POZ October / November 2012 by Smart + Strong

A SMART+STRONG PUBLICATION OCTOBER/NOVEMBER 2012 POZ.COM $3.99

H E A L T H ,

L I F E

Sweet Charity

H I V

Fighting HIV/AIDS on Broadway and beyond

The cast of Chicago at the 23rd annual Gypsy of the Year competition

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SHE’S BACK

After a year off, our Anonymous blogger shares the rejection in her love life and the support from her peers in her journey as someone newly diagnosed with HIV. To read her posts, go to blogs.poz.com/anonymous.

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Broadway Cares/ Equity Fights AIDS helps fund harm reduction programs for Prevention Point Philadelphia.

32 THE SHOW MUST GO ON The funds raised by Broadway Cares/Equity Fights AIDS support nearly 400 HIV and family service programs nationwide, as well as AIDS research and advocacy. Their performance is deﬁnitely more than showbiz as usual. BY TRENTON STRAUBE 38 A CAPITAL AFFAIR Science suggests that it’s possible for us to start to end AIDS. This July, the XIX International AIDS Conference gathered nearly 24,000 members of the global HIV/AIDS community to discuss whether we can make that possibility a reality. BY REGAN HOFMANN 8 FROM THE EDITOR

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Trench Warfare

9 FEEDBACK

Your letters and comments

10 POZ Q+A

Lambda Legal’s Scott A. Schoettes talks about HIV criminalization in U.S. courts.

15 WHAT YOU NEED TO KNOW

26 WE HEAR YOU

Readers weigh in on a recent case of medical discrimination

28 TREATMENT NEWS

Detecting the link between HIV and brain drain • a new program connects released prisoners to care • the new booster in town • improving HIV testing in the Bronx • how the war on drugs is driving the HIV pandemic

Jamar Rogers releases his debut single • a former Olympic trampolinist publicly discloses his HIV status • spam filters may offer clues to ending HIV • infant circumcision is a global debate • why people with HIV should be offered transplants

30 WHAT MATTERS TO YOU

25 POZ SURVEY SAYS

Kathleen Adams educates and empowers women through hip-hop.

Participating in clinical trials

Finding an HIV vaccine

31 COMFORT ZONE Keeping a journal

44 POZ HEROES

POZ (ISSN 1075-5705) is published monthly except for the January/February, April/May, July/August and October/November issues ($19.97 for a 8-issue subscription) by Smart + Strong, 462 Seventh Ave., 19th Floor, New York, NY 10018-7424. Periodicals postage paid at New York, NY, and additional mailing offices. Issue No. 183. POSTMASTER: Send address changes to POZ, PO Box 8788, Virginia Beach, VA 23450-4884. Copyright © 2012 CDM Publishing, LLC. All rights reserved. No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise without the written permission of the publisher. Smart + Strong® is a registered trademark of CDM Publishing, LLC.

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POZ ARMY

FROM THE EDITOR

Trench Warfare

HE KEY MESSAGE I HOPED TO HEAR AT THE XIX INTERnational AIDS Conference in Washington, DC, did in fact ring through loud and clear: Since we can begin to end AIDS, we must do so. Almost every key speaker referenced the possibility of an AIDS-free generation or the end of AIDS. The devil, of course, is in the details of how we implement the tools and knowledge in our possession to make what’s possible a reality. Ending AIDS won’t be easy or cheap, and it won’t happen overnight. Some criticized the convention’s optimistic rhetoric and asked exactly how we would better battle the beast of AIDS. They are right to highlight the challenges and call for specific blueprints. But the importance of so many leaders collectively acknowledging that AIDS can be ended while pledging to do their part should not be minimized. You can’t win a war you’re currently losing unless you shift the battle plan, nor can you attain victory without the buy-in of leadership. There is a scene in one of my favorite movies, Gallipoli, in which a runner in the trenches of WWI has to carry orders to a general to change the battle plan. The order will save his friend who is fighting on the front lines. The runner was a champion sprinter before the war, and as he prepares to dash through the battlefield, he recalls the exchange he and his coach would have before each race. Coach: “What are your legs?” Runner: “Steel springs.” Coach: “What are they gonna do?” Runner: “Hurl me down the track.” Coach: “How fast are you going to run?” Runner: “As fast as a leopard.” Coach: “Then let’s see you do it.” Tapping all his talent, the runner races to get the orders to the general, hurdling through muddy trenches, weaving through showers of bullets. He delivers the orders, but not before his friend is shot. However, because the runner reached the general, the battle shifts and many lives are spared. There’s a lesson in that scene we should apply to fighting HIV/AIDS. A new battle plan must be delivered as quickly as possible, because the way we’ve been fighting this war isn’t working. And the faster we can implement changes based on the empirical evidence we now have about what works, the faster we will spare more lives. At the end of the conference, I went to the White House reception hosted by President Obama. It was reassuring to hear his commitment to ending the suffering caused by HIV. That said, his inspiring words mean little unless budgets and policies and health care reform are implemented in ways that enable us to better address the problem. (You can help by voting for Obama on November 6.) Every now and then, I have doubts about whether AIDS will ever end. Such a thought flowed through my head at the White House, but then Patricia Nalls of the Women’s Collective walked up and placed a scarf around my neck. It said, simply, “We can end AIDS.” I burst into tears because I knew she was right. We can do it if each of us continues to find the courage and energy to keep running through the trenches as fast as we can, and if we prop up others when their belief falters. Only history will answer whether or not AIDS actually ends. But when we feel like letting up, we should propel ourselves onward with the knowledge that the harder and faster we run, the more lives we will protect.

