There is often high turnover among frontline staff in HIV/AIDS work,” Stephens says. “And with each new staff transition, we lose access to community members and key partnerships. This, I think, perpetuates the kind of destabilization that happens in our communities.” There was a time when all gay men talked this way, a bit too aware of their own mortality. A time when middle-aged men stepped into community elder roles because the generation ahead of them was just…gone. Back then the entire gay community was haunted by ghosts of hundreds of lost friends and lovers, and individual gay men were torn between living it up while they could and trying to quickly archive their generation’s lives and accomplishments before they too were gone, always with the specter of death around the corner. In the darkest moments it seemed almost possible that all gay men would disappear into that sweet night. Though gay and bi men are getting HIV at increasing rates still, for thousands of white, middle-class gay men, those dark days are long gone. Pharmaceutical advancements and adoption of some prevention strategies (better access to health care, testing, condoms) has given those gay men a new lease on life. For them, HIV is a manageable chronic condition. But for gay and bi men of

color, the epidemic is far from gone—and the specter of death still haunts the lives of far too many black men. According to a recent study from Emory University’s Rollins School of Public Health in Atlanta, the incidence of HIV is so high that a black gay man becoming sexually active at the age of 18 today has a 60 percent chance of being HIV-positive by the age of 30. At the current rate of infection, one in four black gay men will become HIV-positive by the time they are 25. The study cited “lack of health insurance and solely having sexual partners from the black community” as key factors, along with unemployment and incarceration. Not only are African-American gay men and transgender individuals more likely to have HIV then their white counterparts, they are also less likely to know it (only 54 percent of black gay and bisexual men knew of their infection, compared with 86 percent of white gay and bisexual men). They are less likely to receive appropriate medical care and (partly as a result) are more likely to die from AIDS complications. Blacks accounted for 56 percent of all deaths due to AIDSrelated causes in 2009, and their survival time after diagnosis is lower on average than that of any other racial or ethnic group, according to the Centers for Disease Control and Prevention’s 2013 HIV Surveillance Report. What’s behind the high rates for gay black men? Some of it has to do with the same socioeconomic forces that lead to the high rates in the southern United States, but, as HIV Plus reported last year, black gay men are also more likely to have sex with other black gay men. Dating within a smaller subset of any population increases the likelihood of one person’s STI being shared with all members of the intertwined group.

While nearly half of all HIV-positive African-American men who have sex with men are unaware of their infection, Jacory isn’t one of them. The 26-year-old gay man was featured on the Our America With Lisa Ling special “Black America’s Silent Epidemic.” He knew he was positive, but he hadn’t started treatment. He didn’t have health insurance, but he also admitted to having a fatalistic attitude, certain that his status would doom him to a poor health outcome. Why bother having a doctor confirm what he already knew? He imagined he wouldn’t live past 35 and would never reach his goal of becoming a fashion designer. When he finally made it—on camera—to a medical provider, he was given what seemed to be bad news: His CD4 cell count had dropped significantly. And yet Jacory left the medical clinic smiling. For the first time, he understood that with medication and lifestyle changes he could actually reclaim his life. He finally felt empowered to take control of his health. Jacory isn’t alone, and his hivplusmag.com

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story touched a chord with black America—at least those who watched the Ling special. HIV workers agree it’s that kind of basic HIV education that needs to reach the thousands of Americans who still believe HIV is a death sentence and think treatment involves swallowing 30 pills a day. Including Jacory’s story in Our America was certainly laudable—the whole special was—but it may be part of the problem. Black gay men rarely make the news except as connected to HIV statistics. “Organizations must be willing to know and imagine black gay men beyond HIV,” Stephens said in a statement issued for National Gay Men’s HIV/AIDS Awareness Day in September. “Black gay men are not merely the sum total of a series of horrible health outcomes. Black gay men are not merely a risk group, representative of the pervasive MSM category, but a people, with a history and a culture, a rich legacy of activism that has meant both our survival and secured our future.”

Aquarius Gilmer

Stephens argues that the “black gay identity [is] a unique social location, point of political struggle, and space of joy” and he hopes that Counter Narrative can “amplify the voices of black gay men” by bringing visibility to broader issues affecting the population, including poverty, criminalization, and lack of housing. “We believe that visibility is necessary for cultural change, and cultural change is necessary for social change.” Rashida Richardson of the Center for HIV Law and Policy agrees that HIV criminalization laws have an inordinately high impact on black gay and bi men. In a recent webinar, “We Are Here: Toward an Advocacy Agenda for Black Gay Men in the South,” Richardson explains this is because HIV criminalization lies at the intersection of forces that affect black gay men disproportionately: incarceration and high rates of HIV infection. “One in three black men will be incarcerated during the course of their lives,” Richardson says. “Gay and transgender youth who end up in the justice system are at risk of being labeled sex offenders, regardless of what crime they have actually committed. Queer people of color are more likely to be targeted by police for stop-and-frisks, which can lead to HIV criminalization charges” if, for example, the officer comes in contact with an HIV-positive person’s saliva. The complexity of the issues facing gay and bi black men—and how they intersect with HIV rates among African-Americans— may be one of the reasons activists like Stephens and Gilmer see the need for black gay men to collaborate with other disenfranchised populations to stop HIV’s death grip on their communities. At the AIDS conference, Gilmer publicly apologized, on behalf of black gay men, for helping render transgender women and men invisible, insisting “we must include transgender issues in the black gay men agenda.” Later Gilmer spoke in the “We Are Here” webinar about

