Plus 140 January February 2021 by Equal Pride

BECAUSE YOU’RE MORE THAN YOUR STATUS

GEORGIA’S HIV HERO AIDS QUILT GOES VIRTUAL

NEW YORK TIMES JOURNALIST

LINDA VILLAROSA WRITES OUR LIVES

HOW DOGS HEAL US BLACK HIV LEADERS ON 2021

JANUARY/FEBRUARY 2021 hivplusmag.com

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IMPORTANT FACTS FOR BIKTARVY®

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.

(bik-TAR-vee)

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side effects, including:

BIKTARVY may cause serious side effects, including:  Those in the “Most Important Information About BIKTARVY” section.  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 (6%), and headache (5%).

 Worsening of hepatitis B (HBV) infection. If you

have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to check your health regularly for several months.

ABOUT BIKTARVY BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults and children who weigh at least 55 pounds. 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. Do NOT take BIKTARVY if you also take a medicine that contains:  dofetilide  rifampin  any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY Tell your healthcare provider if you:

These are not all the possible side effects of BIKTARVY. Tell your healthcare provider right away if you have any new symptoms while taking BIKTARVY.

 Have or have had any kidney or liver problems,

including hepatitis infection.

 Have any other health problems.

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.

 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.  Are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

Your healthcare provider will need to do tests to monitor your health before and during treatment with BIKTARVY.

HOW TO TAKE BIKTARVY Take BIKTARVY 1 time each day with or without food.

Tell your healthcare provider about all the medicines you take:  Keep a list that includes all prescription and over-the-

counter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

 BIKTARVY and other medicines may affect each other.

Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

Get HIV support by downloading a free app at

MyDailyCharge.com

BVYC0197_BIKTARVY_A_7-875X10-5_Plus-Chad_r1v1jl.indd All Pages 19083 Gilead Biktarvy Plus 140.indd 2

GET MORE INFORMATION  This is only a brief summary of important information

about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more.

 Go to BIKTARVY.com or call 1-800-GILEAD-5  If you need help paying for your medicine,

visit BIKTARVY.com for program information.

BIKTARVY, the BIKTARVY Logo, DAILY CHARGE, the DAILY CHARGE Logo, KEEP CREATING, LOVE WHAT’S INSIDE, GILEAD, and the GILEAD Logo are trademarks of Gilead Sciences, Inc., or its related companies. Version date: February 2020 © 2020 Gilead Sciences, Inc. All rights reserved. BVYC0197 03/20

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CHAD LIVING WITH HIV SINCE 2018 REAL BIKTARVY PATIENT

KEEP CREATING.

Because HIV doesn’t change who you are.

BIKTARVY® is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in certain adults. BIKTARVY does not cure HIV-1 or AIDS.

Ask your healthcare provider if BIKTARVY is right for you. See Chad’s story at BIKTARVY.com. Featured patient compensated by Gilead.

Please see Important Facts about BIKTARVY, including important warnings, on the previous page and visit BIKTARVY.com.

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CONTENTS ON THE COVER 32

THE PEN IS MIGHTIER Award-winning writer LINDA VILLAROSA on the power of journalism; systemic racism and its connection to people living with HIV; and how we can begin to heal and move forward in 2021.

FEATURES 14

MAN OF THE PEOPLE Georgia state representative Sam Park continues to fight for people living with HIV.

RESCUE ME A new book explores the healing power of dogs.

26 TURNING THE TIDE These young Black activists are smashing stigma and changing the conversation around HIV. 31

A BETTER TOMORROW? Black leaders in the HIV community on what's needed in 2021.

COVER AND ABOVE Linda Villarosa photographed by Mia Isabella Aguirre

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issue

contents

14 0

BUZZWORTHY

WELLNESS

6 FUTURE OF HISTORY The AIDS Quilt is now educating a new generation online.

44 STICKS & STONES Name-calling can really wreak havoc on your relationship.

10 SAFER SEX WORK The latest research makes a case for its legalization.

46 NO WINTER WOES Don't let depression creep in when it's cold out.

11 NEW YORK BLUES The state's budget issues could mean big trouble for poz folks.

BACK TALK

11 CHANGING OF THE GUARD Meet the new director of the CDC's HIV prevention division.

48 STORMY WEATHER One author recalls L.A. during the original AIDS epidemic.

DAILY DOSE 12 A PLUS SIDE Could HIV be an advantage in a pandemic?

TREATMENT 42 DOUBLE DUTY Could your HIV meds also help ward off Alzheimer's? 42 SUGAR CHECK Steps to keep diabetes at bay.

J ESSE FRIEDEN

43 INDIA LOVES U The South Asian country is embracing the U=U movement.

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chief executive officer & editorial director DIANE ANDERSON-MINSHALL

evp, group publisher & corporate sales JOE VALENTINO

editor in chief NEAL BROVERMAN

vp, branded partnerships & associate publisher STUART BROCKINGTON

EDITORIAL managing editor DAVID ARTAVIA editor at large TYLER CURRY senior copy editor TRUDY RING associate editor DESIRÉE GUERRERO assistant editor DONALD PADGETT contributing editors KHAFRE ABIF, MARK S. KING mental health editor GARY MCCLAIN staff writer MEY RUDE contributing writers CHARLES STEPHENS, JEANNIE WRAIGHT ART executive creative director RAINE BASCOS art director BEN WARD interactive art director CHRISTOPHER HARRITY PRIDE MEDIA EDITORIAL editor in chief, the advocate TRACY E. GILCHRIST digital editor in chief, advocate.com NEAL BROVERMAN editor at large, the advocate JOHN CASEY editor in chief, out DAVID ARTAVIA digital director, out.com MIKELLE STREET editor in chief, out traveler JACOB ANDERSON-MINSHALL editor in chief, pride RAFFY ERMAC deputy editor, pride TAYLOR HENDERSON digital director, pride & senior editor, advocate.com DANIEL REYNOLDS director of podcasts & special projects JEFFREY MASTERS SALES & MARKETING executive directors, integrated sales EZRA ALVAREZ & PATRICIA AGUAYO director, branded partnerships JAMIE TREDWELL creative director, branded partnerships MICHAEL LOMBARDO senior manager, branded partnerships TIM SNOW junior manager, advertising & branded partnerships DEAN FRYN senior director, ad operations STEWART NACHT manager, ad operations TIFFANY KESDEN DIGITAL vp, technology & development ERIC BUI digital media manager LAURA VILLELA social media manager CHRISTINE LINNELL social media editor JAVY RODRIGUEZ PRINT PRODUCTION production director JOHN LEWIS production editors JACOB ANDERSON-MINSHALL & DESIRÉE GUERRERO CIRCULATION director of circulation ARGUS GALINDO FINANCE/ACCOUNTING vp, finance BETSY SKIDMORE accounts receivable controller LORELIE YU accounting manager PAULETTE KADIMYAN ADVERTISING & SUBSCRIPTIONS Phone (212) 242-8100 • Advertising Fax (212) 242-8338 Subscriptions Fax (212) 242-8338 EDITORIAL Phone (310) 806-4288 • Fax (310) 806-4268 • Email editor@HIVPlusMag.com

FREE BULK SUBSCRIPTIONS FOR YOUR OFFICE OR GROUP Any organization, community-based group, pharmacy, physicians’ office, support group, or other agency can request bulk copies for free distribution at your office, meeting, or facility. To subscribe, visit HIVPlusMag.com/signup. There is a 10-copy minimum. FREE DIGITAL SUBSCRIPTIONS Plus magazine is available free to individual subscribers — a digital copy of each issue can be delivered to the privacy of your computer or reader six times per year. We require only your email address to initiate delivery. You may also share your digital copies with friends. To subscribe, visit HIVPlusMag.com/signup. NEED SUBSCRIPTION HELP? If you have any questions or problems with your bulk or individual magazine delivery, please email our circulation department at Argus.Galindo@pridemedia.com. Plus (ISSN 1522-3086) is published bimonthly by Pride Publishing Inc. Plus is a registered trademark of Pride Publishing Inc. Entire contents ©2021 by Pride Publishing Inc. All rights reserved. Printed in the U.S.A.