REGAN HOFMANN EDITOR-IN-CHIEF JENNIFER MORTON MANAGING EDITOR ORIOL R. GUTIERREZ JR. DEPUTY EDITOR KATE FERGUSON, LAURA WHITEHORN SENIOR EDITORS CRISTINA GONZÁLEZ ASSOCIATE EDITOR TRENTON STRAUBE COPY EDITOR KENNY MILES RESEARCHER ERIC MINTON ASSISTANT ONLINE EDITOR LAUREN TUCK, REED VREELAND EDITORIAL ASSISTANTS

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8 POZ OCTOBER/NOVEMBER 2012 poz.com

SUBSCRIPTIONS

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FEEDBACK SOUTHERN HOSPITALITY In the article “Rolling in the Deep” (July/August 2012), POZ interviewed ﬁlmmaker Lisa Biagiotti about her documentary Deep South. The ﬁlm sheds light on why the region has not overcome its struggle to break free of AIDS.

HOT ON THE TRAIL In “The Cure Hunter” (July/ August 2012), Françoise Barré-Sinoussi (who along with Luc Montagnier discovered HIV in 1983) shared her thoughts on the possibility of a cure for AIDS and what it will take to make it a reality. Françoise Barré-Sinoussi’s last remark was on the need for innovation, multidisciplinary collaboration and funding. It’s not only about having more money. [The need for] young medical researchers at universities to collaborate with city public health centers, the Centers for Disease Control and Prevention and technology corporations is paramount for a cure. Please write your congressmen and educate them on the formula, not just the money. ROGER PATTERSON, MO

The United States government is spending billions of dollars building infrastructures in Afghanistan (schools, roads, bridges) that aren’t even being used. Why can’t the United States set aside $1 billion annually for cure research! STEVE LOCATION WITHHELD

Have an opinion about this month’s POZ? Comment on a specific story on poz.com, post a general comment via poz.com/talktous, or send a letter to POZ, 462 Seventh Ave., Floor 19, New York, NY 10018.

I realize it’s premature, but exciting just the same. DON ASHEVILLE, NC

This is one of the best articles I’ve read about living in the South with HIV. [I am] an Alabama native [living] with HIV, and this article again brought to light the dichotomy of loving and hating where I’m from.

It’s too soon to use the word “cure” for these two patients who are still on [antiretroviral therapy]. There was much more caution in the case of Timothy Brown. Encouraging and interesting—but not a cure…yet. Others who have had stem cell transplants in the past have not been cured, so we need to wait for the rest of the evidence. As usual, the doctors are more cautious than (most) media.

MCOGUY ORLANDO

MELANIE THOMPSON ATLANTA

I lived in the South most of my life and grew up with a lot of loving Southerners. The lack of [access] to education, healing or reconciliation for the poor is heartbreaking.

Lord I just pray for a second chance at having an HIV-free life. This virus is nothing less than a monster that needs to be destroyed.

