HIV Plus Issue 111 March/April 2016

BECAUSE YOU’RE MORE THAN YOUR STATUS

3 0 FAC T S A B O U T LIVI N G WITH H IV TH E N E W H E P C CU R E I S IT FO R YO U ?

JOSEPH KIBLER

HOW THIS POZ , DISABLED ACTIVIST B E C A M E A C S I : C Y B E R S TA R

MARCH/APRIL 2016 www.hivplusmag.com

New Genvoya速 is now available

Actual Size

Actual Size

Onepill pill contains One contains elvitegravir, cobicistat, emtricitabine, elvitegravir, cobicistat, emtricitabine, and tenofovir (TAF). and tenofoviralafenamide alafenamide (TAF).

Ask your healthcare provider Ask your healthcare provider if GENVOYA is right for you.

if GENVOYA is right for you.

To learn more visit GENVOYA.com To learn more visit

GENVOYA.com

Please see Brief Summary of Patient Information with important warnings on the following pages.

Brief Summary of Patient Information about GENVOYA GENVOYA (jen-VOY-uh) (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) tablets Important: Ask your healthcare provider or pharmacist about medicines that should not be taken with GENVOYA. There may be new information about GENVOYA. This information is only a summary and does not take the place of talking with your healthcare provider about your medical condition or treatment.

What is the most important information I should know about GENVOYA? GENVOYA can cause serious side effects, including: • Build-up of lactic acid in your blood (lactic acidosis).

Lactic acidosis may happen in some people who take GENVOYA. 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

• Severe liver problems. Severe liver problems may happen in people who take GENVOYA. In some cases, these liver problems can lead to death. Your liver may become large and you may develop fat in your liver.

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 GENVOYA for a long time.

• Worsening of Hepatitis B infection. GENVOYA is not for use to treat chronic hepatitis B virus (HBV). If you have HBV infection and take GENVOYA, your HBV may get worse (flare-up) if you stop taking GENVOYA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before.

• Do not run out of GENVOYA. Refill your prescription or talk to your healthcare provider before your GENVOYA is all gone.

• Do not stop taking GENVOYA without first talking to your healthcare provider.

• If you stop taking GENVOYA, 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 GENVOYA.

What is GENVOYA? GENVOYA is a prescription medicine that is used without other HIV-1 medicines to treat HIV-1 in people 12 years of age and older: • who have not received HIV-1 medicines in the past or • to replace their current HIV-1 medicines in people who have been on the same HIV-1 medicines for at least 6 months, have an amount of HIV-1 in their blood (“viral load”) that is less than 50 copies/mL, and have never failed past HIV-1 treatment HIV-1 is the virus that causes AIDS. GENVOYA contains the prescription medicines elvitegravir (VITEKTA®), cobicistat (TYBOST®), emtricitabine (EMTRIVA®) and tenofovir alafenamide.

It is not known if GENVOYA is safe and effective in children under 12 years of age.

When used to treat HIV-1 infection, GENVOYA may: • Reduce the amount of HIV-1 in your blood.

This is called “viral load”.

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

Reducing the amount of HIV-1 and increasing the CD4+ (T) cells in your blood may help improve your immune system. This may reduce your risk of death or getting infections that can happen when your immune system is weak (opportunistic infections).

GENVOYA does not cure HIV-1 infection or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses.

Avoid doing things that can spread HIV-1 infection to others: • Do not share or re-use needles or other injection equipment.

• Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.

• Do not have any kind of sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

Ask your healthcare provider if you have any questions about how to prevent passing HIV-1 to other people.

Who should not take GENVOYA? Do not take GENVOYA if you also take a medicine that contains: • alfuzosin hydrochloride (Uroxatral®) • carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®, Tegretol-XR®, Teril®) • 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 • phenobarbital (Luminal®) • phenytoin (Dilantin®, Phenytek®) • 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 or a product that contains St. John’s wort

What should I tell my healthcare provider before taking GENVOYA? Before taking GENVOYA, tell your healthcare provider if you: • have liver problems including hepatitis B infection • have kidney or bone problems • have any other medical conditions • are pregnant or plan to become pregnant. It is not known if GENVOYA can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking GENVOYA. Pregnancy registry: there is a pregnancy registry for women who take HIV-1 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.

• are breastfeeding or plan to breastfeed. Do not breastfeed if you take GENVOYA. – You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby.

– At least one of the medicines in GENVOYA can pass to your baby in your breast milk. It is not known if the other medicines in GENVOYA 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. Other medicines may affect how GENVOYA works.

Some medicines may interact with GENVOYA. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

• You can ask your healthcare provider or pharmacist for a list of medicines that interact with GENVOYA. • Do not start a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take GENVOYA with other medicines.

How should I take GENVOYA?

• Take GENVOYA exactly as your healthcare provider tells • • • • • • •

you to take it. GENVOYA is taken by itself (not with other HIV-1 medicines) to treat HIV-1 infection.

GENVOYA is usually taken 1 time each day.

Take GENVOYA with food.

If you need to take a medicine for indigestion (antacid) that contains aluminum and magnesium hydroxide or calcium carbonate during treatment with GENVOYA, take it at least 2 hours before or after you take GENVOYA. Do not change your dose or stop taking GENVOYA without first talking with your healthcare provider. Stay under a healthcare provider’s care when taking GENVOYA. Do not miss a dose of GENVOYA. If you take too much GENVOYA, call your healthcare provider or go to the nearest hospital emergency room right away.

When your GENVOYA supply starts to run low, get more from your healthcare provider or pharmacy. This is very important because the amount of virus in your blood may increase if the medicine is stopped for even a short time. The virus may develop resistance to GENVOYA and become harder to treat.

What are the possible side effects of GENVOYA? GENVOYA may cause serious side effects, including: • See “What is the most important information I should know about GENVOYA?” • 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.

• 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 GENVOYA. Your healthcare provider may tell you to stop taking GENVOYA if you develop new or worse kidney problems.

• Bone problems can happen in some people who take GENVOYA. Bone problems may include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones.

The most common side effect of GENVOYA is nausea.

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 GENVOYA. For more information, ask your healthcare provider or pharmacist.

• Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088.

General information about the safe and effective use of GENVOYA. Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use GENVOYA for a condition for which it was not prescribed. Do not give GENVOYA to other people, even if they have the same symptoms you have. It may harm them.

This Brief Summary summarizes the most important information about GENVOYA. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about GENVOYA that is written for health professionals.

For more information, call 1-800-445-3235 or go to www.GENVOYA.com.

Keep GENVOYA and all medicines out of reach of children.

Issued: November 2015

EMTRIVA, GENVOYA, the GENVOYA Logo, GILEAD, the GILEAD Logo, GSI, TYBOST, and VITEKTA are trademarks of Gilead Sciences, Inc., or its related companies. All other marks referenced herein are the property of their respective owners. © 2015 Gilead Sciences, Inc. All rights reserved. GENC0001 11/15

editor in chief DIANE ANDERSON-MINSHALL SVP, group publisher JOE VALENTINO art director RAINE BASCOS managing editor TYLER CURRY senior editor JACOB ANDERSON-MINSHALL copy editor ELAINE MENDUS contributing editor KATIE PEOPLES 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 VP, integrated marketing AMANDA JOHNSON senior manager, integrated marketing JOHN MCCOURT manager, integrated marketing JAMIE TREDWELL integrated sales/marketing and ad production manager PAIGE POPDAN creative director, integrated marketing CHARLIE PFLAUMER junior designer PETER OLSON senior director, media strategy STEWART NACHT programmatic & yield managerADRIAN GRAHAM sr. director, audience development & consumer marketing ROBERT HEBERT director of social media LEVI CHAMBERS associate social media editor DANIEL REYNOLDS circulation director JEFF LETTIERE fulfillment manager ARGUS GALINDO operations director KIRK PACHECO los angeles office manager HEIDI MEDINA production services GVM MEDIA SOLUTIONS, LLC HERE MEDIA chairman STEPHEN P. JARCHOW ceo PAUL COLICHMAN cfo/coo TONY SHYNGLE executive vice presidents BERNARD ROOK, JOE LANDRY VP, editorial director LUCAS GRINDLEY senior vice presidents CHRISTIN DENNIS, JOHN MONGIARDO, JOE VALENTINO vice presidents GREG BROSSIA, ERIC BUI, STEVEN CAPONE, JUSTIN GARRETT, LUCAS GRINDLEY, AMANDA JOHNSON ADVERTISING & SUBSCRIPTIONS OFFICES 120 West 45th Street, Suite 3800, New York, New York 10036-4041 Phone (212) 242-8100 • Advertising Fax (212) 242-8338 Subscriptions (212) 209-5174 • Subscriptions Fax (212) 242-8338 LOS ANGELES EDITORIAL OFFICES 10990 Wilshire Blvd., Penthouse Suite, Los Angeles, California 90024 Phone (310) 806-4288 • Fax (310) 806-4268 • Email editor@HIVPlusMag.com SOUTHWEST EDITORIAL OFFICES Retrograde Communications, 43430 E. Florida Ave. Ste. F PMB 330, Hemet, CA 92544 Phone (951) 927-8727 • Email support@retrogradecommunications.com FREE BULK SUBSCRIPTIONS FOR YOUR OFFICE OR GROUP Any organization, community-based group, pharmacy, physicians’ office, support group, or other agency can request bulk copies for free distribution at your office, meeting, or facility.

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4 | MARCH / APRIL 2016

MARCH | APRIL 2016 ON THE COVER 22 Walking and Riding Tall Actor Joseph Kibler took inspiration to a whole new level.

OTHER FEATURES 26 Your 30 Biggest Questions Answered The

questions you’ve always wanted to ask but were afraid to.

34 Tiny Prancer

Dancer Kareem Davis is showing what it’s like to live and love with HIV on The Prancing Elites.

ON THE COVER AND THIS PAGE: Joseph Kibler photographed by Irvin Rivera, Graphic Metropolis

HIVPLUSMAG.COM

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BUZZWORTHY 10 Blueberries Give Sex a Boost? A new study shows

they fight erectile dysfunction.

11 Scars to Art

Meet the artist behind “Zebra Boy”

12 We Heart This

Preventing cardiovascular disease in people living with HIV.

12 Hep C’s New Cure

Are you 12 weeks away from better health?

13 PrEP Safety

New study compares the HIV prevention treatment with aspirin.

17 Work It

to your doctor.

45 Weight Watchers

Wasting syndrome might not be as prevalent as it once was, but weight loss is still a problem for many with HIV.

