The Real Reason You Should Start Treatment Now BECAUSE YOU’RE MORE THAN YOUR STATUS
Can Blackbird Get Young Southern Men on PrEP? These Guys Are Betting on It
Wade Davis (left), Keith Brown, and Gary L. Gray
SEPTEMBER / OCTOBER 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. STRIBILD can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL of virus in their blood) and whose healthcare provider determines that they meet certain other requirements. STRIBILD combines 4 medicines into 1 pill to be taken once a day with food. STRIBILD is a complete single tablet regimen and should not be used with other HIV-1 medicines. STRIBILD does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking STRIBILD. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.
IMPORTANT SAFETY INFORMATION What is the most important information I should know about STRIBILD? STRIBILD can cause serious side effects: • 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 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. • 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 herbal supplement 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? Serious side effects of STRIBILD may also include: • 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. • 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 combination of the medicines TRUVADA (emtricitabine and tenofovir disoproxil fumarate), TYBOST (cobicistat), and VITEKTA (elvitegravir).
STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL of virus in their blood) and whose healthcare provider determines that they meet certain other requirements. STRIBILD does not cure HIV-1or AIDS.
I started my personal revolution Talk to your healthcare provider about HIV-1 treatment. STRIBILD is a complete HIV-1 treatment in 1 pill, once a day that combines the medicines in TRUVADA + TYBOST + VITEKTA.* Ask if it’s right for you.
www.STRIBILD.com
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 can also be used to replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL of virus in their blood), and have been on the same HIV-1 medicines for at least 6 months and have never failed past HIV-1 treatment, and whose healthcare provider determines that they meet certain other requirements. • STRIBILD is a complete HIV-1 medicine and should not be used with any 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®) • midazolam, when taken by mouth • 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 elvitegravir, cobicistat, emtricitabine, or tenofovir (Atripla®, Complera®, Emtriva®, Truvada®, Tybost®, Viread®, Vitekta®) • Other medicines that contain lamivudine or ritonavir (Combivir®, Epivir® or Epivir-HBV®, Epzicom®, Kaletra®, Norvir®, Triumeq®, Trizivir®) 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:
- disopyramide (Norpace®)
• Nausea
- estazolam
• Diarrhea
- ethosuximide (Zarontin®)
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
- flecainide (Tambocor®)
• These are not all the possible side effects of STRIBILD. For more information, ask your healthcare provider.
- fluticasone (Flovent®, Flonase®, Flovent Diskus®, Flovent HFA®, Veramyst®)
• Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
- itraconazole (Sporanox®)
What should I tell my healthcare provider before taking STRIBILD? Tell your healthcare provider about all your medical conditions, including:
- flurazepam
- ketoconazole (Nizoral®) - lidocaine (Xylocaine®) - mexiletine - oxcarbazepine (Trileptal®)
• If you have or had any kidney, bone, or liver problems, including hepatitis B infection
- perphenazine
• 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.
- phenytoin (Dilantin®, Phenytek®)
- 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 over-the-counter 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®)
- phenobarbital (Luminal®) - 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 - 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: December 2014
COMPLERA, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, the STRIBILD Logo, TRUVADA, TYBOST, VIREAD, and VITEKTA 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. © 2015 Gilead Sciences, Inc. All rights reserved. STBC0180 03/15
editor in chief DIANE ANDERSON-MINSHALL SVP, group publisher JOE VALENTINO art director BONNIE BARRETT copy chief TRUDY RING contributing editors NEAL BROVERMAN, KATIE PEOPLES, MARK S. KING, SUNNIVIE BRYDUM, JACOB ANDERSON-MINSHALL, DAWN ENNIS assistant editor RAFFY ERMAC wellness editor SAM PAGE mental health editor GARY MCCLAIN 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 program manager VINCENT CARTE front end developer MAYRA URRUTIA drupal developer KEN MERRIMAN traffic manager KEVIN BISSADA
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september / october 2015
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SEPTEMBER | OCTOBER 2015
BUZZWORTHY
WELLNESS
8 HIV’s Sugar Fix
39 How to Date an HIV-Negative Guy
9 You’re Doing it Wrong!
40 Are You Attracted to People Who Are Good for You?
14 A Sign of Stigma
TREATMENT CHRONICLES
15 Is Hatred Killing Europe’s Gays?
45 Never Take Another HIV Pill, Someday
16 Your iPhone Can Now Test for HIV
46 Don’t Do Cocaine!
17 HIV Makes You Tipsy Faster
47 Why You Should Start Treatment Now
Is cutting it off key to a cure? The right way to put on a condom.
Road signs we don’t like to see.
Homophobia and HIV go hand in hand.
An app that takes 15 minutes?
Exactly why is a mystery.
Your status isn’t the only one that matters. Life-changing advice you’ll want to read.
Could an implant revolutionize treatment?
Seriously, when it comes to HIV, it’s worse than you think. It’ll reduce your chance of AIDS by 53 percent.
+ 36 Daily Dose: Dating, HCV, and poz after 50.
48 Barbershop Diaries: Homeless to hero. FEATURES
18 ON THE COVER:
The Blackbird Sings
18
On the cover (from left): athlete turned activist Wade Davis, Blackbird costar Gary L. Gray, and producer Keith Brown
NFL player turned activist Wade Davis got actor Gary L. Gray, producer Keith Brown, and the whole cast and crew behind the breakout gay indie hit Blackbird to team up an AIDS organization in the South for to get young black men on the HIV prevention pill. Our exclusive interviews look at our fave new Hollywood duo.
26 The Missing Generation
Years of research, dozens of survivors, and a dance troupe bring to life the stories of trans women and gay men who lived through the AIDS epidemic.
31 Not a Unicorn
He’s poz and trans, but Teo Drake wants you to know he’s not alone.
PHOTOGRAPHY BY MIGUEL STARCEVICH PHOTO ASSISTANT: WILLIAM THOMAS
hivplusmag.com
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EDITOR’S LETTER
ARE YOU AN AMAZING HIV+ PERSON?
september / october 2015
DE ISSUE
+ CA n THE Y
now CU RE
HIV ? + A nEw 4-In -1
PIl l
FREE STIGMANT & T R E AT M E NEWS H E A LT H
HE ALTH +CULTU RE +FIT NE SS+T REATME NT
DisHiNg wit H siNgLE LADiEs’ brE AkoUt stAr LisArAY E
10
DAtiNg gAMEs
AMAziNg HiV-PositiVE gAY MEN
why dating someone who is positive could be you r safest bet
20 AMAZING
HIV+ GAY MEN N FLARE, SAM PAGE, CYO E G’RY REVENJ, B & MANY MOR ANDY BELL, GRE ICO, SEAN STRU K, JOHN D’AM HUSSAIN TUR
+
THE STRAnGE CASE of UnClE PooDlE
TOBER 2014 SEPTEM BER/OC mag.c om ivplus
www.h
fRom proj ect runw ay To THE ACTI VIST GAY GAmES, JACK KEnRoTH CHAnGE How mACKE IS USInG HIS AmER ICA STATUS SEES HIV-P oSITIVE PEoP To lE MAY/JU NE 2013
www.hivplu
smag.com
20 MOST AMAZING HIV-POSITIVE WOMEN
THE
OF
2015
woman to compete for a national pageant title. And when she walked away with a crown, she became the world’s reigning HIV-positive Gina Brown beauty queen. Gina Brown provides A survivor of childhood sexual abuse, Anderson was pregnant medical at 15 services and by her 20s a suicidal drug user to who lost custody of her two children HIV-positive men and and ended up in rehab, where she was offered an HIV test. She decided women as a medical case to get the test, as she “thought HIV was a gay white man’s disease manager at Priority Health and black women didn’t get it,” she told HIV Positive magazine. Care Inc., a nonprofit in Although she learned then that she was HIV-positive, she didn’t the New Orleans area that seek treatment until her own daughter gave birth. Having a grandchild provides care and seeks was the impetus Anderson needed to turn her life around. to empower underserved She entered the 2010 and 2011 Miss Texas Plus America pageants, in populations. Poz for two Network and worked with Haught competing as an openly HIV-positive contestant, then won at the nadecades, Brown has been the effort to replace Iowa’s outdatedtional level in Miss Plus America, receiving the Ms. Plus America curworking in the HIV field title, law with a statute that reflects one of several the pageant bestows. and for a dozen years and has rent knowledge about the virus “I just didn’t win that night,” Anderson has often said. “Every years become a valued advocate transmission routes. “After two HIV-positive woman won that night!” Iowa and speaker. A board member of lobbying, she knew all 150 Anderson has used her title to for PWN-US, she’s also been raise awareness about HIV and involved with the Women’s Research Initiative; Senate and House members. Legislathe stigma around it, especially among the AIDS Alliance for Children, law women of color, as part of the Youth, and Families board of directors; tors passed Iowa’s reformed HIV CDC’s “Let’s Stop Until It’s Over Inc.; the LouiHIV Together” campaign. Working effort siana AIDS Advocacy Network; at the Afiya because she took the time and Center in Dallas, Positive Leaders Uplifting Sistas; Anderson is also cochair of the one of and Campaign to End Camp ACE. “Gina is an extraordinary to get to know each and every AIDS Texas, a board member for the ADAP advocate and activist, as well as passed Advocacy Association, a social worker, through her excellent them. It became personal. They and a member of the Ryan White Consumer skills as a public speaker, fighting Tami let couldn’t they because Council law HIV stigma, and working to improve the Committee. representation of women living down.” with HIV, increase understanding Monique Howell-Moree of their unique issues and the reWhen she received a 2014 Annual sponse to their needs,” says Misrok. The author of the 2010 memoir Award, Living Inside My Skin of Silence, Friends of Iowa Civil Rights nique Mo“seem Howell-Moree is the founder and CEO Haught told friends it didn’t of Monique’s Hope for Cure that Outreach Services in Holly Hill, S.C., which aims to increase right to be honored for something awareness of HIV and combat advostigma and health disparities in was a labor of love. Love for the rural South do- Carolina. cacy work that I thoroughly enjoy “I who contracted Iowa in HIV in 2005 while pregnant with ing and love for everyone my third son,” Howell-Moree, with a married mother of three, wrote modernizing this law helps; along in a blog post for A Girl Like Me, “and this disease changed justice and peace for myself.” my life in so many ways; most of all be- me the strength to it gave She was equally gracious about endure any obstacle that I may have in my for day is not easy life. Every for me, but every day is worth it, ing the most nominated woman because I still haveshe one more day to live.” this list too. “I am very honored,” incredible many An so administrative are clerk in the U.S. Army when she says. “There discovered she crimhad HIV, Howell-Moree later had leading to make change in HIV are who HIV a relationship with living with another soldier women ere prosecuted Thwas and against people living with HIV. for nondisclosure by the military, inalization, stigma, violence, etc., even though she had him use a condom and he When women come together, never contracted HIV. That led are so many who deserve recognition. infected to acmany incredible people who aretivism around anticriminalization efforts. Since change happens. I have met so then Moore has spoken the stigon Capitol Hill, in addition to to work beside them to fighttwice speaking at colleges, schools, conor affected by HIV. It is my honor works ferences, . We become a family that and churchma, criminalization, and discrimination es nationwide. She us all.” together for better treatment of has received several awards for her work, and she’s also highhivplusmag.com Mary Bowman ly active with the She was 20 years old when she church founded by took the stage at a SpitDat open mike night in Washington, D.C., ready her father, Bishop to reveal a secret her family had kept since she was a child: Mary Bowman Donald C. Howell, is HIV-positive and has been since she was born to a poz drug Solid Rock Interaddict who died when Bowman was still a toddler. You could have heard national Outreach a pin drop when she spoke, but after hearing Bowman ourselves, Ministries. Moore we can surely say that deafening silence was probably sheer amazement. says today she still Her words and her delivery of her spoken-word performances today are wants other women riveting reminders of the universality of experience, but that day it helped to know that they are Bowman first realize she was not alone. She’s brought tears to the not alone, and anyone eyes of people at performances nationwide and has become the voice who knows her is faof a poz generation. But it’s her policy and advocacy work at the Women’s miliar with her signaCollective in D.C., often helping save women like her mother, that ture advice, “You have brings it all together. “She is amazing,” says Carrie E. Foote, an HIV to first love yourself.” activist and a sociology professor at Indiana University-Purdue University Indianapolis.