FREDERICK WRIGHT COACHELLA VALLEY, CA

JUMPING THE GUN In the online article “New Stem Cell Transplant Cases Encouraging, but Cure Buzz May Be Premature,” Tim Horn explained why—despite recent media headlines—it’s too early to use the word “cure” when discussing a presentation by Boston researchers at the XIX International AIDS Conference that focused on two patients living with HIV who underwent bone marrow transplants. This is exciting news. I hope more becomes of this method. Just imagine the ramiﬁcations if it proved to be a successful way to rid the body of the virus!

JAY LOCATION WITHHELD

A POSITIVE HERO In the POZ Staff Blog “Greg Louganis Makes a Splash at London Olympics” (August 3, 2012), Lauren Tuck wrote about the Olympic legend’s appearance on CNN where he discussed the sport of diving, life with HIV and the recent Chick-ﬁl-A controversy. Greg Louganis is an extraordinary human being. Anyone who views his (infamous) dive in Seoul would be impressed at his courage and sheer determination. Knowing the personal drama he was going through at the time makes it all the more powerful. In 1988, being out was not cool, especially if you’re a sports hero;

disclosing his HIV status at that time would have been a professional death knell. I have no problem with him reminding everyone that having HIV is no picnic. To the throngs of kids out there who don’t even know who he is, that’s an important point to include. Thankfully, he’s healthy and can share his wisdom and leadership. WILLIAM COOKE NEW YORK CITY

Greg is one of those few heroes that continue to inspire millions—gay or straight. To be a world-class athlete of his caliber and have the cojones to come out to a world full of bigotry and closed-mindedness to say that one was HIV positive as well as gay during a time when it wasn’t as easily accepted is a great accomplishment by itself! Kudos to this great human being. G FORCE LOCATION WITHHELD

I have always admired and followed Greg. He’s my heroic mentor in deportment, character, humor, health, advocacy and character quality. If we had an AIDS Wish Foundation I would totally love [to spend] a day at the beach and have lunch with Greg Louganis. It would be the greatest single dream of my life. I’m so blessed to have followed his career, his happiness and recovery from trauma, and his ability to thrive with dignity. He inspired me to light up my own star and dazzle. I will be ever grateful. SABAZIUS VANCOUVER, CANADA

poz.com OCTOBER/NOVEMBER 2012 POZ 9

THE POZ Q+A

BY REED VREELAND

Plunkett was released from the Sing Sing Correctional Facility this summer. Here, Schoettes discusses the implications of the Plunkett case and offers his perspective on HIV criminal prosecutions. Why was the Plunkett case classified as an HIV-criminalization prosecution?

Full-Court Press

Scott A. Schoettes of Lambda Legal outlines the battle being waged in U.S. courts over HIV criminalization.

COTT A. SCHOETTES IS THE HIV PROJECT DIRECTOR FOR Lambda Legal, a longtime legal champion of HIV-positive people and LGBT civil rights. He filed a brief in The People of the State of New York v. David Plunkett, an HIV criminalization case heard by the New York Court of Appeals, the highest court in the state. HIV-positive David Plunkett was charged in 2006 with aggravated assault on a police officer—a felony premised on the use of a “dangerous instrument”—when he bit a policeman who was arresting him. Plunkett pleaded guilty to all charges but then appealed. The high court agreed with Schoettes that neither the human body nor its constituent parts or products can be considered a dangerous instrument. They dismissed the aggravated assault charge against Plunkett on the grounds that saliva is part of the human body and could not be used to heighten Plunkett’s criminal liability.

10 POZ OCTOBER/NOVEMBER 2012 poz.com

How will this impact other states?

It’s not binding in any other state because each state has its own criminal laws that are interpreted by its own high court. To my knowledge, it is the first case that makes it so clear that a bodily substance, like saliva or blood [or semen, etc.], should not be considered a dangerous instrument under the law. And the rationale behind that is important, too—a person’s behavior should not be made criminal simply because they have a condition. There should be something else required, like an intent to actually

COURTESY OF SCOTT A. SCHOETTES

Schoettes successfully argued that the saliva of a person living with HIV is not a dangerous instrument.