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JAN UARY/FEB RUARY 202 1

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EDITOR’S LETTER

BY N E AL B ROVE R MAN

The Plus team produced this first issue of the year back in November, as the divisive presidential election dragged on and scary statistics about COVID-19 were hard to escape. The news that dominated last summer — the social justice uprising that sprung from the deaths of unarmed Black people by police — was no longer the top headlines of The Washington Post and CNN. But Linda Villarosa, the awardwinning New York Times journalist and this month’s cover star (page 32), believes the lessons learned from the deaths of George Floyd and Breonna Taylor are here to stay. She noticed that even among her white friends there was finally a realization that Black people face discrimination in nearly all aspects of their lives, including in health-related matters. Villarosa’s articles have shown firsthand how Black people are more at risk from diseases like COVID-19 and HIV than the general population — not because of biology, but rather systemic inequalities that expose them more frequently and often leave them with subpar care and treatment options. As part of this issue centering Black lives, we asked some of the most respected African-American leaders in the HIV community for their feelings on the coming year (page 31). Are they hopeful? Worried? Determined? What do they want to see happen when it comes to treatment, cures, and vaccines? Their answers will remind you that we have brilliant people fighting the good fight.

LU KE FONTANA

HAPPY 2021!

Production editor Desirée Guerrero also heard from young Black people living with HIV (page 26), who shared their harrowing stories and made clear that stigma and a shortage of reliable information remain barriers to eradicating the disease in their community. Down in diverse Georgia, state Rep. Sam Park spoke to copy chief Trudy Ring about his efforts to combat HIV in his rapidly changing state (page 14). Amid all the possibilities politicians like Park offer, along with the excitement generated by a new presidential administration that values science over subterfuge, our current reality remains stressful and uncertain. Editor at large Tyler Curry talks about the upsides of being undetectable during the COVID pandemic (page 42). Mental health editor Gary McClain offers suggestions for getting along with your partner or spouse while you’re both cooped up (page 44) and how to beat back winter blues (page 46). The forthcoming book When Dogs Heal: Powerful Stories of People Living With HIV and the Dogs That Saved Them certainly put a smile on my face (page 18). Guerrero spoke to the authors of this beautiful collection of stories and photos that capture the loving dynamic between humans and canines. “Through the darkest, loneliest moments of [the human subjects’] lives, with the help of their dogs, they found a chance to redefine their purpose,” When Dogs Heal coauthor Christina Garofalo told Guerrero. During this tough winter season, a sweet fur baby may be just what the doctor ordered. If you have the resources, check out your local animal shelter or, if you’re anxious of being in public during COVID, visit the websites of the Milo Foundation (MiloFoundation.org) or the ASPCA (ASPCA.org), where you can make private appointments and view adoptable animals. I can think of no better way to start 2021 than by offering a dog (or cat!) a warm bed and a face to lick. Be well,

NEAL BROVERMAN EDITOR IN CHIEF

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COU RTESY NATIONAL AIDS M EMORIAL

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NOW EVERYONE CAN SEE THE AIDS QUILT THE NATIONAL AIDS MEMORIAL LAUNCHES THE LEGENDARY QUILT’S FIRST-EVER 50-STATE EXHIBITION. BY DANIEL REYNOLDS Memorial Quilt went digital for World AIDS Day, the National AIDS Memorial, the caretaker of

WHEN THE AIDS

the quilt, invited individuals, businesses, and nonprofits across the United States to participate in a pioneering virtual exhibition. In the past, the memorial worked with partners to create thousands of displays showcasing portions of the quilt — a moving memorial that pays tribute to victims of the AIDS crisis with homemade panels — timed to World AIDS Day on December 1. Since this is now impossible due to COVID-19, display hosts — who pay $500, which helps fund the National AIDS Memorial — were invited this year to curate quilt selections in a digital space organized by state. Anyone can now view each of the curated selections as well as search for a specific friend’s or family member’s panel. The program also serves as the first-ever 50-state exhibition of the quilt. John Cunningham, executive director of the National AIDS Memorial, hopes this virtual exhibition will send a vital message during a new pandemic. “World AIDS Day is taking on new meaning this year, as COVID-19 has brought an enormous loss of life and grief to millions of people,” Cunningham said in a statement.

“During the darkest days of the AIDS crisis, the quilt was a source of immense comfort [and] inspiration and used as a tool for social activism to open the eyes of the nation to injustice and to help survivors grieve and heal. Through this exhibition, we hope the power and beauty of the quilt can serve that same purpose for those who are experiencing loss and grief due to COVID-19.” “Even though nothing can replace seeing our beautiful quilt in person, this virtual exhibition allows us to still share the quilt and its stories just as we have done for past three decades around World AIDS Day,” added Gert McMullan, a quilt cofounder and conservator at the National AIDS Memorial. The free exhibition (AIDSMemorial.org/virtual2020) launched November 16 and runs through March 31. Earlier this year, a digitized, interactive version of the quilt was launched on the same website, where all 48,000 panels are available for viewing and searching. The Names Project AIDS Memorial Quilt was conceived by San Francisco-based activist Cleve Jones in 1985 to honor the loved ones he lost to AIDS. It was displayed for the first time in 1987 on the National Mall in Washington, D.C. The quilt is now the largest community art project in the world. H IVPLUS MAG .CO M

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WHY IS SEX WORK STILL A CRIME? BY NEAL BROVERMAN

Voters across the country — from Mississippi to Oregon — voted in November to decriminalize medical and recreational marijuana and other substances that remain illegal on the federal level, including Psilocybin mushrooms (magic mushrooms) and even cocaine. While the country continues to evolve its treatment of those who use drugs, change is slow-going on parallel efforts to decriminalize sex work. Now a new report from the American Civil Liberties Union states that legalizing sex work would produce enormous benefits not just for the health and financial well-being of people who exchange sex for money but all of society. A “comprehensive review” of over 80 studies on sex work convinced ACLU officials to take this position — and their October report, called “Is Sex Work Decriminalization the Answer? What the Research Tells Us,” calls for bold action. The ACLU recommends that American politicians decriminalize sex work fully rather than take half-steps like some other nations have. Certain countries make it illegal to buy sex but not sell it; others allow sex work but regulate it by making workers register with the government. “The research reviewed by the ACLU shows that full decriminalization has the greatest benefits for public health and safety,” the legal advocacy group stated in a press release. Aside from making all sex work legal, the ACLU report warns of the dangers of the 2018 laws known as FOSTA and SESTA, which passed as a response to human trafficking but actually endangered many sex workers by banning online resources where potential clients could be screened. Many sex workers say FOSTA/ SESTA forced them back on the streets to find work, where they can face violence or COVID19 infection. 10

For some members of marginalized groups, like transgender people and immigrants, sex work is often the only option for steady income. Those arrested for sex work are much more vulnerable to financial ruin from fees and fines, and finding an apartment or a nonsex-related job can be complicated because of a criminal record. Criminalization also disproportionately targets sex workers of color, since nearly 40 percent of adults and 60 percent of youth arrested for prostitution in the U.S. in 2015 were Black, Amnesty International reports. On top of all these risk factors, many sex workers have reported harassment and abuse from the police. HIV also is a prominent consideration for sex workers, who are 13 times more at risk for the virus than the general population, according to the nonprofit HIV organization Avert. For sex workers living with HIV, the risk of incarceration and obtaining money for bail is compounded by the life-or-death need to obtain antiretroviral meds. “Right now, millions of people are asking what we can do to reduce abuse by law enforcement, racial disparities in our criminal justice system, and our overall jail and prison populations,” LaLa Zannell, the ACLU’s Trans Justice Campaign manager, said in a statement. “One policy that can achieve all of these goals — particularly for Black trans women and immigrants — is to recognize that sex work is work and treat it like any other industry. Sex workers have been saying they face significant violence from police and clients for decades and it is time that we all listen to these voices when determining how to improve safety for sex workers.” Currently, only Nevada allows sex work, and only in certain settings; a decriminalization effort in Washington, D.C., stalled in 2019. The ACLU is urging cities and states to continue pushing local legalization efforts and urges district attorneys across the nation to not prosecute cases involving the selling of sex.

states and one U.S. territory have laws that increase penalties for people living with HIV convicted of sex work or solicitation offenses: California, Florida, Georgia, Guam, Kentucky, Missouri, Nevada, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, and Utah *Source: The Center for HIV Law & Policy

SH UT TERSTOCK

CRIMINALIZING SEX WORK HARMS EVERYONE, INCLUDING PEOPLE LIVING WITH HIV, THE ACLU REPORTS.

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N.Y. STATE BUDGET CUTS THREATEN HIV CARE HIV care providers in New York State are calling for a reversal in changes to prescription benefits for vulnerable populations.