TS , ION BUT THESE FINALIS MEN MAY GET MORE ATTENT NOMINEES , PROVE FROM OVER 100 WHITTLED DOWN OF THE AT THE FOREFRONT WOMEN HAVE BEEN FOR DECADES . FIGHT AGAINST HIV Tami Haught
Haught, who An Iowa farm girl at heart, Tami recalls lystill lives in a small rural community, death. Posiing about the cause of her husband’s admit that her tive since 1993, she just couldn’t For six husband had died of AIDS complications. “in silence” living lie, to years, Haught continued from family and and hiding her own positive status out as HIV-posifriends. When she finally came lifted off my tive, Haught says, she felt “a burden shoulders.” and proud, she’s Today, Haught is not only out champion of anbecome a leading organizer and with HIV, and ticriminalization efforts for people to many living with what Poz called a “mama bear” board member, a HIV. She’s been a Sero Project People Living With member of the United States a GNP+NA HIV Caucus Steering Committee, of Positive Iowans board member, and president emotional and soTaking Charge, an educational, also the Sero Projcial support group. Haught was coordinator, helping ect criminalization conference a Crime conference, organize the first HIV Is Not held last year. has Her work around HIV criminalization As community gained her the greatest accolades. Advocates of Iowa Network, organizer for Community HIV/Hepatitis repeal and mobilization campaign to Haught led the group’s education statute, making the state the and replace Iowa’s HIV criminalization so. do to first in the nation says Terry Lowman, who launched “Tami is an unstoppable force,” Universalist Witness Advocacy the advocacy group Iowa Unitarian
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hivplusmag.com
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BY BRADFORD ROGNE (DIANE)
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DIANE ANDERSON-MINSHALL EDITOR IN CHIEF EDITOR@HIVPLUSMAG.COM
THE GAY PRI
MONIQUE HOWELL-MOREE (FACEBOOK); GINA BROWN (FACEBOOK); MARY BOWMAN (MAGAZINE CUT/FACEBOOK); VALERIE REYES–JIMENEZ (FACEBOOK)
At last year’s U.S. Conference on AIDS, I was with a group of promising young black gay activists from the South who were talking about HIV. The stats are terrible and these guys are rightly frightened— after all, in 2013, the Centers for Disease Control and Prevention had issued a report saying that by the year 2043, nearly 70 percent of all 20-year-old black gay men will have HIV. Sure, it’s a chronic, manageable disease—if you know you have it and to get access to medication you can afford, which isn’t happening for a lot of African-American men and women. Former NFL player Wade Davis, who has joined the cast and filmmakers behind the black gay indie darling Blackbird for one of the most unusual HIV prevention projects in the South, reminds us that stopping HIV is going to take all of us. “It takes power, and privilege, and money to end this epidemic,” he said. “Unfortunately, the black community is not the gatekeeper of that. I’m the kind of person that believes that what happens to my brother impacts me, or what happens to my sister impacts me. So I look at it from a very holistic view: We’re all on this earth together.” I couldn’t agree more. Which is why it’s time for us to be thinking about how we can all improve the lives of young African-American gay and bi men and trans women, groups hit the hardest by still rapidly climbing rates. Sure, HIV might seem like it’s no longer a problem, but without treatment it can rapidly become stage 3 HIV (or what they used to commonly call AIDS). Right now, 26,688 Americans have stage 3, many because they aren’t on treatment or got treatment too late. “We have to do more,” Davis told us for the cover story. “You have to start with those who have the least, and then you can get to those who have the most. Because people who have the most will never stop until they have what they think they deserve.” Amen to that, brother.
Every year we have a special feature, 20 Amazing HIV Positive Gay Men, which last year expanded to include bisexual men. Earlier this year, we did the same list celebrating HIV-positive women, which included both transgender women and cisgender (or nontrans) women. Why do we do these lists? Because we all need role models—we need to see other people like ourselves who are doing amazing things with their lives and often changing the lives of others along the way. They do this despite being poz; for many, finding out they had HIV was the catalyst to becoming an amazing person, in fact. But after a few years of making the list up ourselves, we’re ready to put it to the test and ask you: Who deserves to be profiled in an upcoming list of the 50 Most Amazing HIV-Positive People in the U.S. (and yes, before you ask: You can sneak in folks who live elsewhere as long as they have an impact on those of us in the U.S.). Here’s how to get us the info: You can email us the name and photo of person you are voting for along with a short note on why you recommend them to editor@hivplusmag.com. You can tweet that info to @HIVPlusMag with the hashtag #amazingpluspeople or post it on our Facebook page at Facebook.com/hivplusmag. Be sure to include the Twitter handle or Facebook tag of the person you are nominating as well! Then we’ll do a huge thing with the winners later this year!
YANNICK DELVA
WE LOVED L.A.
Actor Mel England, our May/June issue cover star, got to be surrounded by fans as he rode in a Ford Mustang convertible at Los Angeles’s LGBT Pride parade in June. England joined editor in chief Diane Anderson-Minshall in doing the royal wave to the crowd. They were joined by England’s publicist Jay Hopkins, Plus magazine contributing editors Jacob Anderson-Minshall and Dawn Ennis, and our senior director of audience development and consumer marketing, Robert Hebert. (Oh, and there were also two of England’s sexy friends for some extra eye candy.) It was four hours of sweaty fun and such a validating experience for everyone in our contingent to see the waves and giant thumbs up from the crowds as we debut our new T-shirts that read, “You Are More Than + — ” and did our own share of hooting and hollering. We really are all in this together. hivplusmag.com
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B UZZWORTHY
Could Cutting Off HIV’s Sugar Fix Lead to a Cure? New study shows virus has voracious sweet tooth By Katie Peoples
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hile we all know that sugar in moderation is best, researchers say that depriving HIV of sugar may put an end to the virus. When the virus enters an activated immune cell, it takes energy from sugar and nutrients in order to replicate. Cut off the supply of sugar, the theory goes, and HIV can’t replicate in the cell. Now researchers at Northwestern Medicine and Vanderbilt University say they’ve found a way to cut off the sugar pipeline to the immune cell, which in effect would starve the virus. september / october 2015
“It’s essential to find new ways to block HIV growth, because the virus is constantly mutating,” said Harry Taylor, a scientist at Northwestern Medicine’s HIV Translational Research Center. “A drug targeting HIV that works today may be less effective a few years down the road, because HIV can mutate itself to evade the drug.” This new approach has several benefits, including applications in treating cancer (another disease with a powerful sweet tooth) and reduction in organ damage in HIV-positive patients. HIV causes an
abnormal proliferation of immune cells, which can cause inflammation and damage to organs over time, even in patients who are on antiretroviral treatment. “This discovery opens new avenues for further research to solve today’s persisting problems in treating HIV infection: avoiding virus resistance to medicines, decreasing the inflammation that leads to premature aging, and maybe even one day being able to cure HIV infection,” said Richard D’Aquila, director of Northwestern’s HIV Translational Research Center.
BUZZWORTH Y
YOU’RE DOING IT WRONG! THE RIGHT WAY TO PUT ON A CONDOM BY EMILY MORSE
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THINKSTOCK
ondoms are ubiquitous. When it comes to preventing sexually transmitted infections (and pregnancies), condoms are usually the first choice. After all, they are inexpensive, easy to get, and good at their job—most of the time. Using a condom during intercourse can be up to 98 percent effective in preventing the spread of STIs. But condoms are only as good as their users. When used incorrectly or inconsistently, condoms can be rendered completely ineffective. Addressing the consistency aspect is easy. If you use a condom every time you put a penis inside someone, you’ve got the consistent part down pat. Using a condom correctly probably seems even easier, especially after you’ve done it a dozen times: You take it out of the package, roll it on, and you’re good to go! Right? However, there are a number of mistakes people commonly make when putting on a condom, and these mistakes can cause the condom’s effectiveness rate to plummet. No worries, if you just follow these simple tips, you’ll be having sex that’s worry-free and even more fun: 1. Size Definitely Matters Sure, those extra-large condoms come with a tremendous ego boost, but there are massive problems using a condom that’s way too big. We’re not talking length here. Usually it’s a question of girth: The problem with extralarge condoms is that they are often too wide. A loose fit leads to friction, and that friction can lead to breakage. So it’s important to make sure you find the condoms that fit the penis in front of
you. It doesn’t matter how skilled you are at the “rip, tip, and roll” if your condom doesn’t fit. Fortunately, some brands, like LifeStyles Condoms, offer a wide range of styles and sizes so you can experiment to find the perfect fit. LifeStyles’ latex Snugger Fit, for example, is shorter and narrower than the average condom, while the longer and wider SKYN Large condom is made from a softer, highly flexible polyisoprene material that conforms more easily to the wearer than latex does. Experiment with a few different condoms to see what really fits. 2. Use Your Wallet for Money, Not Condoms Admittedly, storing your condom in your wallet seems like a brilliant idea. It’s always with you, which means you’ll always be ready for action. The problem is, stocking your wallet with condoms will actually work against you. The same goes for the glove compartment of your car. Storing your condoms where they are exposed to constant pressure, friction, or heat will weaken the material and make the condoms less reliable. Just like your medications, red wine, or smartphone, condoms are best stored in cool, dry places. 3. Take Older Condoms Out of Service Just like you’d never pour a questionable carton of milk on your cereal, you should never put an expired condom on your penis. Condoms have an expiration date for good reason: They expire. Over time, condoms can become brittle and tear. Check the date and make it a habit to inspect the condom before you use it to make sure it’s not dry, ripped, or sticky. When in doubt, throw it out. 4. Roll With It Now that you’ve made sure your condom fits correctly and hasn’t expired, make sure you follow these steps to put it on correctly. Open the package carefully. Avoid using anything sharp that could tear or damage
the condom, including teeth, nails, or jewelry. Adding a drop of lubricant inside the tip of the condom can provide a little extra pleasure for the condom wearer. If the penis is uncircumcised, pull back the foreskin before putting on the condom. Most condoms only roll one direction. Position the tip of the condom so it is pointing away from the body, aiming the same direction as the head of the penis. Next pinch the air out of the reservoir tip, as this will reduce the chance of breakage. Using both hands is a good idea at this point. Use one hand to hold the condom at the head of the penis and the other hand to slip it over the head and unroll it. As you roll the condom down toward the base of the penis, clear out any air bubbles that form on the way. To avoid slippage, double-check that the rolled-down condom covers the entire shaft. Even if the condom is lubricated, you might want to add a little extra lubricant to the outside before you insert the penis. 5. Ready, Set, Sex With the condom worn consistently and correctly, you’re all set for some scintillating safe sex. But your job isn’t quite over yet. After ejaculation but before pulling out, grasp the condom at the base of the penis. Holding the condom securely to the penis as it is pulled out avoids leakage or having the condom fall off inside. Remove the condom, tie the top into a knot to avoid any sticky messes, and discard it in the trash. Making sure the condom you use isn’t expired, fits correctly, and was rolled on properly will only take a few extra seconds, but it can save you a heap of problems like incurable STIs. Once you’ve rolled the right condom on, you’ll be free to have safe, enjoyable sex without the worry of a condom malfunction. Dr. Emily Morse is a sex and relationship expert with degrees in human sexuality and psychology. She runs the popular website SexWithEmily. com and is the host of the top-downloaded podcast Sex With Emily. hivplusmag.com
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B UZZWORTHY
A SIGN OF STIGMA? Lighted freeway signs, normally used to warn of roadway hazards, were instead placed along a major highway in Indiana in May to caution drivers about people with HIV. The message—“Warning HIV Outbreak”—had activists outraged. State health officials eventually removed the signs in June and apologized, blaming “a miscommunication” over what they should have said. The campaign might have been intended to increase awareness after a spike of cases in one Indiana county but didn’t come with any messaging about testing, so activists said it amounted to fear-mongering.
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Thanks to a new law, doctors in Florida no longer have to fill out lots of paperwork to test patients for HIV. Instead, they can provide the test routinely, with patients able to opt out. Public health advocates say the change ensures that more people know their status, which can help prevent outbreaks like the one in Indiana. september / october 2015
THINKSTOCK
THE RIGHT WAY TO STOP AN OUTBREAK
BUZZWORTH Y
DOES HATRED OF GAY AND BI MEN PUT THEM AT HIGHER RISK FOR HIV? A EUROPEAN STUDY FOUND THAT GUYS IN THE LEAST TOLERANT COUNTRIES WERE AT THE GREATEST RISK OF HIV INFECTION
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School of Hygiene and Tropical Medicine. “But the closet is a difficult, shameful place, which is particularly harmful to mental health and well-being. ” For these men, Hickson said, ignorance can mean infection, and possibly a swift path to death of they then forgo treatment. “The homophobia that may have appeared to be protecting these men will now be exposing them to huge risk,” he said. The research was conducted by the Yale School of Public Health, Columbia University, and three respected schools in Europe. Scientists say their findings demonstrate the need for new approaches to HIV in Europe. “There are four key interventions in suppressing HIV: condom distribution, peer-led group education, peer-outreach education projects, and universal access to antiretrovirals for men with HIV,” Hickson said. “All health authorities could be commissioning these services as well as working to protect the human rights of sexual minorities.” —Dawn Ennis
THINKSTOCK
ust as it’s said the bad apples can spoil the entire bunch, new research suggests the most homophobic countries in Europe may be responsible for a boost in the number of HIV cases among gay and bisexual men, but it’s more complex than that. Researchers studied 175,000 gay and bisexual men living in 38 of Europe’s 51 countries, which have various levels of perceived homophobia. The study, published in the journal AIDS, concluded that men in the most homophobic countries had fewer sexual partners and were thus overall less likely to be diagnosed with HIV, most likely because the closet repressed their actions. But those who did have sex with other men in those places knew less about HIV, used condoms less frequently, had riskier sexual behavior, and were thus at the greatest risk of contracting HIV. “Our findings are surprising as it may appear it’s effectively safer for men to stay in the closet in the most homophobic countries because their HIV risk is lower there,” said coauthor Dr. Ford Hickson of the London
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B UZZWORTHY
Will this lead to us testing our dates before we do the deed? By Sam Page
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s tech giants Apple and Google rush to bring their wearable devices to the market, medical researchers at Columbia University have developed a $34 iPhone accessory that performs a point-ofcare test that detects HIV and syphilis from a single drop of blood in about 15 minutes. Three years in the making, the device produces results 10 times faster than traditional testing methods, while performing all the essential functions of a lab-based blood test. Notably, the power required for the test is drawn directly from the iPhone, which is important in countries where electricity is scarce. While the ultraportable attachment lacks the sleek design consumers have come to expect from Apple, it easily plugs into the iPhone’s headphone jack. A drop of blood placed on a microfluidic chip is inserted into a canister and then the device, which analyzes the blood sample quickly, replicating the HIV and syphilis tests patients get in a standard laboratory. Columbia professor Samuel Sia, lead researcher on the project, has already produced inexpensive tests using microfluidic chips for other diseases, including prostate cancer. Similar plug-in optical accessories and chips are being used to detect the virus that causes Kaposi’s sarcoma. “Coupling microfluidics with recent advances in consumer electronics can make certain lab-based diagnostics accessible to almost any population with access to smartphones,” Sia said. “This kind
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of capability can transform how health care services are delivered around the world. … We are really excited about the next steps in bringing this product to the market in developing countries and we are equally excited about exploring how this technology can benefit patients and consumers back home.” Private firms, such as VitaMe Technologies in Ithaca, N.Y., are already developing smartphone accessories that enable users to monitor the pH of their sweat and saliva. These breakthroughs raise important social questions for LGBT people, especially young African-American men, a group in which HIV is still on the rise. Will people require potential sex partners to undergo a “quick prick” test prior to intercourse? And what impact will these devices have on HIV-related stigma, and the social landscape? There are also deep privacy implications for the gathering of personal data from such devices, especially since data from similar health and fitness apps are already being shared with Apple’s new health app. The company has already reassured the Federal Trade Commission about privacy of the HealthKit platform and will likely end up setting the bar for privacy when it comes to mobile health services. ”We designed HealthKit with privacy in mind,” Apple spokeswoman Trudy Muller told Reuters. ”We’ve been very encouraged by [the FTC’s] support.”