46 Squandering Your Cure? New hep C drugs

work, but you only if you take them correctly.

THE BEST OF THE REST 20 Switch Meds

Breaking up is hard to do—with your old meds.

32 The Safest Sex

There’s more than one option to choose from today.

42 Daily Dose

Why an injectable antiretroviral could change our lives.

48 Dating Life

Are gay dating apps changing the way we talk about people living with HIV?

47 Charlie Sheen’s #Fail The TV star came out as poz, then tried a so-called cure. Here’s what happened.

OXYGEN

Does this new ad campaign inspire?

TREATMENT CHRONICLES 43 You Don’t Have to Be in Pain Our handy guide to take

6 | MARCH / APRIL 2016

You want time for important things Š2015 Walgreen Co. All rights reserved.

97483-620-1015

Walgreens HIV-specialized pharmacies can coordinate your prescription reflls so you can pick them all up on the same day. Plus, we can remind you about medication doses and reflls.

It’s our way of helping you simplify your busy life.

To learn more, visit HIV.Walgreens.com.

EDITOR’S LETTER

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

8 | MARCH / APRIL 2016

STRAIGHT OUTTA TIME WHO’S THE BOSS STAR COMES OUT

HIV IN THE BLACK COMMUNITY

+

EASY E’S LEGACY BLACK GAY MEN & DEPRESSION SWITCHING MEDS SAVED MY LIFE

RAPPER LIL EASY E

JANUARY / FEBRUARY 2016 www.hivplusmag.com

Don’t Let Art Interfere With Your Message I enjoy reading your magazine and always learn something from it. Just a little honest feedback on the current issue (January/ February 2016). I found the Straight Outta Compton article (“Can a Hollywood Blockbuster Help Stop HIV?”) very informative and well written, but also very hard to read with the fence pattern overlaying it all. I kept wishing it could have been printed a few shades lighter just to give a faint impression of a fence, because it really interfered with my reading. I was glad to get to the end. Then I turn the page and there are raindrops all over the next 10 (10, count ‘em!) pages.

That made it again very difficult to read “Depression is Teaming Up With HIV to Kill Gay Black Men: Can We Stop It?” In this case I found the article overly long and kind of repetitive—or was it that I just had so much such trouble reading it?

Something to think about while you’re being all artsy for us. Thanks for listening.

Eric Gordon Los Angeles, Calif.

BRADFORD ROGNE

It’s always a bit strange putting together the March/ April issue, which we do in January when the flush of the new year is still upon us and everyone is still working out, ditching booze, or learning how to meditate in order to fulfil their New Year’s resolutions. By the time you read this, of course, all bets are off. Usually by March, I’m parked on the sofa eating potato chips (the kind filled with salt and gluten and everything else my nutritionist hates) with my sneakers gathering dust in a corner.

Not so this year; I’m still out there making strides in my daily hybrid workout (part run, part walk, part yoga with my Chihuahuas crawling all over me). I’m taking inspiration from a new source: our cover star, actor Joseph Kibler. I didn’t even know who he was—or that he was already an up-and-comer in Hollywood—when I first saw his documentary, Walk On. But I was compelled by this HIV-positive young man who had battled his own body—or rather pushed his own body—to train to walk six miles in the Los Angeles AIDS Walk. He did so after years of using a wheelchair because of his disabilities.

He could have easily ridden in the AIDS Walk; plenty of wheelchair users do and even that impresses me. But the kid really wanted to show something else here, something about self-determination, about people with disabilities challenging themselves and others to go further than anyone expects, and to remind us all that there are people living with HIV and disabilities. In fact, a good chunk of our readers are living with some sort of disability beyond HIV, and even those who aren’t could use a good dose of inspiration from Kibler.

Having him show up on CSI: Cyber while we put this issue together was icing on the cake, especially since it was a featured role, not a walk on (er, roll on?).

Joseph joins our bonus cover star (look on the back!), another performer changing the face of HIV on television. Kareem Davis stars on The Prancing Elites Project, a reality TV series about the five members of an African-American, gay, and gender non-conforming dance team from Alabama. Davis, too, is HIV-positive, but like Kibler, and all of you, he’s so much more, and we’re thrilled to catch up with him while his star is on the rise.

Both of these guys are ones to watch out in 2016. There are plenty of other HIV-positive individuals who are changing the world in their own special way.

And I want to hear about them for our upcoming 50 Most Amazing HIV-Positive People issue. Send us your suggestions now to editor@hivplusmag.com.

And, you know, keep on keeping on!

NOW SHOWING AT

WWW.HIVPLUSMAG.COM Check out one of these awesome videos online this month

CHECK OUT OUR DANCING QUEENS The star Oxygen’s The Prancing Elites Project and this issue’s bonus cover star (look on the back!) shows up in this colorful sneak peek of the hit series. http://bit.ly/1RRXXev

WHAT DO WE NEED TO DO NEXT? On the country’s only HIV talk show, The T With Dr. D, our intrepid host talks about the “new care continuum,” what it means to the people currently living with HIV and those at risk. http://bit.ly/1OrsAQx

WORK IT, GIRL! One of our favorite HIV prevention specialists, trans activist Octavia Lewis, shows us why she’s “Positively Resilient.” http://bit.ly/1ZnBgzx

BEAUTIFUL BATTLES We are loving this music video, “Save My Soul,”

by JoJo, which tackles the struggle of addiction and loss. Robin Williams’s daughter actually directed it. http://bit.ly/1njD8fd

HIVPLUSMAG.COM

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buzz

CAN BLUEBERRIES GET YOU HARD?

R E P O R T I N G BY DAW N E N N I S , T Y L E R C U R RY, JACO B A N D E R S O N - M I N S H A L L , A N D KAT I E P E O P L E S

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SHUTTERSTOCK PHOTO CREDIT

Before reaching for that little blue pill, you may want to pop a sweeter blue remedy instead.

According to a new collaborative study from Harvard University and England’s University of East Anglia, consuming blueberries and other flavonoid rich foods like citrus and red wine can reduce your risk of erectile dysfunction.

Even better, you can change your dysfunction risks by eating more fruit and adding exercise. The research, published in January in the American Journal of Clinical Nutrition, shows that an increased total fruit intake was associated with a 14 percent reduction in erectile dysfunction. And combining exercise and a high flavonoid diet reduced those disappointing nights by over 20 percent.

Erectile dysfunction affects up to half of all middle-aged men, but according to a study from the Journal of Sexual Medicine, one out of every four new cases occurs in men under the age of 40. Because erectile dysfunction can be an early indicator of “poor vascular function,” the senior author of the flavonoid study, Dr. Eric Rimm, a professor from Harvard’s T.H. Chan School of Public Health says flavonoids could help “prevent cardiovascular disease, heart attack, and even death.”

“Love Hurts and Even Zebras Fall Down”

TURNING SCARS TO ART The best artists channel their pain and disappointment into creative outlets that end up being cathartic—both for themselves and for the rest of us.

HIV-positive artist René Capone has done just that with “The Zebra Boy Chronicles,” a series of provocative mixed-media artworks and watercolor paintings that provide a compelling visual representation of the many orthopedic surgeries Capone has endured. The show debut at San Francisco’s Gallery @ 611 Hyde Street Feb. 17-19.

Since 2014, Capone has been unable to walk due to a condition called avascular necrosis in which the hip joints begin to deteriorate. Associated with bone loss, which can occur as a side effect of some antiretrovirals, and aggravated by steroids prescribed for an unrelated issue, the condition has left Capone facing a series of painful operations.

“The scars that now run down my legs reminded me of a zebra and my imagination took over from there,” Capone explains. “Even zebras have scars, they just hide them better.”

Undergoing yet another surgery this spring, Capone will continue to use “Zebra Boy” as a therapeutic exercise.

And he hopes to help others follow his example by going back to school and becoming an art therapist. “I’ll still make art, just not like the machine I have been for so long now.”

He says that “artistic powers take many forms and mine have always been in the realm of empowering others— right from the very start.” Capone also created The Legend of Hedgehog Boy, a graphic novel that blends line drawings and watercolor paintings with mythological, whimsical, and erotic gay themes. (Find “The Zebra Boy Chronicles” and Capone’s other works at renecapone.com.)

HIVPLUSMAG.COM

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buzzworthy

PREP FOR HEART DISEASE Could a new medication reduce cardiovascular risks associated with HIV? Possibly.

Although HIV is now highly manageable, people living with the disease are still at a higher risk for certain health issues, in particular, cardiovascular disease. To reduce this risk, researchers from the Massachusetts General Hospital, Harvard Medical School, and Duke University are examining whether a medication called Pitavastatin can prevent cardiovascular disease in people living with HIV. Even though treatment works well to virally suppress HIV and stabilize the immune system, it cannot fully suppress chronic inflammation associated with the virus. Inflammation

12 | MARCH / APRIL 2016

has a known cardiovascular connection and antiretroviral treatments that raise cholesterol increases those risks. Drugs known as statins, such as Lipitor, are used to lower cholesterol and reduce inflammation, but because typical statins and HIV medications both use the same pathway in the body they can have the unintended impact of making both drugs less effective.

Pitavastatin, however, uses a less crowded pathway and does not cause same drug interactions as other statins. Currently the clinical trial, called REPRIEVE, is recruiting people age 40-75, who have been on treatment for six months, and have no history of heart disease for trials in the U.S., Canada, Thailand, and Brazil. (For more info, visit ReprieveTrial.org.)

A hepatitis C (HCV) co-infection can be quite a dangerous combination for anyone living with HIV. HCV can progress faster in us and increase the risk of liver-related health problems. However, newer drugs offer people with HIV a functional cure so you can move beyond the risks of co-infection for good. The newest kid on the block, Merck’s Zepatier, may be able to successfully cure HCV in as little as 12 weeks. Zepatier (a fixed-dose combination of elbasvir and grazoprevir) is an interferon-free regimen that was found to cure 90 percent of HCV patients, including those co-infected with HIV or cirrhosis. In one study, 59 percent also reported regularly using recreational drugs like crystal meth during the study, and still found success on Zepatier.

According to the Centers for Disease Control, one out of every four people in the U.S. living with HIV also has hep C. Those living with both are three times more at-risk for liver disease, liver failure, and liverrelated death. In fact, the CDC reports that liver disease is the leading cause of non-AIDS-related deaths among people with HIV, which is why any hep C cure could greatly improve the health outcomes for HIV-positive people.

SHUTTERSTOCK

12 Weeks to a Hep C Cure?

SHUTTERSTOCK

New Study Shows PrEP is as Safe as Aspirin Ever since Truvada was approved for use as PrEP in 2012, detractors of the HIV prevention pill have strongly cautioned against the drug because of the alleged side-effects associated with its use.

