Plus 128 Jan Feb 2019

BECAUSE YOU’RE MORE THAN YOUR STATUS

MTV’S SHUGA: DOWN SOUTH STAR GIVEN STUURMAN IS EDUCATING TEENS IN AFRICA ABOUT HIV

A NEW MED GETS FAST TRACKED

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JANUARY/FEBRUARY 2019 www.hivplusmag.com

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What is BIKTARVY®?

BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults. It can either be used in people who have never taken HIV-1 medicines before, or people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements.

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about BIKTARVY? BIKTARVY may cause serious side effects: ` Worsening of hepatitis B (HBV) infection.

If you have both HIV-1 and HBV and stop taking BIKTARVY, your HBV may suddenly get worse. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to monitor your health.

Who should not take BIKTARVY? Do not take BIKTARVY if you take: ` dofetilide ` rifampin ` any other medicines to treat HIV-1

What are the other possible side effects of BIKTARVY? Serious side effects of BIKTARVY may also include: ` 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 BIKTARVY. ` Kidney problems, including kidney failure.

Your healthcare provider should do blood and urine tests to check your kidneys.

If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY. ` Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death.

Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat. ` Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.

The most common side effects of BIKTARVY in clinical studies were diarrhea (6%), nausea (5%), and headache (5%). Tell your healthcare provider if you have any side effects that bother you or don’t go away.

What should I tell my healthcare provider before taking BIKTARVY? ` All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney or liver problems, including hepatitis virus infection. ` All the medicines you take, including prescription and over-the-counter medicines, antacids, laxatives, vitamins, and herbal supplements. BIKTARVY and other medicines may affect each other. Keep a list of all your medicines and show it to your healthcare provider and pharmacist, and ask if it is safe to take BIKTARVY with all of your other medicines. ` If you are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking BIKTARVY. ` If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

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.

Ask your healthcare provider if BIKTARVY is right for you.

Please see Important Facts about BIKTARVY, including important warnings, on the following page.

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Get HIV support by downloading a free app at MyDailyCharge.com

KEEP EMPOWERING. Because HIV doesn’t change who you are.

BIKTARVY is a 1-pill, once-a-day complete HIV-1 treatment for adults who are either new to treatment or whose healthcare provider determines they can replace their current HIV-1 medicines with BIKTARVY.

BIKTARVY does not cure HIV-1 or AIDS.

BIKTARVY.COM

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IMPORTANT FACTS This is only a brief summary of important information about BIKTARVY® and does not replace talking to your healthcare provider about your condition and your treatment.

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IN THIS ISSUE JANUARY / FEBRUARY 2019

40 18 23 FEATURES

ALLAN FILIPE SANTOS DIAS/UNSPLASH (18); COURTESY GIVEN STUURMAN (40)

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ON THE COVER

40 SUGAR AND SPICE The star of MTV Shuga: Down South, Given Stuurman, plays Africa's first out gay character—and has become a superstar in the process. But will that help improve HIV prevention and treatment in South Africa?

YOUTH IN REVOLT Study finds poz teens involved in end of life planning actually have better health outcomes.

Here's why.

20 5 FOR FIGHTING Addressing disparities facing the black community with these five steps.

21

TRANS WOMEN TRUMPED? The Trump administration's proposed gender definitions could put poz women's lives in danger. What's next?

Cover and above top right: Given Stuurman, star of MTV Shuga: Down Under; 2nd cover and right: Activist and celeb Emil Wilbekin, photographed by Steven Duarte

HIVPLUSMAG.COM

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CHILL CHILL URBAN DICTIONARY DEF: COOL, TIGHT, WICKED, SICK, SWEET, NICE, EASY GOING, SEX

A MAGAZINE FOR US P R E M I E R I N G A P R I L / M AY 2 0 1 8

OUR DEF: A NEW MEN’S MAG THAT’S ALL THAT AND MORE C H I L L . U S | @ C H I L LT H E M A G

CHILL.US

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@ C H I L LT H E M A G Photo by Alex D. Rogers

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IN THIS ISSUE JANUARY / FEBRUARY 2019

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COURTESY ALECIA TRAMEL (23, ALECIA); FEDYA ILI (23, CECIL); SHUTTERSTOCK (8); CHUCK HODES/FOX (9)

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25 MOST AMAZING PEOPLE LIVING WITH HIV FOR 2019 23

From Welcome to Night Vale's podcast star to a powerful politician, a McArthur genius, and the courageous women of color who've gotten arrested fighting for our rights; here are the bad-ass poz people you should know right now.

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DAILY DOSE 8

HIV IS NOT YOUR ENEMY Don't let stigma get in the way of living your best life.

BUZZWORTHY 9

EMPIRE OF EMPATHY The series breaks new ground with a sexy poz love interest for a gay character.

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LOVE IS HIV EQUAL How to Get Away With Murder's serodiscordant couple weds.

10

LIFE STORIES Inspiring memoirs and bios from the AIDS epidemic.

RESISTANCE

46 VIRAL VICTORY A real answer for those with major resistance issues?

TREATMENT

44 HEARTBREAKER A commonly prescribed antibiotic could mean heart trouble, even years later.

45 METHOD MAN Can methadone, a drug that fights addiction, also reduce HIV viral loads?

BACKTALK 16

CAMPING OUT This activist finds a new use for camping gear with One Tent HIV testing.

HIVPLUSMAG.COM

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editor in chief DIANE ANDERSON-MINSHALL • svp, group publisher JOE VALENTINO associate publisher PAIGE POPDAN

creative director RAINE BASCOS associate art director PATRICK MADISON deputy editor JACOB ANDERSON-MINSHALL editor at large TYLER CURRY-MCGRATH senior editor SAVAS ABADSIDIS managing editor DAVID ARTAVIA associate editor DESIRÉE GUERRERO assistant to the editor DONALD PADGETT editorial intern ASHLEY SCHEIBELHUT contributing editors KHAFRE ABIF, GERALD GARTH MARK S. KING, ZACHARY ZANE mental health editor GARY MCCLAIN contributing writers BENJAMIN M. ADAMS creative director, digital media DAVE JOHNSON interactive art director CHRISTOPHER HARRITY online photo and graphics producers MICHAEL LUONG, TEVY KHOU front end developer MAYRA URRUTIA senior drupal developer NICHOLAS ALIPAZ, SR. traffic manager KEVIN BISSADA manager, digital media LAURA VILLELA executive director JOEL SHOEMAKER assistant vp, integrated sales STUART BROCKINGTON executive directors, integrated sales ADAM GOLDBERG, EZRA ALVAREZ senior director, ad operations STEWART NACHT manager, ad operations TIFFANY KESDEN senior coordinator MICHAEL TIGHE evp, branded partnerships GREG BROSSIA designer, branded partnerships MICHAEL LOMBARDO directors, branded partnerships BRANDON GRANT, JAMIE TREDWELL associate directors, branded partnerships ANDREW PARK, ERIC JAMES, MICHAEL RIGGIO associate director, branded partnerships and experimental JOHN O’MALLEY manager, branded partnerships CASEY NOBLE editor, social media DANIEL REYNOLDS branded content producer LENNY GERARD branded content writer IAN MARTELLA senior fulfillment manager ARGUS GALINDO operations director KIRK PACHECO office manager HEIDI MEDINA print production director JOHN LEWIS

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JANUARY / FEBRUARY 2019

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LUKE FONTANA (ANDERSON-MINSHALL); EDUARDO CAPRILES (GROUP)

EDITOR’S LETTER

T H E N E W Y E A R is always a great time to step back and look at where you’ve been and where you’re going. For a lot of people, that means making resolutions about getting fit, staying healthy, or spending more time doing stuff you love—or with the people you love. In the grueling world of HIV activism, this kind of self-care can be especially important.

There were some great gains last year on the HIV front, including a fasttracked new drug for people with resistance, a couple of new medications approved for both those just diagnosed and long-term survivors, and some jurisdictions made great improvements to their HIV criminal statutes.

In my adopted state of California, a law signed by Governor Jerry Brown that took effect January 1 decriminalized HIV. It changed knowingly exposing someone to HIV from a felony offense with up to eight years in prison to a misdemeaner worth a six-month prison term (making it more comparable to what you could get for exposing someone to a number of other communicable diseases).

But we’re living in a political environment that has deprioritized the needs of many people living with HIV. That’s especially true for those who are transgender, who were shocked to learn this winter that the Trump administration proposed new definitions of gender, which experts fear could put trans people’s lives at risk and undermine the fight to end HIV. (We talk about this on page 21.)

People of color have also been under attack in the plast year, which is why this African-American issue is particularly timely and we celebrate with two black men on the covers (an actor on front and activist, author, influencer Emil Wilbekin on back). We also look at some solutions to the issues blacks face around HIV, including how to improve care of African-American youth living with HIV, and combat the broader discrepancies facing black folks in the U.S. Our cover star, Given Stuurman, is an celebrity (and bonafide superstar) on MTV in South Africa. The actor stars in MTV Shuga: Down South, and has helped raise conversations about HIV in South Africa and elsewhere on the continent simply by being a visible force talking about prevention, treatment, and LGBTQ issues (even if his show is censored in many African nations).

This annual issue is one of my favorite, for its celebration of what I think of as the extraordinary ordinary, that is, the every day people who are making the lives of those with HIV better through their work and activism. This year’s 25 Most Amazing People Living With HIV (page 23) are making a bigger contribution to your life, wellbeing, and happiness than you’ll ever know—by advocating for change, busting stigma, fighting archaic laws—and showing that happy, healthy, sexy, powerful people are living with HIV, too. My many, many thanks (and props!) to them. They deserve every accolade and all of our support. Now it’s your turn to tell us who and what we missed, and what you want to see in 2019.

Thanks for sharing this journey with us! Happy New Year!

Emil Wilbekin (above) graces our back cover as one of our 25 Most Amazing HIV-Positive People.

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

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D A I LY D O S E

YOU CAN’T ESCAPE YOUR HIV… BUT YOU DON’T NEED TO YOUR STATUS IS NOT WHAT IS STANDING IN THE WAY OF YOUR HAPPINESS. THERE ARE MANY ways that stigma can manifest when it comes to sex and dating. When most people think of stigma around HIV, they think of the kind where others place judgment on or have an unnecessary fear of a person living with HIV. This certainly does exist, but it isn’t the kind that I have personally witnessed the most as an HIV activist. Instead, the kind that I most often encounter comes in the form of self-doubt and internalized judgment and shame.

I recently had a friend move to another city because he believed it was impossible to find love while being HIVpositive where we both lived. It didn’t matter that we had multiple friends who are living with HIV and are in various forms of happy relationships. (Or that I’m living proof you can find true love while poz.) His mind was made up and his bags were packed.

But the thing is—whether you try moving to a new place, changing your hair, or buying a new wardrobe—nothing can help you escape the stigma of HIV if it’s coming from inside you. I should know. I used to be a perpetual runner (even if it wasn’t specifically from internalized stigma). I thought that I would be happy if I just moved someplace new. If the move didn’t go well, I figured I’d just picked the wrong place. You move often enough, and you eventually start to realize that the neighborhood may be new, and the faces may be different, but the experiences have a funny way of repeating. And maybe you’re just dragging your problems around with you.

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That being said, a little change can do you a world of good. But you don’t necessarily have to cross state lines to embrace it. In fact, you can change your entire life if you change something as simple as your approach.

Even though it’s been a minute since I have dated while positive, I still believe it’s as simple or as complicated as you make it. When I was first diagnosed, I treated my status as this massive secret to reveal, complete with angst and agony—as a whole dramatic rigmarole. My gentleman callers’ responses usually mirrored my method, treating it as a BFD. But it wasn’t long before I came to the realization that this approach totally sucked. I didn’t need to feel sorry for myself or seek forgiveness or approval from someone that I wasn’t even sure I liked yet. That was especially true once I reached viral suppression. Quite simply, once I was undetectable, there was zero reason for me to be worried about someone being willing to date me. There was no longer a risk that I could transmit HIV to someone else, and my value and my health were completely intact— why wouldn’t someone want to date me? I was a catch!

As you probably guessed, my second approach to meeting someone new was just the change I needed. I didn’t treat my status as some dark secret that I hoped he would forgive me for. I didn’t act as if I was thankful that someone would be willing to date my HIV. It was a simple, matterof-fact disclosure before the drinks were even served, and the responses matched the approach. Just like that, dating became easy, or at least easier.

Unless you can change how you treat yourself, no changes you make to your environment will make a lick of a difference. If you are worried that you may never find love or acceptance because of your status, first ask yourself if you have found the love for yourself that you absolutely deserve. I promise you, your HIV status is not what is standing in the way of your happiness. However, your opinion of yourself and your value might be.

Editor at large Tyler CurryMcGrath is also contributing editor at The Advocate magazine, and the author of A Peacock Among Pigeons. (@IamTylerCurry)

SHUTTERSTOCK (MIRROR); COURTESY TYLER CURRY-MCGRATH (TYLER)

B Y T Y L E R C U R R Y- M C G R AT H

JANUARY / FEBRUARY 2019

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BUZZWORTHY

A TV SHOW GETS IT RIGHT ON HIV

A SERODISCORDANT WEDDING ON ABC

How to Get Away With Murder's Connor and Oliver get hitched.

CONNOR (JACK FALAHEE) AND OLIVER (CONRAD RICAMORA),

Empire is finally tackling HIV and its sexy star is ready. of Fox’s Empire is going beyond its usual subject matter of music, fashion, and family drama.

Jussie Smollet’s character, Jamal, learns that Kai—the man he’s in an intimate relationship with— is HIV-positive. Smollet told reporters that Empire writers had long been planning an HIV storyline, but since the show launched in 2015 the timing was never quite right. Until now.

With this new storyline, Smollett hopes his character’s relationship with Kai (played by Toby Onwumere) will help eradicate stigma and educate viewers on what it’s like to live with HIV today.

Thanks to modern medicines, people living with HIV no longer need to look at the virus as the death sentence it was once portrayed as. Today, people living with HIV have a similar life

CHUCK HODES (EMPIRE); MITCH HAASETH (HTGAWM)

THE FIFTH SEASON

expectancy to their HIV-negative peers, but attitudes, especially in certain parts of the country, haven’t caught up with reality.

Today, when treatment suppresses viral loads to undetectable levels, a person living with HIV cannot transmit the virus. But many people are still unaware of this.

Other television shows— including Looking, Transparent, How to Get Away with Murder, and Pose—have also tackled HIV in their plots. Empire, like Pose, has a cast predominantly of people of color, and it raises issues that touch on communities at higher risk of new HIV diagnoses.

By showing Kai as a proud, fearless, black man living with HIV who is, above all, healthy and happy, Empire can help viewers shake stigmatizing ideas about people living with HIV.

the serodiscordant couple from ABC’s How to Get Away With Murder, finally got married (but naturally, because it’s still a thriller, there’s murder in the air).

Since 2015, Connor and Oliver have been one of the most prominent same-sex couples on network television. In their run on How to Get Away With Murder, they have also made history; Oliver received an HIV diagnosis, making the depiction of his and Connor serodiscordant relationship a rare (happy) one.

The pair tied the knot in the winter finale. However, there was a murder tied in to the celebration, as the identity of the victim was revealed in the aptly titled episode “I Want to Love You Until the Day I Die.” (It is a drama after all.)

The series, created by gay writer Peter Nowalk and produced by Shonda Rhimes, stars Viola Davis as a cutthroat law professor and her legal team of students, including Connor. It has broken boundaries in bringing portrayals of gay sex and sexuality, such as its infamous rimming scene, to American screens.—DANIEL REYNOLDS

—DAVID ARTAVIA

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BUZZWORTHY

Stonewall Strong: Gay Men’s Heroic Fight For Resilience, Good Health, And A Strong Community

by John-Manuel Andriote is the longtime Washington, D.C., health journalist’s own story of life after learning he was HIV-positive. Andriote had made a name for himself reporting on the AIDS epidemic from the perspective of an HIV-negative gay man for two decades, then he became poz. Stonewall Strong is Andriote’s story of coming to accept that it was his own resilience and desire to stay healthy and alive that would determine his quality and length of life. More than a simple autobiography, it instead includes pivotal moments in recent history as manifestations of the resilience of gay men in the face of the AIDS epidemic.