DONALD AGARRAT

Charles Stephens the need for black gay men to fight for justice alongside other underprivileged groups rather than becoming involved in what he calls “privileged movements.” For example, Gilmer points to the fact that marriage equality has been the primary focus of the larger LGBT community but “gay black youth believe that HIV should be the central issue.” (Presented by the HIV Prevention Justice Alliance and the Counter Narrative Project, the webinar focused on HIV criminalization and incarceration, mental health and trauma, intersectionality, social justice, engaging faith communities, access and barriers to health care, and the role of culture in community engagement, mobilization, and building power. You can watch the entire 90-minute video at HIVPlusMag.com.) Building coalitions can be difficult, even with seemingly natural allies like black women with HIV. As Ling reports, there’s still a widespread belief among African-American women that HIV is contracted via sex with their male partner who has gotten it from another man. This narrative, says Moore, paints black gay and bisexual men as “the enemy” who are “single-handedly responsible for HIV in black women.” Which in turn sets up what Gilmer calls “a fight for who is more devalued—black women or black gay men.” Although studies indicate the narrative isn’t true, black gay men are frequently forced to “carry the burden of HIV,” Moore adds, because they often become the focus of HIV stigma and fear. Fear played a role in Gilmer’s own coming-out story. When he was first diagnosed, he was working in Mozambique assessing community-based, in-home HIV care. Although he was working in the HIV field and knew he was likely positive, Gilmer admits he avoided seeking medical attention. Finally he reached out to a friend, but even then he couldn’t admit the advice he sought was for himself. Instead, Gilmer said he had a “friend” who wouldn’t see a doctor because he was afraid. His friend said, “Tell your friend, HIV won’t kill him, but fear will.” “It is fear,” Gilmer knows now, “that paralyzes many of us.” Whether it is fear of losing your church or family, or of what might come with treating the disease, he says, “it’s the fear that anchors

the shame and stigma; [the feeling that] if I speak and admit this, then my world as I knew it will crumble. Now, realizing that the possibility of life is on the other side of taking a pill? The other side of a doctor’s appointment?” Despite all the hurdles facing black, poz gay men, activists like Gilmer and Stephens remain cautiously optimistic. “Given the opportunity,” Gilmer says, black gay men “could help lead this country…because we are so much more than HIV.”

Stephens happily acknowledges the “great work happening in the scientific and policy realms,” but adds, “I would merely offer that we should continue to work to strengthen our institutions, sustain our culture, and really invest in our communities.” It is in investing in the “proliferating black gay media, art, community institutions, and other innovative forms of community development” that, Counter Narrative maintains, black gay men will find the care they need to overcome HIV. “Linking black gay men to culture is linking black gay men to care.” And for a young gay black man reading this article? “I would want him to know that he has a community behind him,” Stephens says. “He has a history, a culture, and a future. As black gay men, as fearlessly as we look back at our past, the joy and the trauma, we have to be just as willing to consider the future.” ✜ hivplusmag.com

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At current rate of infection, 1 in 4 black gay men will become HIV-positive by the time they are 25 and 1 in 2 will have HIV by the time they are 35.

AfricanAmericans accounted for

Of those who have HIV, fewer than half are prescribed antiretroviral therapy and just 37 percent have achieved viral suppression.

50.3%

Three percent of Washington, D.C.â&#x20AC;&#x2122;s population is living with HIV, a number on par with that of many subSaharan African nations.

of new HIV diagnoses between 2005 and 2008

The South represents 37 percent of the U.S. population but 49 percent of new HIV diagnoses. Fifty percent of men and 71 percent of women diagnosed with HIV in the South between 2005 and 2008 were African-American.

The Southern states have the highest new HIV diagnosis rates as well as the highest AIDS mortality rates, the highest number of individuals living with HIV, death rates greater than the U.S. average, and the highest rate of other sexually transmitted infections. Areas with the highest poverty rates also have high HIV infection rates. Black Americans account for 44 percent of people living with HIV, although they represent only 12 percent of the U.S. population. Blacks also accounted for 49 percent of new AIDS diagnoses in 2011. Regionally, the South accounts for the majority of blacks newly diagnosed with HIV (61 percent in 2011) and blacks living with an HIV diagnosis, 55 percent at the end of 2010.

1 in 16 black men will be diagnosed with HIV infection, as will 1 in 33 Native Hawaiian/

Over the course of their lifetimes,

Other Pacific Islander men, 1 in 36 Hispanic/ Latino men, 1 in 100 American Indian/ Alaska Native men,

1 in 102 white men, and 1 in 145 Asian men.