Although the more sensational claims of drug resistance and rampant kidney failure have largely been dispelled, discussions about PrEP still receive static when the safety of PrEP use is discussed.

Now, at least part of the debate has been settled more or less. A new report published in the Oxford Journal has found that PrEP is as safe as Aspirin.

Researchers from the David Geffen School of Medicine at the University of California Los Angeles performed a narrative review comparing five major

studies on PrEP for HIV infection with two major studies on aspirin Safety. Each medication was given a score based on how numbers needed to harm (NNH), or cause a reported side effect.

For PrEP, the NNH for gay and bisexual men and transgender women was 114 for nausea and 96 for unintentional weightloss. In heterosexual couples, the NNH was 68 for moderate decreased absolute neutrophil count. Aspirin received an NNH score of 909 for major gastrointestinal bleeding and 123 for any gastrointestinal bleeding. Bleeding problems received a 15 for men and easy bruising received a 10 for women.

The report concluded that the use of Truvada as PrEP was favorable to Aspirin in terms of safety, but that more studies on long-term use were needed.

Still, those users who have engaged in short or medium term PrEP should be reassured of the drug’s safety.

HIVPLUSMAG.COM

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buzzworthy

NOW WE WANT TO WORK OUT The compelling new ad campaign from Equinox, the upscale fitness chain, dubbed “Commit to Something,” make us want to hit the gym stat! Shot by renowned fashion photographer Steven Klein, the photos celebrate commitment through the rubric of socially relevant issues including activism, sexuality, personal freedom, and women’s rights. From a young mother unapologetically breastfeeding in public (portrayed by Lydia Hearst), to

14 | MARCH / APRIL 2016

an activist who is seen fearlessly taking a stand for her cause (featuring Bianca Van Damme, daughter of Jean-Claude Van Damme), to a male-cheerleading champion who wasn’t threatened by a stereotype and dedicated himself to winning in his own way (featuring MMA fighter Alan Jouban), the shots, says Klein, address “today’s issues and social commentaries, which is a powerful approach instead of portraying people as superficial objects with no narrative.” Similarly moved? Equinox has 77 clubs in all, including New York, Chicago, Los Angeles, San Francisco, Miami, Boston, New Jersey, Texas, London, Toronto, and Washington, D.C.

We All Have Boobs The Keep A Breast Foundation has teamed up with Rude Records to promote breast cancer awareness through a twovolume Music For Boobies album featuring a mix of new, remixed, and previously-released tracks from hot alternative bands like The Maine and Emarosa. Fifty percent of all proceeds (musicforboobies. com) from the compilation will go to support Keep a Breast’s ongoing efforts to empower youth around the world with breast health education and support.

Back in Black

SHUTTERSTOCK

HIV rates are skyrocketing among young gay and bi men of color, even as new cases of HIV in the general population have dropped 20 percent. The Centers for Disease Control and Prevention released a new report revealing a nearly 87 percent increase in the number of new HIV infections between 2005 and 2014 among black and Latino gay and bisexual men and boys between 13 and 24. And while one out of eight people living with HIV in the U.S. are unaware of their status, that number rises to one out of three for young, black gay and bi men.

Overall, HIV infection rates have been leveling off since 2010, decreasing 63 percent among intravenous drug users, nearly 50 percent among AfricanAmerican women, 35 percent among all heterosexuals, and 22 percent among African-Americans overall. However, during the past decade, black and Latino gay and bisexual men of all ages saw increases in HIV rates by about 22 percent.

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THINKSTOCK

20 | MARCH / APRIL 2016

B Y C H R I S TAY L O R

BREAKING UP IS HARD TO DO I’VE BEEN ON THE SAME HIV MEDICATIONS FOR NEARLY A DECADE. IS IT TIME TO SWITCH? I ’ V E B E E N O N T H E SA M E HIV medications for nearly a de-

cade. My treatment works, so I haven’t been eager to change things up with a new regimen. Why risk messing with a good thing?

Okay, it’s not that I’m in love with my current therapy, but we’ve been together through thick and thin. Sure, I have some annoying side effects I end up having to treat as well, but I remember how bad things were 1015 years ago and I can’t imagine giving up the life I’ve been able to build around the success of this therapy. It’s like a relationship, when you’ve been through emotional rollercoaster with enough Mr. Wrongs, you’re thrilled to meet Mr. Good Enough. Before I got on this treatment I couldn’t work and I could barely get myself out of bed on the bad days.

With Mr. Good Enough, I figured there was no reason to switch meds.

After all, a lot of experts only talk about when to switch meds only in the context of when your HIV therapy stops working, which mine hadn’t. My doctor says antiretrovirals can stop working for a variety of reasons like poor absorption, drug interactions, adherence issues, and the ever-present development of drug resistance. So why would my doctor want me to switch?

No, I haven’t taken my meds 3,850 days in a row without fail, but I’ve come damn close, and as far as I know, I’m not having absorption issues.

Are my drugs interacting with other meds I’m on? Possibly. My doctor has suggested that I could be building up a resistance. But I’ve been on these same meds and pretty much this same dose for years and I’m not noticing any new issues. So I’ve been hesitant to even consider turning in a winning hand for the slim chance I’ll get an even better one next time around.

My logic has always been that all antiretrovirals have side effects. I’ve been taking calcium to combat bone loss, over the counter meds for constipation and diarrhea (thankfully not on the same day), and prescriptions for sleep, depression, and pain. I’m already used to taking the stuff I take to deal with the side effects I have (and the stuff I take to deal with the side effects of the stuff I take for side effects) and don’t want to go through starting over again. At least I didn’t use to.

I’ve had an epiphany: maybe things can get even better. I’ve adjusted to living with side effects that I just might no longer need to put up with.

Sure, these days I’m managing my chronic condition, but somedays it feels like that’s all I’m doing. Managing. As so much has changed with HIV treat-

ment in the past 10 years, there are a handful of new medications on the market that are better and easier to stomach (literally), and I can also switch to a pill I take only once a day. (I also got new insurance under the Affordable Care Act, so the newer treatments I was afraid weren’t covered, actually are.)

I’ve changed too. I’m sneaking up on the half a century mark and my doctor says both HIV and the treatments I’ve been on have “aged” certain parts of my body faster than others. My concerns have changed over time too. When I was younger I was terrified of developing one of those “buffalo humps” I saw some of the older guys with. So I refused to take meds that listed fat redistribution as a potential side effect.

I’m less afraid of looking like Quasimodo now (as long as my husband still finds me sexy) and more concerned that my kidneys might fail.

I’ve never had a fear of commitment, just change. I’m realizing just because I can stick with one HIV treatment regimen for decades doesn’t mean I should. I’m not heading to divorce court, but I might just play the field anyway—at least when it comes to HIV meds. After some research and long conversations with my doctor, I started taking a new single pill regimen that uses a different form of tenofovir, which has shown to reduce kidney toxicity and have fewer decreases in bone density compared to other antiretrovirals.

I have high hopes but what if this experiment in playing the treatment field fails? Well, I can always run back to my old flame. Which isn’t that bad of a fate.

Except maybe for the diarrhea.

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BY RAFFY ERMAC PHOTOGRAPHY BY IRVIN RIVERA

,

GRAPHIC METROPOLIS

Walking (and Riding) Tall

DOCUMENTING HIS OWN LIFE AS A POZ PERSON WITH DISABILITIES HELPED ACTIVIST-TURNED-ACTOR JOSEPH KIBLER INSPIRE THOUSANDS OF OTHERS

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PHOTO CREDIT

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OU MIGHT IMAGINE PERSONAL PROJE C T S are the easiest to embark upon. More often than not though, it’s these very undertakings that challenge people the most, forcing us to look long and hard at how we relate to the world around us. Such is the case with Walk On, a documentary film that actor, writer, producer, and former casting director Joseph Kibler made about his own journey training to walk more than six miles in the annual Los Angeles AIDS Walk—a feat all the more impressive once you realize that the now 26-year-old Kibler has been using a wheelchair most of his life.

As a child, Kibler believed that it was cerebral palsy that led to a series of body casts, medications, specialist visits, and finally a wheelchair. But when he turned 12, his physician let it slip that it was being born with HIV that led to his disabilities. He wasn’t expected to live, much less walk at the time; his mother didn’t even know she was positive until after Kibler and his twin brother (who died as an in“I FIRST STARTED fant) were diagnosed.

Today, Kibler is part inspirational activist, part HollyOUT WITH THIS wood up-and-comer—his most recent guest spot was IDEA THAT I WAS on CSI: Cyber alongside actress Patricia Arquette— A LONE SOLDIER who exhibits the same spirit that keeps viewers cheerMARCHING OUT TO ing him on in Walk On. The award-winning doc inFIGHT THE BATTLE troduces us to Kibler’s friends, including quadriplegic FOR DIVERSITY, comedian Jay Cramer, Paralympic amputee sprinter Katy Sullivan, and Purple Heart recipient-turned-proINCLUSION, AND ducer LyVell Gipson.

THE END TO HIV Not bad for what was originally just going to be a AND DISABILITY public service announcement for AIDS Walk, before STIGMA. BUT THERE Kibler decided to flip the script and let the cameras ARE PLENTY OF into his life to try and educate the world on what it is PEOPLE FIGHTING really like living with HIV and other disabilities.

“It didn’t take long for it to evolve and eventually TO HAVE THEIR become the biggest thing I’ve ever been able to be a VOICES HEARD. IF part of,” Kibler said. “Mark [Bashian] came on as diI TRULY TRIED TO rector and I focused my energy on being the subject. In SPEAK FOR EVERY those first few production meetings we discussed my SINGLE PERSON, I private life and how I needed to get used to it not exWOULDN’T BE HEARD isting. We would delve into every aspect. Not to make this the Joseph Kibler show, but because that was truBY ANYONE.” ly the only way to be fair to our audience. If I could be brutally honest about my life and my struggles, hopefully it would allow others to open up, to speak out, and to grow.”

He admitted, “Walk On probably went through as many versions as I have drug trials, but over time we were able to find a balance… It is something I am immensely proud of. Mark and I spent countless hours carefully deciding each scene and what it meant and why it was important. We weren’t being paid to do it; in fact, it was quite the opposite. This film wouldn’t have been made without the support of many people, but most of all, not without the generosity of time, creativity, and financial backing of its director.”