BY TRUDY RING

SH UT TERSTOCK (NY ); GARY G ERSHOFF/ G E T T Y IMAG ES (DASK AL AKIS)

A C H A N G E T O New York State’s budget will take hundreds of millions of dollars away from clinics and hospitals treating lowincome and underserved people, including those living with HIV — and health care providers are calling for a reversal. The change involves the 340B Drug Pricing Program, a federal program under which certain providers serving the neediest people can obtain prescription drugs at deep discounts but bill insurance plans, including Medicaid, for the full price. The money representing the difference between the insurance payment and the discount price of the drugs can be kept by the provider to hire staff, expand services, and make other investments to improve care. This difference is known as the “spread.” But under the budget adopted by the state legislature and signed into law by Gov. Andrew Cuomo, in order to save money on Medicaid, the 340B pharmacy benefit will be carved out from the Medicaid managed care program. The drugs will be switched to a fee-for-service arrangement, under which the state will reimburse providers at cost and save the state $87 million (opponents question this figure). New York has seen a reduction in tax revenues due to the economic fallout of the COVID-19 crisis, and state law requires a balanced budget. But the state shouldn’t balance its budget on the backs of its neediest people, says Save New York’s Safety Net, a coalition of more than 40 health care providers and related organizations.

MOVING ON UP Demetre Daskalakis, who has managed infectious disease programs in New York City, is the new director of the CDC’s Division of HIV/AIDS Prevention. Demetre Daskalakis, MD, who has led New York City’s response to HIV and other health crises including the COVID-19 pandemic, has been named director of the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention.

“HIV providers will lose hundreds of millions of dollars because of this policy change,” says Doug Wirth, CEO of Amida Care, an insurer that offers managed care services to New Yorkers. “It’s bad policy and the savings contestable,” Wirth says. It’s also “shortsighted and counterproductive,” he says, threatening to undermine previous successes.

As deputy commissioner for the Division of Disease Control at the New York City Department of Health and Mental Hygiene, Daskalakis has directed all infectious disease programs for the city, managing responses to HIV and other sexually transmitted infections, tuberculosis, vaccinepreventable diseases, and general communicable diseases. He has been incident commander during the 2020 COVID crisis and the measles outbreak of 2018-2019. He has contributed to Plus and one of its sister publications, The Advocate, and hosted a Plus video series, The T With Dr. D. He will join the CDC December 21. “Dr. Daskalakis was integral in designing and leading many HIV and STD programs in New York City, including their Ending the Epidemic program, which is credited with decreasing HIV incidence to an historic low,” says a CDC press release. “We are excited for him to bring this leadership and experience to CDC to advance meaningful research, guide surveillance and programs, support and implement effective policy, and ultimately prevent HIV infections and increase HIVrelated health equity across the United States.” Daskalakis, who is gay, has been an activist physician with a particular focus on underserved populations, including the LGBTQ+ community. “We have the tools at our hands to prevent infection and to keep people living with HIV healthy,” he said. “Our barrier to achieving this vision is no longer science, it is systemic racism,sexism, homophobia, and transphobia.” —T R H IVPLUS MAG .CO M

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D A I LY D O S E

BY T YLER CURRY

Editor at large TYLER CURRY is also a contributing editor at The Advocate magazine and the author of A Peacock Among Pigeons. (@IamTylerCurry)

COU RTESY T YLER CU RRY

THE UPSIDE OF BEING UNDETECTABLE DURING A PANDEMIC

risk for developing a severe case of COVID. Naturally, I was relieved. Just like in all other facets of my life, being on treatment meant that my life was relatively unaffected. In fact, I was at an advantage. Not only did my lab results reveal my T cell count and viral load, it gave me a detailed insight into the status of my health. From my liver and kidney functions to my bone density, I had literal inside information LIVING THROUGH COVID-19 that most people my age never IS A DIFFERENT EXPERIENCE get, much less on a quarterly FOR PEOPLE LIVING WITH HIV. basis. This didn’t give me license to be reckless or disregard precaution, but it did give me reassurance YO U M AY N O T think that were would be perks that can come with being HIV-positive that my health was in my control. This perk of being HIV-positive and and undetectable during a pandemic, and you undetectable isn’t as much of a side effect would be wrong. As we all continue to make it through this of my status as it is a symptom of my hellacious year of COVID, many of us are privilege. And in 2020, privilege is the still vacillating between overly cautious and largest underlying condition that can overly exposed. Even though the Centers for often be the difference between being Disease Control and Prevention has issued at-risk or not. And yet for so many who what seem to be pretty clear guidelines are privileged enough to be able to work to curb the spread of infection, each state from home, access health care, and stock has taken its own approach reflecting their up on food and other household items, political culture, which has left us all a the simple task of wearing a mask and little confused. However, everyone seems avoiding crowds is still apparently too to grasp that those with underlying health much to ask. You know, another advantage that comes conditions should proceed with the most from being HIV-positive and undetectable caution, for they are the most at risk to die. Throughout the pandemic, I have heard is that is has taught me to not just value several iterations of the same sentiment my own health, but the health of my from well-meaning people. The belief that I community. I don’t just take my medication should be more cautious than most because so that I can stay healthy; I take it to do of my HIV-status. And in the beginning, I my part in stopping the spread of the virus. certainly was concerned as to whether my After all, what is the point of surviving if immune system was, indeed, considered those who you love are no longer around to an underlying health condition. However, share your life with? The differences between HIV and COVID as the year has progressed, my nervous far outweigh the similarities, but there is a concern turned into a careful confidence. During my routine quarterly visit with lesson of placing the health of others ahead my physician to check my labs, I was of your own wants and desires that carries able to ask questions and confi rm what throughout. So mask up and stay vigilant, my friends. the logical side of my brain suspected all along. So long as I was undetectable, For some people, this is actually their first my HIV status was not a factor in my rodeo. But it sure as hell isn’t ours. JAN UARY / FEB RUARY 202 1

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ALE X AN DR A KOCH/PIX ABAY

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THERE’S JUST SOMETHING ABOUT SAM GEORGIA REPRESENTATIVE SAM PARK IS AN ATTORNEY FIGHTING FOR BETTER HIV LAWS AND HEALTH CARE IN THE CONSERVATIVE STATE. BY T R U DY R I N G

COU RTESY OF SAM PARK

am Park, an advocate for people living with HIV and for better health care for everyone, is in many ways the new face of Georgia. He’s a gay man of Korean descent — the first out gay man and first Asian-American Democrat elected to the Georgia legislature, where he’s fighting to expand Medicaid availability and modernize the state’s HIV law. He is also an attorney for Positive Impact Health Centers, a nonprofit organization that provides HIV treatment and prevention services for thousands of people in hard-hit counties around Atlanta. In November, the 35-year-old was elected to his third term in the Georgia House of Representatives from a suburban Atlanta district in Gwinnett County. Earlier this year, Park was one of three gay politicians who participated in the virtual keynote address at the Democratic National Convention — the first members of the LGBTQ+ community to appear in a keynote slot at such an event. He was also on the steering committee for Out for Biden, an initiative aimed at mobilizing LGBTQ+ voters to support the Democratic nominee. He’s worked with several prominent Georgia Dems, such as Stacey Abrams, a former state lawmaker and gubernatorial candidate, and Jon Ossoff, a current candidate for U.S. Senate (his race is in a runoff). Park was motivated to enter politics because of his mother’s terminal cancer diagnosis in 2014. With insurance coverage through Medicaid and Medicare, she received treatment that allowed her to spend her final years in relative comfort and see her son elected to the legislature in 2016. The experience, Park says, “taught me health care was a matter of life and death.”

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Another of his priorities is modernizing Georgia’s HIV law, which makes it a felony for an HIV-positive person to have consensual sex, donate blood, or share needles without disclosure of their status, along with criminalizing a variety of other acts by those who are positive — including spitting. (Spitting cannot transmit HIV, and those who are undetectable cannot transmit the virus.) A reform bill that reflects modern science regarding transmission risk and removes penalties except in cases where there’s intent to transmit HIV passed the Georgia House overwhelmingly with bipartisan support early in 2020. Unfortunately, the state Senate ran out of time to consider it before shutting down for the COVID-19 crisis. Still, the House vote “gave me a lot of hope,” Park says, and he’ll try again in the upcoming session. In his other job, his primary task is assuring that Positive Impact follows all the laws regarding its government funding. A key component of that is the federal government’s 340B Drug Pricing Program, which allows certain health care providers to buy drugs

COU RTESY OF SAM PARK

In his first election, Park defeated Republican incumbent Valerie Clark, who had resisted Medicaid expansion in Georgia and also voted for a so-called religious freedom bill that would have allowed discrimination against LGBTQ+ people; then-Gov. Nathan Deal ended up vetoing the measure. Park bested Clark again in 2018, by a larger margin than the first time around, and in 2020, he easily beat another conservative Republican, Carol Field. Park is still trying to get the state to adopt Medicaid expansion, which he calls his number 1 issue. Medicaid is a joint federal-state program that provides health insurance for certain people with low incomes or disabilities; a part of the Affordable Care Act allows states to offer Medicaid to all people below a certain income level, so it would be far more widely available. Georgia is one of only 12 states that have not opted in, even though it’s been demonstrated that the impact on state budgets is minimal. Georgia has the second-highest proportion of uninsured people in the nation and expanding Medicaid would go a long way toward addressing that, Park says.