Sources: NCBI, AidsVu, and CDC

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YOU DESERVE

ANSWERS HIV Answers gives you the information you want, privately, right on your phone. Get started online at

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WHY ARE SOME PEOPLE BETTER AT STAYING ON THEIR MEDS? Did you know that which pharmacy you go to for your prescriptions might actually determine how well you do on your medication? It’s true. A 2011 study in the Journal of Managed Care Pharmacy showed that for people with HIV, going to an HIV-specialized pharmacy was the most important factor associated with likelihood of antiretroviral medication adherence. The same study found that those patients were more likely to remain on a single antiretroviral therapy (ART) regimen and are much less likely to have excess refills or use medications that can’t be taken together. Even better: Going to an HIV-specialist pharmacy doesn’t cost more. The reason why these pharmacies work better is simple. Many, like Walgreens (which has more than 700 HIV-specialized pharmacies in the U.S. and Puerto Rico), employ pharmacists who have been specially trained to understand

your HIV drug regimens and who are better at knowing the side effects or drug interactions your medications may have with each other or with other over-the-counter medications. (This includes PreP, the HIV-prevention pill.) Studies have found that knowledge is key to ensuring your medication adherence, as is having a pharmacy that can offer you private, one-on-one counseling with a trained pharmacist; aligning refill dates so your medications can be picked up the same day; and the availability of free home delivery. Walgreens’ HIV-specialized pharmacies offer all of these options, as well as a confidential pharmacy online chat and a free mobile app with tools to remind you to take your pills and refill your prescriptions. Remember, you deserve a pharmacy that knows and cares for the whole you. Find out more at HIV.Walgreens.com.

A New Video Series Presented by HIV Plus and Walgreens LAUNCHING THIS FALL ON HIVPLUSMAG.COM

WE KNOW HIV/AIDS medication therapy But we also know you want a pharmacy that cares for the whole you. That’s why the pharmacists at our HIV-specialized pharmacies offer complete, compassionate care for your individual needs now and in the years ahead. You can rely on us to provide services such as: • Expert guidance in managing HIV, combined with other conditions you may have • A range of immunizations to help you avoid illness*

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

14CS0018-B-0814

After a successful career in the music industry, Maria Davis is now promoting HIV awareness. By Daniel Reynolds

In 1995

Maria Davis was a hot young hip-hop music promoter, running a legendary New York City party called Mad Wednesdays that helped launch the careers of now-legendary rappers including Jay-Z, Lil’ Kim, and Sean “Puffy” Combs. She was already well known in hip-hop circles, even featured on JayZ’s “22 Two’s” track from his debut album, Reasonable Doubt. The future Mr. Beyoncé told XXL magazine Davis helped him move his energy from the streets to making music. “I was pretty focused when I was creating the album, ’cause there was Maria Davis every Wednesday.” (And that song with Davis’s spoken word, he says, became “my secret weapon. Any show I did, I would pull that out.”) It’s safe to say that New York native Davis was riding high: young, hip, black, and a curator of cool in the music scene. Then she received a letter that would change her life. Standing in a post office, Davis read the note from her life insurance company, which had screened her for preexisting conditions as part of its application process. “You are HIV-positive,” the letter informed her. “Please go and seek help.” At the time, the news seemed inconceivable to Davis, a woman who had unknowingly become infected by her then-fiancé. The topic of HIV was taboo to many African-Americans, who considered it a “white gay man’s disease” and referred to AIDS in hushed tones as “the monster.” The same held true in the music industry and among her friends, so when Davis was directed to go and seek help, she says she just didn’t know where to turn. Even as she was “dwindling away” from the virus, which caused extreme weight loss and a hole “the size of a nickel” in her tongue, no one dared to ask about her health. No one asked if she needed help. Three years after receiving her initial diagnosis, the virus had advanced to AIDS, the “monster” had arrived, and Davis feared the end was near. Imagine her joy, almost two decades later, as Davis walked

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onstage at the 2014 U.S. Conference on AIDS last fall to thunderous applause. She struggled to hold back tears. A video had just introduced her story to the hundreds of prominent leaders, activists, and officials gathered for the event, where she was invited as a spokesperson for Merck’s HIV awareness campaign, I Design, alongside designer and TV personality Mondo Guerra and photographer Duane Cramer. “To be diagnosed in 1995 and then turn around and be almost 20 years into this illness,” Davis said to the standing ovation with a box of tissues in hand. “I just thank God.” In this time, Davis has proved herself a survivor. In addition to running several marathons, she has become a prominent activist and a much-needed voice around HIV and women, people of color, and her beloved music industry. In those 20 years, she has partnered with initiatives like Lifebeat: Music Fights HIV/AIDS and BET’s Rap-It-Up Campaign and was also the keynote speaker of the National Black Leadership Commission on AIDS. Today, she has a new partner: Merck’s I Design campaign, which offers people with HIV online tools to record information on symptoms, treatment, and the side effects of medication. For Davis, the goal is to provide others with the education and resources that she once lacked. “When I saw the video, it reminded me of how far I’ve come,” Davis told HIV Plus after the emotional presentation, the waters of San Diego Bay sparkling behind her. She says that 20 years ago she just “didn’t have information. I didn’t have Merck’s educational HIV campaign to empower people living with HIV to have open and honest conversations with their doctor. Nobody did that, because you were afraid to talk.” Davis says fear is still a major obstacle to HIV prevention: not only the fear of contracting HIV but the fear of discussing one’s positive status with others and not knowing what others might do with that information. It was these same fears of “the monster”