Beginning with the famed 1969 Stonewall Riots, to the initial shock of the early years of dealing with the crisis, and pushing onwards to the fight for marriage equality and basic human rights for all, Andriote has penned an informative and insightful yet touching work that will resonate deeply with readers. (Rowman.com) The Weight of the Earth: The Tape Journals of David Wojnarowicz edited by Lisa Darms and David O’Neill is a raw and revealing look at the thoughts and emotions of the 1980s avant-garde American artist.

During the height of the AIDS epidemic, Wojnarowicz began an audio journal using cassette tapes, reflecting on his life, his art, his dreams, and the world around him. The resulting transcripts take the reader back to a wilder time coming to grips with a horrifying disease, and the impact it was having on a recently-liberated gay and bi male community. His words and thoughts are unflinching as he struggles to understand and accept his own fight against the disease, at a time before 10

Memoirs and bios that remind us it was the best of times, it was the worst of times.

medication made it manageable. At times funny, angry, despairing, and uplifting, The Weight of the Earth covers a period largely missing from the artist’s written journals. Darms and O’Neill have astutely edited this volume of recordings in a way that captures both the vitality and uncertainty of life in this era, when America did not extend empathy to those whose community was dealing with the early sunset of life from an unrelenting plague that showed no pity or mercy for the afflicted. (MITPress.mit.edu) Exile Within Exiles: Herbert Daniel, Gay Brazilian Revolutionary by James N. Green, paints a dynamic portrait of the significant and complex gay Brazilian revolutionary and activist of the book’s title. Born in 1946, Herbert Daniel was originally a medical student at the Federal University of Minas Gerais, but soon gravitated towards the leftist uprisings of the time. He joined a guerilla organization and took up arms against the oppressive military dictatorship, but was forced to conceal his sexuality from his comrades in what he aptly described as internal exile. Following a government crackdown in the 1970s, he was forced to flee to Europe where his political self-education continued unabated. Upon his

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The Sea is Quiet Tonight by Michael H. Ward is the author’s deeply personal yet inspirational memoir of the early years of the AIDS epidemic. Ward is a retired psychotherapist and award-winning author who eloquently takes the reader back to a time where little was known about the disease and few survived.

He candidly chronicles the decline and death of his partner, Mark, from AIDS complications. In doing so, Ward seeks not only to honor all lost in this generation, but also open a vital window to the past before modern medical advances helped to save lives. His story is wrenching in its detail of a time when a diagnosis was also a death sentence, and the humanity of the LGBTQ community shined brightest as it took care of its own.

Ward’s partner Mark was only the 100th person in the state of Massachusetts diagnosed with AIDS, and Ward captures this terrifying moment in our history when even well meaning doctors had little to offer beyond hospice care. (QuerellePress.com)

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return to Brazil in 1981, he became a political and social activist for LGBTQ rights, feminism, environmental justice, and the fight for awareness and a response to both the scourge of AIDS, and the discrimination and ostracization of those living with HIV. Exile Within Exiles speaks to Daniel’s personal struggle not just against the Brazilian dictatorship but also the left’s construction of revolutionary masculinity—as well as his ultimate losing battle against AIDS. Green positions Daniel as a link between a more violently intolerant past and a progressive movement that seeks dialog and results.

(DukeUPress.edu) Everywhere Home: A Life In Essays by longtime journalist and activist Fenton Johnson showcases his preoccupations with the politics of gender and sexuality, art, desire, religion, geography, and the intersectionality of these themes. These writings span nearly 30 years, from the 1980s gripped with AIDS and the Reagan revolution, to the hope and change of Obama and the overt racism and division of the Trumpian present. From Kentucky to Calcutta and Paris to San Francisco, Everywhere Home reveals a dynamic portrait of a mind exploring central questions of belief and identity over a period when the LGBTQ community was coming into its own while dealing with outside forces seeking to oppress and destroy it. Johnson eloquently interweaves pop culture, spirituality, history, and politics with the musical cadence of a natural storyteller. (SarabandeBooks.org) —DONALD PADGETT

THE AIDS ACTIVIST PROJECT is a powerful photobook and the result of a 28-year-long project by photographer and AIDS activist Bill Bytsura. The book features powerful photographs of AIDS activists from around the globe, including many members of ACT UP in the U.S. and Europe. The book, which began when Bytsura lost his partner Randy Northup to AIDS complications in 1989, was both a way to channel his grief but also to show the “heroic and mournful” sides of AIDS activists that were never shown on the nightly news. Many of those featured in the collection are no longer living, making the book all the more moving and compelling.

“The AIDS Activist Project is a memorial to the brave men and women who struggled and died while fighting the epidemic and government neglect,” says Bytsura. “But this book is also a renewed call to action, because the AIDS epidemic is not over. Infection rates are rising again and the Trump administration, like Reagan and Bush, is ignoring the dangers.”

(TheAIDSActivistProject.org) —DIANE ANDERSONMINSHALL

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B AC K TA L K

PITCH PERFECT THIS YOUNG ACTIVIST IS DISRUPTING HIV TESTING WITH ONE TENT AND HUNDREDS OF PASSIONATE COLLEGE KIDS

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F O U R Y E A R S A G O , 21-year-old college student Mackenzie Copley got tested for HIV outside a grocery store near Georgetown University in Washington, D.C. Volunteers had set up a station offering shoppers a chance to be screened. Impressed by the work and passion behind the volunteers, he decided to ask the management about volunteering himself. A week later, he was regularly skipping class to join them.

As he continued the work, however, Copley discovered that while this particular group was screening 60 people a day, it was also turning away 20 uninsured people each time. That didn’t sit well with him.

“It pissed me off,” Copley, now 25, reflects. “So, I asked management if we could start screening [uninsured people]. They said they were a private, for-profit company and they couldn’t make money off of those people, so, no, they couldn’t screen them.

21-year-old me said, ‘Well, fuck you!

I’m going to go start a nonprofit and screen everybody.’”

That’s exactly what he did. Three years later, Copley and cofounder David Schaffer launched One Tent (OneTentHealth.org), a D.C.-based nonprofit offering free HIV screening and PrEP navigation in a 10-by-10foot canvas tent, pitched outside local grocery stores, convenience stores, and laundromats.

To date, the organization has recruited 300 undergraduate volunteers from six partnering universities— G e o r ge t o w n , Ho w a r d , G e o r ge Washington, American, University of Maryland, and University of the District of Columbia. Copley says it will soon have a total of 700 volunteers, and it plans to keep growing from there.

What makes One Tent particularly valuable is its cost-effectiveness.

Copley explains, “We’re finding new cases of HIV for only half of the market average cost. It only costs us $8,500 to find a new case of HIV and link them into care, relative to $17,000 for everyone else. We’ve screened hundreds of people so far.”

COURTESY MACKENZIE COPLEY

B Y D AV I D A R TAV I A

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COURTESY MACKENZIE COPLEY

The organization plans on screening 4,000 in D.C. this calendar year, and hopes to expand into Prince George’s County and other parts of Maryland, a state that ranks fifth in America in new HIV diagnoses, and ninth in the cumulative number of stage three HIV (AIDS) cases.

The endless hours behind One Tent have been paying off, but not as cashin-hand. “No one has ever been paid by One Tent, so far,” Copely admits. That speaks to the level of passion within the messaging itself. This summer, One Tent’s devoted COO, Lindsey Sawczuk, donated her time between vacation and medical school. For free.

Copley and Shaffer are creating a board of directors and strategizing around their dependence on college students. “We do screening on the weekends because that’s when our college kids are available,” Copley explains.

Another goal is to “de-medicalize” HIV screenings. “Our whole pitch, we try to be chill about it. If we bring our tent we say, ‘Hey, we’re doing free HIV

screenings. It only takes 15 minutes.

It’s right over there.’” After all, “we’re screening out of a fucking tent. Let’s not be all hoity-toity about it. I like speaking in terms that I understand, and that other people understand, too.”

Gilead recently gave One Tent a $50,000 grant, the full amount it requested, to help fund One Tent’s HIV screenings. The grant was exactly the helping hand Copley says the organization needed to expand beyond D.C., as well as to reimburse the debt accumulated by the team in bankrolling the efforts so far. It was also the sign he needed to quit his bartending job to commit to One Tent full-time.

College kids are paying more attention to One Tent since it began collaborating with Via, a ridesharing app popular with students. Anyone who volunteers with One Tent can get 30 percent off their round-trip rides through Via. One Tent also recently teamed up with the hookup app Grindr. This fall, Grindr is posting One Tent locations to users in the general vicinity, so they’ll

know where to get tested. Notices go out every Friday with information for One Tent events the following Saturday and Sunday.

Copley isn’t tied to just providing HIV testing in front of grocery stores, either. He’s willing to go where—and provide what’s—needed.

“I want to provide any services that the community needs. And we need to be mobile and nimble to react to whatever they need. If that’s hep C, then we’ll do that.”

While it’s still taking baby steps now, One Tent is growing faster than anyone expected. Copley dreams of eventually being able to pay his team. He adds, “One of my really big goals is to create [paid] jobs for 23- and 24-year-old kids that I would have wanted to have, but nobody was offering.”

“At the end of the day, we need to provide great services to people to increase access to care, access to HIV screening, access to prevention,” Copley says of One Tent’s mission. “But we also, number one, need to make sure that we’re keeping people safe.”

Mackenzie Copley (ACROSS & ABOVE) with cofounder David Schaffer (CENTER) and their enthusiastic One Tent volunteers

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MAYBE WE SHOULD LISTEN TO BLACK YOUTH

By including teens with HIV in their own health decisions, we also might be able to limit their chronic symptoms.

ALLAN FILIPE SANTOS DIAS/UNSPLASH

BY DAVID ARTAVIA

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NEW RESEARCH SHOWS THAT YOUNG PEOPLE LIVING WITH HIV

suffer fewer virus-related symptoms when they’re able to map out their own long-term health goals. Data also found that when this type of planning, referred to as end-of-life care, isn’t mapped out by the youth or a family member, young people living with HIV are more likely to suffer negative health outcomes.

The study, published in the journal Pediatrics, evaluated 105 mostly black adolescents (93 percent African-Americans) aged 14 to 21 and their families who received care from six U.S. hospital-based HIV clinics between July 2011 and June 2014. One-third of the family participants were also poz themselves.

Lead investigator Maureen E. Lyon, a clinical health psychologist at Children’s National Health System at The George Washington University School of Medicine and Health Sciences in Washington, D.C., tested an intervention known as Family Centered pediatric Advance Care Planning (FACE pACP). In one-hour sessions, one group of youths and their families went through advance care planning, while another group received traditional assessments.

The advanced care sessions involved discussions assessing the youths’ values, beliefs, and life experiences while determining when to begin end-oflife discussions. They also involved decision-making, discussions of death and dying, preparing guardians to respect youths’ wishes, and providing directives to be followed in case the youths are unable to speak for themselves.

After a year of evaluations, the investigators found almost 75 percent of the advanced care planning participants reported having fewer disease related symptoms, compared to 27 percent reporting a high level of symptoms.

According to Lyon, the results show the benefits of speaking to young people living with HIV about not only their treatments, but also their future. “Patients living with HIV and their families found FACE pACP to be an emotional and worthwhile experience,” she told MD Magazine. “One adolescent after completing the intervention said, ‘I feel alive.’”

According to the Centers of Disease Control and Prevention, this age group makes up nearly 21 percent of all new diagnoses. Despite their youth, the study also reported that young people living with HIV are also six to 12 times more likely to die than the general public.

According to the recently released 2017 HIV Surveillance Report from the CDC, African-Americans account for the highest rates of HIV diagnoses in the United States at 41.1 percent—followed by Latinos, who make up 12.6 percent of all new cases. The report also shows that youth aged 13 to 24 saw 8,164 new diagnoses in 2017. Of that number, 4,257 were black.

There is a growing understanding of the benefits of involving youth in their own health decisions. In 2018’s Histories of the Transgender Child, Julian GillPeterson argues, “As simple as it sounds, pediatric trans medicine would be radically transformed by actually asking trans children what they want and truly basing care on that knowledge.”

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5 WAYS TO FLIP THE SCRIPT According to the Centers for Disease Control and Prevention’s 2017 HIV Surveillance Report, AfricanAmericans represent 41 percent of new HIV diagnoses yet comprise only 12 percent of the U.S. population. In 2018, an article in Journal of Racial and Ethnic Health Disparities offered a fivepoint “action plan” for community leaders to address and reduce that disparity.

—JACOB ANDERSONMINSHALL

ENDING HIV IN BLACK COMMUNITIES COULD START WITH THESE STEPS: BE IMMERSIVE: Although the authors don’t go as far as suggesting all efforts must arise from black communities, they do note the need for work to be done in collaboration with those communities, and for answers to these challenges to be culturally relevant to AfricanAmericans. (Pointing to an “unavailability of access to HIV healthcare and testing,” the researchers also call for “free or reduced-cost testing.”)

BE NONJUDGMENTAL: The authors call for leaders and service providers to work to eliminate prejudices and unconscious biases that may interfere with HIV diagnoses and treatment.

After all, they point out, some of the most-impacted populations are those who face stigma, including LGBTQ people, drug users, and those currently or formerly incarcerated. In particular, the researchers call out “cultural HIV/AIDS stigma” and “homo-negativity.”

BE KNOWLEDGEABLE: The authors stress the importance of understanding “new approaches” to prevention and treatment—clearly referencing the recent consensus that undetectable equals untransmittable (U=U, which shows that once an HIVpositive person in treatment reaches viral suppression they are no longer at risk

of transmitting the virus to a partner), and explicitly mentioning the use of pre-exposure prophylaxis (PrEP) as a highly effective barrier to transmission.

BE AN ADVOCATE: The authors want community leaders to become more vocal in calling attention to the epidemic and its impact on the black community. But that’s just the beginning. The action plan notes that much larger social issues must also be addressed in order to “eradicate secondary factors such as incarceration rates, poverty, STDs, and other factors that increase the chances of contracting HIV.” Essentially, they are calling for intersectional activism.

BE INNOVATIVE: The plan says to be “proactive and create solutions that evolve with the times and the changing needs of the affected populations.”

Certainly, that includes new technologies and treatments, but the authors also point to innovative programs such as Many Men, Many Voices (3MV), aimed at black men who have sex with men who may or may not identify as gay or bi, in which small groups talk about cultural, social, and religious norms; sexual relationship dynamics; and how racism and homophobia influence HIV risk behaviors.

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In the case of black poz teens, activists and researchers make the same argument.

“Some families and physicians have said if adolescents and young adults just took their HIV medications, they would live a long life and it would avert the need to have these conversations,” Lyon noted. “However, adolescents living with HIV have told us they want to have these conversations, have thought about death and dying, and have even experienced deaths due to HIV in their family.”

Lyon added, “FACE pACP increased the odds that families understood their adolescents’ treatment preferences, which in turn, predicted fewer HIV-specific symptoms in their adolescent a year later.”

It’s important to provide poz youth with the facts they need to make informed decisions about their care. That means sharing the real consequences of following (or rejecting) treatment plans, including the possibility of death if they don’t take their medicine.

“Adolescents express a desire to be involved in goals of care conversations with their families,” Lyon said, and letting them has positive results. “FACE pACP gives teens a voice, helps families ‘break the ice,’ and provides an extra level of support to their doctor. Don’t be afraid.”

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TRUMP VS. TRANS

CAROLYN KASTER/AP PHOTO

THE TRUMP ADMINISTRATION DECLARES WAR ON TRANSGENDER PEOPLE, ESPECIALLY WOMEN OF COLOR LIVING WITH HIV. THEY WON’T TAKE IT LYING DOWN.

Since Trump took office, there’s been a steady assault by this administration on transgender rights. But none were as shocking and potentially wide-reaching as the memo obtained by The New York Times in October 2018. As the paper noted, “The Trump administration is considering narrowly defining gender as a biological, immutable condition determined by genitalia at birth, the most drastic move yet in a government wide effort to roll back recognition and protections of transgender people under federal civil rights law.”