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COU RTESY G EORG IA HOUSE M EDIA SERVICES

at deeply discounted prices and also generates income for the providers. It’s a useful source of funds to expand staff and services, Park says. Park, who is HIV-negative, has been with Positive Impact for two years. He first became involved when he was recruited to the organization’s board, and now handling its legal work has become a full-time job. Positive Impact has clinics in Duluth, Decatur, and Marietta, each in a county that’s considered a hot spot for HIV, with rates comparable to those of developing nations, Park says. Georgia as a whole has one of the highest rates of new HIV diagnoses in the nation. Park is a graduate of Georgia State University and its law school, and he also has a master’s in law from American University Washington College of Law. He attended a Christian elementary school and says faith still shapes his outlook. When he came out in his teens, there were difficulties with some conservative family members and friends, but the situation eventually got better. Some relatives in California and New York, however, only learned he was gay from news articles when he first ran for office in 2016. But that turned out OK too. “When all was said and done, they were able to see beyond the stigma.... They just saw me for who I was,” he says. He is fighting for progressive measures in a deeply conservative state, where Republicans control the governorship and both houses of the legislature. Just the same, he says, “I remain optimistic and excited.” And there are signs that things are changing. Joe Biden swung Georgia into the Democratic column in the presidential election, and Park is “incredibly ecstatic” about that, he says. “My celebration is also tempered by the reality which we face,” he adds, citing the pandemic and economic challenges. Georgia, however, could help the nation meet those challenges, he notes. Both of its U.S. senators, Republicans David Perdue and Kelly Loeffler, are facing Democrats — Ossoff and Raphael Warnock, respectively — in runoff elections January 5. If both Dems win, their party will have 50 Senate seats and Republicans 50, but Kamala Harris, as vice president, will have the power to break ties, therefore giving Democrats a majority. “The best thing we could do is to send two Democratic senators to Washington, D.C.,” Park says. H IVPLUS MAG .CO M

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BY DESIRÃ&#x2030;E GUERRERO

SH UT TERSTOCK

THE AUTHORS OF A NEW BOOK DISCUSS WHY MANY PEOPLE LIVING WITH HIV FIND HOPE AND HEALING THROUGH FOUR-LEGGED FRIENDS.

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an age when support animals are now commonplace in airports and restaurants, it’s no secret that animals, dogs in particular, can provide enormous therapeutic benefits to their human counterparts. And now a new book geared toward young adults delves even deeper into the subject from the viewpoint of people living with HIV. When Dogs Heal: Powerful Stories of People Living with HIV and the Dogs That Saved Them is a powerful portrait of a diverse group of HIV-positive people and their canine companions. The book highlights how dogs offer not only numerous health benefits to people — including decreased blood pressure and cholesterol levels — but significant mental health boosts as well. The ability of dogs to combat loneliness is especially important these days, as many struggle on their own during the COVID-19 pandemic. When Dogs Heal is a group effort created by writer Christina Garofalo, award-winning dog photographer Jesse Freidin, adolescent HIV specialist Dr. Robert Garofalo, and LGBTQ+ advocate and journalist Zach Stafford. Freidin’s beautiful and moving images are certainly a highlight of the work — as are the intimate and inspiring stories offered throughout. Recently, Plus got a chance to catch up with the book’s contributors to discuss how the project came to be. “Rob Garofalo commissioned me to photograph him and Fred many years ago in San Francisco, when Fred was just a puppy,” Freidin recalls of first meeting one of the book’s coauthors and his dog, also featured in the book. “That started a long friendship that not only kept us in each other’s lives but helped open my eyes to the ways in which dogs help heal

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The original humancanine duo that inspired the book, When Dogs Heal: Powerful Stories of People Living with HIV and the Dogs That Saved Them: Dr. Robert Garafalo and his Yorkshire terrier, Fred

PHOTOGRAPHY BY JESSE FREIDIN

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humans from the deepest of hurts and illnesses. From then on, my focus has truly been to uncover the ways in which humans and dogs heal each other simultaneously — and to remove hurtful stigma from the pains and challenges that we all go through in life.” Dr. Garofalo shares why it was especially important for him to be a part of the project: “It’s my personal journey living with HIV, as well as the healing brought to my life by my dog Fred, that inspired this project,” he says. “It’s an honor to be among the participants in this book. However, the book is decidedly not about Fred or me. Over years of researching this book, we had the good fortune to meet so many brave and beautiful people who risked being vulnerable and told us absolutely mesmerizing stories of survival, gratitude, and hope. The people in this book have often gone unseen and their stories therefore, too, often untold because of the stigma and fears that surround being honest about HIV…. Each person you will read about was once broken by a devastating diagnosis but, with the help of a four-legged companion, found the strength to rise and heal and overcome.” “Most people don’t know this,” says Stafford, a former editor of our sister publication, The Advocate. “But I have lost two family members to the HIV/AIDS epidemic. The first person being my maternal grandmother and the second being an uncle on my dad’s side. Both of their deaths had a profound impact on how I saw the world, and in many ways helped steer me to wanting to tell stories of those of us that the world decides to ignore or erase…. As we set out to meet more people like Rob, people who adopted dogs after being diagnosed, I was overwhelmed with how vast and diverse the stories were. And the one thing they gave to me, in each interview, was hope.” Coauthor Christina Garofalo says that for her, the work is very personal as well. In fact, it’s a family affair.

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Brent with dogs Monty and Sallly

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Lynnea with her baby and beloved dog, Coconut

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“Well, first off, Rob is my uncle,” she says. “I saw the ups and downs since his own diagnosis and how his relationship with Fred inspired him to bring more good to the world, and that moved me…. But really, I met the participants — many of whom told me that, given the choice, they wouldn’t change their diagnosis. Through the darkest, loneliest moments of their lives, with the help of their dogs, they found a chance to redefine their purpose…. That is the kind of exquisite, human truth every writer dreams of capturing.” “Their stories speak to every one of us that’s ever feared we aren’t worthy of love,” she adds. “Thanks to the participants, When Dogs Heal captures a subject that for 40 years has been about death, and transforms it into a love letter to life.” When Dogs Heal: Powerful Stories of People Living with HIV and the Dogs That Saved Them will be released March 2 from Zest Books, and is available for pre-sale on Amazon. A portion of the proceeds from the book’s sales will benefit Fred Says, an organization founded by Robert Garofalo, dedicated to financially supporting health care for teens living with HIV. H IVPLUS MAG .CO M

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generation change Young leaders share their own stories of being Black and HIV-positive.

CL AY BAN KS/U NSPL ASH

BY DESIR Ã&#x2030;E G U E R R E RO

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DEONDRE MOORE

States…. Now, the survey findings show that Gen Z and millennial participants — the furthest removed from the HIV crisis of the ’80s and ’90s — are not being effectively informed about HIV and its transmission. Ultimately, we have been left behind. After we share these initial survey findings, we issued a call to action to address this public health threat. And today we seek to deliver on this call.”

As millennials and Gen Z, we now account for the majority of new HIV diagnoses in this country. —Deondre Moore

ELIZ AB E TH B ROOKS (BOTH PAG ES)

Last year, a first-of-its-kind survey from the Prevention Access Campaign (PAC) in partnership with biopharmaceutical company Merck revealed some harsh realities around young people and HIV — particularly the startling lack of knowledge about the virus and how it is transmitted. In response, the Owning HIV campaign was created, which focuses on bringing the most current and accurate information to young adults about HIV, as well as combating its enduring stigma. One of the most jarring pieces of data revealed by the survey was that young adults (ages 18-34) now account for the majority of new HIV diagnoses in the U.S. Then in November of 2020, additional previously unreleased data was revealed concerning Black Americans and HIV. To discuss these new findings, PAC and Merck partnered again to host a free live virtual event in November led by DEONDRE MOORE. During this Owning HIV webinar, several young HIV activists, including Moore, shared some of their own stories. Diagnosed when he was a freshman in college, today Moore, now 26, says his mission “is to turn the tide and empower others…to join me and be the change we need in this world.” He was the first speaker at the event to share his personal journey. “At the time that I received the positive diagnosis, I was 19 years old and HIV was far from a concern to me,” recalled Moore. “As a Black gay man, I was at high risk for contracting the virus, yet I never received the proper education about HIV up to that point, or really any meaningful sex education overall. I’ll be honest, I was devastated. I’ll never really forget the feeling of having to tell my most important person in the world, my mom, that her baby boy is now HIV-positive. I was also angry because I didn’t have the knowledge that I deserved to have to protect myself from HIV.” Moore then turned his attention outward, reflecting on how HIV has affected younger generations of Black Americans. “As millennials and Gen Z, since 2017 we now account for majority of new HIV diagnoses in this country,” Moore said. “Think about it like this: the HIV and AIDS crisis that caused so many to die in the ’80s and ’90s is swinging back at us. Today’s crisis impacts the Black community even more deeply. In the United States, Black and African-American people made up 42 percent of new HIV diagnoses in 2018, making us the most impacted group compared to all of the races and ethnicities in the United JAN UARY / FEB RUARY 202 1