BUZZWORTH Y
HIV MAKES YOU TIPSY FASTER
NEW DATA INDICATE THAT YOUR HIV MAY BE CONTRIBUTING MORE TO YOUR BUZZ THAN YOU IMAGINED BY KATIE PEOPLES
THINKSTOCK
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new study from Yale University and the National Institutes for Health indicates that men with HIV may be cheap dates, at least where alcoholic beverages are concerned. Researchers studied the effects of alcohol on both HIV-positive and HIV-negative men and found that those with HIV, especially those who were not virally suppressed, were far more sensitive to liquor than guys who did not have the virus. “All else equal, people who have HIV infection have a lower tolerance for alcohol than similar people without HIV infection,” said Dr. Amy C. Justice, professor of medicine and public health at Yale. The Yale researchers reviewed data on 2,600 men from the Veterans Aging Cohort Study. They looked at surveys answered by a number of veterans about how much alcohol it took for them to feel buzzed. They compared HIV-positive and HIV-negative men, and among the guys with HIV, those with viral suppression and those without. Those with HIV, especially those with a detect
able viral load, reported needing fewer drinks to feel “buzzed” than those who did not have HIV. The results of the study are particularly worrisome for poz men who just want to let loose on the weekend. Justice added that it is unclear whether HIV-positive men are more susceptible to alcohol or whether they achieve greater blood alcohol concentration. Regardless, the data show that there’s no clear safe amount of alcohol for HIV-positive people. Alcohol, across all populations, has negative effects on the immune system and liver, leads to riskier behavior, and is the number 1 cause of 2 a.m. text messages to your ex. But those Friday night beers or appletinis may be worse than all that if they cause you to forget to take your HIV meds, which means we should all be cutting down a bit. And hey, at least there will be fewer Snapchat booty calls, amiright? hivplusmag.com
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“HIV is not just a gay issue; it is an issue. Any health concern this big cannot continue to be pushed upon a demographic. It’s cruel and inhumane. We can’t be…afraid to talk about the issue at hand.” - Gary L. Gray, costar, Blackbird
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L H T A D AN
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R E T S R T A A T S M E I S V E O V I M V I H L K G C N I A P L # B N S S TO P A E M Former football star Wade Davis, Academy Award-winner Mo’Nique, actors Julian Walker and Gary L. Gray, producer Keith Brown, and the entire team behind the film Blackbird have joined forces with Alabama’s largest HIV organization to talk about the world’s first HIV prevention pill and to break the silence that is literally killing young black gay and bi men. By Daniel Reynolds Photography by Miguel Starcevich Photo assistant: William Thomas
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“That’s why I’m a producer. Because visibility in the media is so important to me and always has been. You have to use that platform when you can and how you can.” - Producer Keith Brown
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he weekend after the Supreme Court ruled in favor of nationwide marriage equality, Julian Walker marched in San Francisco’s LGBT Pride parade. The 22-year-old gay actor is star of the indie hit Blackbird, director Patrik-Ian Polk’s new film based on Larry Duplechan’s iconic novel about a gay Christian teen coming of age in a zealously religious Mississippi town. Walker was at San Francisco Pride with a costar of the film, singer-dancer-actor D. Woods, to perform on the Soul Stage. It was his first LGBT Pride and it was exhilarating. “The experience was absolutely amazing,” Walker says of the event, which drew a jubilant crowd of over 1 million people, many there also celebrating the historic Supreme Court decision, Obergefell v. Hodges, that legalized same-sex marriage nationwide. “It was just so beautiful to see so many people out there happy and celebrating. It wasn’t even just gay and lesbian people out there. There were straight people with their family and friends. Everyone came together for one purpose, which was love.” Pride and self-acceptance are sentiments that Walker’s character, Randy, experiences precious little of throughout the majority of Blackbird. A high school student in Hattiesburg, Miss., Randy struggles with the shame he feels about his attraction to other men. Leaders in his black church, where he sings in the choir, as well as his devout mother, played by Mo’Nique, stoke the stigma—sometimes unwittingly—that surrounds his (secret) sexual orientation. Sadly, Randy’s experience is one that is still alarmingly common among African-American teens and young adults in America. Black gay and bisexual men, who already weather the socioeconomic hardships of racism and mass incarceration, are particularly vulnerable to the stigma of homophobia. Many are left to battle discrimination and homophobia without traditional support networks like church, family, and community, and the result, experts say, is the perfect storm for a health crisis.
Young gay and bisexual African-American men bear the terrible brunt of the HIV epidemic today. The Centers for Disease Control and Prevention reports that this group has more than twice the rate of new HIV infections as white or Latino men in the same age range. At the current rate of HIV infection, a black gay or bi man has a 60 percent chance of being HIV-positive by the time he turns 40. As a young black gay man, Walker finds that statistic terrifying. “That’s scary,” he says, then pauses. “That’s really scary.” Despite stereotypes, this epidemic is not limited to gay and bisexual men. Though African-Americans make up only 12 percent of the U.S. population, they account for nearly half of new HIV infections. The rate of new infections among African-American women is 20 times that of white women. An estimated 56 percent of black transgender women are HIV-positive. Racism, poverty, and homophobia are key factors in this epidemic. And their mixture is volatile. Many black communities already lack essential resources like education and health care, and the stigma attached to being LGBT or having HIV prevents many from getting tested, using HIV prevention methods, getting treatment for HIV after testing positive, and accessing health care resources overall. Studies also show that for a variety of reasons, black gay men are most likely to date other black men, which ultimately increases the likelihood of HIV transmission because of the overall high rate of HIV within the population. So how does society even begin to address such entrenched problems? One major tool is media. Blackbird is an ambitious and far-reaching film, insofar as it takes on issues that few, if any, other Hollywood projects are tackling. Homophobia among African-Americans, the so-called down-low culture, interracial relationships, abortion, the hypocrisy of religious leaders, and the plight of missing black children are among the hot-button issues addressed. hivplusmag.com
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“I’m a sex-positive person, so I think we should be having these conversations around the beauty of sex and the vulnerability of sex, and to start having conversations about the dangers as well so young people can make their own informed choices.” - Athlete-turned-activist Wade Davis
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Oscar-winner Mo’Nique (here with Julian Walker) says homophobia is destroying black lives. “It’s time for us to say, ‘Let’s make it a better place and accept people for who they were made to be.’ ” It also travels where few other films have dared: to the health clinic, where Randy’s best friend, Efrem (played by Gary LeRoi Gray), gets an STD screening—and yes, an HIV test—after a risky encounter in a midnight cruising spot leaves him with a strange rash on his genitals. The purpose, Walker says, is to send a clear message to the audience: “Go get tested and continue to have safe sex. You have to protect yourself, because you never know what may happen.” Gray, a 30-year-old straight actor and rapper who first rose to fame as a child actor on The Cosby Show and as an in-demand voice actor, has played a gay man before. He had a pivotal role in the film Noah’s Arc: Jumping the Broom, based on the popular black gay TV series created by Blackbird director Polk. Still, he says, he learned much from his experience on Blackbird. The film, he says, takes a strong stand against “the fear that comes along with coming out, being free,” the same fear that “causes things like health to be overlooked in many cases.” Gray also thinks it’s important to remember that “HIV is not just a gay issue, it is an issue.” Even though it’s disproportionately hitting African-American gay and bi men and trans women, “any health concern this big cannot continue to be pushed upon a [single] demographic,” he says. In a groundbreaking move, the cast and producers of Blackbird are taking this message of HIV prevention and care off of the screen and into the real world. The actors and filmmakers have partnered with AIDS Alabama—a small but mighty statewide organization committed to providing resources like housing and health assistance to those with HIV—to help launch its PrEP Up Alabama program. The initiative will raise awareness of the HIV prevention tools available to gay men of color, including PrEP, the use of a preventive medication, a strategy that has seen little pickup in the South. The PrEP Up Alabama initiative will also help AIDS Alabama reach the at-risk youth demographic with its services.
As part of this partnership, Mo’Nique, who also served as an executive producer of Blackbird, released a video invitation to a screening and Q&A with the cast. Folks who wanted a ticket to the July event at the Birmingham Museum of Art found that the admission price was an HIV test, a marketing tactic that may be the first of its kind for Tinseltown. (It’s been utilized at hip-hop and rap concerts in other states, however.) “Not only are we asking you to support the film, but also yourself,” Mo’Nique said in a video she released on social media and which quickly went viral. “Get a ticket and get tested. How amazing is that?” The collaboration continues the mission of what Mo’Nique set out to do with the film’s creation, which was to counter the homophobia she says is destroying the lives of so many people. “It’s enough,” she says. “It’s enough for us to stop hurting, and hurting one another. It’s time for us to say, ‘Let’s make it a better place and accept people for who they were made to be.’ ” “I’ve played the video a million times, and I still can’t believe our agency’s name came out of her mouth,” says Dafina Ward, the director of prevention and community partnerships at AIDS Alabama. “It’s pretty amazing. I have so much respect for Mo’Nique and for celebrities who truly utilize their platform to empower others.” In addition to the Alabama premiere of Blackbird, which was timed just before its August 4 DVD release, PrEP Up Alabama also kicked off a series of community discussions that will raise awareness about pre-exposure prophylaxis, the daily dosage of a pill that some studies have shown to be 99 percent effective in preventing HIV. Funded in part by Gilead Sciences, the new initiative will survey and educate those who are most at risk. “African-American men are not engaging in PrEP services as much as we would like them to be,” Ward admits, which she attributes in part to a lack of awareness as well as hurdles like employment and health insurance. In many areas, PrEP is available at little to no cost, but most African-Americans don’t know that. hivplusmag.com
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GE T T Y IMAGES; ALBERTO E. RODRIGUEZ
“It’s enough for us to stop hurting, and hurting one another. It’s time for us to say, ‘Let’s make it a better place and accept people for who they were made to be.’” - Mo’Nique
“There’s no reason—no logical reason—for the infection rates of gay black men to still be as high as they are,” adds Blackbird filmmaker Patrik-Ian Polk, whose past projects like Noah’s Arc, Punks, and The Skinny also addressed HIV issues in the black community. “The medical advancements are there…we just need to make them more widely known and more widely available.” In addition to economic hurdles, stigma against HIV and LGBT people is a force that remains a sizable barrier in prevention in communities like Birmingham. Keith Brown, a producer of Blackbird, immediately recognized what this city has in common with the film’s Mississippi milieu. HIV affects the South more than any other region in the United States—in 2013 it had more than half of the nation’s new HIV diagnoses, according to the CDC, and for a variety of reasons, more of those cases progress to AIDS than in any other part of the country as well. Brown wanted to be a part of the plan for addressing that. “People don’t want to be seen near the testing center because of the stigma with it,” says Brown of one of the barriers in Birmingham and beyond. He adds that, much like Randy, the young man at the center of Blackbird, many men worry that “they’ll be shunned by their family and friends, and called out” for trying to seek testing and treatment. Movies can play a big role in changing hearts and minds, says Brown. He says a star like Mo’Nique is a bit like “sugar” on a bran muffin; a little bit of her input sprinkled on certain subjects—like HIV and homophobia—may make them palatable to audiences, inducing some folks to listen to ideas they’d not normally want to consume. Brown doesn’t say it, but the fact that the cast and filmmakers are primarily African-American helps too. Of the film and its use in HIV awareness, he does say, “It’s such a perfect fit. We’re excited to be involved. We’re hoping, by involving the star power that we have with a film, we can up those numbers
and get more people tested than [AIDS Alabama has] been able to in the past.” Of course, this all came about because of an athlete. The man who first connected Blackbird with AIDS Alabama is Wade Davis, a gay former football player and a PrEP Up Alabama ambassador, who led many of the HIV discussions on “Game Changing Weekend” in July. His career as an athlete gives him sway among young men, but his activism background more than qualifies him for the role. Davis is the executive director of the You Can Play Project, which fights homophobia in sports, and he is also a board member for Gay Men’s Health Crisis, one of the country’s largest HIV service organizations. Davis, “a firm believer that visibility is advocacy,” recognized how black Hollywood could battle stigma with star power. “Someone of a Mo’Nique stature, to use their platform to have these hard conversations in a very public way? Hopefully, that will spark another person to think that they should educate themselves on the issue,” he says. While he may not wish to see every actor in Hollywood championing this cause—some celebrities, he points out, are just off-brand for the message—he speaks highly of the value of the “right people who have the right lived experience” in speaking out about HIV. By “lived experience,” Davis doesn’t mean they need to be HIV-positive or have grown up in a disenfranchised community. They just need a passion for the cause and a drive to educate themselves about the issue. This is the first, crucial step that anyone can take to help fight daunting battles against HIV, poverty, and racism. “It’s really hard for someone to be thoughtful about something they’ve never thought about,” Davis says. Armed with this knowledge, a person can make an active choice to have conversations with people in their daily lives about this issue and “be fearless” in doing so. This will inspire others to do the same.