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Though the film (produced by the likes of Steve Carell, Alfred Molina, and Emma Thompson) has made him the public face of multiple marginalized communities, Kibler is wary of representing any narrative that isn’t his own.

“I first started out with this idea that I was a lone soldier marching out to fight the battle for diversity, inclusion, and the end to HIV and disability stigma,” he admitted. “I felt that way because just like those who don’t understand HIV, I was uneducated on the subject of my own community. The fact is, there are plenty of people fighting to have their voices heard.

If I truly tried to speak for every single person, I wouldn’t be heard by anyone.”

But, he insisted, “I don’t have to, because by just sharing my story and experiences, someone will relate to it. Most of us have dealt with many of the same struggles and stigmas.”

He’s understanding, encouraging people with HIV to let those who might perpetuate stigma, or those who aren’t informed about the virus, to “learn without feeling foolish or stupid. Often people are afraid to ask me questions because it will make them seem uneducated. It saddens me that some people would rather live in the dark about something if it keeps them from being embarrassed. Whether it be because

of the school we went to, the communities we are a part of, or our family structure, we are the product of our environments. If HIV wasn’t something [that was talked] about, it wasn’t talked about. So now it’s a matter of talking about it.”

And with Walk On, which toured the film festival circuit and is now being shown in schools across the country, Kibler is starting the conversation. He hopes this conversation will empower others, regardless of their HIV status. Now he’s got multiple Hollywood projects in development, and is getting kudos for a groundbreaking LA Metro ad he starred in as well.

“Whether or not we want to admit it, being marginalized, placed in a box where we are told what we can and can’t do, is actually the best thing that could ever happen to us,” he said. “We are constantly being challenged. We have to push back and fight for every little thing we have. Every inch of success feels like yards. So if you don’t know what it’s like to be discriminated against, talked down to, been told no, then you’re missing out on the most rewarding experience of proving every single one of them wrong.”

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You’ve got questions about HIV, we’ve got the answers. Here’s what you need to know to stay healthy, protect yourself and others, and move forward with what should still be a long, happy life.

BIGGEST QUESTIONS ANSWERED 26 | MARCH / APRIL 2016

PHOTO CREDIT

R E P O R T IN G BY JAC O B A ND E R SO N - M INS H A L L , S U NNI V IE B RY D U M , T Y L E R C U R RY, K AT IE PEO PL ES , A N D D I A NE A N D E R SO N - M INS H A LL

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PHOTO CREDIT SHUTTERSTOCK

1. I just tested positive for HIV. Could it be a mistake? Although false-positives aren’t common you should have a confirmatory test, basically a second test to verify your results. The likelihood of two false positives is extremely rare. If you took the at-home test, it’s a good idea to have a doctor or clinic run the second test.

2. My partner’s test was negative, are they in the clear? Unfortunately, false-negative test results can happen too, so if your partner gets negative results and yours came back positive, it is wise to be cautious and have your partner retested. According to AIDS.gov, the likelihood of a false negative depends on the time between when you might have been exposed to HIV and when you take the test: “It takes time for seroconversion to occur.

This is when your body begins to produce the anti-

HIV isn’t some kind of karmic punishment. It is a virus that is communicable and therefore travels between people. Certain types of activities may increase your risks, but these still don’t make you “responsible” for being sick.

bodies an HIV test is looking for—anywhere from two weeks to six months after infection. So if you have an HIV test with a negative result within three months of your last possible exposure to HIV, the Centers for Disease Control and Prevention recommends that you be retested three months after that first screening test. A negative result is only accurate if you haven’t had any risks for HIV infection in the last six months—and a negative result is only good for past exposure.”

3. How did I get HIV? This is a question you’ll ask and get asked exhaustively, and the bottom line is that you likely acquired the HIV virus by coming in contact with the blood or semen of someone who is HIV positive. The most common modes of transmission include unprotected anal or vaginal sex and sharing needles (regardless of whether they are for injecting drugs or medication like gender-confirming hormones). The CDC says it’s still possible to also acquire HIV through contact with

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blood, blood transfusions, blood products, or organ transplantation, “though this risk is extremely remote due to rigorous testing of the U.S. blood supply and donated organs.”

4. Is it my fault? No. HIV isn’t some kind of karmic punishment. It is a virus that is communicable and therefore travels between people. Certain types of activities may increase your risks, but these still don’t make you “responsible” for being sick. We wouldn’t blame a diabetic for their diabetes even though Type 2 diabetes is preventable.

5. But I thought “tops” can’t get HIV? Actually, the “top” or insertive partner in both anal and vaginal sex is less likely to contract HIV. According to one 2012 study, in the case of anal sex, tops have 86 percent reduction in transmission. But that still means tops can and do get HIV from having unprotected sex.

6. Is it true that a lot of people with HIV also have hepatitis C? Yep. About 25 to 30 percent of people with HIV in the U.S. also have hepatitis C (or HCV). This is a concern because HIV causes HCV to move faster in the body, resulting in faster development of cirrhosis and end-stage liver disease. According to the Los Angeles Office of AIDS Programs and Policy, you can get HCV by sharing infected needles, sharing personal items that may have come into contact with blood (e.g., razors, nail clippers, toothbrushes, or glucose monitors); unsterilized tattoo or piercing equipment; or condom-less sex with someone who has HCV. Rough sex, sex with multiple partners, or having a sexually transmitted disease or HIV appears to increase a person’s risk for hepatitis C. The good news: while there’s no vaccine but there are new successful treatments for HCV now, so even if you’ve had treatment that failed there are newer options that could work. Talk to your doctor immediately.

7. Does being HIV-positive mean I also have AIDS? Absolutely not. Confusing HIV for AIDS or using them interchangeably is one of the most frequent mistakes made by people and even media outlets. In the U.S., the majority of people living with HIV will never develop AIDS, the most advanced stage of HIV disease. HIV is the virus that causes AIDS, but for most people, proper treatment and regular medical care keep their immune system strong enough to prevent them from ever developing AIDS. An HIV-positive test result means only that: You have HIV. AIDS is its own diagnosis and many clinicians are moving away from the word itself and embracing the more descriptive “stage three HIV.” 8. Am I going to die? Yes, but probably not anytime soon, and not because of the HIV. The truth is, with treatment, people with HIV can live as long and as healthy of a life as those without it.

You’re more likely to die from a car accident than from HIV. There can always be complications, just as there are with any chronic condition (like diabetes, for example), and you will be susceptible to the same medical conditions that affect all people.

There is some indication that conditions associated with aging (like osteoporosis) may become an issue for people with HIV earlier because of the long term impact of the lifesaving antiretroviral drugs you’ll need to take. But, to reiterate, as long as you continue treatment you can continue to live a long healthy life with HIV. 9. What if I’m black, or trans, or live in the South? Okay, so here’s the sad truth: not every demographic has had the same chance of seeing positive health outcomes. People of color, transgender women, and people living in Southern states continue to have higher mortality rates from AIDS complications. Some of those disparities have to do with access to health care, poverty, substance abuse, and untreated mental health issues. But getting and staying on treatment is the first step in altering those disparities and there are government programs that can help you afford it. Reach out to your local AIDS organization for info.

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10. When should I start treatment? Right now. Ideally you should begin treatment as soon as possible, like the day you get your positive result. Early HIV treatment has been shown to provide long-term advantages. Even if you don’t have symptoms, if your infection runs unchecked it can compromise your immune system. Scientists think the longer you go without antiretroviral treatment the larger the hidden HIV reservoir can become.

And the sooner you’re on treatment, the sooner you can lower your viral load and even reach undetectable levels where it becomes highly unlikely for you to transmit HIV to a partner. So get that prescription and start taking your meds right away.

11. Do I have to take antiretrovirals every day? Forever? Yes, and no. Staying on your meds is hugely important and a 2015 study shows that only combining early treatment with continuous adherence gives patients the best hope of reaching a near-normal ratio of CD4 to CD8 cells. The nearer to normal, the more HIV-fighting cells you have keeping you well and giving you the health and longevity of someone without HIV. Those health benefits are nothing to scoff at. But doctors and pharmaceutical companies alike realize that maintaining a daily regimen can be a real struggle and new options are in the pipeline. Earlier this year, a bi-monthly shot was shown as effective as a daily pill (it may still be a year or two away from your pharmacy). So, yes, you do need to stay on your treatment religiously (pretend it’s like going to the gym or taking daily vitamins) but your treatment may not end up being a daily medication forever.

12. Does a positive HIV test mean I have to stop having sex? Absolutely not. In fact, most doctors will encourage you to continue having a healthy sex life. Orgasms can be wonder drugs in themselves: They help you sleep, boost your immunoglobulin levels (which fight infections), and reduce stress, loneliness, and depression. But being positive does mean you’ll need to protect yourself and your intimate partners.

13. How do I protect my sexual partners? There are a variety of ways to protect yourself and your partner, including honest communication about your status and risks, consistent condom use, having a partner who is on PrEP, keeping your viral load undetectable, and even choosing the right lubricant (avoid two ingredients: polyquaternium and polyquaternium-15, both types of polymers, which can increase the risk of HIV transmission).

14. What is “Treatment as Prevention?” HIV medication reduces the amount of virus in an HIV-positive person’s blood. The goal is to reduce your “viral load” to a level so low it’s considered “undetectable.” Large-scale studies on both gay and straight couples in which one was HIV-positive and the other was not, have continued to demonstrate that when the HIV-positive person’s viral load is undetectable, the risk of transmission falls below 5 percent (even without the use of condoms). When you become healthier you reduce the chance of communicating HIV. If everyone with HIV was on treatment, we could prevent a significant percentage of new cases.

15. What is PrEP? PrEP is short for pre-exposure prophylaxis. If you’ve read a condom box, you might already be familiar with the term prophylaxis, which is an action to prevent disease. Currently Truvada is the only FDA approved PrEP treatment—essentially a daily HIV prevention pill—but other medications are in the pipeline. (Find more PrEP answers at HIVPlus Mag.com.)

16. Do I have to disclose? There are a number of reasons to tell your sexual partners that you have HIV and one is to protect them from acquiring the virus. But if you are using a condom or have an undetectable viral load or know your partner is on PrEP, it may seem irrelevant. And it may be irrelevant from a health perspective or maybe even an interpersonal one; but there’s one way it may matter a great deal, and that has to do with the law. Numerous states have HIV disclosure laws and in some of them it doesn’t even matter whether your partner becomes poz or not. Know what the laws are in your state and protect yourself.