There are two ways that prosecutions are brought against people living with HIV based on their HIV status. One of them is through general criminal laws, and that’s what we had in the Plunkett case. The other way is through HIVspecific criminal law. Since New York State does not have any HIV-specific criminal laws, when [HIV criminalization] prosecutions are brought up, they’re brought under generally applicable criminal laws, like the aggravated assault law. For example, you could charge someone with aggravated assault for various reasons, if someone is using any kind of dangerous instrument [such as a baseball bat or a crowbar]. What makes it an HIV criminalization case is when the so-called “dangerous instrument” is the person’s HIV. [Based on the high court ruling,] no longer will prosecutions be able to be brought against people living with HIV under this statute because they bit someone, or because they spit at someone. Even if there was blood in their mouth during either of those instances, whether it was a biting situation or a spitting situation, it would not be possible to bring a prosecution because, in my reading of this decision, it applies to blood as well as to saliva.

transmit that condition. So this decision could potentially influence the decision [of other state courts if they are] looking to interpret the [assault with a dangerous instrument or deadly weapon] statute in their state. How do HIV-specific criminal laws work?

Some states have laws that specifically call out HIV and make it a crime to expose or potentially expose another person to HIV. A lot of these [HIV-specific] laws were passed prior to the introduction of [modern antiretroviral therapy, as well as pre-exposure prophylaxis, or PrEP, and post-exposure prophylaxis, or PEP,] and a lot of them came into existence when there was a mandate from the federal government attached to Ryan White funding. To get Ryan White funding [for HIV-related services] the state had to have a way of addressing the intentional transmission of HIV. Unfortunately, a lot of states took that to mean that they had to have an HIV-specific law. That was not the case, obviously, because not all states decided to create an HIVspecific law. The other piece is that the “intentional” piece kind of fell away. So a lot of the statutes that now exist are not addressing the intentional transmission of HIV. They oftentimes don’t address transmission at all. Could an HIV criminalization case be brought to the U.S. Supreme Court?

This is one of our challenges, because this issue does not lend itself to resolution at the U.S. Supreme Court. A case involving HIV criminalization would end up in the Supreme Court if we were trying to have a law declared unconstitutional. That would be a challenging thing to accomplish. It’s hard to believe that bad medical information—such as stating that saliva is infected with and can transmit the “AIDS virus”—could be rendered in a court’s decision in New York State in 2009. Do other HIV criminalization prosecutions fail to understand the basic facts about HIV? There is a lot of misinformation out there. It’s hard to know how many of the prosecutions across the country are being based on erroneous information.

Do you think HIV criminalization discourages people from getting tested?

Yes. It’s important to realize that if we stigmatize the condition in the way that we do, that we are actually discouraging people from testing. Right now, under a lot of the HIV-specific laws, you cannot be convicted unless you know that you are HIV positive. [This establishes] an incentive for people who think that they might be HIV positive but want to remain sexually active [to not find out their HIV status]. If they don’t want to be limited by the condition or don’t want to risk being sent to prison for a long period of time, oftentimes people simply do not get tested. [HIV-specific criminal laws are not] protecting public health. Have you thought about an alternative legal framework?

If it’s just reckless conduct that we are

misdemeanor for the first time that this happens. Maybe there should [be mandatory counseling and] not any actual criminal sentence in terms of incarceration for that act. Perhaps, if there’s a second time, then maybe there’s a different level. We have other systems in which we use tiers of punishment depending on both the intent and the consequences. Drunk driving is one that comes to mind in terms of what we do when someone is engaged with what we consider reckless conduct by getting behind the wheel of a car while intoxicated. We don’t send them to 25 years in jail the first time that we catch them doing that. We need a system that more appropriately tailors any punishment—if there’s going to be criminal punishment—to the actual culpability of the conduct in question.

“Ignorance is no defense. People with HIV need to be aware of these laws.” trying to address and prevent, then we should have a system that is tailored to that kind of act, and the punishment for that reckless conduct should fit both the recklessness of the conduct and the real consequences. The way the system is set up right now, we actually punish the person who has no intent to harm anyone the same as we punish someone who may be out there intentionally trying to spread HIV. It would make sense to me that if we were going to have a system for addressing unprotected sex without disclosure, that it should apply not only to HIV but to other conditions that could have similar consequences—HPV [human papillomavirus] is one that comes to mind. So it shouldn’t be HIV-specific. Also, the punishment should fit the crime, and if there’s no proof that there was any intent to harm anyone, well, then maybe we should be looking at a

How does HIV criminalization affect the average person living with HIV?