that had prevented her from obtaining help all those years ago. It’s all about education, Davis says, which is why she partnered with Merck. At ProjectIDesign.com, visitors can download tools like a conversation checklist, a medication worksheet, and a desktop app that will help them communicate with their physicians and tailor their treatment regimen to fit their needs. This method has an additional advantage, Davis notes—online research in the privacy of one’s home may be an essential first step for those who may feel scared to ask others about HIV in person. “The power comes from us—those that are living with HIV. And if we stand together, we start to be very strong,” Davis says, and that strength can start “melting away the stigma [and] the ignorance.” Davis acknowledges that while she cannot be sure how being HIV-positive has affected her career, she is certain that it has impacted her life, by offering a deeper mission than one initially promised by her calling in entertainment. “A lot of people I had to leave by the wayside because they didn’t understand—even some family members,” Davis says. “God was building me up so I could help other people to understand that you don’t have feel shameful [about your status] or worry about stigma. And if you stand strong, there’s a community that will embrace you.” ✜

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TH E STIG M A PR O JEC T

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TREATMENT CHRONICLE S

10 SYMPTOMS NEVER TO IGNORE Always wondering if something might be a problem? Turns out most people ignore symptoms that could be a problem. Edward T. Creagan, MD, cancer specialist and author of How Not to Be My Patient: A Physician’s Secrets for Staying Healthy and Surviving Any Diagnosis, says, “The careful physician will encourage you to elaborate on how you’re feeling, and then with insight, professionalism, and judgment can outline the most appropriate tests to home in on your symptoms. Ultimately, your health is in your hands. No one has a greater stake in your health than you do.”

RAMCREATIV; MICHAEL JUNG; KLADYK/THINKSTOCK

Here are Creagan’s top 10 symptoms to watch for. 1. Fatigue lasting more than a week without obvious explanation. 2. Cough that lasts more than five to 10 days, especially if you are a smoker and particularly if you start coughing up thick green or bloody mucus. 3. Pain that lasts more than three to five days in a specific area without obvious explanation. 4. Chest pain. It’s the big one many men and women foolishly ignore. Don’t toy with disaster. Get emergency care now. 5. Blood in the rectum, stool, urine, or mucus. 6. A new lump or bump that’s not particularly painful or associated with trauma. Cancer usually is not painful. A lump or bump that has occurred relatively quickly and feels tender is almost always not cancer. But if it doesn’t disappear over a week or so and you can’t remember if you hurt yourself there, see your doctor. 7. Moles. If a mole appears rapidly or darkens or itches over a relatively short number of months, or starts to bleed, you need to have a biopsy (cells viewed under a microscope). 8. Weight loss. As a society, we are obsessed with diets. But weight loss without a diet is another matter. Many people who experience a dramatic loss of weight might dance with joy. But a relatively quick loss of weight—faster than two or three pounds a week—may signal an underlying problem. 9. Headaches often are related to tension and stress and rarely are brain tumors, although that can be your first thought. Don’t ignore the new onset of a new type of headache, especially if it occurs in the morning and increases when you cough or sneeze. 10. Stroke signs: Weakness of an arm or a leg, or numbness and tingling of an arm, leg, face, or tongue, or difficulty with speech, could indicate the potential onset of a stroke. Stroke causes the death of brain tissue because the blood supply to certain parts of your brain is interrupted. This is a 911 emergency. Edward T. Creagan, MD, is a professor of medical oncology at one of the world’s leading medical centers in Rochester, Minn., and the author of over 400 scientific papers. @AskDoctorEd HowNottoBeMyPatient, and online at HowNotToBeMyPatient.com

MERCK’S DORAVIRINE ONE STEP CLOSER The pharmaceutical company Merck’s new HIV drug, doravirine, worked so well in patients new to treatment that it moved to Phase III clinical trials—the last stage before drug approval—at the end of last year. In previous trials, once-daily oral doravirine, an investigational next-generation nonnucleoside reverse transcriptase inhibitor that’s used in combination with tenofovir/emtricitabine (brand name Truvada) was compared to another drug, efavirenz (Sustiva), also used with Truvada, in previously untreated patients with HIV. Hedy Teppler, executive director for infectious diseases at Merck Research Laboratories, says she’s “encouraged by the antiviral activity and the overall tolerability” of doravirine and it “underscores Merck’s ongoing commitment to the research and development of new therapeutic options for patients with HIV.” Data from 48 weeks of previous trials showed a 76 percent response rate for doravirine versus 71 percent for efavirenz, and users had increased CD4 cell counts, a lower overall incidence of drug-related adverse events, and a lower incidence of increased total cholesterol. While abnormal dreams showed up in nearly 10 percent of users in both groups, other side effects, such as fatigue, diarrhea, and dizziness, were significantly lower in those taking doravirine. —Diane Anderson-Minshall