17. Will I need to use a condom forever? No. You can have condom-less sex that carries low risk, especially if you have an undetectable viral load and your partner is taking PrEP. Jeremiah Johnson, the HIV Prevention Research & Policy Coordinator for Treatment Action Group points to two studies, HPTN 052 and the PARTNER study, both of which found no new infections while the HIV-positive partner’s viral load remained undetectable. Another groundbreaking study, the Kaiser study in San Francisco, followed serodiscordant couples for several years and found not a single case of HIV transmission when the negative partner remained on PrEP. 18. So, I can throw away my condoms? You probably shouldn’t (unless they’re expired). Even if you and your sexual partners are confident that the extra protection isn’t required to prevent HIV transmission, there are half a dozen other sexually transmitted diseases that you do need a condom to avoid getting. Remember, there are a lot of people out there with STDs who don’t realize they have them. Getting gonorrhea or syphilis can lead to serious health complications. Last year an outbreak of ocular syphilis occurred among mostly HIV-positive gay men and it permanently blinded several of them. Having HIV doesn’t prevent you from getting other diseases (or even another strain of HIV). In fact, it can make you more susceptible to them.

19. What about oral sex? After former TV star Danny Pintauro came out, saying he thought he acquired HIV through oral sex, alarmists theorized about HIVPLUSMAG.COM

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Each state has its own toll-free HIV and AIDS hotline...you can talk to nonjudgmental people (in English or Spanish) who will listen to you, share their experiences, offer you accurate information about HIV, and help you navigate health care obstacles and talk to doctors about your concerns. the dangers of oral sex. But, the media failed to mention that Pintauro’s body was ravaged by meth use, and he had open sores in his mouth at the time. Jeremiah Johnson tells us, “In 2014, the Centers for Disease Control and Prevention conducted a systematic review of existing research to estimate the risk of getting HIV through specific sex acts. They concluded that the risk of getting HIV from performing oral sex is low, citing a 10year Spanish study of heterosexual couples with opposite HIV statuses where no new infections occurred after nearly 9,000 instances of giving head.”

(In comparison, the CDC estimated that bottoming without a condom carries a transmission risk of 138 per 10,000 exposures). If no HIV is transmitted in 9,000 blow jobs, I think you’re safe. When ejaculation occurs during fellatio, the risk of HIV transmission rises; but you lower that to almost no risk if you pull out for the money shot. Meanwhile, performing cunnilingus on someone is extremely lowrisk as long as the poz recipient isn’t menstruating.

20. Can I still have kids? Yes. Medications can make it so there is less than a 1 percent chance of transmitting HIV between mother and child during pregnancy and birth. Sperm from an HIV-positive donor needs to be “washed” of HIV prior to insemination. The main difference for couples is that you’ll need a specialist who deals with HIV, fertility, and insemination. PrEP has also recently been prescribed by doctors off-label to prevent transmission during intercourse when couples are trying to conceive. If you want to adopt or foster parent, there are protections for HIV-positive parents-to-be that ensure you can’t be discriminated against.

21. How much do I need to tell health care workers offering me nonsurgical treatment?

All health care professionals use “universal precautions” to prevent the transmission of blood-borne diseases like HIV and hepatitis C to and from patients, according to Robert J. Frascino, MD, of the Robert James Frascino AIDS Foundation, and an

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expert for TheBody.com, Frascino says he’d recommend disclosing your status to your dentist, though, so that he or she could be on the lookout for HIV-specific problems in the mouth. “Health care professionals, including dentists, are trained to look for certain conditions more closely if they know you have an underlying medical problem, be that diabetes, cancer, HIV or whatever,” he writes. “Why would you not advise your dentist of your HIV status? If you feel that dentist would discriminate against you for being HIV-positive, that’s not the office you want to be treated in anyway, right? Being HIV-positive is not something to be ashamed of.

It’s a viral illness.” The same is true for other health care providers: You don’t have to tell them, but it’s in your best interests and best health to do so.

22. Will being HIV-positive affect my ability to undergo gender confirmation surgery, plastic surgery, or gastric bypass surgery?

No. There was thought to be heightened risk from surgery, but a study published in 2006 in The Journal of the American Medical Association compared surgery data for both HIV-positive and HIV-negative patients and found that the two groups had the same level of complications from surgery. Moreover, medical workers are better educated about HIV than they once were, and the fear of positive patients has eroded. But you may still have to work harder to find a surgeon who has worked with HIV-positive patients, or if you’re transgender, a doctor who can work with both your HIV specialist and your confirmation surgeon.

23. What about hormone therapy for transgender people (or post-menopausal women)? Do HIV meds interfere with estrogen or testosterone levels? According to the Well Project, some studies have shown that both HIV itself and some HIV medications can impact hormone levels. With that said, there are HIV treatments that won’t interfere with your hormone therapy.

Work with your doctor to find the right medication

regimen to control your HIV, stay on your hormones, and enable you to live in your authentic gender.

24. Do I need a special doctor for my HIV-related issues?

Yes. It is important to find a health care provider who specializes in HIV medical service right away. Sometimes your HIV testing center will recommend someone, or you can also ask your primary health care provider. Finding an HIV specialist who fits your needs is a huge first step after being diagnosed as positive.

That person will literally be your lifesaver.

25. How do I find support centers or support groups near me? Each state has its own toll-free HIV and AIDS hotline, and Project Inform has the full list at ProjectInform.org/hotlines. If you call Project Inform HIV Health InfoLine (800-822-7422), you can talk to nonjudgmental people (in English or Spanish) who will listen to you, share their experiences, offer you accurate information about HIV, and help you navigate health care obstacles and talk to doctors about your concerns.

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26. If for some reason I’m bleeding, do I need to worry about people who are helping me? This probably depends on the situation, but often the answer is no. HIV is rarely transmitted in a household between family members (outside of sex and injection drug use, of course). And, if, for example, you get hurt playing football or duking it out at the gym, it’s “highly unlikely that HIV transmission could occur in this manner,” according to the University of Rochester Medical Center. “The external contact with blood that might occur in a sports injury is very different from direct entry of blood into the bloodstream which occurs from sharing needles or works.” The same goes for blood on a Band-Aid or a nosebleed or a cut finger, says Lisa B. Hightow-Weidman, MD, MPH, an associate professor of medicine in the Department of Infectious Diseases, University of North Carolina-Chapel Hill, and an expert for TheBody.com. “There is no risk of getting HIV from blood that has been sitting outside of a human body. Even if the [person bleeding] was infected, HIV begins to die once it leaves the body and becomes unable to infect anyone else.”

One caveat: If you’re in a serious auto or other accident, the emergency medical techs who are helping you should be using universal precautions, but it’s always good for your own health to tell them you’re HIV-positive (it’s illegal for health workers to refuse you care based on your status, per the federal Americans With Disabilities Act).

27. How do I answer when people ask, ‘Can you get HIV from...’? Start by telling them how it is not transmitted, since old myths die hard. Since the virus cannot survive outside the body, you cannot get it from toilet seats or shared cups or utensils. You can’t get it from kissing or from spit, since it’s not transmitted in your saliva. It is also not transmitted in sweat or urine. You can’t get it from a swimming pool, hot tub, sauna, mosquito or rodent bites, tattoos, or ear/body piercings. Only four bodily fluids are known to carry HIV in quantities concentrated enough to infect another person: blood, semen, vaginal fluids, and breast milk. According to the Centers for Disease Control and Prevention, it is one of these fluids from an HIV-positive person that must come in contact with a mucous membrane or damaged tissue, or be directly injected into the bloodstream (from a needle or syringe) for HIV transmission to possibly occur.

28. Is there a cure? No. There has only been one “cured” patient who has continued to live HIV-free for more than half a decade: Timothy Brown, also known as the “Berlin patient.” He was cured via a bone marrow transplant that he received as treatment for cancer. Since his case a number of other people have been called cured, but those cases haven’t held up to scrutiny or time, with the virus reappearing in many individuals thought functionally cured. As David Margolis, head of the Collaboratory of AIDS Researchers for Eradication, explains, “Timothy Brown [has] probably been cured, and that’s a wonderful thing. But there are close to 80 million people that’ve been infected around the globe over the last century. So one in 80 million is not great odds. What it is, is proof of a principle: that a cure is feasible. But I want to manage expectations and convey the reality about this whole cure expedition, and that is: It ain’t gonna happen fast.”

29. It’s been 30 years, why isn’t there a cure yet? Dr. Rowena Johnston, vice president and director of research at amfAR, explains there are roadblocks to curing HIV and they almost all revolve around “reservoirs,” pockets of virus that persist in tissues and organs even after a positive person’s viral load has become undetectable. Antiretroviral therapy helps contain any new viruses that these infected cells produce, but the blueprint for making HIV remains within an infected cells’ DNA. If treatment is stopped, there is nothing to prevent those new copies from being made, and they can quickly spread unchecked. Therefore, in order to cure HIV, we need to first find the reservoirs. “Locating all the places where HIV is hiding in the body is a bit like finding a needle in a haystack. A particular body part—such as the brain or the gut—can harbor a reservoir of HIV. Particular cell types, including immune cells that are found throughout the body and are not limited to one place, can also be reservoir sites. We will not be able to eradicate or neutralize this latent virus unless we know exactly where all of it is.”

30. What will it take for a cure? Jerry Zach, MD, of the David Geffen School of Medicine at UCLA explains that HIV seems capable of “going to sleep” in these reservoirs, and because it’s not reproducing, doctors can’t detect or treat it. In order to eliminate the virus, doctors need to find ways to activate those reservoirs and make them visible for treatment with “latency reversing agents” to give patients with HIV who are being treated with antiretroviral therapy. Whatever is used to make those hidden reservoirs “turn on” needs to avoid making undetectable patients sick. Once the virus can “be seen,” Zach says the next step is to develop treatments to clear those infected cells and remove the sources of HIV from the body. He says that should lead to “eradication of the infection,” but real life examples like the Mississippi baby suggest that even low levels of the virus can later rebound and restart the infection all over again. The Mississippi baby was born HIV-positive but began antiretroviral treatment at birth before later being off the medications and appearing cured. But then the virus came back. Any HIV cure, Zach explains, therefore needs to offer “some extra protection,” something that stays behind to kill the virus in case any of it remains hidden and later rebounds.

Different researchers are working on different aspects of this multipronged approach and each year new discoveries put us one step closer to finding a cure.

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CHOOSING YOUR SAFER SEX PREVENTION METHOD A lot has changed

since 1983. Bangs are out, beards are in, and condoms are no longer the only option when it comes to preventing sexually transmitted infections.