Ignorance is no defense. There are a lot of these laws in a lot of states, and I know a lot of HIV-positive people who are completely unaware of them. People with HIV need to be aware of these laws. They need to help us advocate for change in these laws so that we don’t end up with people serving 25-year sentences for engaging in safe sex with another consenting adult. We are looking to change the laws so that a person living with HIV doesn’t end up on the opposite side of a prosecution that they had no idea could ever be brought against them. We’re not going to get it all done in one fell swoop. But we’ve got to start somewhere, and [the Plunkett decision] is an important step along that journey to dismantling these unjust laws that have been targeting people with HIV for many years. ■

poz.com OCTOBER/NOVEMBER 2012 POZ 11

WHAT YOU NEED TO KNOW

BY TRENTON STRAUBE

Australian trampolinist Ji Wallace

(ROGERS) GETTY IMAGES/NBC/MITCHELL HAASETH; (WALLACE) GETTY IMAGES/DOUG PENSINGER

Olympic Winner Tells the World He’s Positive

The Voice contestant releases a debut single.

Jamar Rogers’s Voice Will Go On

We haven’t heard the last of Jamar Rogers, the HIV-positive former meth addict who captured America’s hearts and ears on The Voice. The singer didn’t make it to the reality show’s finals, but lucky for us he has made it to the recording studio (and he’s also been doing duty as a general in the POZ Army). This summer, Rogers dropped his debut single, “Where Would I Be Without You,” on iTunes—it’s a thank you to his fans, and to friends who helped him through rough days—and a second release is slated for fall. Rogers, who recently moved to Los Angeles from the Bronx, New York, is collaborating with Shiny Toy Guns and producer Mario Marchetti. He described his sound to JasonTheGleek.com as “Sam Cooke meets MGMT and Skrillex—electronic beats but with soulful melodies.” Sounds like a favorite to top our playlists this fall.

The summer Olympics inspired awe among billions. For gay Australian Olympian Ji Wallace, they inspired a public disclosure that he has HIV. After watching an interview with Olympic icon Greg Louganis, who spoke about his own life with HIV, Wallace penned a letter to the Australian Star Observer. “I, too, am an Olympic medal winner living with HIV,” Wallace wrote, adding that another influence was CNN’s Anderson Cooper, whose recent coming out letter described “value in being seen and heard” in the face of discrimination and bullying. Wallace, a trampolinist who won a Silver in 2000, says he has the support of his boyfriend and family but realizes that many people with HIV aren’t so lucky. “I am doing this to raise awareness,” he wrote. “It is still here.” The International Olympic Committee played a winning game too. It gave out 100,000 condoms to the 12,000 athletes at the London Games and created a toolkit to help coaches share HIV info (the committee also urged positive athletes to disclose as a way to fight stigma). The kits inspired more than 10 countries to adopt versions for their own Olympic committees. For that, they deserve a Gold Medal.

poz.com OCTOBER/NOVEMBER 2012 POZ 15

Educating, Inspiring and Empowering the HIV/AIDS Community Since 1994

poz.com An ofďŹ cial media partner of the XIX International AIDS Conference (AIDS 2012)

WHAT YOU NEED TO KNOW

BY TRENTON STRAUBE

Pesky Email Spam Offers Clues for Eradicating HIV

David Heckerman, the guy who invented Microsoft’s email spam filter, is now fighting another type of invader: HIV. The two are similar in that they constantly mutate, explains Heckerman, a scientist with Microsoft Research who is collaborating with the Ragon Institute. To create strong spam filters, scientists must crunch enormous amounts of data about spam. Similarly, researchers are cataloguing huge databases of HIV, looking for fragments where the virus is vulnerable to attack. They’ve narrowed it down to about 20 areas, and that’s where scientists like Ragon’s Marcus Altfeld begin their work in the lab, hoping to one day delete HIV like so much annoying email.

Infant Circumcision Grows to Global Debate

The health benefits of circumcising baby boys outweigh the risks, the American Academy of Pediatrics says in an updated policy statement. But it stopped short of recommending the procedure, which can lower the risk of HIV and other sexually transmitted infections. The topic continues to make headlines: ● In Germany, a court ruled that circumcising a child amounts to

bodily harm. The ruling applied to one specific case, but it put Jewish and Muslim leaders on the defensive.