The memo states that “the sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”

Such wording would narrowly define sex as either male or female and gender would be determined by the attending physician at a child’s

birth. The change could have broad ramifications for transgender, gender nonbinary, intersex, and two-spirit people—and would go against expert consensus that gender is not determined by physiology.

According to The Times, “The Department of Health and Human Services has called on the ‘Big Four’ agencies that enforce some part of Title IX—the Departments of Education, Justice, Health and Human Services, and Labor—to adopt its definition in regulations that will establish uniformity in the government and increase the likelihood that courts will accept it.”

The memo clearly sets out to “erase our very existence as transgender people,” noted Transgender Law Center executive director Kris Hayashi in a statement to the press at the time, “We know now that the administration intends to ignore the preponderance of law, science,

and evidence on gender identity to empower hate and rollback access to healthcare...”

It’s in the area of healthcare that the ramifications may be particularly dangerous for trans women of color.

Transgender women—especially black trans women—have higher rates of HIV than nearly any other demographic. The Centers for Disease Control and Prevention estimates around a quarter (22-28 percent) of trans women are currently HIVpositive, and more than half (56 percent) of black trans women are already living with HIV. Compare that to past predictions that one out of every two gay and bi black men will become HIV-positive in their lifetime if things do not change.

Cecilia Chung, codirector of programs and policy at Transgender Law Center and a trans woman living with HIV, told the San Francisco Bay Area radio station KQED in October

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Activists like Achim Howard (top) and Octavia Y. Lewis (bottom), who are both living with HIV, say they #WillNotBeErased.

don’t necessarily respond to the same prevention messages, and have different and often complex healthcare needs. So if we want to end HIV [and] AIDS in America, we have to pursue strategies that are tailored specifically to the needs of this often marginalized community that continues to bear the brunt of the HIV epidemic.”

Achim Howard (top left), founder of Trans Men Rising and an advocate for black trans men living with HIV, fears an even bleaker future in which we “would be reliving a dark, historically horrific time where instead of Jews and blacks being the target, it will be transgender individuals such as myself, living healthy—with HIV—who would be looked at as the outcast or mutants of society, living without a voice [or] equality and only existing to die.”

PrEP navigator Blossom C. Brown, a black trans woman who appeared on I Am Cait and volunteers for the Human Rights Campaign, calls the effort to redefine gender “not only un-American but despicable!” She’s especially concerned about “black trans women not being able to potentially access resources that could be lifesaving, like health care, housing, employment, etcetera.” But she’s not giving up hope. “We are strong,” Brown declares.

“We are resilent! And dog gone it, the same way they couldn’t erase our ancestors for their blackness, they will not erase our transness!”

Indeed, there are reasons to hope.

Thousands of trans people recently made #WillNotBeErased a trending hashtag. Numerous organizations and activists came out against the memo.

And legal experts like Hayashi reassured us, saying, “To be clear: nothing this administration can do will undermine the scores of federal courts that have recognized our humanity and hundreds of state and local legal protections we’ve already won.”—JA M

COURTESY ACHIM HOWARD (HOWARD); COURTESY OCTAVIA Y. LEWIS (LEWIS)

that the definition change could impact trans people’s access to health care, including HIV prevention and treatment.

“As a black woman of transgender experience living with HIV, I understand the nuances and hardships of navigating the system,” Octavia Y. Lewis (bottom right) tells Plus. Lewis, who sits on the advisory boards of Positively Trans and the Center of Excellence for Transgender Health at the University of California, San Francisco adds, “This ruling will definitely be a life or death situation as I try to figure out how to continue to get my medication so that HIV will only reside with me and not kill me.”

The Department of Health and Human Services allocates resources for HIV treatment and prevention services based on which groups are most affected by the epidemic. Right now trans women are high on that list. Changing the definition of gender to exclude trans people would make it harder for them to be counted. “It would certainly make us more invisible,” Chung said. “And… you can’t allocate resources to an invisible community.”

At the time of The Times report, amfAR, the Foundation for AIDS Research, released a strongly worded response, arguing, “This is the latest in a string of moves that constitutes a sustained assault on the rights of the estimated 1 to 1.4 million transgender individuals in America. Not only is it a flagrant violation of the human rights of an already marginalized and stigmatized minority, but it would also seriously undermine efforts to combat the nation’s HIV epidemic.”

Kevin Robert Frost, CEO of amfAR, elaborates, telling Plus, “After working with transgender individuals in the U.S. and around the world for many years, it’s clear that a one-size-fits-all approach to HIV prevention just isn’t effective.”

The organization points out that a wide range of intersecting challenges place trans people— particularly those of color—at high risk of HIV, including widespread discrimination by employers and health care providers, social stigma, poverty, and racial discrimination.

“Because HIV is primarily a disease among marginalized populations in the United States, the fight to combat HIV is intrinsically a human rights issue,” Greg Millett, vice president and director of public policy at amfAR said in the earlier statement.

Trans advocates also note that not that longago researchers and program administrators still lumped trans women in with gay men, thus burying their unique needs among those of men, and failing to target trans women with prevention and treatment outreach. Returning to those policies would once again render trans women invisible, and undoubtedly increase trans women’s risks of contracting HIV and having poorer health outcomes once HIV-positive.

“Transgender individuals face unique challenges and extremely high levels of stigma and discrimination,” Frost says, adding, outreach to gay men doesn’t help them. “They may not congregate in the same places as gay men and other men who have sex with men, JANUARY / FEBRUARY 2019

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2019’S

Most Amazing People Living With HIV

During these turbulent times in D.C. and around the world, it’s important for those living with HIV to be reminded of the impact of other poz folks.

Throughout HIV’s history, those affected by the virus have spearheaded tremendous change at both local and federal levels. And the time to rise, again, is now. That’s why this year we’ve chosen to highlight 25 of the most amazing people living with HIV who are fiercley battling for the rest of us. To those who made the list (and to the thousands who didn’t), we salute you.

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Emil Wilbekin creates visibility and awareness for a generation of black queer men.

BY GEORGE JOHNSON

i n t h e 1 9 8 6 essay “Brother to Brother: Words from the Heart,” Joseph Beam famously wrote some of the most important words to ever be spoken to black queer men: “Black men loving black men is a revolutionary act.”

For the better part of his life, Emil Wilbekin has been the walking and talking embodiment of these very sentiments, carving out a space in a media market traditionally dominated by white men, helping to birth some of the biggest movements in black creativity while serving as a founding editor of Vibe magazine, editor at large of Essence, and editor in chief at Giant magazine. Wilbekin understands what it means for him to be visible and a representation for a community that has often had to live in the shadows.

“Live in your truth,” is the first piece of advice Wilbekin offers to the new generation of black queer and gay men who stand upon his shoulders. “Don’t let anyone tell you what you aren’t. Be really proud of who you are because you stand on the shoulders of a lot of men who didn’t have the freedom to be their most authentic selves as black queer men.”

Wilbekin comes from very humble beginnings, adopted at 8 months old to “wonderful parents” who poured into him lessons about “being a good person, being a good black person, a good Christian, but most importantly a good man.”

The latter is where Wilbekin met his first struggle. As his homosexual expression became more apparent in his teen years, it became clear it was viewed at odds with those admonitions to be a good man. At age 21, he officially came out to his parents, a moment his mother—the person Wilbekin refers to as the closest in his life—did not take well. “She was reading passages from the bible and crying, and it really put some distance in our relationship. When you see pics of me growing up I was always with my mother.”

Wilbekin saw two options. Stay. Or run. It was the words of his brother that made him stay and the challenge to “educate them about what it meant to be gay, and to be patient and compassionate with them. Through many, many years of my own therapy and kind of pushing back and forcing the issue about not just my gayness, but the community, my mother and father finally came around.”

With this support, Wilbekin found the courage to do even more for his black queer and gay community creating Native Son—named in homage to Notes of a Native Son, the collection of essays by James Baldwin, who Wilbekin references as “the first person that allowed me to know that I could be who I was and be seen.”

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For Wilbekin, Native Son is a “movement and a platform to bring black gay and queer men together to be in a safe space. I felt that there was this discomfort between black queer men with each other when we are out socially, and we had limited spaces to be in the light and interact with each other outside of chat rooms and bars.

I think it’s important that as a marginalized c o m m u n i t y, we build ourselves up to empower, inspire, and support each other. I’ve seen it in white spaces and felt, why don’t we have that? So I decided to create it.”

It was at the first Native Son Awards (created to honor black gay men in activism, media, and entertainment) in 2016, that Wilbekin would reveal one of his biggest secrets to the world: he was a person living (and thriving) with HIV. “It was scary to disclose my status,” Wilbekin admits.

“Some of my friends knew and some family, but I had just never publicly disclosed. I was less scared about how people would react to me but more fearful because I had to tell my mother. I’ve carried the virus for more than 15 years and I’m healthy and I go to the doctor, but I felt ashamed I didn’t tell my mother. The person closest with me and that’s where I felt uncomfortable.

I disclosed at the Native Son Awards because I felt how could I lead a movement and not live my truth fully? I wouldn’t have done it if I couldn’t have given that speech because I know for people who are HIVpositive, they live with this shame.”

Wilbekin recalls the day after disclosing how walking in New York, “everything was in technicolor.

I could for the first time feel my feet on the pavement.

It was like a veil had been lifted off of me.” Since that time, he has continued walking proudly upon the pavement, most recently taking over in June of 2018 as Afropunk’s chief content officer.

“Afropunk is a brand that I’ve been a big fan of because it creates safe spaces for people in the African diaspora around the world to be themselves outside the margins of society,” Wilbekin says. “They are super political and highly intelligent and it’s an important CONTINUED ON PAGE 39

WARREN WHITE

FATHER TO NATIVE SONS

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FIGHTING THE PRISON PIPELINE

GIRLS DOING IT FOR THEMSELVES Activist and advocate Andrea Johnson is working hard to empower marginalized people—especially women and girls.

JEREMIAH PAGE (ANDREA); COURTESY SANJAY JOHNSON (SANJAY)

BY DESIRÉE GUERRERO

though community activist Andrea Johnson is currently battling cancer and pursuing a law degree, in 2018, the dedicated humanitarian still managed to collaborate with Operation Turkey and It Takes A Village Foundation to help feed 1,000 people in need this Thanksgiving, while continuing to advocate for the rights of women and girls with the Positive Women’s Network-USA and her own organization, Girl U Can Do It, Inc. (GirlUCanDoIt.org) Johnson tells Plus that GUCDII is a community-based organization focused on addressing “societal ills that negatively affect humankind. My inspiration in starting GUCDII was seeing so many youths and young adults face a lot of the injustices I faced growing up as a child. Whether it had to do with race, gender identity, domestic violence, or self-esteem—I saw I could use my life as an example to help not only youths and young adults but adults as well.”

The 47-year-old mother and grandmother is most passionate about helping women and girls escape dangerous and oppressive situations and “live their best life.” Including GUCDII and PWN (she’s co-chair of PWN Pennsylvania and was part of their inaugural policy fellowships), Johnson is associated with numerous national and international organizations that help save lives from domestic violence, human sex trafficking, and acquiring HIV. As a woman living with HIV for “11 years, four months, and four days,” Johnson says ignorance around the condition, whether one is positive or negative, continues to be one of the biggest issues regarding HIV. “Stigma, and the lack of applied knowledge from persons living with HIV and AIDS and those who are not” are today’s biggest challenges, she says.

To help combat that stigma, Johnson also recently created the “Red, White & U HIV Anti-Stigma Photo Shoot,” a campaign that highlights beautiful, brave, and courageous women living with HIV from around the world. All we can say is—you go, girl!

what happens when a hookup you had at 22 turns into a criminal case His mug shot turned years later that threatens to Sanjay Johnson into an overnight activist. send you to prison for three decades? If you’re Sanjay

BY DIANE Johnson, you fight back.

ANDERSON-MINSHALL “Becoming an instant visible HIV activist took time,” he admits. “It was scary at first. Having my mug shot and charges plastered permanently over Facebook and other internet outlets was hurtful.”

Three years after he met another young man on a gay hookup app, Johnson recalls, police came to his front door “with a complaint citing myself as ‘knowing and willfully exposing another to HIV.’” The case has been winding its way through the Arkansas courts ever since. Now a series of motions and delays stand between Johnson and a prison cell, as he attempts to explain the science of HIV transmission in a region far more focused on stigma and outdated ideas about the supposed “death sentence” of living with HIV. “I had to find strength mentally,” Johnson notes, adding that he eventually realized “I can take control of the narrative to show that I’m not this monster or evil person that I was pictured as. It gave me courage to educate and correct [untruths] about HIV and AIDS and HIV criminalization.”

His trial is currently set for February 26, 2019, but his attorney has “filed a second motion for dismissal with the new evidence” that includes the new wording from the Centers for Disease Control and Prevention that those whose viral loads are undetectable cannot transmit HIV. Living with the virus since 2012, the Little Rock, Ark., resident was undetectable within a week of that one-night stand, something his medical records back up. He’s hopeful that he can keep pushing his case as far as he needs to in order to be fully exonerated. The 25-year old artist and photographer admits this year has been a tough one.

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THE VOICE Podcast star Cecil Baldwin on how we can combat HIV stigma with the power of speaking out.

BY DAVID ARTAVIA

t h e r e i s t r e m e n d o u s power in using your voice. For Cecil Baldwin, that is particularly true. The renowned performer has been lending his voice to one of iTunes’s most popular podcasts, Welcome to Night Vale, which recently celebrated its 333rd performance in a six-year run. For this HIV-positive actor and activist, that night was one of his proudest moments.

“The performance was quite awe-inspiring,” Baldwin reflects.

The show itself has toured 23 states and 17 countries, and sold over 250,000 tickets.

But Baldwin says, his sense of achievement about Night Vale pales in comparison to the pride he felt when he was invited to speak at his alma mater about “how my career as an actor was shaped by being an HIV-positive gay man, who was willing to say so in a public forum.”

But the journey of getting to that day last year didn’t happen overnight. The 39-year-old Brooklynite discovered he was HIV-positive in 2007, soon after moving to New York City. At the time, he knew nothing about antiretrovirals or other resources available, but with the support of friends he made in the N.Y.C. theater scene, he quickly rectified that to the point where he would soon be the one passing on HIV knowledge.

After all, “education is the most powerful weapon we have,” says Baldwin, explaining that HIV “attacks the body, but the stigma against those people with HIV… is a disease of society.

The language we use in reference to HIV and AIDS and our sexual health and wellbeing is just as important as any medication, and deserves the same amount of scrutiny.”

Baldwin argues, “Being honest and open with an individual takes far more bravery than marching in a rally, and the aftereffects will last far longer. As hard as we fight for the rights of people with HIV [or] AIDS within our own community, we must fight 10 times harder for the rights of people with HIV [or] AIDS worldwide.”

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“My journey with HIV has been dealing with isolation and fear of rejection,” Johnson says. “[From] coming out slowly to being bold speaking out.”

He says he’s learned that family is important, but “you get to pick” who they are. Anti-criminalization activists have rallied around Johnson, with support from organizations like Cornelius Mabin’s Arkansas RAPPS, the Black United Leadership Institute, and the Sero Project.

These agencies are providing support for what his attorney, Cheryl Maples, has repeatedly said: “Sanjay Johnson could not have passed on and exposed anyone... therefore, he cannot be guilty of this particular statute.” Arkansas is one of 34 states that have HIV-specific criminal statues on the books.

Still, Johnson is hopeful his case can change both the laws and public opinion around criminalization of HIV. This year, along with his art and photography, which is popping up all over social media in the South, he admits, he’s proud “that I’m still fighting even when I feel alone.”

He’s using his art as “an outlet to me for therapeutic reasons,” he says, as his 2019 resolution is to acquire “mental, emotional, and physical freedom… for people living with HIV and also those fighting to decriminalize HIV.” Many of the biggest challenges he faces are what he sees as the those anyone living with HIV deals with: “Fear and stigma.” That won’t stop him, he insists. Johnson has continued to update his followers and fellow activists on his every mood, challenge, and court directive. The reason he does it is simply smart thinking, though.

“No one will control the narrative of me,” he says.