TO DAY, A N H I V - P O S I T I V E G AY or bisexual man has a variety of options

to avoid transmitting HIV and other STIs, none of which should come with fear or shame when using. Unfortunately, the pitiful sex education provided to most LGBT youth fails to provide a practical, safe approach to same-sex sexual experiences—especially for those who are living with HIV. To make up for that, here is a quick and easy guide to selecting the safer sex method that works for you.

Condoms There haven’t been enough studies on the efficacy of condoms in anal sex, but in a nutshell, condoms are the easiest and cheapest way to prevent HIV and other STIs. However, if condoms were all it took to prevent HIV, new infections wouldn’t be on the rise among young gay and bi men. Studies have show that the majority of gay men admit that they don’t wear condoms 100 percent of the time. Even so, attempted consistent condom use was 76 percent effective in preventing new HIV infections. In other words, condoms work, but only if you use them. If you are someone who doesn’t always manage to slip on a rubber, condoms aren’t the failsafe you might have thought.

TIP: The standard condom was created for vaginal sex. Buying extra strong condoms, or anal condoms, decreases your risk of condom failure if used anally.

Pre-exposure Prophylaxis (PrEP) Having a partner who is on pre-exposure prophylaxis, or PrEP, might not be as easy to use as condoms, but that might be a good thing. PrEP requires your partner to take real action about his or her health and it can give you both the reassurance you are looking for. The use of PrEP requires a prescription from a doctor and quarterly check-ups to ensure ones health and compliance. In studies of couples where one is HIV-positive and one is not, PrEP has reduced the risk of HIV transmission between 96 and 99 percent, when used daily. Even if someone misses one or two doses per week, PrEP’s efficacy remains high. The key difference between PrEP and condoms is timing. PrEP is taken daily, with your morning breakfast or right before bedtime. Although it directly impacts sexual health, taking PrEP is separate from the sexual experience (unlike condoms) because you aren’t fumbling for a pill at the height of passion.

Condoms + PrEP Even if you or your partner takes PrEP religiously, the HIV prevention treatment does not protect either of you against other STIs, and Truvada as PrEP is only approved in conjunction with condoms. For the safest bet, if you are unfamiliar with your partner’s sexual history or wish to be as careful as possible for your partner’s sake as well, combining condoms and with his or her PrEP use is your best bet.

32 | MARCH / APRIL 2016

Treatment as Prevention (TasP) Think of treatment as prevention, or TasP, as PrEP for HIV-positive people, but with the added benefit of keeping you alive and healthy. Of course, there are numerous reasons for you to get on treatment early and stay compliant with your medication, but its use as TasP is probably the most applicable to your everyday dating life. When you achieve an undetectable viral load through treatment—which, for many people, is just one pill a day now—you reduce your risk of transmitting the virus by 96 percent. But don’t let that four percent risk trip you up. To date, in multiple studies, there has never been a confirmed case of someone with an undetectable viral load transmitting HIV. TIP: Stay on top of your health and use a pill box. It is all about the pill box. (These days there are even discrete pill containers that fit on key rings or in a wallet.)

Condoms + TasP As with PrEP, combining condoms with maintaining an undetectable viral load protects you and your partner from other STIs as well as HIV. It may also place you or your partner at ease if either of you are not yet comfortable with the science around treatment as prevention. The use of condoms in addition to TasP is virtually foolproof and leaves you worry-free.

Post-exposure Prophylaxis (PEP) PEP is absolutely not a first line effort to prevent HIV, but a secondary option if your partner may have been exposed to HIV (for example, if the condom you were using broke, he isn’t on PrEP, and/or you aren’t virally suppressed). He or she can elect to take PEP up to 72 hours after possible exposure, but it’s ideal to start the regimen within 24 hours of exposure.

The treatment consists of a 28-day course of highly active antiretroviral therapy (HAART), which is administered by a doctor or medical facility. PEP has a reported efficacy rate of reducing HIV transmission by 83 percent. PEP can come with some unpleasant, but temporary, side effects such as vomiting, nausea, and fatigue. Still, PEP is an excellent option if sex or injection drug use has potentially exposed to HIV. Sero-sorting Sero-sorting is the act of choosing your sexual partners based on their HIV-status, and many experts say it’s an outdated, antiquated, and ineffective way to prevent HIV. A study presented at the 2012 Conference of Retroviruses and Opportunistic Infections found that restricting sex to partners who think are HIV-negative isn’t effective prevention strategy because many just assume that they are HIV-negative. (Yet one in eight people currently living with HIV is unaware of their status, and this accounts for one out of every five new cases of HIV.) Importantly for HIV-positive people, only dating other people living with HIV can be quite a limitation on your own sex life.

SHUTTERSTOCK

BY TYLER CURRY

HIVPLUSMAG.COM

| 33

BY T YLER CURRY PHOTOGRAPHY BY OX YGEN MEDIA

EVERYBODY

DANCE NOW THE PRANCING ELITES PROJECT S T A R K A R E E M D AV I S IS DONE WITH PUTTING L I M I TAT I O N S O N H I S L I F E .

N O W, H E J U S T WA N T S T O D A N C E .

34 | MARCH / APRIL 2016

HIVPLUSMAG.COM

| 35

e’s terrified. Kareem Davis isn’t hidden by makeup or costumes today. He’s gathered the rest of his five-member dance troupe to finally open up about a personal struggle he’s been keeping secret.

Davis isn’t afraid of telling his teammates he has HIV, but of coming out to the world. The cameras are rolling and soon this will air on national TV for all to see.

But in the moments after the performer begins to talk, and tear up, a look of relief washes over his exhausted face. His watery eyes have soon dried and he can finally breathe normally again. His friends and teammates—all of whom have been crying as well— offer shows of support.

And in a snap, Davis lifts his chin to the sky with a new lightness.

“Right now, I need to dance,” he says. And they do.

The Mobile, Alabama native is the youngest member of the Prancing Elites, an all-male, all-black, gender-nonconforming dancing troupe from the Deep South that rocketed into the national spotlight after videos of the team hit the web. It wasn’t long before the Oxygen Channel gave Davis and his fellow teammates—Adrian Clemons, Kentrell Collins, Jerel Maddox, and Timothy Smith—their own TV show, solidifying the group as reality TV stars and LGBT icons.

The first season of The Prancing Elites Project aired nearly a year ago becoming an instant hit that was as inspiring as controversial. The show was also one of the first of its kind to showcase the group’s sig-

36 | MARCH / APRIL 2016

nature J-setting style of dance, a type of synchronized choreography that originated with Jackson State University’s J-Settes, an all-female dance troupe.

Week after week, TV audiences have been tuning in to see The Prancing Elites as this all-male, gender-nonconforming dance troupe serves up the best of Beyoncé in the middle of the Bible Belt. Each week the team seems to have some foreboding obstacle and Davis’s poz status and coming out is just one of them. But for him, the silence only increased his anxiety.

Davis was diagnosed with HIV just as filming for the reality show began but no one knew what he was going through.

“I was diagnosed and then I went to my first doctor’s visit right before we started filming,” Davis said.

“It was very hard because I was so stressed out at the time. I was going into filming with all of this on my shoulders and on my heart and I really didn’t have time to deal with it.”

At the age of 23, Davis was not only trying to cope with an HIV diagnosis, but also trying to keep it private while TV cameras were documenting his every move. Even though Davis tried to put on a brave face and act as if nothing was wrong, it was becoming more and more evident that he wasn’t okay. His fellow teammates could sense something was amiss and tried to get Davis to open up about what he was going through. In a touching and emotional episode, Davis finally broke down and revealed his status, both to his friends and to TV audiences around the globe.

“I was afraid to say the words,” he recalls. Davis is relaxing at home, a rare break from filming and dancing. “I protect myself very well, not only physically, but emotionally and mentally… So I was a bit embarrassed. I was afraid of what people would think.”

Telling his teammates was one thing. All four members embraced him with love and support immediately after he revealed his status. But when the episode finally aired a few months later, David was nervous about how the show’s audience would react.

“At first I thought I would face more judgment, but I have actually had people show more respect than anything. People are definitely more excited when they see me [because] I’m an individual that shared such a profound story and I am still doing this whole jazz of the Prancing Elites while maintaining my health at the same time… I’m grateful that it went in a positive direction.”

Davis has no interest in looking back on the episode. He never even watched it himself.

“I really didn’t have to watch the episode,” He explains. “Because people were talking about it and asking questions. It was very emotional and I didn’t want to revisit that emotional side of it. It was like being re-diagnosed all over again.”

This year, Davis says, “The sky is the limit. I don’t want to set any boundaries for myself—and for the team. I don’t want there to be a limit to what we can do. I would love to get in the studio with Laurieann Gibson or to have a quick moment with someone like Ciara or Lady Gaga. Someone who is very authentic in the music industry. But my main goal is that we never stop getting better.”

So far the group has performed as the opening act for the legendary Patti LaBelle and hip hop star Common. They have participated in numerous Pride parades around the country. But Davis is looking to move beyond mere opening acts.

“I have always dreamt of doing productions on stage,” he admits. Sure, the troupe has hosted and performed in competitions and danced on many stages, “but we have never just had it be about us. And I think that will probably be the next major move.”

For Davis and his fellow Prancing Elites, the future is full of possibilities. With the second season airing on Oxygen now, viewers will get to see just how far the team has come since their early days as viral video stars, And we’ll get an inside look into the drama that often comes with success.

“In season two, you…get everything season one offered times 1,000.” Davis predicts. “The performances are bigger and better. You will definitely see a couple of complications in the team. There are some moments where we kind of falter; we don’t really act like a team. Over all, you will see a lot of lessons being learned and a lot of growth… At the end of it all, we become this huge powerhouse.”

Some fans of course want to know most about Davis’s growing relationship with Jaesean, a member of a

competing dance team in Mobile. Davis credits Jaesean with being one of his biggest supporters during the past year. Davis is wary of sharing too much about his romantic life, but he says viewers will get to see how his relationship with Jaesean develops in season two.

Even though viewers might expect his relationship with a rival dancer to cause friction within the Elites, Davis insists it hasn’t. But he occasionally helps Jaesean’s team and admits that can make it challenging.

“You will see me lose my mind, well almost lose my mind, dealing with both of [the teams]. You have two competitive teams that mean a lot to me. But I have to make a decision… What’s better for me?

What do I want for the Prancing Elites?’”

Davis has also jumped into HIV activism with gusto. After his own coming out episode aired, Davis’s doctor reported seeing a local surge in HIV testing.

Other advocates told Davis that they noticed more people seeking HIV treatment as a result of seeing Davis come out about his status.