● In San Francisco, anti-circumcision advocates (or “intactivists” as

in “having intact genitalia”) gathered enough signatures to put a child circumcision ban on the ballot. A judge nixed it, saying that regulating medical procedures is a matter for the state, not cities.

In the United States, circumcision rates for male newborns have plummeted from 79 percent in the 1980s to 55 percent in 2010 (partially because more health insurers, including some Medicaid programs, no longer cover the cost). This alarms Johns Hopkins researchers who estimate that if rates drop to 10 percent—similar to Europe—health care costs will climb $4 billion and we’ll see a 12 percent increase in HIV among men.

(BANANA) ISTOCKPHOTO.COM/STUART PITKIN; (RANKL) COURTESY OF ABC

●

Circumcision Capiton can lower goes in HIV thisrisk. space.

Veteran John Rankl gets a new heart.

Why Folks With HIV Can Be Excellent Transplant Recipients Gulf War veteran John Rankl is a true American hero. He served his country not only in the military, but also on prime-time television. Appearing on a July episode of the ABC medical documentary series NY Med, Rankl inspired and educated millions by sharing that he was openly gay, HIV positive and in dire need of a heart transplant. The episode opens at the New York-Presbyterian Hospital, one of the nation’s few programs, we are told, that offer transplants to positive people. When we meet Rankl, a doc says that if he doesn’t have a transplant soon, he’s going to die. Luckily, a donor heart becomes available. Rankl is prepped for surgery, but a mishaps occurs: The organ is damaged, and the operation is cancelled. Rankl changes to Harvard Hospital, where Jonathan Hammond, MD, says that Rankl will be the transplant center’s first HIV-positive patient. “It’s going to take a while for everyone to adjust to the concept,” the surgeon says, because the misperception is that people with HIV are going to die, so why transplant them instead of a negative person. “Actually,” Hammond explains, “[Rankl] is perhaps a better transplant candidate than people who haven’t shown that they have the discipline [needed] to survive with a heart transplant.” Studies—particularly of liver and kidney transplants—are also proving that HIV-positive recipients can do as well as their negative counterparts. Good news because people with HIV are living longer—and are in greater need of transplants. (Federal law forbids people with HIV from donating organs—even to other positive people.) The NY Med episode closes nearly four months after the transplant, as the Rankl family celebrate his new start. “Even my doctor is amazed at how well I’m doing,” he says. “It’s great to be alive.”

poz.com OCTOBER/NOVEMBER 2012 POZ 21

THE POZ SURVEY SAYS Taking Risks to Help Others

All HIV-positive people alive today because of their meds owe a bit of gratitude to yesterday’s clinical trial volunteers. Since HIV was ﬁrst discovered, thousands of people have participated in scientiﬁc research studies that have led to the development of more and more easily tolerated treatments for HIV. As a result, we have nearly two dozen antiretroviral HIV drugs that help sustain lives and slow the spread of the virus. The next era of HIV research is focused on biomedical prevention (think PrEP, pre-exposure prophylaxis), vaccines and the cure. We asked whether you’ve ever participated in a trial—and if so, what it was like— and whether you’re ready to be part of the next generation of healers. Here are your answers.

BY CRISTINA GONZÁLEZ

HAVE YOU EVER PARTICIPATED IN A CLINICAL TRIAL?

% 39 YES

61NO%

THE NO. 1 BENEFIT OF JOINING A TRIAL OR STUDY IS:

IT MAY BE HELPFUL FOR PEOPLE LIVING WITH HIV, BOTH NOW AND IN THE FUTURE. HOW WOULD YOU RATE YOUR OVERALL EXPERIENCE IN THE TRIAL(S) YOU’VE PARTICIPATED IN?

72% 24%

VERY POSITIVE SOMEWHAT POSITIVE

2% SOMEWHAT NEGATIVE 2%

VERY NEGATIVE

5 3

TOP 5 REASONS FOR NOT PARTICIPATING IN A CLINICAL TRIAL:

1. Didn’t know where to find the information 2. Health care provider never mentioned clinical trials to me 3. Trials were too far from my home 4. Was told I didn’t qualify 5. They didn’t offer any or enough money for participating

Source: December 2011 POZ Survey

TOP 3 THINGS THAT WOULD BE HELPFUL IF YOU WERE TO JOIN OR REJOIN A TRIAL OR STUDY: 1. Money for your time 2. Ability to connect with other people in the trial or study 3. Access to a case manager or social worker at the study site

Every couple of years

WOULD YOU CONSIDER JOINING (OR REJOINING) AN EXPERIMENTAL CLINICAL TRIAL IN THE FUTURE?