Mo’Nique and executive producer Sydney Hicks at the Outfest screening of Blackbird
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Two years in the making, a breathtaking new show is giving voice to long-term survivors of HIV.
By Jacob Anderson-Minshall
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eople just disappeared. Survivors say that was one of the most disconcerting things about living through the early days of the AIDS epidemic. “Girls were just disappearing,” recalls Cheryl Courtney-Evans, the Atlanta-based transgender activist who founded the support organization Transgender Individuals Living Their Truth. “If you missed seeing a girl that you were accustomed to seeing every night or all the time and you weren’t hearing about her being busted in some sort of sweep or raid or getting picked up, if you weren’t hearing about her calling somebody to bring some money down to the jail and you hadn’t seen her, you generally assumed that she was in the hospital.” It was a tough period for transgender women, Courtney-Evans says: “If you didn’t see her [after] about a week or two weeks, well, she’s gone. And we knew they were in a pauper’s grave somewhere…we didn’t know their legal names, the names that we could find them under. So they would just disappear and we would just assume, well, there’s another one gone.” Back in the 1980s and early ’90s little was known about the disease originally dubbed “the gay plague,” except that within weeks—sometimes within mere days or hours—of being diagnosed, tens of thousands of once-healthy and vibrant individuals withered and died. Many in the beginning were transgender women.
The dancers of “The Missing Generation” Photo by Lydia Daniller
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Jimmy Mack (right) says talking with choreographer-creator Sean Dorsey (left) about the early epidemic was still “difficult and emotional.” At the epidemic’s peak, AIDS-related fatalities in the United States were over 51,000 a year according to the Centers for Disease Control and Prevention. By the end of 1995, over half a million cases of AIDS had been reported in America, leading to 319,849 deaths. We don’t know the number of trans women who died, although we do know that today trans women have one of the highest rates of HIV infection. A 2009 report from the National Institutes of Health found that nearly a third of transgender Americans are HIV-positive and more than 55 percent of black trans women are HIV-positive.
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As Plus reported in April 2013, a “complex web of intertwining oppression and discrimination” puts trans women at higher risk of being infected. “HIV data collection methods often either mistakenly categorize transgender women as men who have sex with men, or don’t distinguish between transgender and nontransgender women,” the article noted, which is still the case. The disappearance of these women and men certainly didn’t go unnoticed at the time—at least not to those of us in the LGBT community—and their absence has left a scar on survivors and the communities they left behind. A scar no less painful because it has become nearly invisible in the decades since. Mack says he turned to drugs and alcohol to deal with the loss of “many, many friends, lovers, mentors, and heroes.” But once he got sober in 1992, Mack remembers, “It became clear to me that I had survived a plague so that I could tell my story and hopefully prevent others from getting it as well as do my part to dissipate the negative stigma attached to the disease.” Many survivors like Mack have begun telling their stories. Last year Sean Strub’s memoir Body Counts recounted his life during the early days of AIDS in New York City; the HBO film of Larry Kramer’s The Normal Heart put a very handsome face (actor Matt Bomer’s) on his origin story; and Perry Halkitis’s anthology The AIDS Generation: Stories of Survival and Resilience included the stories of 15 gay poz men, making it the first book to document the life experience of long-term HIV survivors. Still, those born after antiretroviral drugs transformed HIV from a usually fatal virus to a chronic, manageable condition often haven’t heard these stories. Younger people don’t even know what they’ve lost or what it means for queer and trans communities and even the country at large that more than half a million men and women simply vanished seemingly overnight at the prime of their lives. But that doesn’t mean younger LGBT people don’t want to know about those dark days. “There is a real hunger for information about this period, this history and these lost lives,” Chris Bartlett once told The New York Times. A former classics scholar, Bartlett developed an online memorial for Philadelphia men who died of AIDS in the 1980s and ’90s for GayHistory.Wikispaces.com. Charles Stephens agrees. The founder of the Counter Narrative Project and coeditor of Black Gay Genius: Answering Joseph Beam’s Call tells Plus that younger black gay men want to know “our legacy,” including the work of Tongues Untied filmmaker Marlon Riggs, and authors Joseph Beam and Essex Hemphill, all of whom died of AIDS-related illnesses. “[It] is really inspiring,” Stephens says of today’s youth. “They want to know more about the 1980s black gay renaissance.” Six years ago, author Sarah Schulman, a lesbian activist and director of the ACT UP Oral History Project, complained to The New York Times, “There is absolutely no permanent social marker of the hundreds of thousands who died of AIDS in this country. There’s not even a postage stamp.” Today there remains no stamp to commemorate those who died of AIDS complications in America, but there are a U.S. Postal Service AIDS awareness stamp and a variety of international AIDS-related stamps, a memorial stand of trees in San Francisco (the National AIDS Memorial Grove is located in Golden Gate
SEAN DORSEY
“You could go real fast,” adds Dee Dee Chamblee, another transgender woman in Atlanta. “You could have a cold one day and go the same day. It wasn’t no ‘have a cold today and maybe you die next week.’ It was like, ‘You have a cold today, you die today.’ ” “It was unbelievable,” recalls Jimmy Mack, a gay, HIV-positive man who now blogs for The Body. “I watched so many of my friends, previously healthy men, die horrible deaths from an unknown disease that was first called GRID and then finally AIDS.” Mack, who says he was “given a death sentence” at 29, moved to New York City in 1981 and came down with his first “AIDSdefining illness” that same year. It was a trying time, those early days when death seemed to attack overnight. “We couldn’t even keep up with how many people were dead,” continues Chamblee, who is the founder of La Gender, a regional trans advocacy group. “It was like at least two or three every other day of your friends, of people you know. And we had no grief counseling or anything like that. So the community just kind of like blotted it dry.” For some it would be more accurate to say blotted it out. Because while everyone knows that a generation of gay and bisexual men disappeared into the eternal night that was AIDS, far fewer realize that transgender women were dying too—in droves.
SEAN DORSEY
Park), and not one but two AIDS monuments in development. In May the Foundation for a National AIDS Monument received a $500,000 gift from Cedars-Sinai Medical Center, pushing the total amount raised by the Los Angeles nonprofit to over $1.2 million, making it all but certain it will succeed in building an AIDS monument in West Hollywood. Meanwhile a coalition is developing the New York City AIDS Memorial, dedicated to the “recognition and preservation of the ongoing history of the AIDS crisis,” as the project’s website puts it. Having seen more than 100,000 residents die of AIDS-related illnesses, the city has the highest number of AIDS deaths in the country. Brooklyn-based architecture firm Studio a+i is designing the memorial, which will have an 18-foot steel canopy and sit at the entrance to the new St. Vincent’s Hospital Park in the West Village. As these physical reminders of the epidemic’s toll break ground, other efforts to recover our history are uncovering stories that have been long silenced or ignored. “One of the worst things AIDS took from us as black gay men has been our stories,” Stephens says. “Which is why we must keep telling them and keep remembering them. Our stories matter. 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.” Stephens calls passing down that history to young gay black men critical “proof we existed” and says it’s necessary for them to “know that they not only have a community behind them, but a culture and a history.” A similar impetus fuels award-winning queer dancer and choreographer Sean Dorsey’s sweeping and achingly wonderful new AIDS history performance piece, The Missing Generation. “As a trans person, I’m passionate about documenting and sharing transgender experiences of early AIDS,” Dorsey tells Plus. “Despite being decimated by the early epidemic, trans women have been all but forgotten in most AIDS histories and narratives. Bringing these stories forward is really important to me.” But why now? “There is an incredible urgency to undertaking this project now,” Dorsey says. “During my lifetime we will see the passing of the last generation of people who actually experienced the early years of the AIDS epidemic firsthand. We are already rapidly losing our community’s stories.” It was that necessity that pushed Dorsey to spend two years of his life researching that time period and traveling the country collecting stories from AIDS survivors. “I think our culture has largely turned our backs not just on the early AIDS epidemic, but also on the generation of survivors who lived through those terrifying early years,” he says. “There was so much terror, so much death, so much mass death and grief that people individually had to pack a lot of it away just to keep functioning. But then we as a culture turned our backs on all those survivors.” The director of Sean Dorsey Dance for the past 10 years, Dorsey is recognized as the nation’s first acclaimed transgender modern dance choreographer. He is also the founder and artistic director of Fresh Meat Productions, which creates year-round multidisciplinary transgender arts programs in San Francisco. With The Missing Generation, Dorsey says he hopes to “capture and share part of this important history and reckon with the loss
and grief this generation endured. And to collectively face this history and grieve and heal together.” In some cities, a quarter of all gay and bi men and transgender women died of AIDS-related causes within a few years. It’s a world far removed from the lives of today’s millennials. “Younger people don’t get taught this history,” Dorsey complains. “But young trans, queer, LGBT people lost an entire generation of elders. People who today would be their mentors, teachers, heroes, gay mothers, gay uncles. We need to grieve this together.”
Dee Dee Chamblee: “We had no grief counseling or anything. We just blotted it dry.”
For GayHistory.Wikispaces.com, Bartlett was able to create a database of men who died by searching obits, hospital records, and registries of both the Names Project Quilt and a local church that buried the unclaimed. But finding trans women lost to the disease is a much harder proposition. During that period many police and medical professionals routinely misidentified trans women as drag queens or transvestites. In death, these women were routinely stripped of their feminine accoutrements and counted by coroners and hospital workers as merely another dead gay man. As Courtney-Evans recollects, most trans women had been “put out” by their families and were using names they hadn’t been given at birth. They may not have had identification with their real names. So when they died, these women just disappeared. Many of the dead can be found on the Names Project Quilt, although because of stigma at the time, many of those commemorated with quilt patches were listed only by their first name, a nickname, or simply a single initial. Perhaps there’s better luck if a trans woman (or man) died in New York City; there’s a project to document paupers’ graves in the city’s potter’s field, Hart Island. HartIsland.net has a database going back to 1980 and is searchable by name (if available), date of death, or where the person died (i.e. the name of a hospital). But be warned: 63,484 people have been buried in mass graves on Hart Island, and all of their stories certainly can’t be told.
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ABilly S. Jones-Hennin: “We have made progress.”
Jimmy Mack, who says that despite telling his story to thousands of middle and high school students in the 15 years since he joined Love Heals, the Alison Gertz Foundation for AIDS Education, talking about those days was still “difficult and emotional.” Not so for Jones-Hennin, who founded one of the country’s first black HIV organizations. “It was not a painful experience for me,” he admits, “because we have made progress. Yet we have so much more work to do on a personal, community, national, and global level. The painful part was recalling all of the men, women, and children lost due to complications associated with HIV and failure of communities, government, faith-based [groups], and health officials to respond in a compassionate manner.” In addition to conducting interviews for two years, Dorsey did extensive archival research and hosted LGBT and HIV community residencies in six major U.S. cities to further expand his understanding of the AIDS era. In the end, he had 75 hours of oral history and enough material to write a book or two. “I truly could have made a 200-hour long show!” Dorsey admits. “It was actually very painful to have to choose the final excerpts and stories that are featured in the show because they are all important and powerful for me.”