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T REATMENT CHRONICLES

The year 2015 may be the most important yet for our collective understanding of sleep. The time we previously thought of as “offline maintenance mode” is actually a highly active, important process of cataloging short-term memories. And a sleep deficit as small as one hour per night substantially increases the risk of high blood pressure, unwanted weight gain, and rapid onset type 2 diabetes. Science has also discovered that it’s not just how much sleep we get, but the quality of that sleep. Deeper, darker sleep (with blackout shades and cool temperature) is now being linked to better outcomes and longer lifespan in breast cancer survivors. (Experts call this practicing “good sleep hygiene.”) The positive effects on the immune system are undeniable. As parents, we protect our kids from colds and other infections by teaching them to wash their hands. Why not put a couple of basic systems like that in place to enhance our nighttime brain activity? If you’re a “night owl” type who has a difficult time adhering to traditional sleep schedules, these 10 tips may help you get to sleep faster: 1. Go to bed and get up at the same time every day. 2. Get out and move more. Take Yoko Ono’s advice: “Walk until your body feels like dancing, then dance! You will find that you no more have difficulty in sleeping at night.” 3. Cover any clocks in the bedroom, and don’t look at the time in the middle of the night. 4. No alcohol, caffeine, or food two to three hours before bed. 5. Make the room very dark and cool, setting the temperature somewhere between 65 and 72 degrees. 6. Use white noise or guided sleep meditation to quiet your mind while falling asleep. 7. Establish a pre-bedtime ritual, such as a bath or shower. 8. Use essential oils or homemade sachets of real lavender in your bedding. Don’t change bed linens too often—slightly slept-in sheets are more comfortable to the body. 9. If after 20 minutes you haven’t fallen asleep, go do something outside the bedroom that is relaxing and boring. Then try again. Don’t lie in bed kvetching. 10. Last but not least, consider any stimulants you’re using (especially caffeine). Dark chocolate, while packed with antioxidants, also packs a wallop of caffeine compared to milk chocolate. Many people don’t even think of caffeine as a drug, because it’s in everything—energy drinks, Frappuccino, etc.; even some yogurts and ice creams contain 30 to 60 milligrams of caffeine. “If you have any sleep disturbances—fairly common for people with HIV— caffeine can make them worse,” says Cade Fields-Gardner, director of services for a Chicago-based HIV nutrition firm. In a study of HIVpositive people and caffeine use, those who reduced their caffeine intake by 90 percent for more than 30 days saw a dramatic improvement in sleep quality. “It may be worthwhile to look at your caffeine consumption and, in some cases, to make the choices to reduce your intake.” Wellness editor Sam Page is a fitness trainer and lifestyle expert in Los Angeles. @SamPageFitness SamPageLA

NO MORE INJECTIONS FOR PEOPLE WITH HEP C Two new all-oral regimens improve hepatitis C treatment People with hepatitis C, a common coinfection with HIV, have just gotten more medication choices, and unlike earlier treatments, the new ones don’t need to be accompanied by interferon injections. They build on the success of two drugs first approved in 2013, Sovaldi and Olysio. In the fall the Food and Drug Administration approved two all-oral treatments. Harvoni, from Gilead Sciences, combines its highly successful Sovaldi medication (generic name sofosbuvir) with a drug called ledipasvir. The tablet is to be taken once daily for a duration of eight, 12, or 24 weeks, depending on prior treatment history. In three Phase III studies, it achieved cure rates of 94 to 99 percent, according to Gilead. The FDA also gave the green light to physicians to prescribe Janssen Therapeutics’ hep C drug Olysio along with Sovaldi. Some doctors have already been prescribing them together, but many were reluctant to do so without the FDA’s blessing. The latest action clears up any uncertainty. The two drugs are taken for either 12 or 24 weeks, depending on the patient. Studies showed cure rates of 93 to 97 percent. In addition to allowing patients to skip the interferon injections, which can cause flu-like symptoms, the new regimens don’t require the use of another antiviral drug, ribivarin. Experts estimate that one quarter of all people with HIV have the hepatitis C virus as well, and one half of all HIV-infected injection-drug users. If left untreated, the hep C virus can result in lifethreatening complications such as cirrhosis and cancer. —Trudy Ring