% 76 YES

21 MAYBE

3NO%

WOULD YOU CONSIDER JOINING A CLINICAL TRIAL TESTING A POSSIBLE CURE FOR HIV, EVEN IF YOU WOULDN’T BENEFIT AND THERE WERE RISKS OF SIDE EFFECTS?

62% YES

% 31 MAYBE

7NO%

poz.com OCTOBER/NOVEMBER 2012 POZ 25

WE HEAR YOU Dr. No

BY REED VREELAND

A case of HIV discrimination by a medical practitioner made national headlines recently when a New Jersey man living with HIV sued a Catholic teaching hospital, Trinitas Regional Medical Center, for allegedly denying him access to treatment and visitors after he disclosed that he was gay and HIV positive. He also alleges he was denied a prescription for his HIV medication. Regardless of the ruling on the case, when health care providers refuse to serve an HIV-positive person it reinforces HIV-related stigma (in itself a barrier to care) and violates his or her right to access health care protected by the Americans with Disabilities Act. Despite the overwhelming amount of information indicating that it is safe for physicians to treat people with HIV and to allow them to have visitors, HIV discrimination among medical personnel still occurs—frequently. A 2007 study conducted by the Williams Institute on Sexual Orientation, Law and Public Policy showed that 56 percent of Los Angeles County skilled nursing facilities denied HIV-positive patients care for services commonly offered to HIV-negative patients. Additional studies confirm relatively high levels of HIV-related discrimination in U.S. medical settings. Often, these cases are linked to other forms of prejudice, including homophobia, racism and discrimination based on education level, socioeconomic status or history of drug use. Here’s what you had to say about the issue. About eight years ago a Catholic hospital in Dallas told me they did not carry HIV medications. This was after I had my gall bladder removed. They kept me a week and monitored my condition [since I am also] a diabetic. I could get no help. I was told [withholding medication] was common to see how a person healed after surgery. Hogwash! —Marty McCormack, Dallas

I can’t believe people think they can get away with things like this. Religious hospitals aren’t any better [or different] than any other hospital. They have no right to deny someone their required medication. You don’t see them telling diabetes patients they can’t have insulin, or heart patients they can’t have their blood pressure meds. —John, AL The moral of this story is that if you know you are going to be hospitalized, BYOM [Bring Your Own Medication]. Last year when I had my gall bladder removed, I brought my own meds. Having said that, there is no excuse for bad behavior by doctors, nurses and hospital administrators. I hope this guy gets his day in court. —Name withheld, Puerto Rico

ISTOCKPHOTO.COM/HAVESEEN CREDIT

This is so reminiscent of what went on during the early years of the epidemic. Where have these people been for the past 25 years? It’s a disgrace to the health field. —Michael, Long Island, NY

I am so sorry for this to happen to this man. I was first diagnosed in December 2005, and I was at a very religious hospital. I was told that I have AIDS and meningitis and that I would be dead in five days. No one returned except [the person who came] to sign me out with a referral. —Rick, CA

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TREATMENT NEWS

BY LAURA WHITEHORN

Useful info on heart health

Detecting the Missing Link Between HIV and Brain Drain

Researchers at Georgetown University Medical Center have released data that HIV interferes with a protein that supports brain function. The news provides an important piece to the puzzle of why, even when the virus is successfully suppressed by HIV meds, some positive people still suffer a loss of cognitive function. “This finding is extremely important,” says Georgetown’s Italo Mocchetti, PhD, “because it suggests a new avenue to understand, and treat, a fairly widespread cause of dementia.” The researchers, led by Mocchetti, found that gp120, an HIV fragment, disrupts the maturing of a protein called BDNF that protects neurons in the brain. In its immature state, the protein is toxic, possibly causing psychological and cognitive problems such as depression and loss of memory and motor function. For HIV-positive people concerned about brain health, the research holds hope: Mocchetti believes certain drugs—made of molecules small enough to penetrate the blood-brain barrier—might block immature BDNF from doing its damage. The theory will be tested in mice, with the first stage expected to take about two years. “Then [if the concept proves viable],” Mocchetti adds, “we will use these mice to test small molecules.”