No one but him. He makes sure the information in the public sphere is correct and as de-stigmatized as possible, “because I am the source.”

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BEING A RAINBOW IN THE STORM Dr. Joyce Turner Keller shines for others but doesn’t gloss over the challenges people with HIV face.

NOAH FECKS (BALDWIN); COURTESY DR. JOYCE TURNER KELLER (KELLER); COURTESY OF SHEILA CROCKETT (CROCKETT)

BY GERALD GARTH

“t h e y d o n ’ t s e e the storm—they only see the rainbow,” says Dr. Joyce Turner Keller. “People don’t see me as someone who has challenges.

There are so many challenges that come with [living with] HIV, and often times people don’t get the chance to acknowledge that.”

Because of that, Keller, 69, created “Straight Talk at the Kitchen Table,” a teaching tool of conversations in a safe space where people living with HIV can find support. Nationally, black women account for 66 percent of new cases of HIV among women, according to the Center for Disease Control and Prevention. Black women are at much higher risk of HIV due to such factors as lack of access to healthcare, poverty, and the intersection of racism and sexism. Another risk factor often forgotten is sexual assault.

Keller, from Baton Rouge, La., is very open with her story. She has been living with HIV as a result of a 2011 rape, but chooses not to dwell on the trauma. “I’m grateful for knowing my status, which allowed me to get into treatment. I’m grateful that a platform has been carved out of everything I’ve been through.”

Keller founded Aspirations, a nonprofit organization serving the needs of those affected by HIV because “people are always dealing with challenges—mentally, physically, and spiritually.”

Keller also encourages women, regardless of status, to find their voices. “Write, draw, sing, whatever! And if that isn’t you, teach—work with the less fortunate, with youth. People underestimate how much strength lies in being someone others can lean on. And for those living with HIV, it’s okay to feel lost… at first. But HIV is not the end. The process is not overnight, but you will rise.”

Keller certainly found her own voice, and created The Shackle Series, a collection of plays and artwork that bring education, entertainment, and awareness. With titles like “No,

STILL SHE PERSISTED This long-term survivor has been arrested multiple times protesting Trump’s policies.

BY DAVID ARTAVIA

No, Ain’t No AIDS in My Church” and “He Loved Me in the Dark, Denied Me in the Daylight,” she addresses a spectrum of issues that impact black communities—particularly faith, and stigma around HIV, depression, and the LGBTQ experience. “I’m not asking anyone to change their religion, but people [of faith] should be less judgmental and more empathetic. Suicide and acts of violence are rampant, and it is compassion that changes lives.”

Keller’s work in HIV has been honored by President Barack Obama and recognized by members of Congress, Louisiana governors Kathleen Blanco and Bobby Jindal, and Baton Rouge’s mayor. She was featured in Poz magazine’s “35 Ones to Watch.” Being chosen as one of Plus magazine’s most amazing people of the year, she says, “encourages me to keep speaking out, to never give up, to know my work and efforts are not in vain. I am empowered knowing my voice counts!”

But Keller sites her greatest accomplishments as being able to speak publicly as a black woman minister and businesswoman living with HIV. “Just being able to say that I did not give up on God and that I’ve made it means everything.”

for the 29 years since being diagnosed with HIV, Shelia Crockett has stopped at nothing to uplift the voices around her, especially those who can’t speak for themselves—no matter what the cost.

Last September, Crockett was arrested in Washington, D.C., after protesting proposed budget cuts and Congress’s threat to the Affordable Care Act. She joined dozens of other HIV-positive activists who have helped lead the charge to save the health care of millions of Americans.

She was arrested again while protesting at the capital against the nomination of alleged sexual predator Brett Kavanaugh, who has since been confirmed to the Supreme Court.

These days, the 55-year-old is co-chair of Positive Women NetworkUSA’s Dallas/Fort Worth chapter and a current PWN Policy Fellow.

Despite the countless hours Crockett has clocked toward eradicating stigma, and defending health care, she says the

biggest challenge she sees right now is “getting the world to understand undetectable equals untransmittable.”

And while the activist has long used her life to bring awareness to poz women’s stories, but she says we still need “more articles and billboards with women of color standing on the foundation of U=U” to encourage them they can live “longer, healthier, sexual lives.”

As an activist and community organizer, Crockett has accomplished a lot. But, if she could talk to her younger self she would still urge herself, to “not wait 26 years to sit at the table, to speak up and out for others who don’t have a voice.”

Moving on, Crockett says she will stop at nothing to push progress forward. Much of the work she does now is on behalf of the memory of those in her life she’s lost— including a dear friend who died late last year, Nippy Tymes.

“R.I.P. Nippy,” is a new rallying cry for this activist.

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Lifelong activist Alex Smith is going right to the top to end HIV in our country.

BY DESIRÉE GUERRERO

at 30 years old, Alex Smith has become a major player in federal policy in the fight to end HIV and AIDS. But his fight has been a long journey. “I’ve been volunteering for [HIV causes] as long as I can remember,” he recalls. “Shortly after I was diagnosed in 2011, I struggled with what to do: go on about my life in banking and communications and keep my diagnosis to myself, or lean into my diagnosis, shed my shame, and do something.” He chose the latter.

Though “nervous and unsure,” he opened up about his diagnosis and joined a program at AIDS Alabama geared toward building the policy and advocacy skills of people living with HIV. “Through my work and growth with this inspiring group of leaders, it became clear that policy was my passion,” Smith says. In 2017, he departed AIDS Alabama to serve as executive director for Equality Alabama. In May 2018, Smith was appointed as AIDS United’s new senior policy manager in D.C. where he assists in the analysis, development, and implementation of policies that will help end HIV in the U.S., including access to prevention and treatment services for the most marginalized communities.

“Sound public policy—coupled with the meaningful involvement of people living with

AGING GRACEFULLY WITH HIV Diagnosed at 59, Anna Fowlkes represents older Americans having to navigate aging and HIV.

BY SAVAS ABADSIDIS

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HIV and other marginalized persons—is one of the greatest tools we have in our response to HIV,” says Smith, warning that the topic should not be overpoliticized.

“The response to HIV has long enjoyed bipartisan support in both chambers of Congress, and this newly elected Congress is no different. It’s time for our longtime champions to act up, and time for new champions to step up.”

Smith says we’ve come a long way in terms of HIV, but not nearly far enough. “We’ve made remarkable progress in the nearly 40 years of response to the HIV crisis.

The biggest remaining challenge, however, is the pervasive stigma faced by people living with HIV. This stigma manifests itself in so many ways and is exacerbated by other

forms of bigotry and oppression— racism, misogyny, homophobia, transphobia, xenophobia, ageism, classism, and so on.”

These days, when he’s not changing the world for the better, Smith spends his free time participating in the D.C. area’s Stonewall Sports league, or cooking, traveling, and spending time with husband Michael and their three dogs.

six months after being diagnosed with HIV, Anna Fowlkes was invited to be on a panel at the University of Maryland. The topic was HIV and aging. “That was the beginning of an awesome journey, a ministry, and personal growth for me,” she says. “I often am amazed, humbled, and grateful for the opportunities that have come my way... I now take better care of me. I have family and friends that I have known for many years who have stood by me on this journey. I now also have a family of sisters who are living with HIV, who are supportive, encouraging, and uplifting.”

At 71 years old, Fowlkes has been living with HIV for 12 years now. The Baltimore native discussed relationships and dating among older PLWH with her partner Paul Johns in a cover story for Poz magazine last year. Johns is HIV-negative and Fowlkes has incorporated educating people about being in serodiscordant relationships, and uses their personal life as a corner stone in her mission to amplify the message that being undetectable means it’s almost impossible to transmit HIV to one’s partner. Fowlkes was also one of the faces of New York City’s 2014 Age Is Not A Condom campaign. Created by ACRIA, the campaign encouraged older adults to practice safer sex.

Since her diagnosis in 2006, Fowlkes’s role as an HIV and AIDS education and prevention advocate, activist, and spokesperson has positioned her to host the Baltimore City Health Department’s e-learning HIV management program Positively!, a definitive guide for promoting safe and healthy living. She wrote and produced the videos, “Senior Dating: Older, Wiser, Safer” and “Love Ain’t Supposed to Hurt” on the topics of safer sex and domestic abuse among seniors.

Fowlkes was also inducted into SisterLove’s 2020 Leading Women’s Society in 2013, served six years on the Greater Baltimore HIV Health Services Planning Council, and was a member of the Baltimore City Health Department’s health literacy panel. She also has appeared on several television news programs, sharing her personal story on secular and Christian radio shows.

“I am glad that I have been able to help others and make a difference,” she says. “I am proud to be part of the solution and not part of the problem. I realize that many are still suffering from stigma, some are angry, some depressed, and some may suffer from low self-esteem or self-worth. To eliminate those issues is one of the biggest challenges we face.”

NORA DARLING (SMITH); COURTESY ANNA FOWLKES (FOWLKES)

MR. SMITH GOES TO WASHINGTON

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TURN-AROUND ARTIST From a CD4 count of 2 to undetectable: how one man’s HIV journey led him to become a community leader.

BY SAVAS ABADSIDIS

adrian neil jr. serves as a capacity building specialist for AIDS United’s Getting to Zero initiative. Prior to that Neil served as the program manager for the Ohio AIDS Coalition, the policy and advocacy division of Equitas Health. He shares his own personal experiences as an African-American same-gender-loving man to promote self-love, self-affirmation, self-empowerment, and healing as these elements are an integral part of his own personal journey and work.

Neil’s goal is to change the mindset about HIV and AIDS in the communities around him. He also believes in addressing other disparities that marginalized communities face.

He was diagnosed with AIDS in July 2009, a day that changed his life forever.

With a CD4 count of just two and a viral load “well into the six figures, I honestly didn’t know what I was going to do,” Neil admits. “The day I found out, I actually went back to work—I’m a workaholic— as if nothing happened and put it in the

FREEDOM FIGHTER As multiple arrests prove, Mary Jane Maestas is not afraid to take on the Trump administration to fight for our rights.

COURTESY AIDS UNITED (NEIL); COURTESY MARY JANE MAESTAS (MAESTAS)

BY DESIRÉE GUERRERO

despite living with several chronic health conditions, Mary Jane Maestas has spent a considerable amount of her time traveling to D.C., from her home in Delta, Colo. First, to protest Trump’s attempt to repeal the Affordable Care Act, then to fight the administration’s attacks on immigrants, and then again to protest Brett Kavanaugh’s confirmation to the Supreme Court.

Throughout these two years, the fierce activist has been arrested several times for civil disobedience—which hasn’t scared her off one bit.

back of my head hoping that I could escape it, but it wouldn’t let me. In just three to four years, I was hospitalized three times. Neil admits, even when he wasn’t hospitalized, he feared he would never have sex again or be in a healthy intimate relationship. He recalls, “I was outed by coworkers and the company that I worked for attempted to terminate me multiple times after I was outed, and my status became company knowledge.”

The feisty 52-year-old Latina says these issues, along with HIV, are all connected more than we realize in this country, and that focusing on where they intersect is key: “These issues are connected because they affect the most vulnerable of people.

The poor, elderly, children, and the sick, which are also the most marginalized and ignored by the powerful, often are without a voice in national politics,” explains Maestas.

Public assistance programs are life-saving for people in these populations and need to be protected. “After being homeless for a little over a year, I was blessed with a HOPWA housing voucher and moved into my own apartment in August,” she says, talking about the Housing Opportunities for Persons with AIDS program from HUD’s Office of HIV/ AIDS Housing. “While there were times that I was frustrated,

That experience was particularly traumatic for him because of his workaholic nature. He prided himself on doing amazing work.

With the help of his mother and her strength, his medical team, and the support of family and friends, Neil not only recovered, but reached an undetectable status in 2012. Empowered by his miraculous health turnaround, Neil began sharing his story at various community groups, schools, and universities. He also began volunteering for an Mpowerment Project program focused on supporting young black gay men living with HIV in Dayton, Ohio.

“While volunteering, I heard about a position as a testing coordinator and decided to apply,” He didn’t get the job, but instead, the organization created a position for him, where he “had the opportunity to work with congressmen and women, mayors, and senators to reduce HIV in the state of Ohio.

Now with AIDS United, Neil is developing and implementing trainings for organizations across the country on leadership development, communication, conflict management, cultural humility and other topics.

“I have been blessed to influence various communities and meaningfully influence various people in an effort to educate.”

I never gave up believing I deserved a safe place to call my own.”

Today, she says there is still fear of disclosing, due to stigma. Maestas was diagnosed in 2011.

She says, “I feel that the language we use can be stigmatizing.

I prefer not to call myself a ‘HIVpositive’ person. I say I am ‘a person living with HIV,’ instead.”

Though poz folk’s preferences on terminology varies and continues to evolve, Maestas’s statement is an important reminder to be sensitive of everyone’s humanity, and to not chop anyone down.

“I want to become more involved with the issues that are affecting my rural community. Also of course,

universal healthcare and holding my elected officials to high standards are also high on my radar for 2019.”

Maestas says being part of this year’s list is “such an honor. Since being diagnosed with HIV, this is definitely my biggest achievement, so far—I am truly blessed!”

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ONE BAD ASS SISTAH This long-term survivor has been a leading HIV specialist in St. Louis for decades.

BY SAVAS ABADSIDIS

HIV STOPS WITH HIM Jasán Ward leads the way for LGBTQ people of color, particularly those living with or at risk of HIV.

BY SAVAS ABADSIDIS

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transmission for decades. “I remember back in the 2000s I had an opportunity to share my story about being a woman who is pregnant and living with HIV,” she recalls of her own personal experience. “Oh, the controversy!” she laughs.

Parkinson believes the biggest challenge facing people living with HIV is not being able to be their true selves. “For me, this was a challenge early on in my diagnosis,” she remembers. But Parkinson reached out to a sibling for help. “My sister and I made a list of people we most felt comfortable with sharing, who would be a support system for not just me but the entire family.”

“All my mother spread is love and education,” says Parkinson, some 20 years later, before adding, “Learn your status.”

n o w 4 6 , j a s á n Ward, has been living with HIV since 1995 and began his work in health and wellness for LGBTQ people of color and people living with HIV and AIDS in 2007, while employed at In Our Own Voices, an Albany, N.Y. organization. He was instrumental in creating numerous programs for marginalized communities.

In 2012, Ward became an employee at the MOCHA Center. His work in this role culminated in the implementation of the conference Building a Strong Foundation: The Changing Landscape of HIV Prevention.

Ward has also provided training and workshops to a broad range of service providers to help increase their cultural awareness and sensitivity enabling them to provide more effective services

for LGBTQ people of color and PLWHA. In 2012, he was invited to the White House, as an emerging black LGBTQ leader, to address HIV and other issues affecting the LGBTQ POC communities. Ward was invited back to the White House in 2013 and 2014.

A trainer for the National Coalition Building Institute and The Trevor Project, Ward has served on community advisory boards related to HIV and cancer, HIV vaccine trials, and PrEP. He later served as the manager of prevention programs and senior director of programs and evaluation for MOCHA’s Rochester location. In that city, he helped develop Building Leadership and Community Knowledge (BLACK), created in the wake of Michael Brown’s murder by the Ferguson, Mo., police in 2014.

Currently, Ward is a program administrator for the New York State Department of Health, AIDS Institute, Division of HIV Health Care, Bureau of HIV Ambulatory Care Services.

He oversees PrEP services, specialized care centers, adolescent and young adult programs, and transgender health programs.

Despite all of these accomplishments, the thing Ward says he is most proud of the fact the he recently earned his Bachelor of Science in Community and Human Services from Empire State College—a journey he began when he was young but which initially ended after a suicide attempt. When not at work, Ward loves to plays the flute, engages in dance movement to release stress, and writes poetry.

COURTESY KNEESHE PARKINSON (PARKINSON); COURTESY JASÁN WARD (WARD)

this past september, Kneeshe Parkinson (pictured on right) served on the host committee for the United States Conference on AIDS (USCA 2018) in Orlando, Fla.—a high point this year. The woman who once couldn’t conceive she’d even survive is now thriving.