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WANONA

Next to share her story was WANONA THOMAS, a young mother who was pregnant with her fourth child when she discovered her positive diagnosis at 24. “As a straight woman, I am excited to bring my perspective to this conversation that is often overlooked within our HIV community,” said Thomas. “When I found out I was HIV-positive, I was absolutely crushed. I also was like the other 80 percent of the HIV-negative African-American respondents who reported being highly confident that they were not at risk of contracting HIV. This is why we are having these conversations today. Not only did I contract the virus from an unfaithful partner, but I was also four and a half months pregnant. I remember in that moment feeling like I disappointed my family and myself. I felt like from that moment on, I would be viewed as a contagious thing instead of a person.” Despite the difficulties she faced at the time of her diagnosis, Thomas ultimately was able to give birth to a healthy, HIV-negative child. Now she is dedicated to helping others who are struggling as she once did. In 2017, Thomas founded Live in Your Truth, a nonprofit empowering and inspiring individuals living through lifealtering tragedies or health diagnoses. (Facebook.com/LIYTruth) “Ultimately, I now know that HIV does not define me,” Thomas said. “It’s just something that I have. Owning HIV to me means owning that part of my life, and living a normal, healthy life with HIV. Following my diagnosis, I quickly took actions by educating myself and working with my doctors to get on the right treatment. And after becoming undetectable, I was able to give a natural vaginal birth to a healthy baby boy. When I was diagnosed, I didn’t know anyone else who was outwardly HIVpositive — so I didn’t have anyone else who I could empathize with…. By using Facebook as my platform to communicate with the outside world, I was able to help others while also helping myself. It is a powerful platform to share information in a raw and unapologetic way.”

THOMAS

Thomas added that education around HIV in Black communities is key in both ending the epidemic and eradicating stigma. “In the [PAC-Merck] survey, 53 percent of the African-American women living with HIV reported losing the option to have children due to their HIV. This doesn’t need to happen again. My experiences again are not singular, and I realized that there were so many other women out there who have faced similar situations and felt the same way I did. Based on my experiences [and] these shocking survey statistics, it’s time that we women find our voices within this HIV community and learn how to come together and lift one another up and overcome this type of stigma together.”

Owning HIV to me means owning that part of my life, and living a normal, healthy life with HIV. —Wanona Thomas

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YONCE JONES

ELIZ AB E TH B ROOKS

The Owning HIV campaign is a movement to alleviate stigma and take steps to become educated, empowered, and mobilized.

Next to speak was YONCE JONES, a young transgender woman who discovered she was HIV-positive at 17. “My story is a little bit different,” Jones said. “Before I was diagnosed, I was educated about HIV as part of a peer training program, while I was living in a group home. I thought I took the steps to protect myself based on this education. From a textbook point of view, I thought I did a good job…. But that’s why it’s so important that you hear my story about how I became HIV-positive. When I was 17 years old, I was in a committed relationship. I just knew we were in love. But what I didn’t know was that my man was HIV-positive. —YONCE JONES And guess what? He didn’t tell me.” After her diagnosis, Jones didn’t receive any counseling around HIV treatment options or emotional support for the weight she was carrying on her shoulders. “I was still in high school and was valedictorian that year,” Jones said. “I was scared and so ashamed. And most of all, I was alone.” “The Owning HIV campaign is a movement,” Jones continued. “It helps so many people, transgender women and transgender men included. It helps to alleviate stigma and take steps to become educated, empowered, and mobilized. We must stop the pain and the suffering we have endured with ourselves and each other. Based on my experience working with the transgender community, there’s very little awareness about U=U [undetectable equals untransmittable]. We deserve to have this education and tools just like everyone else to protect ourselves, become empowered and stop suffering.” The panel also included Cameron Kinker, the program and communications manager for PAC and the U=U campaign; Dr. Peter Sklar, the director of clinical research at Merck Research Laboratories; and journalist Josh Robbins of ImStillJosh.com. For additional survey information and more about the Owning HIV campaign, visit Merck.com and enter “Owning HIV” in the search bar. To learn more about U=U, visit PreventionAccess.org. JAN UARY / FEB RUARY 202 1

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what’s next?

After an unprecedented and emotionally exhausting year, Plus asked some of the most respected Black leaders in the HIV community what they want to see happen in 2021. By Desirée Guerrero

COU RTESY B L ACK AIDS INSTITUTE (COPEL AN D); AVEN CRE ATIVE COM PANY (G IBSON); COU RTESY OF SU B J EC T (ALL OTH ERS)

Raniyah Copeland President and CEO, Black AIDS Institute “Despite a pandemic that has disproportionately ravaged Black communities, the Black AIDS Institute and our Black Treatment Advocates Networks are proud to have contributed to the voter mobilization that propelled this historic presidential win. While we are cautiously optimistic about a new leadership that has acknowledged white supremacy, our commitments to ending HIV will continue to be driven by the communities most impacted in 2021 and beyond. In 2021 we will be launching a national biomedical research initiative to educate Black communities about scientific advancements like HIV and COVID vaccine trials; expand our direct HIV and health services in Los Angeles; a new celebrity engagement video conversation series called Black Voices Matter; and a justlaunched website to better engage Black communities. Ending HIV in Black America will only happen if our efforts to end HIV are led by Black communities most impacted, and BAI is at the forefront of ensuring that Black America isn’t left behind in those efforts.” Donté Smith Lead patient educator for infectious disease, Legacy Community Health “This year has seen so much beautiful mobilization and community support building in queer/ trans/people of color communities. I’m so proud of the work my folks have been doing. I pray that we can keep this momentum up in the next year. Also, as people living with HIV who are involved in health justice activism, I hope that we can grant ourselves the spaces to grieve, breathe, and re-center ourselves, and to recognize that our communities face intense systemic health challenges from institutional racism — not just COVID-19.”

Harold Brown Retired educator & advocate, founder of the Hoosier IAC Scholarship “I, as a person living with HIV, am honored to be asked to convey my request to the honorable PresidentElect Joe Biden to what would begin to fulfill my hopes in 2021. The farreaching impact of Plus magazine has become a vital connection among LGBTQ+ elders who have survived the HIV pandemic. I am reminded of the story of God telling Moses to go to Pharaoh and tell him ‘let my people go.’ Moses spoke and said he was of poor speech and asked who was he to tell Pharaoh what to do. Since I have only such authority in my heart, I, too, have no words to tell Biden what to do. This is my quote: ‘Mr. President, let my people be healed and let them be cured.’” Ahmier Gibson Lead community engagement coordinator, Legacy Community Health “My hope for American HIV care in 2021 is that systems seeking to provide well-care services continue to embrace technology and new multi-level approaches that are creative, peoplecentered, culturally responsive, and traumainformed. Many people living with and vulnerable to HIV deal with a wide range of identified challenges, barriers, and needs that are systematically unmet before HIV is ever added to their experience. The reimagining of outdated care policies and practices, being intentional about focusing on the quality of care, and genuinely diversifying the administrators of care services far beyond the front desk must not be overlooked when implementing modern strategies to bring and keep people in care. The world is changing rapidly, and the response from provider to community in partnership with each other needs to change with it. The time to be innovative is now, and technology and science are both on our side. Together, we can end the epidemic.”