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Over the course of his investigation, Dorsey says he began to sense common threads in all the stories he heard, which helped him develop the 65-minute performance piece based around four fantastic dancers and scores by four composers. “I built the show around the themes that began to emerge.” One of those themes is about aging while HIV-positive. “I met with people who have been HIV-positive for 30 or 35 years,” he says. “What we don’t talk about as a culture, let alone in LGBTQ community, are the long-term realities of being HIV-positive. Being a senior and negotiating care homes or medical care as a transgender or LGB person. Being an invisible elder in our youthobsessed queer culture.” From talking with women like Chamblee and men like Mack, Dorsey came away sounding like a health care activist too. When antiretroviral medication first became available the dosage was set way too high, Chamblee recalls. “The medicines that they had was so harsh and the side effects and the way…it made you look, your eyes and everything, most people did not want to go out like that,” she says. “I stopped taking it in like the first six months, because it had really just depleted me of everything. I had nothing left.” Even though today’s treatments turn HIV into a manageable disease, Dorsey adds, “We’re only starting to understand some of the very intense long-term side effects of being on HIV meds for decades. Some long-term survivors are dealing with additional painful diseases and conditions prematurely because they are being brought on by long-term use of HIV meds. And no one I talked to will be able to afford their HIV meds once they ‘retire.’ ” While the resulting performance by Sean Dorsey Dance’s multigenerational troupe is “a love letter to a forgotten generation of survivors, those who witnessed and experienced the loss,” Dorsey stresses that The Missing Generation isn’t just for those over 40. “All audiences can relate to this show,” he says, because “it speaks to all of us. All of us want to be loved, all of us want to live, all of us want community and safety and happiness. All of us carry rage at injustice and all of us want healing.” Indeed, San Francisco Chronicle critic Allan Ulrich called the show “a metaphor for dealing with any inexorably destructive force. At moments, The Missing Generation seems like a primer for living well; at other times, it seems a prescription for just living.” The performance features a score (which took 350 hours to create) that layers original music with voices and life stories collected on Dorsey’s travels. “What audiences hear are actual excerpts of the actual interviews,” Dorsey explains. He says we should all pay attention to these AIDS survivors. “I think we talk and ask and listen and advocate and fight like hell with and for them,” he says. The Missing Generation, he says, is one tiny step in that direction. The performance premiered in San Francisco and is now on a 20city tour that includes stops in D.C., Pittsburgh, Boston, Atlanta, Los Angeles, and Maui between now and fall 2016. (For locations, times, tickets and more information, visit SeanDorseyDance.com.) “Sometimes we are frozen by [a sense of ] overwhelm in the face of big problems,” Dorsey says. “But what I want people to take away is, just do it. Just show up. If we just show up with an open heart and sit with each other, we can hold what comes. We can hold all of it. But first we need to show up for each other. With heart. I hope this project sparks our hearts in that direction.” ✜
SEAN DORSEY
But The Missing Generation isn’t as much about documenting those who died as it is about honoring the survivors and healing the pain of their loss—and ours. “The people I met with were extraordinary,” Dorsey says of his “life-changing” cross-country journey documenting these stories. “These are people who lost dozens, hundreds, as many as a thousand friends and lovers and clients and patients and family. The warmth, generosity, humor, intelligence, insight, and wisdom that everyone shared blew my heart wide open.” ABilly S. Jones-Hennin, a legendary bisexual activist in Washington, D.C., who Dorsey interviewed for the project, says the choreographer was “very comforting, assuring, and full of energy. Although it was my first interaction with him, it felt like we had known each other for decades.”
WE ARE HERE TEO DRAKE IS THE MYTHICAL UNICORN OF THE HIV-POSITIVE COMMUNITY: AN OUT, POZ, QUEER TRANS MAN. BUT HE’S NOT ALONE BY RAFFY ERMAC
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ainstream visibility of transgender men living with HIV is nonexistent. There’s plenty of anecdotal evidence that gay and bisexual trans men get HIV as often as their nontrans peers, but little scientific research addressing their increased risk, and even in the LGBT media, you still won’t find stories about poz trans men. That’s something Teo Drake wants to see changed. Drake, an activist, educator, and artist in Greenfield, Mass., is also an HIVpositive, queer trans man who hopes to bring visibility to the issue with the help of the Transgender Law Center’s newest project, Positively Trans. Drake is the only man on the national advisory board for the project, dubbed T+, which is conducting a groundbreaking community needs assessment of HIV-positive transgender and gender-nonconforming people in the U.S. “Sometimes I think we are the mythical unicorns of the HIVpositive community,” Drake says of being a poz trans man. “We aren’t talked about. There isn’t research looking at our experiences with HIV. It’s very hard to find educational materials to help us talk with prospective partners about risks and prevention options in ways that honor our gender identity and accurately reflect our anatomy in whatever configuration that is.” The activist says the isolation is “sometimes hard. I haven’t met that many trans men living with HIV. There is something powerful and healing in shared experience that I miss.” Drake, who was invited by the TLC’s senior strategist, Cecilia Chung, to bring the perspective of a trans man with HIV to T+, a project that already has plenty of strong, vocal trans women involved (including Dee Dee Chamblee, Tommy Luckett, and Octavia Lewis). The purpose of the project is to form a network, tell stories, and develop advocacy strategies “in response to inequities, stigma, and discrimination over punitive laws and lack of legal protections” that affect trans people, according to its website. “For me, the invitation to take part in T+ and the needs assessment project came at a meaningful time,” Drake says. “July is the 20th anniversary of my HIV diagnosis. I believe that following a spiritual calling of service to my community has brought me hope and meaning over the last 20 years. That hope and sense of purpose has kept me alive.” As the National Center for Transgender Equality reported in its “Injustice at Every Turn” survey, transgender people face intense discrimination in employment, housing, education, and health care. The Centers for Disease Control and Prevention also points out that “because data for [the transgender] population are not uniformly collected, information is lacking on how many transgender people in the United States are infected with HIV.” Compared to trans women, the CDC reports, “little is known about HIV risk and sexual health needs among transgender men.
“I want trans men to make choices that are authentic to them about wrapped or raw and not be pressured into choices for fear of being rejected.” One meta-analysis of 29 studies involving transgender people showed that only five of them had separate data concerning transgender men.” “I would like people to know we exist. That we are gay, straight, bi, and queer just like nontrans people with HIV,” Drake says. He worries “that HIV-negative trans men who are either new to the experience of transition and negotiating dating or sex with cisgender men will see HIV as a marker of being accepted a gay man,” something many activists have heard anecdotally. Early trans activist Lou Sullivan once quipped, after he acquired HIV, that naysayers had told him he couldn’t live as a gay man, but he would now die as one. “I want trans men to make choices that are authentic to them about wrapped or raw and not be pressured into choices for fear of being rejected,” Drake adds. He continues to use his experiences with HIV to help others, and he’s sure to not let his status define who he, or the community he identifies with, is. “I’m grateful to still be alive. I’m grateful that I lived long enough to become the man I am. Feeling more comfortable and at home in my own skin after gender transition is still magical every day,” he says. Living with HIV for decades, Drake says it was coming out as trans and living life as a queer man that helped him get healthy. “I know how healing living authentically can be,” he says. “In 2002, prior to choosing to transition, I had 33 T cells and a viral load above the limits of detection. No treatment worked. The side effects were all too severe, and I didn’t have it in me to fight for a life that wasn’t the one I wanted to be living. I made the decision to transition as a last kindness to myself because I didn’t think I would survive another few years. The paradox is that as I stepped more and more into an authentic expression of my inner self, my health improved. I was able to tolerate the medication side effects because I had the life I finally felt was worth fighting for. Turns out that loving yourself is a powerful healing force.” ✜ 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 that combines the medicines in TRUVADA + EDURANT in only 1 pill a day.*
Ask your healthcare provider if COMPLERA may be the one for you. *COMPLERA is a combination of the medicines in TRUVADA (emtricitabine and tenofovir disoproxil fumarate) and EDURANT (rilpivirine).
Pill shown is not actual size.
COMPLERA does not cure HIV-1 infection or AIDS.
To control HIV-1 infection and decrease HIV-related illnesses you must keep taking COMPLERA. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them. It is not known if COMPLERA is safe and effective in children under 18 years old.
IMPORTANT SAFETY INFORMATION What is the most important information I should know about COMPLERA?
COMPLERA can cause serious side effects: • Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. • Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions. • Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking COMPLERA, your hepatitis may suddenly get worse. Do not stop taking COMPLERA without first talking to your healthcare provider, as they will need to monitor your health. COMPLERA is not approved for the treatment of HBV.
Who should not take COMPLERA?
Do not take COMPLERA if you: • Take a medicine that contains: adefovir (Hepsera), lamivudine (Epivir-HBV), carbamazepine (Carbatrol, Equetro, Tegretol, TegretolXR, Teril, Epitol), oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin, Dilantin-125, Phenytek), rifampin (Rifater, Rifamate, Rimactane, Rifadin), rifapentine (Priftin), dexlansoprazole (Dexilant), esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole sodium (Protonix), rabeprazole (Aciphex), more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate, or the herbal supplement St. John’s wort. • Take any other medicines to treat HIV-1 infection, unless recommended by your healthcare provider.
What are the other possible side effects of COMPLERA?
Serious side effects of COMPLERA may also include: • Severe skin rash and allergic reactions. Call your doctor right away if you get a rash. Some rashes and allergic reactions may need to be treated in a hospital. Stop taking COMPLERA and get medical help right away if you get a rash with any of the following symptoms: severe allergic reactions causing a swollen face, lips, mouth, tongue or throat which may lead to difficulty swallowing or breathing; mouth sores or blisters on your body; inflamed eye (conjunctivitis); fever, dark urine or pain on the right side of the stomach-area (abdominal pain). • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood tests to check your kidneys before starting treatment with COMPLERA. If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider may also check your kidneys during treatment with COMPLERA.
Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: feeling sad or hopeless, feeling anxious or restless, have thoughts of hurting yourself (suicide) or have tried to hurt yourself. • Changes in liver enzymes: People who have had hepatitis B or C, or who have had changes in their liver function tests in the past may have an increased risk for liver problems while taking COMPLERA. Some people without prior liver disease may also be at risk. Your healthcare provider may do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking COMPLERA. •
The most common side effects of COMPLERA include trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, and depression. Other common side effects include vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), and pain. Tell your healthcare provider if you have any side effects that bother you or do not go away.
What should I tell my healthcare provider before taking COMPLERA?
All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, mental health, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking COMPLERA without first talking with your healthcare provider. • If you take rifabutin (Mycobutin). Talk to your healthcare provider about the right amount of rilpivirine (Edurant) you should take. • If you take antacids. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. • If you take stomach acid blockers. Take acid blockers at least 12 hours before or at least 4 hours after you take COMPLERA. Ask your healthcare provider if your acid blocker is okay to take, as some acid blockers should never be taken with COMPLERA. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking COMPLERA. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in COMPLERA can pass into breast milk, and it is not known if this can harm the baby. •
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.
Brief Summary of full Prescribing Information COMPLERA® (kom-PLEH-rah) (emtricitabine 200 mg, rilpivirine 25 mg, tenofovir disoproxil fumarate 300 mg) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information, including Patient Information. What is COMPLERA? • COMPLERA is a prescription medicine used as a complete HIV-1 treatment in one pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and who have no more than 100,000 copies/mL of virus in their blood (this is called ‘viral load’). Complera can also replace current HIV-1 medicines for some adults who have an undetectable viral load (less than 50 copies/mL) and whose healthcare provider determines that they meet certain other requirements. • COMPLERA is a complete HIV-1 medicine and should not be used with any other HIV-1 medicines. • COMPLERA should always be taken with food. A protein drink does not replace food. • COMPLERA does not cure HIV-1 or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider about how to prevent passing HIV-1 to others. Do not share or reuse needles, injection equipment, or personal items that can have blood or body fluids on them. Do not have sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. What is the most important information I should know about COMPLERA? COMPLERA can cause serious side effects, including: • Build-up of an acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take COMPLERA or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: – feel very weak or tired – have unusual (not normal) muscle pain – have trouble breathing – having stomach pain with nausea or vomiting – feel cold, especially in your arms and legs – feel dizzy or lightheaded – have a fast or irregular heartbeat • Severe liver problems. Severe liver problems can happen in people who take COMPLERA. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems: – your skin or the white part of your eyes turns yellow (jaundice) – dark “tea-colored” urine – light-colored bowel movements (stools) – loss of appetite for several days or longer – nausea – stomach pain • You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time.
• Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take COMPLERA, your HBV may get worse (flare-up) if you stop taking COMPLERA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. COMPLERA is not approved for the treatment of HBV, so you must discuss your HBV with your healthcare provider. – Do not run out of COMPLERA. Refill your prescription or talk to your healthcare provider before your COMPLERA is all gone. – Do not stop taking COMPLERA without first talking to your healthcare provider. – If you stop taking COMPLERA, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking COMPLERA. Who should not take COMPLERA? Do not take COMPLERA if you also take any of the following medicines: • Medicines used for seizures: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal); phenobarbital (Luminal); phenytoin (Dilantin, Dilantin-125, Phenytek) • Medicines used for tuberculosis: rifampin (Rifater, Rifamate, Rimactane, Rifadin); rifapentine (Priftin) • Certain medicines used to block stomach acid called proton pump inhibitors (PPIs): dexlansoprazole (Dexilant); esomeprazole (Nexium, Vimovo); lansoprazole (Prevacid); omeprazole (Prilosec, Zegerid); pantoprazole sodium (Protonix); rabeprazole (Aciphex) • Certain steroid medicines: More than 1 dose of dexamethasone or dexamethasone sodium phosphate • Certain herbal supplements: St. John’s wort • Certain hepatitis medicines: adefovir (Hepsera), lamivudine (Epivir-HBV) Do not take COMPLERA if you also take any other HIV-1 medicines, including: • Other medicines that contain emtricitabine or tenofovir (ATRIPLA, EMTRIVA, STRIBILD, TRUVADA, VIREAD) • Other medicines that contain lamivudine (Combivir, Epivir, Epzicom, Triumeq, Trizivir) • rilpivirine (Edurant), unless you are also taking rifabutin (Mycobutin) COMPLERA is not for use in people who are less than 18 years old. What are the possible side effects of COMPLERA? COMPLERA may cause the following serious side effects: • See “What is the most important information I should know about COMPLERA?” • Severe skin rash and allergic reactions. Skin rash is a common side effect of COMPLERA but it can also be serious. Call your doctor right away if you get a rash. In some cases, rash and allergic reaction may need to be treated in a hospital. Stop taking COMPLERA and call your doctor or get medical help right away if you get a rash with any of the following symptoms: – severe allergic reactions causing a swollen face, lips, mouth, tongue or throat, which may cause difficulty swallowing or breathing – mouth sores or blisters on your body – inflamed eye (conjunctivitis) – fever, dark urine or pain on the right side of the stomach-area (abdominal pain) • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking COMPLERA. If you have had kidney problems in the past or need to take another medicine that can cause kidney problems, your healthcare provider may need to do blood tests to check your kidneys during your treatment with COMPLERA.
• Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: – feeling sad or hopeless – feeling anxious or restless – have thoughts of hurting yourself (suicide) or have tried to hurt yourself • Change in liver enzymes. People with a history of hepatitis B or C virus infection or who have certain liver enzyme changes may have an increased risk of developing new or worsening liver problems during treatment with COMPLERA. Liver problems can also happen during treatment with COMPLERA in people without a history of liver disease. Your healthcare provider may need to do tests to check your liver enzymes before and during treatment with COMPLERA. • Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms and face may also happen. The cause and long term health effect of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having any new symptoms after starting your HIV-1 medicine. The most common side effects of COMPLERA include: • Trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, depression Additional common side effects include: • Vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles), pain Tell your healthcare provider if you have any side effect that bothers you or that does not go away. • These are not all the possible side effects of COMPLERA. For more information, ask your healthcare provider. • Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What should I tell my healthcare provider before taking COMPLERA? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, mental health, bone, or liver problems, including hepatitis B or C infection. • If you are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn child. – There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed if you take COMPLERA. – You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. – Two of the medicines in COMPLERA can pass to your baby in your breast milk. It is not known if this could harm your baby. – Talk to your healthcare provider about the best way to feed your baby.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements: • COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works. • If you take certain medicines with COMPLERA, the amount of COMPLERA in your body may be too low and it may not work to help control your HIV-1 infection. The HIV-1 virus in your body may become resistant to COMPLERA or other HIV-1 medicines that are like it. • Be sure to tell your healthcare provider if you take any of the following medicines: – Rifabutin (Mycobutin), a medicine to treat some bacterial infections. Talk to your healthcare provider about the right amount of rilpivirine (Edurant) you should take. – Antacid medicines that contain aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or at least 4 hours after you take COMPLERA. – Certain medicines to block the acid in your stomach, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine hydrochloride (Zantac). Take the acid blocker at least 12 hours before or at least 4 hours after you take COMPLERA. Some acid blocking medicines should never be taken with COMPLERA (see “Who should not take COMPLERA?” for a list of these medicines). – Medicines that can affect how your kidneys work, including acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex), and valganciclovir (Valcyte). – clarithromycin (Biaxin) – erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) – fluconazole (Diflucan) – itraconazole (Sporanox) – ketoconazole (Nizoral) – methadone (Dolophine) – posaconazole (Noxafil) – telithromycin (Ketek) – voriconazole (Vfend) Know the medicines you take. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Do not start any new medicines while you are taking COMPLERA without first talking with your healthcare provider. Keep COMPLERA and all medicines out of reach of children. This Brief Summary summarizes the most important information about COMPLERA. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about COMPLERA that is written for health professionals, or call 1-800-445-3235 or go to www.COMPLERA.com. Revised: May 2015
COMPLERA, the COMPLERA Logo, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, TRUVADA, VIREAD, and VISTIDE are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners.
©2015 Gilead Sciences, Inc. All rights reserved. CPAC0167 06/15
DAILY DOSE
OLD DOGS, NEW TRICKS
After decades with HIV, one gay senior gets a shocking diagnosis that makes him rethink By Robby Sherwin
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et’s get the basics covered out of the gate: I’m 63. I’ve had HIV since the early 1980s or late ’70s. I’m healthy, active, considered stable, intelligent, and attractive. I’m in a 20-plusyear open relationship with another man. Having accomplished all of that, I see a new landscape of language and potentialities emerging before me more rapidly than a cold sore after a quick encounter. Grindr, Scruff, Growlr, Manhunt, Adam4Adam, BBRTS, ad infinitum. And add one more acronymistically neutral sounding event in the dating arena: PrEP. Pre-exposure prophylaxis, or PrEP, is the daily administration of a magic-bullet pill that prevents those engaging in what people my age call “risky behaviors” from the trauma and life sentence of HIV. Like a lot of gay men my age, I was against PrEP before I was for it, much like the political posturing that came before the actual votes were taken for the “wars” of the new generation in Iraq and Afghanistan. My initial thought was, This is a license for bad behavior. After all, I come from the condom culture way back in another century when that latex liner was really all we had to even begin to ensure our continued longevity and still allow us to be sexual beings—if not the fully realized ones we thought we were becoming before the plague. What’s to stop the rapid resurgence of barebacking now that people assume that they are safe from HIV, even though all the literature and health care workers continue to remind us that PrEP does not prevent other sexually transmitted diseases? I used to ask. As I came to know more and more people who began taking PrEP, sponsored largely by their insurance carriers making the calculated assumption that a little spent on prevention would save a lot more on treatment over the long haul, I only had more questions. But I did pause in my Negative Nancy, knee-jerk responses to think about it. Aha, I thought, if I were a mid-hormonal 20-something, trying to find my sexual self amid the onslaught of online porn and gay perfectionism, I would so totally take that pill, gladly. I realized that at the very least, PrEP is another instrument in the toolbox for HIV prevention. And so I switched my allegiance to the pro-PrEP camp. Go for it, guys. I’ve already got HIV—and I’m managing it quite well, thank you—but I do hope you can avoid all the anguish, errors, and expense that I have had to endure over three decades. ( Just as an informational
THINKSTOCK
note, the medicine cabinet is a large enough hurdle when you have HIV; the annual tally of what those meds cost you is another. In my case, it’s upward of $85,000 per year and climbing.) HIV is part of me, a companion on my journey. Still, here is where the narrative can easily take an ugly twist. There comes a point in all people’s lives when they begin to look in the mirror at the self-perceived ravages that aging entails. I presume we gay men are slightly more apt to be self-critical, as we have been taught by our peers, from our earliest inklings and urges, that looks are currency and the body must be beautiful. The new instant, selfie-stick, handheld, jerk-off technologies only ramp up the pressure to perfect and classify and reclassify us all into tighter and tighter boxes. Just look at those profiles: DDF (drug and disease-free), clean, no one over 35, VGL (very goodlooking) only, NEG UB2. These acronyms make it clear: HIV and the men with it are unwanted commodities. Who but a fresh-faced farm fella from the wilds of Kansas, right out of high school, can possibly meet these criteria? And so we lie. To ourselves, to each other, to the greater world in which we crave to be accepted but fear that we will never be. We lie to get laid. Period. We’re men, after all, and our relationship to our orgasms is preordained in many respects, and the axiom of which head we think with is never more true than in today’s world of split-second decision-making apparati. Disclosure was a bitch back in the days of face-to-face, in a bar or a club or, if we were lucky, someone’s home or bedroom. When and to whom do I disclose my HIV status? If I use a condom, do I need to tell that anonymous trick? Or just someone with “potential” (i.e. relationship material)? The price to be paid was often too great to overcome the need to remain a morally coded adult. Now today, with most effectively treated HIV virtually undetectable and therefore almost impossible to pass on to others, we are back in a new era: to disclose or not. And I see more and more reasonable humans posting their PrEP status on hookup sites, and I think kudos to them. It shows they are thoughtful, engaged humans who, whether through dislike of condoms or simple casual laissez faire-ism, know they will encounter men who have HIV— and they are no longer frightened of them. Of us. Men will lie, especially in the heat of the moment. These guys who take PrEP are no longer requiring men to lie to them. Still, the ugly truth comes back to that disclaimer that all the prevention people, drug companies, condom manufacturers, astute parents and teachers, and anyone who knows better espouses: PrEP does not prevent a host of other, often serious, sometimes deadlier, diseases. Back in the day, many of us spent more than a little time at the free clinic in our fair cities getting a jab in the butt to cure a dose of something. A shot, a few days of self-imposed abstinence, and we were good to go. In fact, some of the better dating pool candidates were the other guys in the clinic waiting room because you at least knew that they too, in three days, would be fresh meat on the market shelves—at least until the next slip-up. But I digress. I really let my standards lag along the way as the years passed. Having assumed early on that I would die an ugly and early death, alone, I am continually amazed at the life I have been graced with. Still, I was lazy, casual, self-critical, and yes, horny. Who wouldn’t, with the all-access pass to people I never imagined I’d come across? “There’s someone for everyone,” the old adage goes. Nowadays there’s an unlimited pool of playmates.
Unfortunately, the pool has bacteria floating in it, and no amount of chlorine or PrEP can protect you from the host of ill-gotten gains left swimming around from body to body. Think about the math here. Back in my heyday, one person hooked up with one person in a bar (that was the major way to find a “date”), and it took them at least a night to recover before they wandered out again in search of more tail. Today, thanks to apps, we can line up our potential tricks like cards in a stacked deck, whisking them off as easily as a Vegas croupier. And our behaviors with each of these encounters slip incrementally as their youth, looks, and availability multiply. And so we arrive at yesterday. The call from my doctor just said, “Repeat your labs and come in; your liver enzymes are wonky.” I had long assumed that my HIV meds might take a toll on my liver or some other vital organ, but I have been so steady, so healthy for so long that I was lulled into a very false sense of security. When I was told years ago that I had HIV, I honestly was not surprised. I had no life crisis, no fretful nights. I had expected it. All my friends were poz, either dead or dying. I assumed my fate was sealed. Decades of struggle and activism had forged in me a steely core that has served me well in all of life’s challenges. But I’ve lived and I was healthy until this call from the doctor. Had my HIV meds done me in? Nope. When my doctor turned to me and said, “You have acute hepatitis C,” I finally had my moment. I was too shocked to even respond. My mind literally went blank. This is no joke. Hep C, or HCV as it’s called, comes with a whopping price tag for treatment and a host of other don’ts. For the next six months, maybe longer, I could have no alcohol, no Tylenol, no cholesterol medications, only a minimal amount of marijuana (medical or otherwise). The list of “nos” was long. Contracting HCV came from an invincibility factor that I thought only belonged to the young. The arrogance of youthful noblesse oblige. A haughty thought that I was past all of this. I had done my worrying. I had persevered. I had survived. I was healthy. And now I’m back to the beginning. To rethinking how I live my life, choose my partners, which behavior patterns I like and which I should finally ditch. I have disclosure issues like never before. I am an old guy having to have awkward, painful, intensely personal conversations with [past] casual encounters, informing them of their risks, hoping they will seek immediate attention yet knowing that, because this is largely a symptomless starter, many will not. And then knowing too that it could mushroom from there, everyone passing it on unknowingly. So I look at PrEP with yet another twist of the kaleidoscopic lens that is life. What shapes will the shiny, colorfully tantalizing pieces fall into before they settle? That too-hot-to-say-no-to guy who hit me up yesterday on Grindr, flattering my flagging youth with urgent longings and tempting pics? Do I write, “No, sorry, I have HCV and couldn’t possibly have sex with you for the next few months?” As the Tempos sang back in the 1960s, “See You in September?” I think not. I can’t say how this will change me in the long run— these tectonic shifts take time to settle, and the aftershocks are absorbed with a shifting of the soul and a morphing of mood. I can say this: Yes to PrEP, but guys, PrEP with precautions may be the more prudent path. ✜ hivplusmag.com
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“Start to imagine a world that is outside your own mirror,” Davis says. “Oftentimes, people focus on things that only impact them.” Once they step outside this comfort zone, he says, people can realize, “Wow, we are really all a part of this together.” This lesson could be particularly valuable to LGBT people in the aftermath of the marriage equality movement. That fight united many organizations and individuals, including major civil rights groups, in a common cause, and its seeming speed led to a realization of what could be done through collaboration. The marriage equality win has left many searching for the next battle and wondering how such success could be replicated. “Marriage is a great thing, but it is a privileged idea,” Davis says. He points out that young black gay and bi men have far greater things to worry about—HIV, unemployment, homelessness—before wedding bells become an item on their checklist. The key, he says, is to “connect the dots” between the people who have the money, power, visibility, and access and issues that affect those who don’t necessarily look like that person in the mirror. “We have to stop being so damn afraid to see ourselves in everyone else,” he says. “When we as a country can get to that point, we will actually genuinely care about each other. In order to end this epidemic in communities of color, it’s going to take all of us—black and white, male and female, gay and straight.” AIDS Alabama’s Ward agrees. She points out that the lion’s share of HIV work is shouldered by LGBT organizations, at a time when a variety of groups should be working in tandem to create change. “The torch should not have to be carried solely by the LGBT community,” she says. “It’s a social justice issue. It’s an issue of classism and access and so many other things.” She says stars like Gray, Walker, and Mo’Nique help push these ideas into the mainstream. “Celebrities need to be more engaged in having these conversations,” she adds. “We can’t decide that we only care about certain people’s lives. And that’s been part of the problem.” But Wade Davis and the rest of the Blackbird team certainly aren’t alone in the fight against HIV. Broadway star Sheryl Lee Ralph has been educating audiences about HIV with her one-woman show for years. Rihanna was the 2014 spokeswoman for Viva Glam, a makeup line that contributes proceeds to the MAC AIDS Fund. Alicia Keys has become one of the most visible musicians talking about HIV among women. Actors like Dennis Haysbert, Alimi Ballard, Jason George, Nadine Ellis, and Jussie Smollett are all voices for Greater Than AIDS, an organization that works to raise awareness of HIV issues in at-risk communities. Smollett, the star of the Fox smash hit Empire, has been an HIV activist for all of his adult life, he says. In a recent panel at New Orleans’s Essence Festival called “The Power of Love and Family,” the gay actor revealed a crucial conversation about HIV he had with his mother when he was about 10 years old. The discussion occurred after a crew member to whom the young Smollett had grown attached while filming a television show died of an AIDS-related illness. “It is a parent’s duty” to educate their child about HIV and testing, Smollett stressed, before it’s too late to have that conversation. He compared the stigma of having such talks to letting kids outside in a snowstorm without a shirt. This is a sentiment echoed by both Davis and Polk, who in their interviews with Plus said they never had such a conversation with their parents growing up. Such silence, if it continues, will only prolong the HIV epidemic, they say. “Parents have to actively engage in the lives of their gay children, underage or adult,” Polk says, or they risk them obtaining misinforseptember / october 2015
mation about sexual health that will put them in danger. Moreover, Smollett believes that it is a celebrity’s duty to use their platform to enact positive change. This was another lesson imparted by his mother, who gave him and his siblings “no choice whether we were activists or not. If millions of people are listening, shouldn’t you say something that’s worth hearing?” “I’m 30 years old, and I’ve never lived in a world that was free of HIV and AIDS,” he said with sadness during the panel. But he also emphasized that the world has all the tools needed to eliminate AIDS, something he hopes the next generation will accomplish in their lifetimes. At the panel, Smollett’s own shirt was printed with “Black Lives Matter: Know Your Status.” This text illustrates how some activists are trying to expand the meaning of the Black Lives Matter movement, which many associate with issues like violence and mass incarceration of black people, to include topics like the disproportionate impact of HIV. “I believe that Black Lives Matter movement is really about addressing systemic oppression and systemic prejudice,” Ward says. “And I think that HIV is definitely a piece of that.”