In the episode that followed him coming out, the Prancing Elites put on an HIV testing and awareness event in Mobile. Davis has already formed relationships with the National AIDS Minority Council and the AIDS Healthcare Foundation and he is looking forward to focusing on advocacy even more once the second season has aired.

Davis says that many people have told him he is helping to break down the shame and guilt so often associated with HIV stigma in Alabama.

“It is definitely on my agenda to do outreach programs,” he says. “Not only that, but to hold events.

We are definitely working on it.”

Davis hopes to do more, both in Alabama and on a national scale to further eradicate the stigma of living with HIV—and to help get people connected to treatment. It’s ironic how something as simple as treatment can save so many lives once people move past their fear of HIV. “The stigma is still just so bad. Some people take the stigma of HIV to their grave. And I just think it is no longer that deep.”

HIVPLUSMAG.COM

| 37

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

D A I LY D O S E

HOW AN INJECTABLE HIV TREATMENT COULD SAVE LIVES TAKING DAILY MEDICATION TAKES MORE THAN A PILL BOX, IT TAKES A COMMITMENT THAT SOME ARE NOT CAPABLE OF MAKING. B E I N G A G AY man diagnosed with HIV in 2012, there isn’t much I can complain about when it comes to treatment. After the hell that so many went through in the early years, I feel pretty damn lucky to pop my pill once a day and rest assured that my viral load is undetectable and my body is healthy. Still, no matter how healthy I may feel, my daily medication reminds me that somewhere in my body there is a disease. And for many living with HIV, this little reminder carries a stigma they would rather avoid altogether, even at the cost of their health.

Some may think today’s generation should be happy with what we’ve got. Forgive me, but I want more. This month, ViiV Healthcare and Janssen Sciences Ireland (a division of Johnson & Johnson), announced that Phase III trials

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for a bimonthly HIV treatment injection would begin in mid2016. This year, the two companies will be evaluating the commercialization of a long-acting formulation to be used as an injectable maintenance treatment for patients who have achieved viral suppression.

Injectable treatments have been the buzz in HIV treatment research for a while, but this announcement represents a tangible hope that a new form of treatment is within our grasp. In a few years, many people living with HIV might be able to throw away their pill bottles for good.

The current oral regimen continues to be a reason for poor adherence to treatment. The daily pill can feel like a symbol of second-class status. No matter how healthy I am, people still see someone whose health is subpar. In the U.S., the majority of people living with HIV are not able to stay on treatment and maintain viral suppression. The possibility of a bimonthly injection wouldn’t just improve adherence to medication and reduce transmission, it could revolutionize the lives of HIV-positive people.

Imagine being a young person and being told that you can still live a long and healthy life, but only if you adhere to this daily regimen with few to no mistakes. Sounds simple enough, but factor in trying to carry the enormous weight of HIV stigma and concealing your diagnosis to the outside world—as most initially try do—and you have 365 reasons to fail.

For so many, that bottle isn’t just medication, but an embarrassing reminder to yourself and others, that you contracted a virus that is avoidable.

That sounds harsh. HIV shouldn’t have to be something people are ashamed of. But what should be does not change the reality of the majority of people living with HIV who are utterly mortified and almost paralyzed by the idea of other people finding out their status.

Now, imagine being told that all it will take to keep you healthy is six doctor visits a year. Sure, it still may not be ideal, but what disease is? It is a hell of a lot better than the alternative. An HIV injectable treatment represents an opportunity to resume life knowing that you are virally suppressed even if you are not quite ready take on managing your virus full time. Today, managing HIV doesn’t just require a daily pill. It requires a person to develop an entirely new state of mind—one that requires an awareness of what it means to be positive today, the strength to fight instead of hide, and the willingness to accept the support of friends and loved ones. If that mindset were easy to come by, HIV wouldn’t remain the problem that it is.

An injectable treatment would remove the daily reminder of living with a disease that shouldn’t, but often does, hold people back. It would mean the freedom of waking up and going about your day without a surge of panic because you forgot to take your medication. It would mean removing my shackles to a pill bottle so sleepovers could be spontaneous, or packing for a vacation could be done with a little less stress.

Frankly, an injectable treatment would simply mean a better life.

I’ll take it.

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BY TYLER CURRY

treatment NO, THOSE ACHES AND PAINS ARE NOT ALL IN YOUR MIND.

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The aches and pains of HIV are often overshadowed by concurrent illnesses or concerns about elevated cholesterol, blood sugar, liver enzymes, or blood pressure. Sometimes they are simply considered trivial complaints by a patient or by a physician who feels that the stabilization of HIV by combination therapy is such a godsend that it is inappropriate to complain about sore muscles and aching joints. This dismissal is not acceptable. M

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treatment

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— DA N B OW E R S

Dr. Bowers is an HIV specialist with a family practice in New York, who has worked with numerous LGBT and HIV-positive patients in the last two decades.

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This brief overview of rheumatology may be hard for those outside of the medical field to follow. In fact, many HIV doctors actually rely on rheumatologists to treat such conditions. All you must remember as a patient is that your aches and pains are real and should be addressed.

An infection like HIV causes the body to produce a host of immune responses—antibodies, whitecell activations, and various circulating immune complexes that attack invading organisms and surrounding tissues. Usually these responses target only infectious organisms, but defenses sometimes lose their specificity and attack normal tissues. And occasionally, defense mechanisms attack tissues without provocation.

These are called collagen-vascular or rheumatologic diseases and are treated by the medical subspecialty rheumatology. In the simplest form, joint aches, called arthralgias, occur in 45 percent of people living with HIV. No clear cause is identified, but treatment with nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen helps.

People with HIV often think they are getting neuropathy because of the persistent low-grade pain of arthralgias. But the presentation is different. Here it is often the larger joints that ache, compared to neuropathy’s onset of pain in the ends of the fingers and toes. The reassuring feature is that these joint aches do not lead to degenerative joint disease or arthritis.

Many viral infections cause a joint to become hot and swollen, and HIV-associated arthritis behaves

similarily. It lasts up to six weeks and gets better with nonsteroidal drugs or steroids like prednisone.

HIV-associated reactive arthritis is more involved. Fingers and toes may swell. The Achilles tendon and the plantar fascia in the arch of the foot may be inflamed. The skin often has extensive scaly dryness: psoriasis. Mucus membrane irritation, specifically urethritis, can occur. A nonsteroidal drug called indomethacin works well here. Also, rheumatoid arthritis medications called tumor necrosis factor blockers may help in difficult cases.

While psoriasis and the arthritis associated with it both are worse in the presence of HIV, improvement can be seen during combination therapy. There is a wide range of HIV-associated muscle diseases, starting with the marked muscle aches (myalgias) often seen at the time of seroconversion. About a third of HIV patients have some myalgia or fibromyalgia, which also includes joint pain. As in HIV-negative patients, nonsteroidal drugs and antidepressants can help.

Polymyositis is muscle inflammation characterized by mild weakness in the large muscles and an elevated enzyme called creatine phosphokinase. The cause is unclear, but biopsies usually show infiltration of CD8 cells. Steroids usually help, but immunosuppressants may be needed.

Unique to HIV is diffuse infiltrative lymphocytosis syndrome, indicated by enlarged parotid salivary glands at the angle of the jaw in front of the ear.

DILS also includes dry mouth and higher levels of CD8 cells, which are the prominent infiltrates in the parotid glands. Prednisone or local radiation may be used to shrink the parotid glands.

Interestingly, rheumatoid arthritis and lupus may go into remission during HIV infection. When HIV is controlled, rheumatoid arthritis and lupus may return or sometimes even appear for the first time. This would correlate with the observation that T cells are part of this inflammatory process.

BY JEANNIE WRAIGHT

WEIGHT WATCHERS Wasting isn’t the

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same scourge but weight loss with HIV is still an issue.

In the 1980s and early ‘90s, long before antiretroviral treatments, extreme weight loss—wasting syndrome—became a visible indicator of a person living with HIV, leaving the hauntingly gaunt, skeletal look etched in the public mind as the easily recognizable face of AIDS. After the widespread use of HIV antiretrovirals became the norm in the United States, wasting syndrome began to diminish and became a less common occurrence. While it is less visible, weight loss continues to exist in people living with HIV and evidence shows it’s still an important HIV co-morbidity with dangerous implications. Approximately 10 percent of people living with HIV experience HIV-related weight loss, despite the use of antiretrovirals. A study conducted in

2002—after the advent of ARVs—found that with weight loss of 10 percent or more, there was a four to six-fold increase in death compared to those with a stable weight. More recently, AIDS Map reports, “unintentionally losing 5 percent of your body weight in a six-month period is an indicator that you could become seriously ill because of HIV.” Numerous factors can cause or contribute to weight loss among people with HIV. Other comorbidities such as cardiovascular, respiratory, and kidney diseases may be a factor for some.

Others can experience weight loss from HIV enteropathy (unexplained and prolonged diarrhea); a loss of appetite due to isolation, depression, or the use of multiple medications; or a reduced food intake due to economic disparity, food insecurity, oral infections, or difficulty eating.

HIV itself can cause weight loss as the virus can increase the body’s metabolism.This speeds up the rate at which nutrients are used. HIV can also have an effect on the lining of the gut, which can lead to malabsorption, making it harder to for the body to absorb nutrients. M HIVPLUSMAG.COM

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SQUANDERING YOUR ONCEIN-A-LIFETIME CURE? New Hep C drugs offer a nearly 100 percent cure rate—unless you miss a dose.

Hepatitis C is a liver disease caused by the hepatitis c virus (HCV), which kills about half a million people each year. That’s the main reason why it’s a surprise for many to hear there’s a virtual cure.

With HCV, what begins as an infection frequently becomes a chronic illness with serious, longterm health consequences. Although many people with HCV don’t realize they have it, the Centers for Disease Control and Prevention estimates that 3.5 million Americans are actually

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The use of antiretrovirals is actually the most prominent way to treat or correct HIV-related weight loss.

Next comes eating healthier and consuming enough protein and nutrients. This is one of the cornerstones of maintaining good health, but it often remains overlooked.

Nutrition, particularly for those with medical conditions, can greatly affect both physical and mental wellbeing. Adequate nutrition is especially important for people living with HIV as the virus causes inflammation and damage to the digestive system that can leave them vulnerable to malnutrition and related illnesses. Many HIV-positive people experience deficiencies in protein, selenium, and vitamin D. To resolve these deficiencies, doctors and nutritionists may prescribe a protein-based nutritional supplement to boost protein and caloric intake. Unfortunately, the supplements most often prescribed to treat weight loss are little more than sugar water with a multi-vitamin. Nutrition is not taught in medical schools, and data on protein supplements (and supplements in general) is limited. As a result, physicians often prescribe the products they are most familiar with, which aren’t necessarily the ones that are most effective. Too often, familiarity is built on in-office visits from pharmaceutical reps working for companies with large enough budgets to facilitate these visits.