At 40-years-old, Parkinson has been in the HIV trenches for half her life and describes herself as a “bad-ass leader.” As a long-term survivor of 21 years, she’s earned many accolades. Her career began in the late ‘90s when she joined Washington University School of Medicine’s Project ARK. An HIV specialist and a certified health coach, she helps educate the St. Louis community about HIV, hepatitis C, addiction, harm reduction, treatment adherence, and addressing stigma. She is on a steering committee for ViiV Healthcare and is working with the Ryan White HIV/AIDS Program Center for Quality Improvement and Innovation (CQII).

Parkinson, a Saint Louis native is a recipient of a Positive Women Network-USA policy fellowship, which teaches participants how to advocate for policy change; and serves as the PWN state lead for Missouri. She has also been inducted into the 2020 Leading Women’s Society by SisterLove, an organization dedicated to eradicating “the impact of HIV and sexual and reproductive oppressions upon all women.”

Parkinson is a passionate advocate for pregnant women with HIV. She says some people’s response is always, “Why take the risk?” about HIV-positive women carrying and birthing children. The question belies the importance that children (and experiencing pregnancy) play for many women—and ignores the modern medical reality that has been able to safely prevent vertical

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MIGHTY MAMA This amazing survivor has dedicated her life to helping the Houston area’s forgotten ones.

BY DESIRÉE GUERRERO

dr. keith green has loaned his voice to the fight against HIV This Chicago social for nearly his entire adult life. An worker, activist, teacher, established spoken word artist, and journalist is a community journalist, and educator, resolute supporter of he has been a frequent contributor black gay men living to TheBody.com and was the with HIV or at risk of associate editor for Test Positive becoming positive.

Aware Network’s publication

BY GERALD GARTH Positively Aware from 2005 to 2009.

He currently serves as an adjunct professor at the University of Chicago, assistant professor at Loyola University Chicago, and director of the Philadelphia African American Leadership Forum.

“It’s imperative that black gay men be present and active in this fight,” argues the activist about why the demographic needs to be part of the discussion around HIV. He consistently speaks to issues that impact black gay men, such as stigma, education, and advocacy.

In his career, Green has led advocacy efforts at the AIDS Foundation of Chicago. He’s also a founding member the Chicago Black Gay Men’s Caucus. In 2012, Green was inducted into the Chicago LGBT Hall of Fame. Through his work on Project PrEPare, Green is thought to have become the first black gay man in the world to become directly involved in the management and implementation of a study focused on the biomedical HIV prevention strategy. A native of Chicago’s southside, he was diagnosed at age 17, and has embraced the journey of living with HIV. “Each individual situation requires a different internal dialogue, if you will, about the need to disclose,” he reflects. Green sees two essentials being faith and family. “A big part of that support base is spirituality, so tap into whatever spiritual base you are comfortable with and begin to really seek a higher being.”

Family is the other critical element. “My grandfather. My mother. [She] is very influential, even in those ways where I’m like, ‘I’m never going to be like her!’ That’s influential too.”

Green says another person he admires is Dr. David Malebranche a Haitian-American medical doctor working in the field of HIV who teaches at Morehouse School of Medicine.

“I’m just smitten by him,” Green raves. “People, period, influence me. Because I am a social worker by profession, I study people, and I’m changed by people.”

COURTESY KEITH GREEN (GREEN); COURTESY TANA PRADIA (PRADIA)

HALL OF FAMER

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d e s p i t e h e r a m a z i n g ly youthful appearance, mother of three, Tana Pradia, is also a grandmother, and greatgrandmother. A true survivor, she’s been living with HIV for nearly 20 years and has overcome everything from drug addiction, to a near-deadly bout of tuberculosis, to once having her T cell count drop to 14 with an out-of-control viral load.

After being given a “second chance” in life, Pradia threw herself into advocacy work, becoming a patient mentor at the Harris Health System’s Thomas Street Health Center in Houston.

Today, Pradia speaks openly about her long battle with addiction, “I was addicted to drugs for over 15 years, I have been clean for over seven. After getting clean, I moved back to Houston. I joined a women’s support group in 2014 and from there, I took the Ryan White Project L.E.A.P. class.” Pradia explains that the free Houston-area, Ryan White Planning Council-sponsored, 17-week training course helped her develop skills needed to help plan for HIV prevention and care services in the region. “This was the beginning of my advocacy.”

Today Pradia is a part of several organizations, most notably, a cofounder and co-chair of the Positive Women’s Network’s greater Houston area chapter. She also recently received one of the organization’s policy fellowships. Despite these seemingly bureaucratic positions, Pradia is anything but a paper-pusher.

The fierce activist is known for showing up on the front lines to stand up for all marginalized people in her community—and the Trump administration’s extremism has only fueled her fire.

Not only was Pradia active in the fight for immigrant justice in Texas, joining several marches and going to the border to protest family separations, she also traveled to D.C. to protest Brett Kavanaugh’s confirmation to the Supreme Court.

“I have been fighting for immigrants and their families and women’s rights in 2018,” says Pradia, reflecting on the past year’s many political upheavals that put such groups at risk. “If I’m asked to act, I jump into action. These issues are important to me, as a woman living with HIV. In the world we live in today, it’s important to have our voices heard. We don’t need money to fight issues, we can fight with numbers and be successful.”

“I am so proud to have been able to overcome addiction and find my passion as a woman living with HIV,” she concludes, expressing her gratitude to be able to do the work she does.

“I would have never imagined years ago that I would be here, fighting for women living with HIV, or myself. This has saved my life, as an addict giving back to a community I love.”

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POP! GOES HIV AIDS United’s Julio Fonseca leads important initiatives, including the activism-fueling People Organizing Positively.

BY DAVID ARTAVIA

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Irwin became involved in the now-defunct Ohio AIDS Coalition, a division of Equitas Health, which ceased operations in March of 2017. Her work there began a journey of advocacy that has guided her to this day. In 2012, she first heard of Positive Women NetworkUSA, and within two years she was co-chairing the Ohio regional chapter. In 2017, she became a policy fellow and a spokesperson for PWN-USA’s steering committee around undetectable equals untransmittable (U=U). Irwin was also awarded the Trailblazer Award at the Equitas Health Institute’s 2017 Transforming Care: LGBTQ & HIV/AIDS Health Equity Conference.

One of the things she’s most proud of this year was protesting the nomination of Judge Kavanaugh. There she was on Capitol Hill— visible in news footage and sitting in senators’ offices. “What I loved the most is being able to actually get there and protest. And since Trump became president, boy have I been protesting. I have even lost track of how many times I’ve been to D.C.!”

“She’s been arrested I think six times in the past year for civil disobedience in D.C. around health care, immigration, and Kavanaugh,” notes Jennie Smith-Camejo, communications director for PWN. “She has several chronic conditions and uses a walker, but she never fails to show up when and where she’s needed. She was our January 2018 Shero of the Month.”

The fact that Irwin made so many trips despite having being diagnosed with an arthritic back and suffering a stroke speaks even more to her tenacity. “I went with mouth, body, and walker and wheelchair. I was always one to speak out and point to things that just are not right and unjust—[I] was taught this as child. I was also taught to never give up rights that many people fought for, died for, and came to America for.”

Irwin, who has a bachelor degree in social work from Youngstown State, is also an award-winning crocheter and cross-stitch artist. In 2019, she’ll finish her training as PWN-USA policy fellow, which is helping her understand more about policy planning and how to affect change.

j u l i o j . f o n s e c a is a program manager at AIDS United, where he leads the Partnering and Communicating Together to Act Against AIDS (PACT) and People Organizing Positively (POP) initiatives.

Through the POP initiative, supported by Gilead Sciences, Inc., Fonseca works with people living with HIV across the country to support grassroots organizing and leadership development aimed at eliminating stigma, developing new leaders, and educating policy makers. Through PACT, a partnership funded by the Centers for Disease Control and Prevention, Fonseca works with partners across the country to find innovative ways to raise awareness about HIV prevention, testing, care, and treatment at community events and on social media.

“My proudest accomplishment this past year has been to see and support people living with HIV really continue to move forward in their leadership path through the People Organizing Positively initiative,” Fonseca says. “It’s so important to cultivate and nurture new leaders as the demographics of the epidemic are changing, and leadership needs to reflect that.”

Fonseca is passionate about this work because he knows first-hand the value of leadership development, supportive communities, and innovative programming.

He brings 20 years of advocacy, coalition development,

COURTESY OLGA IRWIN (IRWIN); COURTESY JULIO J. FONSECA (FONSECA)

ohio’s olga irwin cannot remember the exact day she was diagnosed, but it was late November in 1999 and at the time, she was told she had only about three months to live. Because she was shocked and believed the prognosis, Irwin initially refused treatment.

Thankfully Irwin’s family wouldn’t take that answer to heart. Her mom and sister WHEELCHAIR set about to find her the right WARRIOR doctor and treatment. They finally found a suitable local This award-winning needlepoint artist has clinic, but it took Irwin’s been to D.C. more times husband to drag her kicking than she can remember— and screaming into the place. often in a wheelchair That was the first time that or walker.

Irwin was told that she had a

BY SAVAS ABADSIDIS chance at a normal life if she kept up her treatments.

“It was not easy at times—most of the time because the side effects of the meds, and the stigma. Also, I was one of the only of handful of women in the support groups I frequented. While there were many groups for men who have sex with men, there were few for women.”

Irwin endured stigma from those who assumed all cisgender women with HIV were either sex workers or drug addicts. But that wasn’t her story.

Because of side effects of HIV medications and her co-morbidities, Irwin had to have quadruple bypass heart surgery by the time she was 38.

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COURTESY OF ALECIA TRAMEL

capacity building, and community outreach experience to his work with a focus on supporting people most heavily affected by HIV. Fonseca began his career at the nonprofit Mental Health America, where he worked on a research project examining the behavioral health needs of people living with HIV. This sparked a lifelong interest in bridging gaps along the HIV treatment cascade.

Most recently, Fonseca worked for two national HIV nonprofits addressing workforce shortages, and fiscal sustainability of Ryan White-funded agencies, and he helped address the barriers experienced by those with HIV. As a person diagnosed with HIV in 2009, one of the areas he’s most concerned about is defending the Affordable Care Act. “Healthcare has been consistently under attack in the current administration,” he explains.

“We should not have to crowd fund people’s healthcare treatment. Ever.

Elected leaders need to actually live the principles that they are so fond of quoting.”

Fonseca has also recently found a renewed voice as a writer and blogger, sharing his story as a queer Latino man living with HIV to raise awareness, break down stigma, and empower others to start conversations about HIV. His writing is honest, personal, and often moves readers to tears. He has written about his experience being simultaneously diagnosed with HIV and AIDS and how he felt a burden lift when he learned that undetectable means being unable to transmit the virus to a partner.

Out of the office, Fonseca volunteers as a mentor for people who are newly diagnosed with HIV at WhitmanWalker Health in Washington, D.C., an LGBTQ-affirming, community-based health and wellness provider. Since 2014, he has served on the Metropolitan Washington Regional Ryan White Planning Council.

Next up, he hopes to learn the piano and continue on his path towards a graduate degree. “I want to continue to find the balance between doing the work, living with the condition, and also finding the joy that makes life worthwhile,” Fonseca reveals. As to any advice he would offer to his younger self? “This is your life to live.

You are most accountable to yourself at the end of the day for how you treat people and how you love yourself.”

POSITIVELY DETERMINED This indomitable mother of three is set on changing South Florida—and the world.

BY DAVID ARTAVIA

putting words into action has always been part of Alecia M. Tramel’s DNA. The 48-year-old mother of three has been a staunch HIV activist since finding out she was poz in 2000. Her journey as a respected voice in the community has grown richer every year.

Tramel says she founded the group Positive People Network in 2015 to unite people from all kinds of backgrounds who are living with HIV in an effort to make positive change in the world.

“Next year, I want to incorporate Positive People Network and help at least 100 people by creating safe social events for people living with HIV in South Florida to meet each other, find support, and build community,” she says. “I want to inspire long-term survivors to mentor the folks who are newly diagnosed, to help and support the next generation.”

This year she became the South Florida state lead for the Positive Women’s Network-USA, an activist organization advocating for HIV-positive women and their issues. She also sits on several boards and is part of the Florida HIV Justice Coalition, which is working to change the state’s discriminatory HIV criminalization laws. And she’s not done yet.

Tramel is fully aware the power our government holds on the lives HIV-positive people, and she vows to never let them forget. “D.C. can help by making sure that funding stays in place to help pay for the programs and services that are critical to care for the health and wellness of our positive community,” she declares, adding that we as citizens also play a role in keeping politicians accountable.

“The biggest problem is still stigma,” she says about issues facing the HIV-positive community.

“It seems as strong as it was 35 years ago. We need to confront this fear and discrimination with education and acceptance.”

Today, the activist continues speaking on causes that impact those living with HIV at local organizations, public schools, community health centers, and media outlets. Tramel encourages faithbased communities to get involved too. “Churches can start by being open and accepting, like they should be,” she says. “They need to get involved and help advocate and provide for positive people, setting the example of how we should care for our neighbors.”

Looking back with gratitude, Tramel explains that her demanding life journey couldn’t have happened any other way. “I would tell my younger self to brace herself,” she reflects. “It’s going to be a bumpy ride, but you have everything you need to succeed inside of you.”

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This HIV-positive New York City power broker hopes to use his position to address the disease of poverty that HIV has become.

BY DAVID ARTAVIA

corey johnson made history this year when he was elected New York City Council Speaker, becoming the second most powerful elected official (behind the mayor) of the nation’s largest metropolis— and the most powerful elected LGBTQ official in the country who’s out about living with HIV. The 36-year-old is fully aware of the impact he’s making. Last fall, Johnson was presented with the Larry Kramer Activism Award by GMHC, for his visibility and efforts to include queer and HIV initiatives in the public narrative. But 14 years ago, the now-proud politician didn’t exactly see himself as a trailblazer.

“I was 22 years old when I was diagnosed and I lost my health insurance shortly after,” he reflects.

“I remember feeling shame and living with fear and anxiety. Today, I am healthy. I have good health insurance and stability that keeps me free from worrying about whether I can afford both my rent and my medicine. I am at a place where I do not live in shame, and I hope to help others with HIV just like I was helped.”

Johnson sees political ramifications of the epidemic, saying, “HIV has warped into a disease of poverty, primarily affecting lower income people of color.”

“When wealthy and famous people like Rock Hudson, Magic Johnson, and Freddie Mercury were diagnosed with HIV or died from AIDS, there was so much more attention on the disease and those suffering from it,” he argues, contrasting that with the current situation. “Today, it can feel like you’re forgotten.”

As a council member, Johnson vows to use his position to help others. He knows he stands “on the shoulders of all the brave men and women who came before me. I do this in honor of the ones who put their lives and body on the line which, in the end, when I found out I was positive, is why I had access to lifesaving medication.”

Times are changing, including the social perception of HIV itself, argues Johnson, who says, even as a high-ranking politician, his status has “never once been raised in any kind of negative political attack.”

But he also recognizes, “how lucky I am to live in a city where being HIV-positive isn’t the stigma it is elsewhere, and I’m proud to be as public as possible about my status to reduce that stigma everywhere.”

A lot of that enlightenment comes from Johnson’s own compassion, which he admits wasn’t always so strong—especially when he was newly diagnosed. Looking back, he says he would have done things differently.

“After I seroconverted, I was so angry and disappointed in myself for a very long time and that self-loathing fueled my abuse of drugs and alcohol,” he says. “It was an awful cycle that took a long time 34

to break. If I had known then the kind of rich and fulfilling personal and professional life in store for me, I think I could have avoided a lot of that selfdestructive behavior.”

Johnson’s experience with drug abuse and a lack of access to healthcare led him to become a staunch activist in both spheres. Ultimately, he knows his political position comes with great responsibility.

“I have and will continue to use my position to advocate for all New Yorkers who need a voice, especially those living with HIV,” he declares.

“This year’s midterm election really opened up a wealth of opportunities for New York City, New York State, and our country for 2019,” he adds. “I hope that the Democratic-controlled state government in Albany can advance a sweeping progressive agenda that will improve the lives of tens of millions of New Yorkers. I hope that the Democratic-controlled House of Representatives will serve as a desperately needed check on Trump’s ongoing assault on the best of our country, including its vicious attempts to erase the trans community out of existence.”