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TRUTH TELLER NEW YORK TIMES MAGAZINE CONTRIBUTING WRITER LINDA VILLAROSA IS THE NATIONâ&#x20AC;&#x2122;S PREEMINENT EXPERT ON HEALTH DISPARITIES IN THE AFRICANAMERICAN COMMUNITY. SHE HAS A LOT TO SAY ABOUT COVID, STRUCTURAL RACISM, AND WHAT BIDEN CAN DO FOR BLACK PEOPLE LIVING WITH HIV. BY NEAL BROVERMAN + PHOTOS BY MIA ISABELLA AGUIRRE

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eteran journalist Linda Villarosa — the writer, reporter, and editor behind numerous award-winning health and race-related articles for publications like Essence (where she twice served as executive editor) and The New York Times — was not surprised by how destructive COVID-19 has been for Black people. “Not one iota,” she says. Villarosa is in regular contact with public health experts at universities like Harvard and the University of California, Berkeley, and the issue of Black people and increased COVID risk was something they discussed in the earliest days of the pandemic. They desperately tried to make their concerns public knowledge. “We were trying to get articles placed about [the specific risks of COVID-19 to Black people],” the New York-based writer and journalism professor recalls. “Even in medical journals, the answer was ‘No.’ No one was interested. Now everyone is busy talking about this topic. I think it took COVID bubbling up and revealing the inequality for it to become important for people. For it to become real. For it to become the truth.” In her journalism career, Villarosa has rung the bell on numerous health disparities involving African-Americans, including HIV transmission rates and deficiencies in care and treatment. Her 2017 New York Times Magazine article “America’s Hidden H.I.V. Epidemic” shined a light on low-income Black Southerners struggling to survive HIV amid little to no compassion or assistance from local officials. The article won an Excellence in Journalism Award from NLGJA: The Association of LGBTQ Journalists, and that organization recently inducted Villarosa into its LGBTQ Journalists

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Hall of Fame. Villarosa has also been nominated for a National Magazine Award for her 2018 New York Times Magazine cover story “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis,” and she contributed an article on medical experimentation of Black bodies to the 1619 Project, the Times’s Pulitzer Prize-winning 2019 series about the origins of American slavery and its aftermath. Villarosa has also written or cowritten several books, including the forthcoming Under the Skin: Race, Inequality and the Health of a Nation. Villarosa describes a personal toll for immersing herself in such heavy subjects but says it’s worth it because the stories can effect change. “After [“America’s Hidden H.I.V. Epidemic”] came out, the funding switched and became much more focused on the South,” she says. “I was very happy about that outcome.” Villarosa and some of the people she chronicled in the article were later asked to be part of HIV conferences and symposiums. Jermerious Buckley, a gay HIV-positive Mississippi man who figured prominently in “America’s Hidden H.I.V. Epidemic,” was at one of those conferences with Villarosa. “What do we do? What do you need?” Villarosa says Buckley was asked by health care industry professionals. “He didn’t say

money; he said, ‘Love.’ That ‘love’ is talking about stigma. And while there’s still stigma out there that needs to be addressed, I’m glad there’s money too.” Villarosa is buoyed by the election of Joe Biden as president and believes he will devote substantial resources to address diseases that disproportionately affect Black people, specifically HIV (African-Americans are 13 percent of the U.S. population but represent 42 percent of new HIV diagnoses) and COVID-19 (Black Americans die from the disease at 2.1 times the rate white Americans do). Regarding HIV, having a president other than Donald Trump is “one answer, but it’s also going to take a rebuilding of our structures, including the Centers for Disease Control and Prevention and the National Institutes of Health,” she says. “Those aren’t the be-all, end-all, but it’s where people get funding and community groups get funding. [The money] can’t all come from pharmaceutical companies and state organizations trying to piece it together. There’s got to be a federal mandate to work on HIV.” Waking the public up to the structural inequities that make Black people more susceptible to certain diseases is part of Villarosa’s personal mission. AfricanAmericans aren’t getting sick and dying more because of some sort of biological difference H IVPLUS MAG .CO M

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or personal neglect — it’s because they have the cards stacked against them, Villarosa points out. “Black people as well as other people of color are just more likely to be frontline workers or to be unable to take off work or to live in crowded housing situations,” she says of heightened COVID risk factors. As an assistant professor of journalism and Black studies at the City College of New York, Villarosa sees this firsthand: “I teach at a college that is predominately people of color, and I can see, or they tell me, people are going in and out of their house because they have to work. They’re not working from home, they’re working outside; they’re delivering groceries, they’re security guards, working in restaurants. So they’re coming in and out, and there’s a whole bunch of people living in that house. So they’re just more likely to come into contact with the virus.” Villarosa also cites the existence of “weathering,” which she describes as the physical toll discrimination takes on a body. Reporting on COVID, Villarosa spoke to a Black man she assumed was in his 60s or 70s; he was only 50, and he later died. “When you are the subject of discrimination over and over again, your fight-or-flight syndrome kicks in too many times and it prematurely ages the body,” she says. “So that’s why, if you look at COVID statistics, Black people are likely to have worse outcomes at younger ages. Our bodies look like the bodies of much older people.” Then there’s the role of racism and discrimination in the health care system. Villarosa says that when she brings up that concept, she’s often met with intense blowback, as if she’s accusing all doctors and nurses of racism. “Doctors and nurses and other health care providers are heroes, but everyone in our society is subject to the poison of structural racism — including the medical system,” Villarosa says. “So H IVPLUS MAG .CO M

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people that work within it, they’re making decisions, they’re stressed around COVID, and that’s when the unconscious bias comes to the surface.” Confronting those biases has gotten somewhat easier, Villarosa says, since the social justice movement went mainstream this summer. The killings of Black people like George Floyd and Breonna Taylor at the hands of police woke many up to the injustice faced by people of color in a way nothing else has, Villarosa says. “But a bunch of Black people shouldn’t have to die to get this needle moved when this has been going on for a while, this state-sanctioned violence and murder,” she adds. Villarosa’s white friends are much more interested in the concept of police violence against Black people and “much more believing of it in a way they didn’t before,” she says. She can see the wheels turning in people’s minds: “A lot of people have talked about the effect of seeing the George Floyd video; for a lot of us, it’s so traumatic. But for others, it’s eye-opening. You cannot think anything besides This is messed up. Then you ask, ‘Why would this happen?’ Then you start to look into it…. I do think this has moved the needle.” There’s also a tinge of optimism and a feeling of opportunity when Villarosa discusses the state 40

of journalism, an industry battered by layoffs and shrinking budgets, and constantly labeled by Trump as “fake.” “This moment has helped me to really push the idea in my classes that you really have to prove everything; journalism is about proving, it’s about evidence, about making sure something is true,” she says. “Now you have to do it much more strenuously because if someone is saying everything that you do is fake, then you really have to prove that you have evidence, that it’s backed by expertise.” In between Villarosa’s classes and deadlines — she had just returned from a reporting trip to West Virginia when she spoke to us in the fall — the journalist maintains a rigid self-care routine. Villarosa sees a therapist weekly, mostly to discuss the intense stories she writes and edits. She also exercises every day at the same time and never works at night. “There used to be this idea that you were a journalist and you just had to strip yourself of emotion,” she says. “Now there’s more of a tilt to say, ‘I’m a human too; I need to take care of myself in order to do my best work. I have to be whole or I can’t do this.’ I’m very clear and careful about that.” A great mantra for journalists — and everyone else too.

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t r e at m e n t

ANTIRETROVIRAL DRUGS DO MORE THAN KEEP HIV IN CHECK, ACCORDING TO NEW STUDIES. BY NEAL BROVERMAN

A F L U R R Y O F stories broke this fall about the versatility of HIV medications and the way they battle other diseases and conditions, and how a medication currently utilized for multiple sclerosis could fight HIV. Based on information about nearly 75,000 people aged 64 or younger and living with HIV, researchers at Penn State University College of Medicine reported that antiretroviral therapy for HIV reduces the risk of Alzheimer’s disease. People living with HIV have a heightened chance of the degenerative brain disease, which impairs memory, speech, and most cognitive functions. The risk is even more pronounced, researchers found, for early-onset Alzheimer’s, but for HIV-positive people who maintain their treatment regimen, the risk is comparable to that of the general population. Scientists will now try to figure out how these antiretroviral drugs fight Alzheimer’s — they currently theorize it may be because the medications hinder “neurological toxicity” caused by unsuppressed HIV or because these meds also reduce the incidence of medical conditions seen as risk factors for Alzheimer’s, like hypertension, diabetes, and high cholesterol. The findings are important for many reasons, including the fact that many long-term survivors are now entering “seniorhood,” Guodong Liu, associate professor at the Penn State University College of Medicine, told Healio. Just days before the Penn State announcement, researchers with the University of Virginia School of Medicine reported that medications 42

STEPS TO PREVENT TYPE 2 DIABETES: 1. Maintain a healthy weight. 2. Eat fruits and vegetables and limit fat, sugar, and salt. 3. Exercise 30 minutes a day most days of the week. *Source: National Institutes of Health

MARCUS AU RELI US/PE XELS

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used to treat HIV and hepatitis B reduce the risk of developing diabetes by a third. The drugs could be “repurposed” to prevent type 2 diabetes, a condition in which the body resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or not producing enough insulin to maintain normal glucose levels. Information for the findings was culled from records of over 128,000 people living with HIV or hepatitis B, some of whom are veterans. “The fact that the protective effect against the development of diabetes was replicated in multiple databases in studies from multiple institutions enhances confidence in the results,” researcher Jayakrishna Ambati, MD, of the University of Virginia School of Medicine, said in a statement. The researchers also studied the effects of one specific drug, lamivudine, (brand name Epivir and a component of Dovato), in human cells and in animals, and found evidence that it could reduce the risk of diabetes among people living with HIV. Most recently, researchers at George Washington University and the University of Montreal found that the multiple sclerosis drug fingolimod, sold as Gilenya, can “hinder several key steps of the HIV lifecycle,” NAM’s AIDSMap reported. Taken orally, fingolimod is now used to treat MS, a chronic autoimmune disease of the central nervous system that disrupts communication between the brain and the body. During their studies, the researchers found that fingolimod prevented cell-to-cell transmission of HIV. “Fingolimod may be useful as a strategy to limit the size of the latent [HIV] reservoir if used prior to [antiretroviral] initiation, such as in acute infection,” researcher Rachel Resop, Ph.D., and her colleagues noted.