Doing your own research is great way to find out which supplements are right for you. Before talking with your doctor about adding a specific protein to your diet you’ll want to evaluate factors like the ingredients, how much protein each serving provides and how many calories are in each serving.

The top three ingredients in the two most commonly used protein supplements are sugar, corn syrup, and water: the same key ingredients as many soft drinks. When looking for a protein supplement, look for those without corn syrup. Also look for ones that have less sugar and little or no sodium. These are usually better for you. Comparing protein and calories among various products will help you determine which supplements will provide the most benefit. For example, the top two supplements have approximately 240 calories in each serving and between 10-12 grams of protein. Meanwhile, a supplement called Enu, made by Trovita Health Science, contains double the calories at 480 per serving and double the protein at 25 grams per serving.

In addition, Enu contains no sugar or corn syrup. The top two protein supplements contain 150 and 200 milligrams of sodium verses 100 milligrams of sodium in Enu. Clearly Enu is a far superior weight gain supplement than the leading supplements, although many doctors prescribe these less healthy alternatives.

HIV-related weight loss can be physically and mentally devastating to a person living with HIV. Although science has come a long way in improving the quality and quantity of life for HIVpositive people, weight loss is an area that doesn’t gain the attention or research it deserves.

Talk to your doctor and a nutritionist and ask them to help you devise a well-balanced meal plan that will assist you with adding healthy weight. Research weight gain supplements and familiarize yourself with those that will provide the calories and protein that you need instead of relying on brand recognition, which may not be the best option for restoring your weight to a healthy level. Information is your best defense against poor health. The more you know, the greater your ability will be to contribute to your own healthy lifestyle and quality of life.

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living with the blood borne virus, which the World Health Organization says is most often transmitted through “unsafe injection practices, inadequate sterilization of medical equipment, and the transfusion of unscreened blood and blood products.” It can be transmitted sexually, as well, though those cases are rarer.

Although there have been treatments available, none offered a longterm solution to the chronic illness—until now. Recent advancements have resulted in what is essentially a cure for 90 percent of users.

Available only to those who haven’t previously treated their hep C, new HCV therapies, such as Gilead’s Harvoni and Sovaldi, make it possible for people living with the disease to achieve a sustained virologic response. In other words, taking a short-term regimen can have a longterm impact on a lot of people, and there are even more HCV drugs in the pipeline.

Gilead just got priority review for a new combo therapy that uses there Sovaldi with velpatasvir, a NS5A inhibitor, for the treatment of chronic genotype 1-6 hepatitis C infection. Merck got approval for Daklinza (daclatasvir) to treat those with chronic hep C genotype 3, while Janssen is fast-tracking the Achillion Pharmaceuticals created NS5A inhibitor, ACH-3102.

Unfortunately, there’s a catch to this 90 percent cure rate. If you miss even a single dose it could render the medication ineffective. Dr. Imtiaz Alam, gastroenterologist and the founder of the Austin Hepatitis Center, told Gastroenterology & Endoscopy News that patients with HCV who forget to take their pill by even 24 to 48 hours could inhibit responses to these newer treatments. Since these curative therapies are incredibly expensive—they can cost $1,000 a day or more—patients are unlikely to get a second chance at a cure.

“With Medicaid restricting this therapy to a once-in-a-lifetime treatment, and most—although not all—insurance companies requiring week four RNA [ribonucleic acid] levels before [they’ll authorize the remaining eight weeks of treatment], it’s essential to keep on top of adherence,” says Alam. “If patients are taking these medications correctly, they all should be negative by the end of week four of therapy.”

Some who doesn’t adhere to their HCV treatment regimen would essentially be squandering a cure, and wasting thousands of their own and tax payers’ dollars. A three-month supply—the recommended treatment span—of Sovaldi or Harvoni costs $80,000. As the Washington Post discovered, much of that money comes from federal programs. For example, Medicare spent $4.5 billion in 2014 on these curative hep c therapies.

People living with HIV are particularly susceptible to the HCV, which can progress more quickly to liver damage in those with both viruses.

The CDC reports approximately 25 percent of all HIV-positive people also have HCV. The coinfection with HIV and HCV is especially high among injection drug users, with as many as 90 percent living with both HIV and Hep C. Because of the cost and the drugs’ effectiveness on non-compliant patients, many people will likely only get one chance to take advantage of the HCV cure. Compliance with HCV therapy is all the more important for people living with HIV. According to a new study, more HIV-positive people in the U.S. are dying from untreated HCV than any other co-morbidity. Because of those risks and the fact that a person can live with the disease undetected for years before presenting symptoms, the U.S. Public Health Service/Infectious Diseases Society of America recommends all people living with HIV get tested for HCV and talk with your doctor about your risks.

And when you get drugs to treat it, by all means, don’t skip a dose.

—T Y L E R C U R RY

CHARLIE SHEEN’S FAILED MISSION Charlie Sheen is searching for a cure for HIV, which is why he he took a radical step: stopping HIV medications and seeking an experimental treatment from a doctor in Mexico, Dr. Samir Chachoua, who claimed to be able to “cure” HIV. The effect saw his health plummet.

Sheen had been on antiretroviral medication for three years, which had reduced the virus to the point that it was undetectable in his system, but he told the incredulous host on The Dr. Oz Show that he had stopped taking the medications when he saw Chachoua.

“I’m been off my meds for about a week now,” Sheen told Oz in the pre-taped segment that aired in January. “Am I risking my life? Sure. So what?

I was born dead. That part of it doesn’t faze me at all.”

But, Sheen said his viral load skyrocketed in the time he was off, and Dr. Oz urged him to resume his antiretroviral treatment. Sheen’s manager, Mark Burg, told People magazine that the actor had resumed taking his medications December 8, just after the episode was taped.

“Charlie is back on his meds. He tried a cure from a doctor in Mexico but the minute the numbers went up, he started taking his medicine,” Burg said. “He said he would start on the plane on the way home and that is exactly what he did.”

Sheen says he “didn’t see it as Russian roulette. I didn’t see it as a complete dismissal of the conventional course we’ve been on. I’m not recommending that anyone. I’m presenting myself as a type of guinea pig.”— DAW N E N N I S

The number of working Americans who don’t take their sick days during the winter germ season because they don’t want to miss work, even when they are indeed sick. Spare your co-workers and stay at home the next time you don’t feel well.

SOURCE: Wakefield Research, 2015

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DAT I N G

BY ALEXANDER CHEVES

AGE, WEIGHT, PREP STATUS?

seven of the most popular gay dating websites and apps— Scruff—two of the most popular BarebackRT, Daddyhunt, gay hookup apps—recently startDudesnude, Grindr, ed seeing profiles advertising the PozPersonals, SCRUFF, and use of pre-exposure prophylaxGAY HOOKUP APPS NEW Gay.com (owned by Plus’ parent is, or PrEP, which the Centers for company, Here Media)—held Disease Control and Prevention FILTERING ARE CHANGING HOW a ground-breaking meeting last year recommended for gay WE TALK ABOUT PREP AND HIV. with public health leaders, amand bisexual men at substantial fAR, and San Francisco AIDS risk for contracting HIV. Foundation, in a first-of-its-kind Jason Marchant, chief prodsummit generating ideas on uct officer of Scruff and one of how to promote HIV/STI testthe app’s founding partners, ing and reduce stigma associatsays he’s been on PrEP for two ed with HIV. years and has listed it on his In his first public endorseScruff profile for most of that ment of PrEP, Joel Simkhai, time. Marchant’s username is founder and CEO of Grindr, “Jason Scruff [PrEP].” Such is says, “I believe all sexually acthe way many Scruff users adtive gay men should be on vertise their PrEP usage; inPrEP, barring, of course, any cluding it in their usernames health risks outlined by a medor in their written profile deical professional. It prevents scriptions. But Scruff is about to HIV infection. Why wouldn’t make it easier to advertise PrEP you take it?” adherence or find other users.

Carl Sandler, CEO and deScruff 5, which launched on signer of the popular gay datiOS devices late last year, has ing apps MISTER, MR X, and two new profile metadata fields, Daddyhunt, thinks it is high Marchant says. “One of them is time for apps like his to endorse sexual practices like top, bottom, PrEP. Doing so, he says, will not only educate more peoversatile, oral, fetish, no sex, stuff like that. The second one ple about its effectiveness, but will also combat the negative is for safer sex practices like condoms, PrEP, and treatment messages about the medication. as prevention.”

Sandlers says that MISTER, MR X, and Daddyhunt will This will give users the option of selecting what they soon offer a hashtag feature that will allow users to tag are into sexually and what safer sex practices they prefer, their pictures and profiles and search for tags among othif any, and displaying the information on their profiles. er users on the app. Since many already advertise PrEP on “Once it’s filled out, it will appear prominently on your their profiles, Sandlers predicts #PrEP will become a popScruff profile,” Marchant says. ular tag.

This is the first time Scruff has publicly endorsed PrEP “It will allow users to meet others who are on PrEP and as a safer sex practice. Grindr, which is the most widestart a conversation about it,” he said. “Increasingly these ly-used gay hookup app in the world with 2 million daiapps are more social communities and places where guys ly users, is more vague about its in-app plans for PrEP, alcan educate each other.” though the company has partnered with big names like Marchant believes that PrEP does more than just preGilead Sciences—the company behind Truvada, which is vent the spread of HIV among gay men. currently the only drug approved for PrEP—on research “We often see that when people say they use PrEP in and educational awareness, a Grindr spokesperson says. their profiles, they also tend to not discriminate [against] Grindr for Equality, a division of the company dedicatother users based on their HIV status,” he says. “I think ed to raising awareness for LGBT issues, recently conductwe’ll be talking in the months and years to come about ed research with the San Francisco AIDS Foundation and how not only is PrEP a powerful tool in preventing HIV, the CDC to poll users about their attitudes toward PrEP. but it’s also taking a significant bite out of HIV stigma.”

It’s one of many sites looking at changes. In fact, last year

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G U YS O N G R I N D R and

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

Starting treatment means you’re protecting your health. Find out why it’s so important at HelpStopTheVirus.com © 2015 Gilead Sciences, Inc. All rights reserved. UNBC1857 03/15

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