Still, he quips, “This year, like every year, I of course want to meet Lady Gaga.”

EMIL COHEN

MISTER SPEAKER

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TAKING US TO SCHOOL This Broadway actor came out HIV-positive, adding visibility and fighting stigma.

BY DAVID ARTAVIA

LIFE’S A CABARET!

COURTESY IRENE SODERBERG (SODERBERG); COURTESY HERNANDO UMANA (UMANA)

This fairy godmother of fundraising hasn’t let HIV slow her down—or stop her from raising millions for the cause.

e q u a l p a r t s l i z a Minelli, Lucille Ball, and Mae West, Irene Soderberg is a force of nature. The “66 years young” cabaret performer has been an iconic fixture in the LGBTQ community for over 30 years.

BY DESIRÉE Soderberg, who now lives in West GUERRERO Hollywood, was an HIV advocate long before discovering her own status.

Though the bubbly blond is a straight cisgender woman, she has always felt at home in the LGBTQ community and still remembers the dark days of the AIDS crisis.

“I lived in Hawaii for five years, ‘82 to ‘87. I talked with my doctor friend who said, ‘See those beautiful boys on the beach? Fifteen of those are my patients.’ I was devastated!” recalls Soderberg. “Having always been a researcher, I knew about GRID [gay-related immune deficiency, as the condition was first called] and Matilda Krim’s work and hypotheses for amfAR, and knew I had to help.”

In the 30 years since, Soderberg has raised millions for those living with HIV with her wildly entertaining and inventive stage shows. San Francisco declared April 21 “Irene Soderberg Day” in 2002 for her tireless work and contributions to HIV and AIDS causes over the years.

Still, her success as a performer at the time was bittersweet.

By the late 1980s and before today’s highly effective antiretrovirals were developed, death was all around. “Three hundred close friends died in three years,” laments Soderberg. “Such tragedy—the humanity of so many incredible beings cut short in the prime of their lives. My reason for being was clear. It was my job to entertain, enlighten, and bring hope to a generation decimated by AIDS.” Soderberg was also dealt another blow in 1990 while living in San Francisco, when she discovered she had acquired HIV from her husband. Despite her activism and support of those living with HIV, she remained quiet about her status for a long time. However, frustrated with the progress our society has made around HIV issues, she recently decided to publicly acknowledge that she is living with HIV, to help eradicate stigma and inspire others.

“I’m speaking out now because it’s important people get inspiration and validation from whatever source they can,” she told the CV Independent in 2013.

Last year proved to be another challenging one for the performer.

After writing a new show, she was in a car accident, thwarting her plans to tour.

But with her trademark toughness and class, the sassy survivor says she’s not letting anything slow her down.

in august, 30-year-old gay Broadway actor Hernando Umana came out publicly about being HIV-positive in a big way. The Kinky Boots and School Of Rock alum posted a heartfelt note on Instagram alongside a photo of himself holding the message: “Living With HIV.” And with that, he was free of the secret he’d kept from the public for nearly 10 years.

Coming out poz remains one of the proudest moments in his life, Umana says. But while it was a milestone for him (and the many others he’s inspired), he says the queer community still has a long way to go in eradicating the stigma that kept him closeted for so long.

Of the biggest challenges facing people living with HIV, Umana says, “In my very privileged community in N.Y.C., it is absolutely the stigma. How are we so behind in education in N.Y.C.? We [also] have to remember that there are so many people in the world who don’t have access to affordable medication—and that needs to be fixed now.”

In addition, Umana wants to see more attention brought to the impact of viral suppression. And he’s certainly walking the walk. In the August Instagram post, he paid homage to HIV activists who’ve come before him to make it possible to have access to medications that suppress the virus to such low levels that it becomes virtually impossible to transmit to others: “I stand on the shoulders of people like [Peter Staley] who risked his life for us,” he wrote. “I stand on the shoulders of the millions of people who had to suffer and die from this disease. I stand on the shoulders of the gay men who were forced out of the closet in such a scary time.

These men and woman fought and died to get to where we’re at now—to take a pill at night and never have to worry about dying.”

Now, Umana continues to encourage other public figures to share their HIV status. After all, “nothing is going to change until people can see what HIV looks like,” he says to Plus. “It wasn’t until we had incredible representation of queer characters in the performance field that real change started to happen. When someone was taught to discriminate their entire lives against a group of people, sometimes they just need to see with their own eyes that we are just like them.”

Umana also started a business called CBD Dog Health (CBDDogHealth.com), a company that supplies CBD-enriched hemp oil to treat medical issues for pets.

Needless to say, the man is busy. He says he simply hopes to “continue my journey.”

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CHANGING MINDS AND TAKING NAMES This bisexual woman of transgender experience is fighting stigma and building HIV advocacy down South.

BY JACOB ANDERSON-MINSHALL

equals untransmittable (U=U). That’s a message Willingham credits in the video with saving her life, because it gave her a reason to become diligent about her HIV treatment and helped her suppress her viral load.

Willingham turned to Thrive Alabama after her diagnosis in 2000 and tells Plus, “for 15 of those [ensuing] years I was satisfied with only being a client as I lived miserably in the closet, but after I came out as a transgender woman, most of my severe depression lifted—for once I was able to concentrate on more than myself.

I felt like Thrive saved my life and I wanted to give something back.”

In 2018, Willingham told Living Proof Advocacy (a brand that advocates the telling of personal stories in order to raise awareness or foster change) that “for 20 years after my HIV diagnosis, I just sat at home waiting to die. I never went to college like I wanted. I had a family and had to work.… I always felt like I missed out on my purpose. I don’t regret having my children... they are

PERVERTED PEN This sex advice columnist believes we can’t really confront HIV until we get over our sexual hang-ups.

BY DANIEL REYNOLDS

thousands can t h a n k Alexander Cheves for a better sex life. That’s because the New York City-based writer pens many of the sex and love advice columns that run in The Advocate and Plus magazines and online at Advocate.com. He may only be 26, but he’s wise beyond in his years in matters of the heart—and the bedroom. In his 36

my greatest purpose—but they’re now grown, so I’m free to find new purpose for my life.”

Since January 2017, she has embraced that newfound purpose with gusto, diving into HIV activism. Willingham now serves on the Community Advisory Board of Thrive Alabama where she chairs the Prevention Committee and is involved in the iAdvocate Project. She describes the latter as “14 HIVpositive individuals, myself included, [who] advocate CONTINUED ON PAGE 39

columns, he dispenses wisdom regarding everything from tips for better fellatio to exhaustive reviews of sex toys.

But Cheves isn’t only interested in the skin-deep.

The gay Georgia native dives deep into the role that sex and sexuality plays in LGBTQ history. An enthusiastic member of the kink and leather communities, Cheves also dispenses guides for newcomers that are helpful and humanizing for those in these subcultures. His pieces that address the hanky code, cruising grounds, or “public displays of affection that straight people take for granted,” educate readers about how queer people have been persecuted—and yet have managed to still find each other and maintain vibrant communities.

Cheves also uses his voice as an activist. In op-eds, he bravely speaks out on issues where others remain silent.

In 2015, he came out as HIV-positive in an article following World AIDS Day, in which he spoke to how stigma prevented him from doing so sooner. To date, he has been living with HIV for over five years. Cheves also wrote about his history of sex work in 2018. He did so, once again, in order to fight stigma (around the world’s oldest profession), as well as to speak out against legislation that would hurt other sex workers.

For Cheves, being honored by Plus as one of the year’s most amazing people with HIV means “I must be doing something exciting, and that’s rewarding.”

COURTESY KATIE ADSILA WILLINGHAM (WILLINGHAM); COURTESY ALEXANDER CHEVES (CHEVES)

k at i e a d s i l a w i l l i n g h a m is a woman of transgender experience living in rural north Alabama. She says her middle name, Adsila, “was given to me by my sister. It’s Cherokee and it means ‘blossom,’ which I think I’ve done much of in the past two years.

I’m 40 years old—and have been for six years now,” she jokes. “I’m bisexual and not in the least bit confused, sex greedy, or attracted to everyone that breathes. I live on disability and the love of my life are my four Shih Tzu’s—they are my self-care, my safe place, my peace and happiness. When depression creeps up or the world just becomes too much, I can snuggle with my babies and the world melts away.”

Diagnosed with HIV in 2000, as a 20-something with three children, Willingham struggled with treatment—in part because she was also struggling with her gender identity, as she explained in a 2018 video for the Prevention Access Campaign’s Positive Series (PositiveSeries.org), a national campaign funded by ViiV to spread the word that undetectable

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However, Cheves stresses that there’s still much work to be done in breaking down barriers in his field. After every piece he publishes, Cheves notes, naysayers invariably give backlash to his sex-positive voice and coverage of formerly-in-the-shadows topics.

“Sex writing is threatening to so many people,” Cheves says.

“Some people have told me that the sex movement is over, that the ‘70s Sandstone experiment failed, that leather is dead, and porn is in its twilight years, so it’s out of touch to keep harping on kinky, filthy things. Others have told me that my writing is problematic in the era of #TimesUp and #MeToo, as if our current focus on feminism and consent is somehow at odds with fighting for sexual autonomy and sex-positivity—it’s not and never has been.”

It is important to keep addressing these topics, Cheves says. “It really helps people. It’s hard to find reliable information about sex on the internet, especially if you’re queer, and especially if you’re into things some people consider taboo, disgusting, or frightening.” He adds, “I receive emails from readers from all over the world asking for advice on how to take anonymous loads, about bug-chasing and extreme BDSM, and so on. All the shaming and fear of sex doesn’t change the fact that people everywhere want to get fucked raw by

THE NEWEST GENIUS Gregg Gonsalves went from the streets with ACT UP to the halls of Yale University.

JOHN D. AND CATHERINE T/MACARTHUR FOUNDATION

BY DIANE ANDERSON-MINSHALL

like a lot of young gay men in the 1980s, Gregg Gonsalves dropped out of college and took a stand as part of ACT UP, the direct action protest group pushing for change around HIV and AIDS policies, medications, and stigma. He wasn’t living with HIV at the time (he became poz in 1996), but he was part of a community that was swiftly overwhelmed by the disease. Fast forward to 2018, and Gonsalves has just been awarded one of the country’s highest honors: The MacArthur Fellowship.

strangers in dark spaces—because it’s fun—and they’re seeking accurate, health-conscious, sex-positive information.”

Cheves’s dreams for 2019 involve visions of a world in which special investigator Robert Mueller takes down President Trump; Cheves finishes the book he’s writing; progress is made toward an HIV vaccine; more people—queer and straight—come out as sex workers and lovers of kink; and he’s able to address a topic he has “purposefully shied away from:” drug addiction—and his own struggles with it.

“A writer benefits from a degree of distance when writing about personal experience,” Cheves says. “But there is no distance from an addict and his addiction. It is present, right here, looking over my shoulder. But I need to write about it because drug addiction directly or indirectly affects every queer person I know.”

If instead the future brings more discouraging days for LGBTQ people, Cheves won’t despair. “When I have doubts, I remember that a conservative pushback, a swing back into sex-phobia and puritanical policing, has happened before and will happen again. And when it does, I’ll be there to fight it.”

Called the “Genius Grant” by those in the know, the fellowship goes to the 25 most promising and innovative thinkers in the country each year—and it comes with a stipend of more than half a million dollars, which can be used in any way to support their work.

For Gonsalves, that money goes towards funding his life’s passion: connecting people living with HIV with top-tier researchers who push for global advances in scientific knowledge of the disease.

After decades of activism, in his 40s, Gonsalves “decided I wanted a new set of tools to do the work, so I decided to come back to school,” he says in a new MacArthur Fellows video. He got a degree in biology and a PhD in quantitative health from Yale University, where he’s currently an assistant professor in the Department of Epidemiology of Microbial Diseases, an associate (adjunct) professor and research scholar at Yale Law School, and codirector of the Global Health Justice Partnership and the Collaboration for Research Integrity and Transparency.

The cofounder of the Treatment Action Group (TAG) in the early-1990s, Gonsalves is now an epidemiologist and global health advocate. Among his projects are mathematical models that help show “how to identify hot spots for HIV testing in real time in order to maximize identification of undiagnosed HIVpositive persons.”

That work helps organizations minimize the places where people living with HIV tend to drop out of treatment, and it also helps understand how emerging outbreaks occur. He mapped out the Scott County,

Ind., outbreak for example, and how the lack of needle exchange programs helped propel transmissions.

In another line of research, Gonsalves examined the link between high rates of sexual violence against women living in Cape Town, South Africa, in settlements where bathroom facilities were far away and left women vulnerable to attacks.

Gonsalves’s mathematical model showed the optimal number of new facilities and demonstrated that sanitation investments by the city would significantly reduce instances of sexual violence as well as their associated costs.

Gonsalves also cofounded the Global Health Justice Partnership, an interdisciplinary initiative between the schools of law and public health at Yale University. The GHJP program uses an interdisciplinary approach to solving contemporary problems at the intersections of global health, human rights, and social justice.

“My work is designed to give politicians and policymakers the information they need to make better decisions for better public health,” Gonsalves says.

In the video, Gonsalves gives an example: “One of the projects I’m working on now is using a set of algorithms or mathematical tools that were originally designed to figure out how to go to the hottest slot machine in a casino.”

He continues, “But we’re using that same kind of thinking and decisionmaking algorithms to figure out where to test for HIV infection, to find the greatest number of HIV-positive people who are still undiagnosed.”

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MUSIC CITY CARES

In 2018, this grandma took on family separation, Kavanaugh, and HIV stigma—and still had time to get out the vote.

After 25 years as CEO of Nashville’s leading HIV charity, this activist turns to the next generation.

BY JACOB ANDERSON-MINSHALL

BY SAVAS ABADSIDIS

“we will never surrender to the injustice,” says Jessi Mona Cartwright-Biggs, a 67-year-young grandmother and activist who lives in Houston, Texas. She’s spent the past year fighting for our rights on numerous fronts and helping the blue wave by getting folks to register and vote in the midterms.

Cartwright-Biggs, who jokes that, “HIV has been living with me for 19 years,” is one of the founders of the Positive Women’s NetworkUSA Texas Greater Houston Area chapter and serves as its strategic communication action team officer.

“I go to different organizations to address and speak about the stigmatizing language they are using and request it be changed,” Cartwright-Biggs says of her work with PWN. “The outcome thus far has been positive.” She also does outreach at re-entry programs for people paroled from prison, is involved in voter registration drives, and speaks to residential facilities for people living with HIV about resources available—especially for women who are poz.

Cartwright-Biggs grew up in upstate New York where she attended a Catholic school in which she was the only black kid in her class until 8th grade. She went on to earn an associate degree in criminal justice and a bachelor’s in human services.

As a survivor of intimate partner violence, sexual assault, and violence in the workplace, Cartwright-Biggs says she’s been able to use her trauma for good to help others and empathize with those who experience trauma themselves. During the Kavanaugh confirmation proceedings CartwrightBiggs says, “I felt the resurgence of the pain all over again,” and she joined in protesting his confirmation to the Supreme Court.

She’s also involved in the fight for immigrant justice in Texas.

“I really was proud to be a part of these major events that affect our country,” Cartwright-Biggs says. When she was younger, she didn’t join the Civil Rights Movement, but says this year, “was my opportunity to get involved and protest to support the cause and injustice that took place, and actually is still taking place.

The immigration events in Texas reminded me of slavery and the Holocaust. It reminded me of the pain and unbelievable injustice to basic human rights. I couldn’t not take the time to speak out for the voiceless. … I am so proud of having had the opportunity to travel with the ACLU to the Texas-Mexican border to protest the immigration separation.”

She’s also proud to be celebrating her 32nd year of sobriety. And in 2019, she’s looking forward to educating more people who are living with HIV, by sharing resources and stressing “the importance of involving themselves in government that affects them. And most of all, I want to show them that they can thrive in their lives, that HIV-AIDS is not a death sentence.”