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U=U FINDS A HOME IN INDIA AN INDIAN CITY TAPS TECHNOLOGY TO UNDERSCORE THE IMPORTANCE OF ADHERENCE AND UNDETECTABILITY.

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BY TRUDY RING I N D I A ’ S G O V E R N M E N T O F F E R S free antiretroviral treatment to all people living with HIV, but still just over half are on meds, and not all of them are able to stick to their regimen. Adherence is key to maintaining health and preventing transmission. So health care providers in Chennai, the nation’s fifth-largest city, are tapping into the power of entertainment and social media to spread the message of undetectable equals untransmittable. Voluntary Health Services, a hospital in Chennai, and Sahodaran, an organization focusing on men’s sexual health, have partnered for the U=U campaign, which features Aarthi Ganeshkar, a popular actress and comedian. The campaign, launched in September, includes posters and videos on Facebook, Twitter, and YouTube, and in WhatsApp groups, The Times of India reports. Other celebrities and activists will help promote it. “We received a grant from Gilead Rainbow Grants and have tied up with Sahodaran to carry it out, as we want to have active participation and engagement with community members,” Arumugam Vijayaraman, director of programs at Voluntary Health Services, told the Times. India has 2.1 million people living with HIV, according to the latest UNAIDS figures. That ranks third in the world for sheer numbers, after South Africa and Nigeria. Prevalence is relatively low — 0.2 percent among adults — but because India has a huge overall population, 1.3 billion, the

number of people with HIV is likewise large. However, only 56 percent of those with HIV are on treatment, and a recent study estimated that just three-quarters of those receiving treatment are able to maintain it continuously. Reasons for not getting or staying on treatment include discrimination and stigma. The epidemic in India is concentrated among sex workers, gay and bisexual men, transgender women, and injection drug users, notes Avert.org. These groups face prejudice and marginalization in India, despite some recent legal changes, like the decriminalization of homosexuality, so there can be reluctance to seek care. The new campaign reminds viewers how important health care is to those living with HIV, as antiretroviral treatment can keep people healthy and ultimately suppress the amount of virus in their body to the point that it is undetectable — and therefore untransmittable to others. That’s a message that shouldn’t get lost even when the world is grappling with a new pandemic, Indian health professionals note. “In the last few months, the entire focus has been on containing the spread of COVID-19,” Suresh Seshadri, honorary secretary of Voluntary Health Services, told the Times. But there’s also a need to focus on HIV, as many people don’t understand the power of antiretrovirals or even know what treatment options are available, Seshadri added. The campaign also includes messages about the importance of nutrition, exercise, mental health, and having a supportive circle of friends. “Health, happiness, energy, and rest are essential to improve the quality of life of HIV positive people,” project manager Sharan Karthik Raj told the newspaper. “But for that, [we] have to suppress the virus so that it cannot be detected and spread to other people.”

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HOW NAME-CALLING DAMAGES YOUR RELATIONSHIP ARGUMENTS ARE ONE THING, BUT INSULTING YOUR PARTNER OR SPOUSE CAN SERIOUSLY DAMAGE YOUR DYNAMIC. L U K E A N D H I S partner, Eduardo, have been having an ongoing disagreement they haven’t yet found a way to resolve. To say they are angry at each other is an understatement. To complicate things, Luke goes in this week for his quarterly labs, which always leaves him on edge for a few days. Between that and work, Luke would be the first to admit that his patience is pretty much depleted at this point. So you can imagine how he reacted when the topic came up again. Luke made the same point he has been making all along, and Eduardo, who is also dealing with some additional stress in his life, made his point. “You are totally not listening to me,” Luke said. “Oh, I heard you,” Eduardo responded. “Over and over. You’re not listening to me!” “What? Not listening to you?” Luke said. And then he said something that even at the moment it came out of his mouth, he knew he would later regret: 44

“You are such a blank blank.” Now, I will let you fill in the two blanks. In the first blank goes an adjective; choose any that come to mind. And in the second blank goes a name that you might call someone out of anger. Examples? Stupid idiot? Stubborn fool? Overgrown child? Or maybe something a whole lot worse. I often talk to couples about name-calling. It happens more than you might imagine. What about at your home? Do you and your partner or spouse have discussions that turn into arguments, with flaring tempers and name-calling? I don’t judge my clients who talk to me about the names they call each other out of anger, though I have to admit I am sometimes

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BY GARY MCCLAIN

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surprised — and not in a good way — at the hateful words they throw at each other. But I am concerned about the impact. First, name-calling can put a wedge between you and your partner. Names can cause resentment and a break in trust that will be difficult to repair. Second, names do emotional damage. Your partner may already be feeling vulnerable, and the name you call them may cause them to feel badly about themselves, to lose selfconfidence, to feel unloved. Third, name-calling is not “fighting fair.” Once you toss a mean-spirited name in your partner’s direction, the words that follow no longer carry any weight. People who call other people names don’t have any credibility; they reduce themselves to spewers of hate speech. And the person being called the name may be so affected by your words that they can’t or won’t respond further. Fourth, name-calling impacts your own emotional wellness. All that poison you allowed to build up doesn’t get released when that name pops out of your mouth. Name-calling can fuel more angry feelings and more name-calling. Later on, the guilt and regret that ultimately result leave you feeling even worse. The bottom line is that name-calling may feel justified and deserved at the moment you hurl a name in your partner’s direction. But the damage to your partner, to you, and to your relationship just isn’t worth it. Here’s how to avoid the urge to call your partner names when you are having a heated discussion.

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Avoid escalation. This is called being proactive. If your discussion with your partner starts to heat up and begins to veer into the territory in which your temper and your vocabulary might get out of control, do something immediately. This might mean suggesting the two of you take a break. Or that you both lower your voices and speak more calmly to each other. Say something like “Let’s not let this get out of hand and say things we will both regret. Maybe we should take a step back.” Go into listening mode. It just might be possible that, out of your own insistence on being right, you are missing something your partner is saying. So consider saying to your partner, “What you’re trying to say to me may not be registering. Please explain the point you are trying to make here.” This will also

give you time to get a handle on your own feelings before they boil over. Monitor your emotions. You know when you’re feeling so angry or frustrated that you’re in danger of saying something you’ll regret, including hurling invective and names toward your partner? Stay in the moment. Be conscious of your own thoughts. If you’re forming names to call your partner in your mind, then chances are you’re in danger of letting them fly. Nobody knows you like you do, and you know the signs of impending loss of verbal control. Set limits with yourself. As difficult as this can be, my clients usually admit that they know how to stop themselves from charging forward in a way that might cause emotional damage to their relationship. More directly, anger is not an excuse to call your partner names. It’s a matter of saying to yourself, “As good as that might feel right now, I’m not going to say it.” And then don’t say it. No excuses! Consider the consequences. One of the best ways to control your speech is to consider how your partner will feel. Do you really want to say something so hurtful to your partner that they have difficulty recovering? Do you really want to cause that damage to your relationship? If you don’t, then rein in your words before they escape your mouth. Keep the focus on what’s important. The couples I work with tell me how much they want to live in a home where they feel surrounded by love — a home that is peaceful, calm, and joyful. That’s an environment in which your relationship can thrive. It’s also important for your emotional and physical wellness. It’s all connected. Make it a goal in your home to speak only out of kindness. If you do that, name-calling won’t even be a consideration. And when you lose control… Apologize. Immediately. And ask for forgiveness. Reconfirm how much you love your partner. Resolve to work together to improve your communication, and then get specific with each other about how you’re going to accomplish that. If you can’t do it on your own, reach out for some couples counseling. You know what you need to do to keep control. Choose your words carefully with the goal of maintaining harmony. Listen to each other. Agree to treat each other with love and respect. You’re a team, right?