NATBASIL/THINKSTOCK

GOOD NEWS FOR NIGHT OWLS

TREATMENT CHRONICLE S

ARE YOU AGING TOO QUICKLY? Recent studies show that even those with suppressed viral loads have diminished physical performance In 2015 half of all HIV-positive adults in America will be age 50 or older. And while people with HIV are living longer, nearly on par with their peers in some cases, there’s been a “growing concern among patients and health care providers that this group is experiencing a premature or ‘accelerated aging’ process,” say the authors of a Duke University study. At the 20th International AIDS Conference, Jules Levin, executive director of the National AIDS Treatment Advocacy Project, reported on the study, excerpts of which are available on HIVage.org, a blog of the American Academy of HIV Medicine. The study

came up with a disheartening conclusion: People with HIV are less mobile as they age, even when they’re on successful antiretroviral therapies, compared with their non-poz peers. “The magnitude of differences observed may be associated with poorer health, more disabilities, longer hospital stays, and higher costs, thus warranting intervention,” the study authors warn. The study evaluated both people with HIV and those without, all over 50, on several physical tests: an eight-foot walk to test gait speed; a 30-second chair stand (basically standing all the way up and down from a chair as many times as possible in 30 seconds); squeezing a dynamometer to measure grip strength (which is predictive of mortality); and a six-minute walk test (to measure aerobic endurance). Even those with suppressed viral loads showed diminished physical performance versus their HIV-negative peers. In the eight-foot walk, for example, the usual gait speed of participants was slower than the walking speed needed to safely cross the street. The study authors warn that health care providers for people over 50 should be aware of the premature aging process, despite not knowing exactly what causes it. Researchers must now find out if this accelerated aging is due to the virus itself, prolonged antiretroviral therapy, other comorbidities, or conditions and lifestyle issues that come with aging while being HIV-positive. —Michelle Garcia & Diane Anderson-Minshall

GREAT NEWS FOR YOUR MEDICINE CABINET

OSTILL/THINKSTOCK

Tivicay Suppresses HIV Even in Those Who Are Drug-Resistant Tivicay, the HIV integrase inhibitor (a type of antiretroviral drug that blocks one of the processes the virus uses to enter a cell’s DNA) approved in 2013, has shown the ability to keep HIV at bay even in people who had resistance to other drugs. After nearly two years of treatment with Tivicay, made by ViiV Healthcare, those on the drug showed no resistance to it. In a study of treatment-experienced patients, 71 percent of participants who took Tivicay saw viral suppression at 48 weeks— even those resistant to other classes of drugs—compared to the 64 percent of those who took Isentress, another drug used to treat HIV. Triumeq Approved as New Single-Dosage Pill Those newly diagnosed with HIV might want to try a new combination drug, Triumeq, which was recently approved by the FDA. It is the first single-dose pill available in the U.S. that includes Tivicay (or dolutegravir) and Epzicom (a combo of abacavir and lamivudine). Together,

those drugs help to prevent HIV from infiltrating a person’s DNA. This drug is the first single-tablet treatment that does not contain Truvada and is therefore a better option for patients with impaired kidney function. Triumeq won’t work by itself for anyone with a resistance to the components in the drug, or resistanceassociated integrase substitutions or clinically suspected INSTI resistance, because the dosage of dolutegravir won’t be potent enough. Tybost Is First New Boosting Agent In Decades Gilead’s Tybost (known generically as cobicstat), which was created to boost the drug levels of Reyataz and Prezista in combination with other antiretrovirals, has received the FDA’s OK. It is the second HIV-drug boosting agent available, following Norvir, which has been on the market since 1996. Studies indicate that Tybost is just as effective as Norvir.

Vitekta Approved as Integrase Inhibitor Gilead’s Vitekta (elvitegravir) was also approved for treatment in HIVpositive adults by the FDA. Vitekta is recommended for those who have taken other HIV medications and is used along with a Norvir-boosted protease inhibitor. Tybost and Vitekta are two of the four components in the single-tablet treatment Stribild, which was approved by the FDA in 2012. Now each of the components (the others are emtricitabine and tenofovir) has been approved separately for use in HIV regimens. —M.G. hivplusmag.com

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T REATMENT CHRONICLES

Dr. Gary McClain has guided thousands of people through life with HIV. In this new column, he’ll answer all of your questions—saving you a trip to the shrink (and telling you when you really need one).

Should I get facial fillers? I’ve had HIV for 30 years and because of it I’ve had lipodystrophy. I want to have fillers injected in my face but my friends tell me I’m being overly obsessive about my sunken cheeks. What do you think? -—Adam This is a great question, Adam. The decision to get fillers is something I often talk about with clients. And it’s a big decision. So let’s get started. Imagine, if you will, a kindly therapist sitting across from you, wearing a cardigan sweater (therapist uniform). That would be me, and I say this with a gentle tone: As I am sure your friends have said, you are much more than any imperfections you might have—and which we all have, in one way or the other, by the way. What about your strengths, your quirks that make you unique, your loyalty to the people in your life? That’s what your friends value you for. So ask yourself about your expectations for getting the fillers. Are you hoping that your life will change in some way? More friends? More dates? More success in some area of your life? What I first encourage you to do is to get clear with yourself on your expectations for what this procedure will mean for your life, and to consider whether your expectations are reasonable. Making cosmetic improvements doesn’t necessarily lead to major life changes. Just ask the next person you see who has clearly had one too many cosmetic procedures. (Or on second thought, maybe you shouldn’t.) Don’t set yourself up for disappointment if the change isn’t life-changing. Having said that…you are the one who looks in the mirror every morning. And it sounds like you aren’t happy with what you see. It’s only human to want to look and present yourself in the best possible light. My clients with lipodystrophy tell me that their sunken cheeks are a reminder that they have HIV. And they express concerns that other people look at them and also see HIV. It’s their perception. But your perception is your reality. If you feel that getting the fillers will make you happier with what you see in the mirror, then that is a reason to consider the procedure. If you think that looking better will give your self-confidence a little boost, then that’s a reason to consider. And that’s not unreasonable. It’s your face. Your bank account. Your life. And your choice. Be clear on your expectations. And then do what you feel is right for you.