Empire star Jussie Smollett: “I’m 30 years old, and I’ve never lived in a world that was free of HIV and AIDS.” Davis adds that the conversation around Black Lives Matter is starting to include the mind’s well-being as well as the “mental scars” developed over a lifetime battling prejudice and stigma. These scars aren’t always visible. Not every assault, he points out, is physical. “Genocide” is a term employed in the Black Lives Matter movement to describe the state violence and imprisonment targeting black people. It is a term also used by Larry Kramer at the height of the AIDS crisis in the 1980s and again in 2015 to describe how government inaction and public indifference lead to wholly preventable AIDS-related deaths. “I believe in evil,” Kramer said at a 2015 awards ceremony for Gay Men’s Health Crisis. “I believe evil is an act, intentional or not, of inflicting undeserved harm on others. Genocide is such an act. I believe genocide is being inflicted upon gay people. Genocide is the deliberate and systematic extermination of a national, racial, political, or ethnic group such as gay people, such as people of color.” The 80-year-old activist adapted his 1985 play The Normal Heart, which chronicled the AIDS epidemic between 1981 and 1984, into an award-winning HBO film in 2014. The project shows the plight of white gay men who fought for their lives against the virus in New York. As communities of color continue to do the same in present day, the world is perhaps well past due for a sequel. ✜
wellness
How to Date an HIV-Negative Guy Think your HIV-positive status is the only one that matters? You’re wrong By Tyler Curry
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Don’t sell yourself short. So he doesn’t have to take med-
Cut him some slack. As long as he is willing to learn, give
Don’t worry about being rejected. Be up front about your status and date with no regrets. So what if you get rejected by someone for being HIV-positive? Plenty of people get rejected for a myriad of reasons each day. The right HIV-negative guy will be able to recognize what a catch you are and feel lucky to have you. Stand tall, make no apologies for who you are, and find the one person who is right for you, HIV be damned. ✜
he aftermath of an HIV diagnosis can often leave you with so much to think about that you sometimes forget what life was like when you were HIV-negative. When the dust settles and you get a handle on your virus, life starts to resemble something close to normal. Before you know it, it’s time to start dating again. You may think it would be easier to date someone with HIV, but your status has nothing to do with chemistry, compatibility, or sexual attraction. You deserve to be with someone who is the right match, regardless of your status or theirs. As much as you worry about how someone will treat you because of your status, there are a few things to be aware of before dating someone who is HIV-negative. Pay attention, and you may just live happily ever after—or at least not break up over HIV.
your date some time to ask questions and become comfortable with your status. After all, it took you a while to figure it out; it will take some time for him as well. Let him know that he can ask any question he wants. Make him feel comfortable enough to talk about any concerns he may have. Soon enough, he will feel at ease with it and you two can move on to more important topics.
ication every day. Big deal. Just because he is negative doesn’t mean he is worth more or less than you are. He has to win your love and respect just as much as you need to win his. Do not mistake his comfort level with your HIV status as a sign of good character or a reason to overlook any flaws. You are deserving of a partner who deserves you, regardless of status.
Tyler Curry is a regular contributor to HIVPlusMag.com, an LGBT and HIV activist, and senior editor at HIV Equal Online.
Be open about your own concerns. Just like you hope he will be open with you, you have to let him know what’s going on in your mind. Talk to him about your concerns and fears regarding HIV. Be honest about any worries you may have. If he is the right person for you, he will be happy to listen to the things that sometimes keep you up at night. It may even bring the two of you closer together. Initiate the talk about sex and safety. You know what
is a risk and what isn’t, but he probably doesn’t. Talk about what is safe. Explain the simple science behind sex and HIV and discuss what it means to have an undetectable viral load. Give him all the information he needs to help him find his comfort level while sharing your own. After the sex talk, both of you can leave the rest up to hormones and chemistry.
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How to Become Attracted to People Who Are Good For You Do you pick the wrong people to date? Here’s how to change that. By Ken Page
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e can’t force ourselves to be attracted to anyone, no matter how “right” we think they are for us. Yet there’s a life-changing insight most of us have never been taught: While our sexual attractions can’t be forced, they can be educated. This article will teach you the most important dating skill of all: how to cultivate sexual and romantic attraction to people who are good for you.
The Attraction Spectrum
Imagine being led into a room with a beautiful lighting console that allows you to play freely with a vast range of colors, tones, and intensities. That console reflects the range of romantic, sexual and emotional attractions available to each of us. Now, imagine being led away from that console, and brought to a simple, old-fashioned on/off switch. Two choices; that’s it. On or off. Either you’re attracted right now or you never will be. That’s how most of us have been taught to understand attraction. This unsophisticated perspective sabotages one of the greatest missions of our adult lives: the search for love. And LGBT people, perhaps particularly gay men, have swallowed that perspective hook, line, and sinker.
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All of us are attracted to a certain type that stops us dead in our tracks. It’s useful to imagine a “spectrum of attraction,” from 1 to 10; the people at the far end aren’t physically or romantically attractive to us at all, but those at the upper end leave us weak in the knees. They trigger longing, desire, and in most cases, insecurity. Harville Hendrix and Helen LaKelly Hunt, founders of Imago Relationship Therapy, illuminate this phenomenon in a way that sheds light on our entire intimacy journey. They teach that these people are so attractive to us in part because they embody not only the best but also the worst emotional characteristics of our parents. That’s right: the worst characteristics. All of us have unresolved hurts that stem from our childhood relationship with our parents—no matter how positive those relationships may have been. LGBT people often carry extra burdens of shame, guilt, or anger. Unconsciously, we seek healing through our romantic partner. And we try to achieve this healing by bonding with someone we sense might hurt us in similar ways to how we were hurt in the past, in the hope that we can get this person to finally love us right.
wellness Our conscious self is drawn to the positive qualities we yearn for, but our unconscious draws us to the qualities that remind us of how we were wounded the most. This partly explains why we get so awkward and insecure around people to whom we’re intensely attracted. It also explains why our most intense, fiery attractions so often go up in flames. Some people react to past heartbreaks by dating only those on the low end of their attraction spectrum. In my experience, people who are willing to date in the midrange of the spectrum are more likely to find real and lasting love. It’s not a matter of selling out, because immediate attraction is a terrible forecaster of future passion. Attractions can grow—and shrink—based on the connection we share with someone. Until we know how to choose healthy relationships and grow our attractions to people who love us for who we are, we’ll always remain at the mercy of the new “next one.”
Cultivating Attractions of Inspiration
Ken Page, LCS, is a leading Psychology Today blogger and author of Deeper Dating: How to Drop the Games of Seduction and Discover the Power of Intimacy.
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So what do we do when we meet someone great and we feel some spark of attraction but not enough to fall in love? Sexual attraction is much more mutable than we’ve been taught. If someone holds a spark of physical attraction for you and has other qualities you love, your attraction can blossom. If you’re meeting someone for the first time, don’t just focus on how they look to you. Notice how you feel with them. If you’ve ever seen artists working on a portrait, you will notice that they often squint. Squinting helps them focus on the essence of their subject without getting distracted by its harsh outlines. We need to do the same in our dating life. It’s so easy to get lost in the hard assessment of people’s imperfections, but it serves us better to simply sense their spirit. That is what makes attractions grow. As we start to care more deeply about someone, invisible tendrils begin to grow in our sexual imaginings and longings, in our growing sense of dependence on that person. Our psyche, our sexuality, and our hearts begin to create attachment to that person, to make him or her our own.
Here’s a sexual secret to growing your attraction to someone: The more you focus on the things that trigger your desire, the more your passion will build. To make an attraction grow, start by giving yourself space. No matter how wonderful the person, you’re not obligated to be attracted to him or her! Forcing your feelings will only block the natural flow of attraction. Instead, allow yourself to reflect on what attracts you sexually and emotionally in your new connection. Take time to let your erotic fantasies unfurl. You might simply want to hold hands at the movies. Or to kiss or just gently touch for a long time. You might imagine kinky, sweaty, wild sex, or long, lazy cuddling. Honor your fantasy, and, as appropriate, ask for what you want—that’s how we can grow our passion. And try not to have sex right away. When we desire someone and then postpone the sex, surprising new pathways of attraction form. It’s a great way to grow passion. More important, having sex too early is like Miracle-Gro for our fear of intimacy. So go slowly on the outside, but allow yourself free rein in your fantasy life. And if your desire is more sensual than sexual, that’s fine too. Years ago, I met a man who lived in Europe. I knew I liked him, but at that point my desire was sensual, not sexual. I began to plan a trip to visit him in Europe. At dinner with a friend, I shared my misgivings. I told him, “I don’t know if I should go all the way to Europe just to cuddle with someone.” My wise friend replied, “Really? I can’t think of a better reason to go to Europe!” I took the trip, and over time, my European friend and I fell deeply in love. No one should have to force an attraction that’s just not there. But we can all learn how to ignite the sparks of our healthiest attractions, and in so doing, we can change our entire romantic future for the better. ✜
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PHARMACIES THAT GO BEYOND PRESCRIPTIONS The HIV/AIDS community is an important support system that supplies information, education, encouragement, friendship and advocacy. Pharmacies that go beyond traditional HIV/AIDS medication management can make a broader impact in the communities they serve. Helping people afford medications With the launch of the Affordable Care Act, many more people living with HIV are now covered by medical and prescription insurance. But even for those with coverage, medication copays can still be high. Clearly, the easier it is for people to afford their medications, the easier it can be for them to stay on therapy. Pharmacies located right in the communities are in a perfect position to help. In addition to their expertise in medication therapy, the staff at more than 800 Walgreens HIV-specialized pharmacies are trained to help customers find ways to afford their medications. They coordinate with insurance companies and doctors to help minimize copays. Even for those with little or no insurance, Walgreens can help find copay assistance programs. Making testing easily accessible Almost one in seven people living with HIV is unaware of their status.1 Getting more people tested is vital, but obstacles such as inconvenient locations and a fear of stigmatization can get in the way. A recent research study found that pharmacies offer easier access to HIV testing, as well as an environment that can be less stigmatizing than a doctor’s office or health department.2
To help improve access to HIV testing, Walgreens teams up with Greater Than AIDS to promote free testing events in more than 200 stores every June. Since 2010, nearly 19,000 free HIV tests have been administered. Testing is also offered in many stores year-round. More information is available at greaterthan.org/Walgreens. It’s all part of Walgreens mission to not only care for their customers living with HIV/AIDS, but to support the HIV/AIDS community. To locate an HIV-specialized pharmacy, visit HIV.Walgreens.com. ■ See how Walgreens pharmacists help support people living with HIV/AIDS with the HIV Plus Ask the Expert video series at HIVPlusMag.com.
1. HIV in the United States: At a glance. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/hiv/statistics/basics/ataglance.html. Updated March 12, 2015. Accessed March 27, 2015. 2. Weidle PJ, Lecher S, Botts LW, et al. HIV testing in community pharmacies and retail clinics: A model to expand access to screening for HIV infection. J Am Pharm Assoc. (2003) 2014;54:486-492. ©2015 Walgreen Co. All rights reserved.
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WE KNOW HIV/AIDS medication therapy
But we also know you want a pharmacy that cares for you and the community. From participating in AIDS walks to offering education and free HIV testing in select stores nationwide, Walgreens is committed to giving back to the local groups and organizations that bring people together and bring us closer to new treatments, avenues of support— and a cure.
To learn more, visit HIV.Walgreens.com.
Š2014 Walgreen Co. All rights reserved.