Mental health editor, GARY MCCLAIN, PH.D., is a therapist, patient advocate, and author in New York. He specializes in working with those diagnosed with chronic and catastrophic medical conditions. (JustGotDiagnosed.com) H IVPLUS MAG .CO M

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FIGHT OFF WINTER SADNESS

EMOTIONALLY, THIS SEASON COULD BE YOUR HARDEST. HERE’S HOW TO TAKE ACTION AGAINST SEASONAL AFFECTIVE DISORDER AND THE REGULAR OLD DOLDRUMS. WINTER IS UPON us. So if you’re in a cold climate like I am, you may be feeling the double whammy of the first blasts of cold weather along with the greatly reduced hours of sunlight. If you are in a warmer climate, you are at least feeling the impact of darkness that starts earlier. Winter can affect us physically and emotionally, and not in a good way. Of course, yet another pandemic wave has made winter even more foreboding this year. Since I am a mental health professional, I especially want to focus on the ways in which winter can affect us emotionally. When it’s nasty out, it can just feel a whole lot easier to stay indoors, to basically hunker down and hope it all ends soon. Winter will end, but in the meantime, you risk falling into isolation, which can result in loneliness and contribute to feelings of depression. Depending on the guidelines where you live, a certain level of isolation may be mandated. Ideally, the best way to cope with winter is by preparing yourself for the months ahead and maintaining your coping and self-care skills. Skills that you may have been fine-tuning during the pandemic. So my advice, in a word: Winterize! Here’s how. 46

Watch what you eat. I’m not a dietitian. But I can personally endorse, as can my clients, the value of a balanced diet during the winter months. Include lots of vegetables and fruit while also limiting consumption of the foods heavy in carbs, fat, and sugar that our bodies crave at this time of year. Healthy eating can be a real energy booster! And a booster to your self-esteem when you are not feeling your waistline in expansion. Keep moving. I’m also not an exercise physiologist, but based on my own experience and that of my clients, I can also vouch for the value of staying active during the winter months. And if you are working at home, it’s especially important to build in exercise where you can. Choose activities that are realistic for you, that you and your doctor agree on, and that keep you moving. Stay grateful. Gratefulness is a proven way to pick up your attitude and help you maintain optimism. Consider starting out the day grateful for something. Is the heat working? There’s a start. Or the sun creeping up as you get going with work? Someone in your life who makes you happy? You might find it helpful to maintain a gratefulness journal or recording what you are grateful for each day. Build in creature comforts. Little things can help keep you grounded on a dreary day. Warm coffee, a healthy snack. An occasional spa treatment or massage. Doing little things to pamper yourself can go a long way toward keeping your mood up and keeping you feeling like yourself during the long winter months. Pay attention to your stress level. As I discussed earlier, the impact of the winter can leave you feeling less in control, less capable of making good decisions. Consequently, you are more prone to stress. Do some selfmonitoring of your stress level. If you feel like it is creeping up, pay careful attention to the other suggestions. Don’t isolate. Any more than you have to, that is. It’s only human to want to stay inside when it’s late afternoon and already pitch-black outside or, depending on where you live, freezing cold, windy, and snowy. With this pandemic, you may have no choice but to be spending a lot of time at home. But days when you’re feeling like crawling into your cave are also the days when it could be best for your emotional wellness to be in contact with people or nature. The presence of other people can be validating and energizing. If you can meet in person safely, do so. Otherwise call, Skype, or Zoom. Just get together. Have something to look forward to. It’s easy to fall into thinking of the dark winter months as one interminable slog. You can turn that attitude around by making plans. The point here is that looking forward to something

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helps you to keep your spirits up, to remind yourself that there is more to life than the limitations forced on you by the weather or shorter days of sunlight. Reach out to someone in need. Be a good friend. Be a support. Many people are struggling with loneliness during this pandemic, and it may only be more difficult during the winter. If you have a friend or family member who you know is having an especially difficult time coping during the winter months, reach out and lend a listening ear. You might find yourself on their gratefulness list.

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Get some sunlight. As you are probably already aware, the sun is an important source of vitamin D. And it’s sure been my experience, as it has probably been yours, that getting out in the sun can pick up your mood. Consider taking a short walk at lunchtime, especially if you have to be at home all day. Get your walks in even if it requires bundling up. Watch for seasonal patterns in your moods. Having a rough time of it this winter? Have you had difficulty in past winters? Does all that darkness get you feeling down? You may have a condition called seasonal affective disorder (SAD), which many people suffer from during the winter months when exposure to sunlight is minimal. Winter symptoms include fatigue, weight gain, trouble concentrating, and a desire to isolate, among others. If you are concerned you may have SAD, it’s time to reach out to your physician or a mental health professional. Some people with SAD have benefited from counseling, medication, and/or light therapy.— G A RY M CC L A I N H IVPLUS MAG .CO M

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B A C K TA L K BY C H R I S TO P H E R Z Y DA

IN THE EYE OF THE STORM

I N 1 9 8 5 , W H E N it came to ostracism Los Angeles wasn’t really all that different from Kokomo. Much of humanity missed the opportunity to do the right thing in the face of the AIDS epidemic. Many of our friends, upon their AIDS diagnoses, simply chose to ostracize themselves and disappear from public out of shame. We would only see them again in hospitals or, all too often, never hear from or about them again — until their obituary appeared on the Athletic Club’s gym bulletin board or in Frontiers, West Hollywood’s gay community news magazine, or maybe never again at all. I became obsessed with searching for and reading obituaries, an obsession that continues to this day. Beginning in 1985, our friends started to leave Los Angeles to scatter everywhere because of the virus. This particularly pained me since it went against my craving for complete order in my life. I couldn’t keep track of where people went. Was he dead? Was he dying in a hospital somewhere? Did he move back to his hometown to be with family? Did he go on disability and move to Palm Springs to die alone in a $10,000 condominium? Did he go back into the closet? Did he go into hiding to ride out the storm? The answer was “all of the above.” As people scattered because of AIDS, so did my life. There could be no order when life itself could not be counted on. I aged much more than a year in 1985. I was only twenty-three years old. 48

That year, I started to spend evenings and weekends visiting friends in hospitals: Sherman Oaks Hospital, UCLA Medical Center, CedarsSinai Hospital, Century City Hospital, and Midway Hospital. I came to know them all, their convoluted hallways, AIDS wards, cafeterias and vending machines, pay telephone booths, and waiting rooms. Try to imagine the insanity of visiting one friend in the hospital, and then discovering that one or more other friends were hospitalized there too, fighting the same illness. I remember seeing worried, grieving partners and friends, sitting stone-faced in hospital waiting rooms alongside me, all of us trying to comprehend the reality of our reality: what do we do now? The AIDS virus has turned the whole world against us. The number of funerals and memorial services that I attended beginning in 1985 eventually made me numb. I stopped crying at them because I had nothing left inside. My AIDS grief was a constant process, like watching a repeating slow-motion film unfolding right in front of me over and over, and knowing how the film ended: always in death. In 1985, AIDS treatments only delayed the inevitable, because at that time the treatments were worthless. The sun was gone, dark clouds now blanketed the sky, and rain started falling all around me. Welcome, Chris, to the storm. Excerpted from The Storm: One Voice from the AIDS Generation by Christopher Zyda (Rare Bird Books, released December 8, 2020).

CHRISTOPHER ZYDA is an author, veterans advocate, and the CEO of Mozaic-LLC, an independently owned wealth management firm. @cjzyda

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In his new memoir, The Storm: One Voice from the AIDS Generation, Christopher Zyda recounts the terrifying early days of AIDS. In the following excerpt, Zyda describes a haunted Los Angeles of the mid1980s and tells a story that feels remarkably familiar 35 years later.

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BIG FREEDIA DOMINIQUE JACKSON SANDRA VALLS

HOUSE BALL

ADRIENNE MAREE BROWN

DAY LONG INSTITUTES WORKSHOPS

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Streaming Online | creatingchange.org

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TWO WAYS TREATMENT CAN HELP STOP HIV.

Starting HIV treatment as soon as possible and sticking with it every day helps you get to and stay undetectable. That means there is so little virus in the blood that a test can’t measure it. And that’s a good thing, because:

BEING UNDETECTABLE HELPS STOP THE DAMAGE HIV CAUSES.

CURRENT RESEARCH SHOWS GETTING TO AND STAYING UNDETECTABLE PREVENTS THE SPREAD OF HIV THROUGH SEX.

There’s no cure for HIV, but if you stick with treatment, you can protect yourself and the people you care about. Talk to a healthcare provider and watch It’s Called Treatment as Prevention at YouTube.com/HelpStopTheVirus

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