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What if people find my meds?

I want to finally go on meds, but I haven’t told anyone I’m HIV-positive. How do I keep the prescription bottles hidden? Should I lie and say I have something else? —Maria First, I want to congratulate you on the decision to get your treatment started. That’s taking good care of yourself. But it sounds like this decision has also brought up concerns about disclosing your HIV status. Do know, you are in control of whom you choose to tell and when you choose to tell them. It’s your decision. If you are living with roommates or family members and aren’t ready to disclose, then it is your choice to keep your medications in a place where they won’t be discovered. If you are living alone and you are concerned that someone might check out your medicine cabinet, this is another reason to keep your medications in a more private place. Do what is going to help you to feel comfortable. Again, take care of yourself. But I also have to say that I am sensing a lot of shame in your question. That tells me you may be viewing your HIV status as something that others might judge you for, and something that you should keep a secret. And the “but” in your question (“but I haven’t told anyone”) makes me wonder if you might be delaying your treatment for fear that others will find out. You know the people in your life, and it sounds like you have given some thought to how they might react to learning your positive status. And based on that, you may be feeling this is something you need to keep to yourself. This raises a question for me: Are you talking to anyone about your HIV status? Getting emotional support is an important part of your self-care. Having a safe place to talk about what’s going on in your life, your concerns, your fears—as well as the joys—and to give you encouragement when you need it. Do you have anyone in your life you can look to for support? Also, is it possible that some of the people in your life might surprise you? I am wondering if you might be doing some mind reading and assuming you might be rejected. You won’t know if you don’t give them a chance. If you haven’t started taking the medication, I hope you will get your treatment on track right away. Designate yourself the decision-maker in terms of how you want to store your medication. You’re in charge. You’re also in charge of when you disclose your status and whom you disclose to. But get support. Think about the people in your life who you can trust to be part of your support network. You might also look into HIV support groups in your area, or talking one-on-one to a counselor (many offer sliding scale fees for lower incomes if money is an issue). Get connected. Don’t go through this alone! ✜ Mental health editor Gary McClain, Ph.D., is a recognized expert in understanding the emotional reactions to getting diagnosed with HIV. He’s the coauthor of several books, including The Complete Idiot’s Guide to Breaking Bad Habits and Empowering Your Life with Joy. Find him at JustGotDiagnosed.com

KEN TANNENBAUM; INGRAM PUBLISHING/THINKSTOCK

THERAPY CORNER

THE BARBERSHOP DIARIE S

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TEENAGERS IN LOVE W

Why you shouldn’t make assumptions about the lives of gay teens in even the most stubborn of red states By Mark S. King

hen Chanse, a 19-year-old gay man living in Shreveport, La., tested HIVpositive a few months ago, his mother reacted with understandable emotion and concern. And then she did something both odd and beautiful: She threw Chanse a coming-out party. “We had a couple of dozen family members and friends there,” Chanse told me during my recent visit to my hometown. “And halfway through the party we started pinning red ribbons on everyone. They didn’t know what to make of it.” His mother then called the group to attention and said she had an important announcement to make. “She wanted everyone to know that something had happened and I would need their support,” he said. “And then she told them that I had tested positive and that she loves me.” The response from the party attendees was immediate and moving. There were tears, yes, but they also congratulated Chanse for taking charge of his health and starting treatment. Since then, several family members have begun to volunteer for the Philadelphia Center, the local HIV services agency where Chanse was tested and participates in wellness programs. HIV continues to devastate the South with alarming infection rates. One might

assume that in the most stubborn of red states, gay men have lives of rejection and misery, that they are apathetic about HIV, that they are ignorant about seeking treatment or accessing prevention strategies such as pre-exposure prophylaxis (PrEP), or that living as a gay teenager brings so many challenges that HIV falls far down the ladder of priorities. That is clearly not the case for Chanse or for his boyfriend, Josh, also 19 years old, who both swept into action when Chanse tested positive and, in another room of the agency, Josh learned he was HIV-negative. “I told him right away that I wouldn’t leave him,” said Josh. “We cried in the hallways for a few minutes, and then we both wanted to know right away what to do about it. One of the men at the agency, Eric Evans, told me about PrEP. I did some research and knew I wanted to start taking it.” I am certainly guilty of making assumptions about the engagement of young gay men in the South. Having grown up in Shreveport, I assigned the same prejudices to the community that I endured when I came bursting out of the closet as a teenager in 1978. But Chanse and Josh were quick to correct my outdated notions. “We have plenty of friends,” Chanse told me. “And we walk down the street