Cartwright-Biggs says she sees the biggest challenges facing Americans living with HIV are healthcare, reproductive rights, and racial, social, and economic justice. “All of these are issues that will keep any civic-minded person engaged and very busy,” she acknowledges. “It is an uphill battle and the struggle continues. ” 38

joseph interrante is the outgoing CEO of Nashville CARES, the second-largest charitable organization in the Music City region, which provides services to those living with HIV or AIDS, or at risk of becoming HIVpositive. Interrante is a long-term survivor who tested positive in 1985, but says, “Since my first life partner was diagnosed with AIDS in Boston in 1983, I have probably been living with HIV longer than 34 years. I am 66 years old now.”

The fact that his partner was the first person diagnosed with AIDS in Boston who was willing to acknowledge his medical condition publicly became an extra incentive for Interrante to become an HIV activist. On a personal level, he says, “the support I received from others during the six months of my partner’s illness and death in 1983 showed me the difference that an AIDS organization could make in the lives of people living with AIDS and their loved ones, and compelled me to ‘pay it forward.’”

In 1988, he became a staff member at a clinic in Cleveland, Ohio. Then he moved to Nashville in 1994, where he’s continued his HIV work ever since.

In 2019, Interrante will retire after 25 years as the CEO of Nashville CARES. During his leadership, the organization has grown and reinvented itself in response to changes in the epidemic. Most recently, CARES changed its mission in 2014 to reflect the advances in prevention and treatment that have provided the tools to end the epidemic. That led to a paradigm shift in how Interrante thought about, carried out, and evaluated the organization’s work.

While Interrante is hopeful that we can end HIV and AIDS, he’s not as optimistic when it comes to our ability to eliminate stigma.

“If the last two years have taught us anything—not to mention, years of work before 2016—efforts to end or eliminate stigma will, at best, produce mixed results.

‘Haters gonna hate,’ to quote a certain artist with Nashville roots,” he says. “We should spend less time and energy on trying to ‘end stigma’ and more time building people living with HIV and AIDS resilience to navigate stigma—as well as recognizing when we’re really the objects of stigma and when we’re just being treated in a lousy way that has nothing to do with HIV—which happens too frequently within some institutional medical settings. That will make us all stronger.”

Interrante says he’s flattered to be recognized for his work, but says, “I try not to give these lists too much weight. Every day in my work at Nashville CARES… I walk down the hall and run into staff and volunteers also living with HIV, who are just as amazing, courageous, and dedicated [as me].”

COURTESY JESSI MONA CARTWRIGHT-BIGGS (CARTWRIGHT-BIGGS); COURTESY JOSEPH INTERRANTE (INTERRANTE)

OURS IN STRUGGLE

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space in the world culturally.” His focus is increasing the stories and intersections that create Afropunk and “build out more digital, video, and branded content to expand on social platforms.” Wilbekin’s career has been “going into places and building them or rebranding them,” and he hopes to bring that wisdom and expertise to Afropunk.

Fo r Wi l b e k i n , h i s b i g g e s t accomplishment over the past year has been the creation of visibility and awareness of black queer community through Native Son. He is most proud of his capsule collection of Native Son apparel in conjunction with Bloomingdales for Pride month.

“I didn’t think in my wildest dreams that I would be associated with a brand in Bloomingdales! It put us on the radar of a much larger audience in the U.S., and the collection sold out in two weeks, which even floored them. It was huge.” Wilbekin also notes that going back into fulltime work with Afropunk while also running Native Son hasn’t been easy, though it was necessary.

Wilbekin’s focus going into 2019 is self-care. Making sure that through all of his amazing work he is also taking time out to preserve himself.

He left with a message to his younger self that “It was okay for you to come out earlier. To have known that it was okay to be gay and the world wouldn’t end.”

Because of Wilbekin, I am. And so will be a new generation of black queer men who can finally live in the light.

Baldwin has seen enormous success and support as a well-known figure who is out and proud with his queerness and HIV status. But he believes that as a culture we need to “keep the conversation going. Keep the information flowing. Keep innovating, and uplifting stories of simple innovations that make life with HIV or AIDS better, easier, and more practical.”

He also urges activists to, “find points of intersectionality. Yes, continue the struggle to end HIV, but also for women with HIV, black women with HIV, trans black women with HIV, Midwestern trans black women with HIV. No matter who you are or how you came to HIV, you are deserving of love and respect, and don’t let anyone tell you otherwise.”

One of the ways we can add more visibility, Baldwin suggests, is by creating a supportive environment for other public figures to come out with their status, especially in TV, film, and “in the field of sports, politics, business, the military, agriculture, technology, and industry.”

He says, “or else all the dignity and poise of those artists and performers will fade away unless representatives from all walks of life take up the fight.”

Having role models for young and newly diagnosed folks is something Baldwin is specifically focusing on. He admits it was mentors that helped guide him to mental and physical health, and he wants to make sure others have that as well.

Looking back, he would offer sound advice to his younger self: “You are a weirdo,” he quips.

“However, there is great power in being a weirdo—and if you can love yourself a little more and doubt yourself a lot less, the sooner you will realize that there are a lot more weirdos in this world than you ever dreamed possible.”

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in their local communities, finding ways to educate everyone they can about the facts of HIV, from individuals to organizations, from social media to local physicians. The need for HIV education is vast, even in our daily lives, the people we see every day.”

Willingham also told Living Proof Advocacy, “When people think about HIV today they [still] think of the ‘80s when the epidemic was deadly, scary, and unknown. The majority doesn’t realize how much things have changed.”

“At any other time, I would say that the greatest challenge facing the HIV community would be the fight against stigma,” Willingham tells Plus, arguing that we’ve yet to really “overcome the fear and disinformation of the ‘80s. This fear and disinformation still remains our greatest challenge to overcome, but now, with the knowledge of undetectable equals untransmittable— along with advances in medical sciences such as PrEP and PEP—perhaps our new challenge will be convincing the world that HIV is still a problem. Now is not the time to defund HIV-AIDS programs and organizations that combat the issue nationally and worldwide. Combating this false information or ideology will require the same fierce determination and undeterrable tenacity that it took in the ‘80s to get the world to recognize HIV as a universal problem in the first place. None of us can do it all, but we can all do something. I will do all I can do to educate the world about modern HIV realities.”

In addition to her work with Thrive Alabama, Willingham serves on the Alabama HIV Prevention and Care Group (a division of the Alabama Department of Public Health).

Willingham says, “2018 has been an amazing year for me. I graduated from the Positive Women’s Networks Policy Fellowship and became the PWN Alabama State Lead. I then became a blogger for The Well Project’s A Girl Like Me… I also created educational Facebook groups: Alabama Poz Life, Alabama Transgender Coalition, and PWN Alabama.”

Although Willingham says, “the midterm elections were not life-altering in the state of Alabama,” she feels “progressives are gaining more ground, even in a state as red as Alabama.”

Looking to 2019, Willingham hopes to build a group of women who have an interest in advocacy in her state, which could become an Alabama PWN state chapter. And she’ll keep her eyes open to what may come: “Sometimes we’re presented with surprises. Like the other day I was invited to possibly be part of a documentary with a production from Amsterdam about being transgender and HIV-positive in America.” Willingham’s determined to continue changing minds, fighting HIV stigma, and advocating for funding and the support of HIVpositive women.

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BY SAVAS ABADSIDIS

Given Stuurman is breaking down barriers for queer and HIV-positive representation across the African continent. iven Stuurman is the first actor to play an out gay teen character on television in South Africa. That depiction plays a part in the hit panAfrican show MTV Shuga, which was developed in association with MTV’s HIVfocused Staying Alive Foundation and PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief, which supports HIV work in Africa).

But even as they were filming his storyline, the producers were aware that much of Stuurman’s part would end up on the cutting room floor—at least for a version distributed to many African nations—because of anti-LGBTQ sentiment on the continent.

“In most African countries it is illegal to be gay,” Stuurman explains. “To be safe, we produced two versions of Reggie’s story: one, the original story is Reggie’s story of coming out and being gay, and the second story is a pan-African version for all the other countries and has Reggie not coming out, but has a metaphorical feel to it.”

MTV Shuga, which will premiere its seventh season in early 2019, is one of the continent’s most renowned shows and is specifically shot as a “pan-African” series—meaning it’s edited to reflect individual countries’ nuances but speaks to a larger sub-Saharan identity. The 2018 season featured Stuurman playing Reggie, a popular kid who’s navigating modern teen life.

That Reggie is also gay is a huge step forward in LGBTQ representation for the region (although as Stuurman suggests, the character was not out and proud in all edited versions).

Season seven returns the show to South Africa where it’s called Shuga: Down Under. The 40

engaging teen drama feels equal parts Degrassi and after-school special—an intentional move by the show’s creators to reach young audiences with the hope of providing needed information about HIV and impacting teen choices.

Shuga is considered a highly successful “behavior-change” or “edutainment” campaign.

Engaging young adult characters and stories about them confronting typical issues around love, jobs, and families are interwoven with information about sexual networks, multiple concurrent sexual partners, substance abuse, and living with HIV. According to a 2013 report by C-Change, an USAID-funded project, a study evaluating the impact of Shuga found more than 90 percent of participants who’d watched the show said the program had an impact on their thinking around HIV testing, concurrent relationships, and stigma.

More than half (52 percent) said they had talked to a close friend about the program’s characters or message.

Shuga is broadcast on over 180 channels in 70 countries and reaches 720 million households.

Production began in Kenya in 2009, then expanded to Nigeria and South Africa, and it has now become one of the most-watched TV shows on the continent. This enormous audience has helped make Stuurman one of the most well-known faces in Africa, and a bit of a heartthrob.

At 23-years-old, Stuurman is already a veteran actor of 18 years. He caught the acting bug when he was only 5 as an audience member on a youth drama kids show on television in South Africa called Yo-TV. “One day someone came up to my mother and suggested that she should get me an acting agent because I seemed to be very comfortable in front the camera,” he recalls. His mom eventually did

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COURTESY GIVEN STUURMAN

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find him an agent, and he’s been getting gigs since. He’s appeared on TV shows like Scout’s Safari and Tshisa, and movies like Straight Outta Benoni and Invictus. A bit unknown in the U.S., he’s a bonafide star in South Africa.

South Africa has the largest HIV epidemic in the world, according to UNAIDS. The country is home to 19 percent of the global number of people living with HIV, 15 percent of all new transmissions, and 11 percent of global AIDSrelated deaths. The country’s young people are significantly affected by the epidemic yet are rarely considered important stakeholders in shaping strategies against the virus. Such neglect has translated into devastating statistics.

In sub-Saharan Africa, 2015 data from 35 countries showed that only 36 percent of young men and 30 percent of young women could identify ways of preventing the sexual transmission of HIV—or identify major misconceptions about HIV transmission. Because one million people are living with HIV in South Africa who are unaware of their status, it can be easy to assume a lack of testing is to blame: only 52 percent of young women (15-24 years old) and 38 percent of young men were tested and received results over the course of a one-year 2016 Avert study. Then again, according to a 2018 report by the Centers for Disease Control and Prevention, the percentage of American youth 15 to 24, who reported they had never been tested has risen to 63.9 percent of women and 73.7 percent of men. Since Africa has been disproportionately impacted by HIV for decades, youth there have higher risks of becoming positive than most young Americans.

COURTESY MTVSHUGA.COM

Given Stuurman mugs with his Shuga costar Lerato Walaza

While Shuga has always made HIV prevention a cornerstone of its programming, it is also breaking new ground by introducing an HIV-positive love interest for Stuurman’s Reggie.

Teaming up with Unitaid (a partnership of the World Health Organization focused on combating infectious diseases) and the London School of Hygiene & Tropical Medicine (a research university focused on global health), Shuga has also unveiled storylines on HIV innovations, including at-home HIV tests, and the use of PrEP to prevent HIV transmission. The program is designed to help young viewers on the continent protect themselves from HIV. “Millions of people in Africa watch MTV Shuga,” says Lelio Marmora, executive director of Unitaid. “Given’s popularity gives us a terrific opportunity to reach young people who don’t have reliable health information and empower them to take charge of their health— including testing themselves for HIV.” On Shuga, Stuurman’s Reggie explores his masculinity and sexual identity as a young teen living in South Africa. The role gave the actor insight into perceptions around LGBTQ issues. As a result, Stuurman has become a thought leader and made invaluable contributions to queer issues within the country. He says South Africa’s constitution, created in 1996 after apartheid ended, is one of the best, and one of the first in the world to legalize same-sex marriage, making modern South Africa one of the world’s most progressive nations—at least on paper.

“It’s implemented, but there’s a big gap between implementing constitutions and laws and society accepting them and following them,” Stuurman says. “Yes, it’s fine for a woman to marry another woman and a man [to marry] another man, but you still must face those social stigmas. That’s another discussion we can have on the show, because the law will not be there to protect you against discrimination in public.”

He says the environment for same-sex couples varies.

“Yes, in certain places in the country people are quite liberal and even openminded in sub-rural and suburban areas,” Stuurman admits. “But homophobia is real and alive in many parts of Africa.

This external reality reflects the internal struggles that Reggie goes through in terms of coming out.”

The show’s title, Stuurman points out, is “Nigerian slang. Someone explained that ‘shuga’ represents material things, because a lot of sexual issues revolve

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COURTESY GIVEN STUURMAN {ALL)

Given Stuurman, who plays the first out gay character on South African TV, is wildly popular.

around material needs in Africa. For instance, we have this thing called sugar daddies in places where sugar represents sex.”

Stuurman researched the role extensively, and although much of the character had been fleshed out prior to filming, it was his job to bring Reggie to life. He says he wanted to do it in a way that didn’t disrespect or offend anyone to give “a new-found light to the community.”

Like his character in Shuga, Stuurman also grew up in Johannesburg, South Africa. However, “Reggie lives in a fictional township outside of Johannesburg.

The show is shot in Johannesburg and Soweto. So we created a fictional township, so we don’t get any backlash troubles about why we created this character in Soweto.”

The show has other concerns American TV shows don’t.

“One of the other issues we have had with gay characters in South African media is that they are often represented stereotypically,” Stuurman observes.

“They tend to paint the community, especially men, with just one brush. For a man in the LGBTQ community, you must be flamboyant.”

That’s not “a fair representation of the community,” Stuurman says, which is why MTV decided to portray Reggie differently. “The important thing about Reggie is that [he’s] not only about his sexual identity. He was a graffiti artist and he plays soccer and he has much more important aspects [that impact] the decisions he makes. The [audience] basically falls in love with Reggie’s character, even before they find out he’s gay.”

Since the storylines are heavily censored in some countries, the producers decided to also post Reggie’s coming out on YouTube, to ensure that those who needed to see this story were still able to.

“Funny enough, most of the positive responses are from the countries where being gay is illegal,” Stuurman says. “I would go on my Instagram and get DMs from people in Nigeria and Jamaica and they would say, ‘Thank you so much for telling Reggie’s story!’ And they are very appreciative. In South Africa, it’s twice as much. The communities love it there and are thankful.”

In 2018, South Africa celebrated what would have been the late Nelson Mandela’s 100th birthday. Mandela was the country’s first black president, and Stuurman explains that his generation of South Africans are known as

Born Free. He describes “Born Frees” as the postapartheid and post-Nelson Mandela generation. “[I] was born free in 1994,” Stuurman says. “Our parents literally had two options when it came to freedom: social freedom and political freedom.”

Now, young people are demanding more, protesting over lingering economic disparities and racial injustices.

“We, the Born Frees, only grew up knowing this democracy. We are able to be in social environments that our parents have never been in. We have been exposed to economic things our parents have never seen. For us, we understand the importance of Mandela—he gave us our democracy. But as we look more deeply, systemically, economically, and socially—nothing has really changed for us.”

What does it really mean? Stuurman asks rhetorically. “Mostly, that politicians are propagating my phone with all these messages about this and that, but there is nothing that they are really doing in my life directly.”

Stuurman explains the youth in his country are discouraged by the slow pace of change, and the continued economic and social disparities facing black people.

“They know of Mandela but… they don’t know what he is doing for us now,” he says. Although they are aware Mandela is dead, they are essentially asking, “What has he done for us lately?”