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Five Tips for Finding True Love When You Have HIV First, stop labeling yourself. You are not your diagnosis. By Gary McClain
The road can feel pretty lonely when you don’t have that one special person walking along beside you. Probably every week a client a tells me how much they want to be in love, how sad they feel about being alone and how hard it is to meet someone to have a life with. Let’s face it: Whether you’re in your 20s and maybe just starting to look for a life partner or you’re further along in life, it’s not easy to find the right person. Living with HIV can add an extra wrinkle to the process of connecting with people who might have dating potential: Disclosing your diagnosis to someone who may or may not be very understanding. And if they are HIV-negative and not very well educated, that can leave you feeling like HIV is a pretty lonely road. The simple truth is that your HIV diagnosis affects the people in your life. It’s not something that you or your partner can pretend doesn’t need to be acknowledged and discussed, as you attempted to do with this guy you were dating. But as you learned (or maybe relearned) not everybody you meet is going to be willing to step up to the plate. As a result, it’s only human that you are feeling a little hesitant to take the risk of meeting new people. And if you’ve had a few disappointments along the way, you might also be wondering if having a partner is even in your future. In my experience, when you are living with HIV, getting connected with the right person is an inside job. By that, I mean it starts with working on your own attitude toward dating and having a relationship. And the important work you do on yourself is a whole lot more important than the dating tips you might be reading about or your well-meaning friends may be passing on to you. To have a healthy relationship, I think it’s important to be comfortable with yourself, and confident in your ability to meet your own needs. Even to be able to face the future on your own and to not only be OK with that but to feel like you have a quality life even if that means being single. After all, we all have to be able to make ourselves happy first. Nobody else can do that for us.
Here are some ways to do that: Build a strong friendship network.
We need people in our life who care about us and whom we care about to be with during the good times and the hard times. Friendships help you maintain a solid foundation. And when your foundation is solid, you are in a better position to be open to a relationship because it will enhance your life rather than arise from neediness or desperation to have someone to make you feel complete. After all, you’re already complete.
Build yourself up.
If you are caught up in reminding yourself how unlovable you are, then your dating life will be all about proving to yourself that you’re right. Stop labeling yourself. Especially with labels you don’t want or need to live up to. Sure, living with HIV presents some challenges. But you are the same lovable and caring person you have always been. Always keep in mind: You are not your diagnosis.
Take your eye off the ball.
By focusing too hard on something, we can end up getting in our own way — and sending other people running for the hills. Instead of making finding a life partner your mission in life, make it your mission to have a quality life—quality in all areas of your life— right now and not sometime in the future (like when you have a partner).
Just be your best you.
Think of it this way: You are what you’ve got. Your interests, your talents, your unique personality, your compassion for others. Let your light shine! When you’re happy with your life and living it on your own terms, you are going to be that much more attractive to others. Who isn’t attracted to confidence?
Make it fun.
Finding a partner is a numbers game. You just have to keep putting yourself out there in the world. So make it about getting to know someone new, to share a smile and few friendly words, and make the day a little more enjoyable. If you’re able to accomplish that much, then that’s a lot. Take the pressure off yourself. And let go of the expectations for other people. Be happy with yourself. You’ll be that much more able to make someone else happy.
Plus’s mental health editor Gary McClain, Ph.D., is a counselor in New York City with a specialty in coping with HIV and other chronic health conditions. His books include The Complete Idiot’s Guide to Breaking Bad Habits and Empowering Your Life With Joy. ✜
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Dear Dr. Gary, I had been dating this guy for a month or so, and we decided it was time to get intimate. So I disclosed my HIV status. He said it didn’t bother him, but he made this excuse about wanting to wait a little longer to really get to know each other. He hasn’t returned any of my texts since then. I don’t want to go through life alone, but sometimes I think maybe I will. Sign me “Lonely in Long Island”
A
NEVER TAKE ANOTHER HIV PILL?
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Hate swallowing pills? Then you’ll love this news
TREATMENT CHRONICLE S
new implanted device could revolutionize HIV treatment by eliminating adherence as a factor in reaching successful outcomes. The matchstick-size device is designed to be implanted under the skin, where it can automatically deliver carefully measured doses of antiretroviral drugs. “To our knowledge this is the first implant to be used for this purpose,” Marc Baum, senior faculty member at California’s Oak Crest Institute of Science, where the device was developed, said in a press release. Working much like a contraceptive implant, the device could dramatically increase treatment adherence by freeing patients from having to maintain a daily regimen of HIV medication. Research has shown that uninterrupted adherence to antiretroviral regimens is critical for maintaining viral load suppression. Patients with an undetectable viral load not only avoid further damage to their own immune system but are also unlikely to transfer HIV to their sexual partners. Shown in clinical trials to be one of the most significant factors in determining successful outcomes, adherence is also widely viewed as one of the most critical elements in the fight against HIV. But some HIV-positive patients still struggle with adherence, especially if they are prescribed numerous drugs—whether to enhance drug effectiveness, provide cheaper treatment options, fight multiple HIV strains, or prevent the virus from becoming drug-resistant. Now researchers at Oak Crest hope their subdermal device will eliminate adherence as a factor in HIV treatment. Their findings, published in Antimicrobial Agents and Chemotherapy, indicate the device successfully delivered a controlled, sustained release of antiretroviral drugs for up to 40 days in tests on animals, with no adverse side effects. “This novel device will revolutionize how we treat or prevent HIV/AIDS,” Baum said, “as it delivers powerful HIV-stopping drugs and eliminates one of the key obstacles in HIV/AIDS prevention—adherence to proper dosing regimens.” Birth control implants, which have been used successfully in the U.S. since 1993, utilize a small, flexible tube that is inserted under the skin of the upper arm. After insertion, it releases hormones that prevent ovaries from releasing eggs. The new HIV device would work in a similar manner. “It is easily inserted and removed,” Baum explained, “and provides sustained release of the potent prodrug tenofovir alafenamide, which is roughly 10 times more potent against HIV than tenofovir disoproxil fumarate [Viread], another tenofovir prodrug that has been shown to prevent sexually transmitted HIV when used as a pre-exposure prophylaxis [PrEP].” Viread is one of the components of Truvada, the only drug approved in the U.S. for PrEP. Now the researchers are moving forward with plans for human trials. “We are very pleased with the results of our preliminary studies and are working diligently to develop a subdermal implant for HIV prevention that will remain effective for a full 12 months,” Baum said. —Jacob Anderson-Minshall hivplusmag.com
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T REATMENT CHRONICLES
CRACK IS STILL WACK!
When it comes to HIV, cocaine’s a double whammy
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esearchers at the University of California, Los Angeles, say that cocaine use’s role in HIV transmission isn’t just that it leads to risky behavior, but that it makes your body more vulnerable to HIV infection. Scientists at the UCLA AIDS Institute and Center for AIDS Research base that claim on their new study, published recently in the journal Scientific Reports, that indicates cocaine disrupts the immune system. They used mice that had been transplanted with human cells so as to have the equivalent of a human immune system. They injected half of the mice with cocaine for five days and half with a saline solution. Then half of
the mice in each group were injected with HIV, and all were given cocaine or saline for two more weeks. They found that the mice that had received cocaine had higher levels of HIV in blood and tissue samples than did those that had received saline. Also, diseasefighting CD4 and CD8 T cells were less active in the mice that had been given cocaine. “This points to cocaine blunting the potency of our body’s defense against the virus,” said Dimitrios Vatakis, the study’s senior author and an assistant professor at the David Geffen School of Medicine at UCLA. The study, Vatakis said, builds on a previous one that suggested cocaine increases the number of CD4 T cells that are vulnerable to HIV. That study was done on cell cultures in the lab, not on living organisms like the latest study. Because the latest study was done on a limited number of subjects and involved brief, intense cocaine exposure, more research is needed, Vatakis said. Further studies, also in “humanized” mice, will involve how cocaine affects vaginal and anal tissues, viral latency, and pre- and post-exposure prophylaxis. —Trudy Ring
Good News on Hep C
+Merck has applied for FDA approval for a once-daily, single-tablet combination med for hepatitis C, containing the drugs grazoprevir and elbasvir. Merck has studied the combo as a treatment for multiple types of the virus and for hard-to-treat patients, such as those who have both HIV and hep C. —T.R.
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THINKSTOCK
+A trial of the popular hepatitis C treatment Sovaldi combined with the investigational new drug Daklinza saw nearly a 100 percent cure rate in patients who took the drugs for 12 weeks, University of Cincinnati researchers report. The cure rate was only 76 percent for eight weeks of treatment. The combo was as effective in HIV-positive patients as in those who did not have HIV.
TREATMENT CHRONICLE S
Why You Should Start Treatment Now Study shows that taking antiretrovirals immediately reduces your risk of health problems by 53 percent
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n a major report from the National Institute of Allergy and Infectious Diseases, researchers found that early treatment of HIV is linked to a considerably lower risk of developing AIDS. They found that when individuals started antiretroviral treatment when their CD4+ T-cell count was still high, they were significantly less likely to progress to AIDS or develop other serious illnesses. “We now have clear-cut proof that it is of significantly greater health benefit to an HIV-infected person to start antiretroviral therapy sooner rather than later,” said NIAID director Dr. Anthony S. Fauci. “Moreover, early therapy conveys a double benefit, not only improving the health of individuals but at the same time, by lowering their viral load, reducing the risk they will transmit HIV to others. These findings have global implications for the treatment of HIV.” The Strategic Timing of Antiretroviral Treatment (or START) study, which began in 2011, will conclude in 2016, but an independent data and safety board recommended the early release of this information after an interim review of the results. START is a randomized study of nearly 5,000 men and women 18 and older in 35 countries, conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT). NIAID, part of the National Institutes of Health, provided primary funding to START. Researchers divided participants into two randomized groups, one to start antiretroviral treatment immediately and the other to start treatment only when CD4+ levels dropped below 350 cells per
cubic millimeter of blood. Then participants were followed for an average of three years. Several health outcomes were measured, including AIDS-related cancer and non-AIDS-related major health events, such as liver or kidney disease. The data, released in March, showed that there were 41 major health events or deaths in the early treatment group, compared to 86 major health events in the deferred treatment group. Further analysis showed that risk of serious illness or death decreased by 53 percent when treatment began immediately. U.S. health officials call for immediate antiretroviral treatment for any HIV-positive person, even those who are asymptomatic, regardless of CD4+ levels. START is the first large-scale randomized clinical trial to provide evidence supporting U.S. guidelines. Current World Health Organization HIV treatment guidelines recommend that HIV-infected individuals begin antiretroviral therapy when CD4+ cell counts fall to 500 cells per cubic millimeter or less. “The definitive findings from a randomized trial like START are likely to influence how care is delivered to millions of HIV-positive individuals around the world,” said principal investigator James D. Neaton, professor of biostatistics at the University of Minnesota, Minneapolis. “Every person living with HIV should have immediate access to lifesaving antiretroviral therapy,” added Michel Sidibé, executive director of the United Nations Joint Programme on AIDS. “Delaying access to HIV treatment under any pretext is denying the right to health.” —Katie Peoples
Injectable HIV Meds?
THINKSTOCK
Soon it may be possible to treat HIV with a weekly injection instead of pills. Biotech firm CytoDyn plans a Phase III study—the final test before seeking Food and Drug Administration approval—of PRO 140, the first self-injectable antibody to treat HIV. The 25week trial will involve 300 HIV-positive patients. If OK’d, PRO 140, which has already shown ability to suppress the virus, will compete with Selzentry (both target the same protein), but PRO 140 appears to be less toxic, with fewer side effects. —T.R.
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104_30_Feat_MariaDavis_v1.pdf 104_36_Feat_MariaDavis_v1.indd
HIV ISN’T A DRAG FOR THIS HERO
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y day, Jahlove Serrano is a hardworking New Yorker, trying to educate youth about the realities of HIV. And some nights, Serrano becomes Jahlisa A. Ross, a striking drag queen who struts across the dance floor. “When I’m in my alter ego and I hit the stage, nothing else matters because I know I’m about to have fun performing for people who love the art form of drag,” Serrano says. Only 29, Serrano has managed to reconcile the different aspects of his life and personality. He gets much satisfaction in his career, working as an HIV health educator for the nonprofit Love Heals, and relieves some of his work stress at New York’s legendary gay nightclubs. He’s lived a lot in three decades, which helped him mature and embrace himself sooner than his peers. Serrano tested positive when he was only 15; within a year, he was a homeless high school dropout trying to survive in the Bronx. “My reaction to my diagnosis was none,” Serrano says. “I was more worried about how I was going to survive without the support of my parents.” The teenager managed to find his way out of poverty, realizing he wanted to help kids avoid the kind of situation he had found himself in as a teen. He grew up in a Catholic Latino household, where sex wasn’t discussed. The situation was the same at school. “I wasn’t taught how to protect myself, especially when having
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sex with another man,” he recalls. Working with Love Heals—which aims to eliminate new HIV infections—has made a passionate advocate out of Serrano. He passes out condoms, pushes people to get tested, and encourages HIV-positive folks like him to stay healthy and, well, positive. Serrano even lent his image to the “I’m Positively ________” campaign, and as his drag alter ego, he was part of the HIV Stops With Me media campaign. (“Treatment gives me strength,” Serrano said in the advertisement.) Serrano is thankful that most people his age now know the facts about HIV—how it’s transmitted and what to do if you get it. Things keep getting even better when it comes to communication about the disease, he says. “Now with PrEP there’s more conversations around HIV and AIDS,” Serrano says. When he was first diagnosed, Serrano avoided conversations about HIV with potential boyfriends. The stigma of the disease prevented him from getting close physically and emotionally. So much has changed, he says, and now Serrano embraces all sides of himself and expects everyone else to do the same. “As I got older and more educated on HIV and my body,” he says, “I became more confident in myself and [lost my] fear of rejection.” ✜
Jahlove Serrano was a homeless teenager. Now he’s a successful HIV counselor and the face of an education campaign
HIV TREATMENT CAN GET YOUR VIRAL LOAD SO LOW, IT’S UNDETECTABLE. GO FOR UNDETECTABLE.
There is no cure for HIV, but being undetectable helps protect your health. See how. Watch “The Goal of Undetectable” at HelpStopTheVirus.com © 2015 Gilead Sciences, Inc. All rights reserved. UNBC1853 03/15