holding hands. I can’t speak for everyone, but it just hasn’t been a problem for us.” Josh has been on PrEP for a month now, and his own choices defy nearly every contention made by critics of the prevention strategy. He is compliant, takes his daily pill on schedule, and hasn’t missed a dose yet. He takes the medication within the context of a committed relationship, not as a license for promiscuity. And taking the prevention measure hasn’t meant abandoning condoms. “Why would we stop using condoms?” Josh asked. “I know Chanse will be undetectable soon since he just started treatment, and I know PrEP is protecting me. But we’re also in the habit of using condoms every time. If we don’t have them, then we do something else. It’s just what makes us both comfortable, and we’re going to keep doing things the same way we always have.” As a middle-aged HIV activist, I thought I had an understanding of what it means to be gay in Louisiana and the level of commitment among young gay men. But I was wrong. I just got schooled by two teenagers. ✜ Mark S. King is the HIV-positive journalist behind the blog MyFabulousDisease.com, where a version of this article originally appeared. hivplusmag.com

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A Phoenix Rising… continued from pg. 17 “Lie Here Tonight” is a beautiful song, a great coming-out narrative that can apply to so many people in different situations. It kind of has a little autobiographical arc to it. It was written the way that my ex and I communicated through some of our dealings with finally coming to the realization that I was gay. I would get in the car and drive, and we would have conversations over the phone so that she didn’t have to see my face as she was having these conversations, just so that it wasn’t uncomfortable for us.

in forever. It’s my mom’s favorite song. It was during a time where I think that I was realizing—I mean, my faith is my faith and that’s how I’ve always kind of viewed it. I don’t try and put my faith on other people. I don’t try and take away from what other people are going through, because you don’t know where other people are at in their walk. You don’t know where they’re at in their journey, and you don’t have a guideline to say, “This is the best way to do it.” It’s easy to forget that God is always there, and through all of this stuff

Did your parents’ divorce impact how long you stayed in your own marriage? Yeah. My parents, both my parents, grew up very strict Christians. When my parents got divorced—the reason the song is written the way it is—when my parents got divorced, my mother left for another woman. It definitely shook our family quite a bit. The process of my ex-wife and I dealing with it all—it was kind of like watching my parents’ divorce relive itself out. Were you thinking, I’m going to do this differently? Definitely. [My ex-wife] Melissa and I had gone through a lot growing up. I had been molested for three years when I was younger, and there was another guy who molested me when I was 12. I had a lot of secrets and things that I kind of kept hidden because I grew up in such a strict home. I’d seen how people reacted to the “gay lifestyle,” and it was definitely hard for me to finally come to the place of being able to say it to my ex-wife. We wanted to work through it together because we had been working through it together all of our relationship. When did you decide to be open about being HIV-positive? [The incident with] Rent really outed me. When I found out [I was poz] I kind of went into a depression. Finally coming out and realizing I had a lot more to say and a lot more to do, I was just trying to find a voice that I could still feel like I was making a difference. The only reason that I allowed the Rent thing to become so public is I didn’t want to have something I felt I regretted and didn’t stand up for my daughters. So, at that time, I had to tell my daughters that I was HIV-positive. There were a lot of choices I had to make before that even came out, for myself and for my family, because I knew that it would be a very public thing. Something that would be a public thing for a long time—because, I mean, you type my name into Google and you type “Byron Rice HIV” or “Byron Rice and gay” and they pop up. It’s not like it’s going to go away anytime soon. I had [to decide] whether I was ready for that. It was hard when I first came out about it all, because I didn’t know how people reacted, because I kind of sheltered myself. And you said your “writing family” kind of surrounded you? Yes, because Nashville isn’t really known for the “put your arm around the gay guy” kind of situation. It was very public, and I was still going out singing. The great thing is that through all that, a lot of people got to experience somebody that’s just dealing with [being HIV-positive and gay]. Some of your songs have little shades of Johnny Cash, the storyteller. Tell me a little bit about the song “Yesterday, Today, Forever.” It’s a great song. Wow, you went to the best stuff. I haven’t talked about that song

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that I went through, it was very easy for me to not see God in it. I saw a lot of anger, and I saw a lot of things that people wanted to condemn me for without looking at where I had come from or where my walk had gone, because they didn’t see all the stuff that led up to where I was. They only saw from that point, and they were judging me from that point. And that’s what that song is about. Saying sometimes I forget that God is there, and I need to remind myself that he said he’s there every moment of the day, and he’s going to be there every moment of the day. He’s there through all of the pains I go through with HIV, and he’s there for all of the rejoicing I get to have when it’s undetectable, when my T cells are high, and I am excited. I mean, I try to remember him in all of those things. What have you learned about HIV that you’d want others to know? I think one of the biggest things is to just remember that HIV isn’t a sin. I think a lot of churches still view it that way. It’s because of something you do but that it doesn’t define who you are. It isn’t defining who I am, and that is why I’m openly talking about it versus trying to be private about it, because for me, I need to let people know that I’m living with it, yes, but it is still something that isn’t going to control me or determine who I am. ✜