“When it comes down to it,” Stuurman concludes, “most of the unrest among youth in the country is the realization that when you’re broke and hungry, what does that mean? You can’t eat democracy.”

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TREATMENT

HEART

BREAKER An antibiotic once commonly prescribed to HIV-positive people may have a potentially deadly side effect in those with coronary heart disease—even a decade after taking it.

In 2018, the U.S. Food and Drug Administration issued a warning, “advising caution before prescribing the antibiotic clarithromycin (Biaxin) to patients with heart disease because of a potential increased risk of heart problems or death that can occur years later.”

Since HIV itself has been casually linked to increased risk of heart disease, cardiovascular health is a top concern for people living with HIV. Clarithromycin is frequently prescribed to treat Mycobacterium avium complex (MAC), a lung infection once common among those living with HIV. Although the widespread adoption of highly effective antiretroviral medication has dramatically reduced the numbers of MAC diagnoses in those living with HIV, it does still impact those whose CD4 cell count falls below 50 cells/µL. A new 10-year follow up study of people with coronary heart disease found those who took clarithromycin, even for short periods of time, could see long-term health impacts.

In the CLARICOR trial, researchers observed an “unexpected increase” in deaths among patients with heart disease who had received a two-week course of clarithromycin a year or more prior. The placebo-controlled CLARICOR trial, researchers claim, provides the strongest evidence to date of the increase in cardiovascular risk due to clarithromycin use.

Six previous studies have followed people with and without coronary artery disease who took the drug, and two found evidence of long-term risks from clarithromycin, but four did not.

Among those with compromised immune systems, MAC had at one point been seen as a potentially dangerous infection and treating with clarithromycin made sense.

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Now, these new findings suggest that equation may need to be reevaluated. Especially given that the FDA noted, “There is no clear explanation for how clarithromycin would lead to more deaths than [a] placebo.”

Still, the FDA is reluctant to completely recommend against the drug’s usage because, “we cannot determine whether results of the CLARICOR trial can be applied to patients who do not have heart disease.”

Therefore, they simply recommend: “Healthcare professionals should be aware of these significant risks and weigh the benefits and risks of clarithromycin before prescribing it to any patient, particularly in patients with heart disease and even for short periods and consider using other available antibiotics.”

Those who are taking clarithromycin, regardless of the underlying medical condition, should be aware of the signs and symptoms of cardiovascular issues, so they can alert their doctors if any appear or worsen.

Clarithromycin has been approved for certain conditions for over 25 years, including those that infect the skin, ears, sinuses, lungs, and other areas. The FDA and the medical community have known that coronary risks are associated with clarithromycin since 2005, but the new study draws attention to long-term risks of even using a short course of the antibiotic.

Researchers have previously observed that antibiotics—including azithromycin, erythromycin, and clarithromycin—can negatively impact those with heart disease. Those being prescribed antibiotics should inform health care professionals if they have heart disease.

Patients shouldn’t discontinue clarithromycin without first consulting a health care provider. If you are being treated for MAC now or in the future, talk to your doctor about the risks associated with clarithromycin compared to other drugs available. —BENJAMIN M. ADAMS

SHUTTERSTOCK

An antibiotic commonly prescribed to treat an HIV-related illness might cause coronary problems years later.

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METHADONE MAGIC

SHUTTERSTOCK

Can a drug used to fight addiction also make HIV virals load fall?

Opioid addiction is an ugly beast.

Addicts will go to great lengths in search of the blissful release of dopamine. With access to prescription drugs like fentanyl (which is 100 times more potent than morphine), overdoses are becoming depressingly common. And getting off opioids is no cake walk.

Physically, opioid withdrawal symptoms are among the hardest to endure of all drug classes. There’s the vomiting and diarrhea, wholebody muscle pain, racing heart, tremors, anxiety—all together it can make someone feel like they are going to die. Fortunately, drugs like methadone are tailormade to bypass some of the worst parts of opioid withdrawal and allow addicts to break their chemical dependency.

But people living with HIV who take methadone to reduce heroin or morphine withdrawals (or for pain— as it is sometimes prescribed) may discover an unexpected bonus: lower viral loads.

A study presented at the 22nd International AIDS Conference in Amsterdam demonstrated that methadone maintenance treatment (MMT) is associated with less time spent with a high viral load. The results are based on data from

the AIDS Care Cohort to Evaluate Exposure to Survival Services in Vancouver, Canada.

Recognizing “people who inject drugs continue to experience individual, social, and structural barriers in accessing and being retained in HIV treatment and care,” researchers wanted to determine if a methadone maintenance therapy program could reduce the time of heightened HIV transmission risk (aka high viral loads) among HIVpositive people who use drugs.

For the study, researchers observed 867 HIV-positive people, all of whom also used drugs. During followups, 60 percent were engaged in methadone maintenance therapy at least once. Researchers found the time participants spent on MMT correlated with fewer days of high viral loads.

Clinical methadone is an opioid, but one that goes through rigorous regulations and is closely monitored. Some risks include slowing breathing, which can lead to death, especially in overdose situations. But methadone has long been the go-to drug to help addicts break their chemical dependency to opioids like heroin.

For those who are on methadone maintenance therapy, the drug can help also keep your viral load

in check, which is a significant finding, as viral suppression is essential to both health and the prevention of transmission.

Researchers wrote, “These findings suggest that low-threshold MMT is an effective intervention in lowering the risk of onward viral transmission among this key population.”

People living with HIV strive for an undetectable viral load, which means the virus is so suppressed that it is virtually impossible to transmit to an HIV-negative partner. Alternatively, high viral loads lead to a weakened immune system and complications down the road.

“These findings demonstrate the important role of evidence-based addiction treatment in optimizing individual and community-level impacts of antiretroviral therapy among HIV-positive patients with comorbid opioid dependence,” researchers added. “Efforts to address barriers to the use and availability of MMT will likely improve HIV outcomes and reduce new infections among this population and should therefore be prioritized.”

Future research may examine the mechanism in methadone that helps to reduce viral loads—and determine if it can be employed in HIV-focused medication. —BMA HIVPLUSMAG.COM

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R E S I S TA N C E B Y D AV I D A R TAV I A

A BREAKTHROUGH IN RESISTANCE

SHUTTERSTOCK

CAN THIS DRUG HELP LONG-TERM SURVIVORS BECOME UNDETECTABLE WHILE ALSO IMPROVING THEIR IMMUNE SYSTEM?

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ost people living with HIV who start treatment now may never have to deal with drug resistance.

Modern antiretroviral drugs are less vulnerable to the development of resistance and have higher adherence rates. Adherence, a critical element in preventing drug resistance, has increased over time due to medications becoming more tolerable (and now being available in easy-to-take, single-tablet regimens).

As one 2016 meta analysis published in the journal of Infection, Genetics and Evolution reported, “Most ART regimens used for first-line therapy are sufficiently potent to completely block HIV-1 replication and have a genetic barrier to resistance high enough to maintain long-term virological suppression.”

Yet the study also reveals that transmitted drug resistance may be as high as 12 to 24 percent of new diagnoses in the U.S. A small minority of others living with HIV (particularly long-term survivors) are resistant not to just one or two antiretrovirals, but three or more entire classes of drugs. For these folks, new treatment developments can literally spell the difference between life and death.

Fortunately, one innovative drug is offering a new way to fight the virus—and it may soon be on the market. Rather than interfering with binding, fusion, or entry of HIV into human T cells—the processes behind most ART therapies—fostemsavir’s strategy targets a different step of HIV’s lifecycle by attacking the virus itself (rather than targeting T cells). Fostemsavir latches onto HIV’s gp 120 receptor, a protein that is exposed on the surface of the virus, and which plays an essential role in allowing HIV to hook onto T cells. By capping the receptors, fostemsavir essentially locks them closed, preventing HIV from being able to attach, and thereby blocking entrance into the immune system.

This new strategy, a first for HIV drugs, puts fostemsavir in a new class of HIV drugs known as attachment inhibitors. Because of its unique mechanism of action, those who have developed resistances to other classes of antiretrovirals are

still unlikely to experience drug resistance to fostemsavir. That’s particularly good news for long-term survivors and others who’ve become resistant to multiple classes of antiretrovirals.

In fact, the 370 heavily treatmentexperienced HIV-positive people who participated in fostemsavir’s phase 3 study (BRIGHTE) all had documented resistance, intolerability, or contraindication to all antiretroviral drugs in at least four of the six drug classes approved to treat HIV. In a statement to the press, John C. Pottage, Jr., MD, chief scientific and medical officer of ViiV Healthcare, described study participants as “failing on their current antiretroviral regimens and had few treatment options left available to them.”

Adding fostemsavir to their current failing regimens helped 54 percent of participants achieve virologic suppression. If that number seems low, keep in mind that participants were experiencing treatment failure prior to the study—so even having half reach undetectable viral loads after adding the new drug is still a remarkable breakthrough.

Fostemsavir’s success with HIV-positive people who have few treatment options helped it score a breakthrough therapy designation from the Food and Drug Administration. This important designation helps speed up the approval process for such medications.

In development by ViiV Healthcare and GlaxoSmithKline, fostemsavir will likely be approved for those experiencing multidrug resistance, to be used in combination with other HIV drugs. Forty-eight week results were presented at the HIV Drug Therapy Glasgow 2018 conference. Researchers showed that fostemsavir, in combination with optimized background treatment, maintained viral suppression from week 24 to week 48.

Not only do these results suggest that the drug suppresses viral loads much sooner than other antiretrovirals, but researchers say it appears to be reviving the immune system simultaneously. Those taking fostemsavir in trials are seeing their CD4 and T cells increase and strengthen, potential evidence of

rebounding immune system health.

But, researchers caution it’s too early to make definitive declarations regarding the drug’s impact on immune system health, and what that might mean longer term.

“Every drug, every antiretroviral that you give to patients, shuts down the viral production because the virus is, if you leave it unchecked, producing almost millions of copies a day,” explains Max Lataillade, ViiV Healthcare’s head of clinical development. “Any drug that stops the viral production… [will] increase your CD4 count level.” But, he says the increase in this case seems particularly sizable and may point to an important (positive) side effect of fostemsavir.

Lataillade hypothesizes that as the fostemsavir is binding to gp 120 on the virus, it inadvertently “locks” the gp 120 into position. It’s being presented to the immune system for the first time in this locked position, and there’s something about that change that appears to make the immune response more effective.

“Binding to the virus is certainly innovative and I think would be a good thing for the immune system,” says Lataillade. “What we are seeing as well, in terms of the normal markers of recovery, is an increase in your CD4 and the CD4-CD8 ratio.”

Lataillade describes CD8 cells as the immune system’s killer cells. In other words, they are the cells that go out and kill invading pathogens.

“If you think about the Marines, your CD8 would be like your SEALs,” he says. “They’re the ones who go by the action, but there’s one guy who’s always telling them where to go—that is the CD4. You always want your CD4 to CD8 ratio to be high. What we’re seeing in [trials] is that that CD4-CD8 [ratio] is steadily, steadily, steadily increasing.”

Another intriguing finding from the phase 3 study was “numerically higher rates of virologic response in patients [over] 50 years, females, or in patients who self-reported their race as ‘black’ or ‘African-American’ compared to their respective counterparts.” Although the researchers have not hypothesized the reasons for better success among women, black individuals, and those over 50, these are all groups facing unique hurdles in HIV HIVPLUSMAG.COM

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“For example, does [fostemsavir] increase the CD4 count in people that even though they’re suppressed, their CD4 count doesn’t go up?” Lataillade ponders. “Is it better than a booster TI in certain situations? We’ll be focused on some key biomarkers to see whether some immune biomarkers are better with fostemsavir versus other drugs.”

Lataillade says ViiV’s long-term goal is to address people’s unmet needs, which includes longacting therapies.

“What we are looking at is convenience,” he adds. “When you give a long-acting formulation to a patient, every month or every two months for example, the

psychological effect is unbelievable.

The patients say to me, ‘The fact that I’m not taking the pill every day is actually giving me relief psychologically that I have HIV.’ I think that that’s a powerful, powerful moment for me when a patient tells me something like that.”

Looking to the future, Lataillade boldly predicts brighter days for all people on treatment for HIV: “What’s going to happen is, if we can dose a patient once a month, once every two months—I’m going to say, why can’t we push it to every three months?

We’re going to push for that.”

Additional reporting by Jacob Anderson-Minshall.

SHUTTERSTOCK

treatment, and these findings may later become relevant.

If ViiV gains FDA approval for fostemsavir as it’s expected to, it would first go on the market as a drug reserved for heavily treatmentexperienced people, i.e., those who’ve been on antiretroviral treatment for long periods (think long-term survivors) or those living with multiple co-morbidities. Because it’s not boosted, the drug also has an advantage in that it will not interfere with medications taken for diabetes, hypertension, or high cholesterol.

Researchers also plan to focus on smaller key studies in the future to better explain the immune recovery they are seeing.

Investigators took a deeper look into what happens when women contract HIV during male-to-female sex.

Even though we’re now some four decades into the HIV epidemic, researchers still don’t seem to appreciate some pretty basic elements when it comes to how cisgender women contract HIV. In particular, the mechanisms behind HIV acquisition via male-to-female sex are poorly understood.

Thankfully, new findings may help unravel how HIV impacts women both at the moment of contraction and long after transmission occurs.

Researchers previously discovered that T cells aren’t present in the outermost portions of intimate regions of the female anatomy (the outer layer of skin cells), so scientists still weren’t exactly sure how women were acquiring HIV. A new study published in The Journal of Clinical Investigation suggests that vaginal epithelial dendritic cells may be where all the action occurs, being both where the infection may originally take place and where the virus may find reservoirs during treatment.

Dr. Manish Sagar, principal investigator of the study and an infectious disease specialist at Boston Medical Center, and his team focused on vaginal epithelial dendritic cells for two reasons. “First, HIV can replicate in these cells,” Dr. Sagar explains. “Second, these cells are located 48

in the outermost part of vagina. While HIV primarily replicates in T cells, T cells are not present in the outermost part of the vaginal mucosa, so they do not have direct exposure to an incoming virus.

Thus, T cells are probably not the first cell infected during sexual exposure. Vaginal epithelial dendritic cells are most likely to encounter HIV when women are exposed to the virus during sexual contact. We think these are probably the first cells infected because of these two reasons.”

With so much focus on T cells, it’s easy to overlook other ways that HIV can replicate. After viral suppression occurs on HIV treatment (in which the virus becomes so suppressed that it reaches undetectable levels—making it virtually impossible to transmit), it can still hide deep inside viral reservoirs from which it can ultimately rebound.

“Our finding that HIV DNA is found in vaginal epithelial dendritic cells suggest that these cells are also one reason why HIV can persist forever even with effective treatment,” Sagar says.

“The basic cellular biology of maleto-female transmission is poorly understood,” Sagar adds, but the behavior

of the virus remains the same in both men and women. Still, he believes his research could lead to new treatments, particularly HIV prevention drugs aimed at women who have sex with men.

“Identifying the first infected cells opens new avenues into developing novel strategies to prevent HIV acquisition.”

Understanding the relationship between vaginal epithelial dendritic cells and HIV is key to the possible introduction of such investigational medications.—BMA

JANUARY / FEBRUARY 2019

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HOW DO WE HELP STOP HIV? A. PREVENT IT. B. TEST FOR IT. C. TREAT IT. D. ALL OF THE ABOVE. Learn how it all works together at HelpStopTheVirus.com © 2015 Gilead Sciences, Inc. All rights reserved. UNBC1856 03/15

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5 WAYS TO FLIP THE SCRIPT ON HIV BECAUSE YOU’RE MORE THAN YOUR STATUS

EMIL WILBEKIN

IS GAY, POZ & PROUD

YOU SHOULD BE REALLY PROUD OF WHO YOU ARE BECAUSE YOU STAND ON THE SHOULDERS OF A LOT OF MEN WHO DIDN’T HAVE THE FREEDOM TO BE THEIR MOST AUTHENTIC SELVES AS BLACK QUEER MEN.

JANUARY/FEBRUARY 2019 www.hivplusmag.com

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