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For the estimated 2 percent of prisoners in this country who are living with HIV/AIDS, release from prison brings challenges—finding housing and employment, reconnecting with family—that can make it difficult to maintain HIV treatment and care. Care providers at Miriam Hospital and the Center for Prisoner Health and Human Rights in Providence, Rhode Island, have created a tool that may help. Brian Montague, MD, reports that the team created a system that coordinates data from the Ryan White program (clinic visits and other health indicators) with correctional records to track whether released prisoners are getting care. That link had not previously been made, Montague says, adding, “The hope is that the program will help develop interventions for specific individuals,” allowing providers to spot problems, offer aid and identify the best ways to help people released from prison get and stay healthy.

A new system Senator connects Bernie released Sanders prisoners with(I-Vt.) care.

(ILLUSTRATION) ISTOCKPHOTO.COM/EDUARD KACHAN; (HANDCUFFED MAN) GETTY IMAGES/CHRIS RYAN

Point of Reentry: Getting Prisoners HIV Care

(BRONX KNOWS POSTER) COURTESY OF BRONX KNOWS; (DRUGS AND PARAPHERNALIA) ISTOCKPHOTO,COM/MARK WRAGG

New Booster in Town: Cobicistat Cobicistat, a new pharmacokinetic (PK) enhancer from Gilead Sciences, is set to unseat Abbott’s Norvir (ritonavir) as the only approved HIV treatment booster. It’s key in the newly approved Stribild tablet (a.k.a. the Quad). It will also be sold as a stand-alone drug for use with other HIV meds, along with plans to combine it in tablets with Prezista (darunavir) and Reyataz (atazanavir). PK enhancers slow the rate at which certain HIV drugs are metabolized in the liver by enzymes. This helps boost the blood levels of the medications, making them easier to take and more effective against the virus. Many protease inhibitors require boosting. So does elvitegravir, the integrase inhibitor in Stribild, which also contains tenofovir and emtricitabine. Compared with Norvir, cobicistat has no activity against HIV and doesn’t block as many liver enzymes, meaning that it won’t likely have as many drug interactions. It does, however, have many of the same side effects as Norvir.

Bronx Cheer: An HIV Testing Program Shows Progress

In a New York City borough hard hit by HIV, a city health department program is putting a dent in the epidemic. An initiative called The Bronx Knows set out to test every Bronx resident who had not previously been screened, linking those who test positive with care and services. The program also aimed to reduce the number of people who are already sick with AIDS when they test positive for HIV. In the United States, an estimated one in five people living with HIV don’t know they have the virus. And while Bronx residents were getting tested at higher than average rates (nearly 70 percent as compared with 40 to 45 percent nationwide), a little over 30 percent of them were late testers, meaning they already had AIDS when they took the HIV test. That makes accessing treatment—and survival—much harder. This past July, Bronx Knows reported on progress as reflected in 2005 and 2009 telephone surveys (a formal evaluation is forthcoming). When the project began in 2005, almost 70 percent of those surveyed reported having ever been tested for HIV. In 2009, more than 79 percent reported having been tested—a relative increase of about 14 percent. Most important, between 2005 and 2009 the percentage of people who already had AIDS when they tested positive fell from a little over 30 percent to less than 24 percent—a relative decrease of nearly 22 percent. Given that it is not possible to stem the epidemic until more people living with HIV are aware of their status, an essential element of ending AIDS is better testing protocols. Here’s hoping the rest of America learns a lesson from the Bronx.

The “War on Drugs” Spreads HIV “The global war on drugs is driving the HIV/AIDS pandemic. Aggressive law enforcement practices targeting drug users have been proven to create barriers to HIV treatment. Mass incarceration…also plays a major role in increasing HIV risk.” The words of HIV activists on the barricades? Nope. It’s a quote from the June 2012 report of the Global Commission on Drug Policy, a high-level group that includes six former heads of state and former U.S. Secretary of State George Shultz. The report, subtitled “How the Criminalization of Drug Use Fuels the Global Pandemic,” urges nations to “halt the practice of arresting and imprisoning people who use drugs but do no harm to others” and to legalize and employ needle exchange. “Failure to take these steps,” the commission writes, “is criminal.” Read the full report at globalcommissionondrugs.org. We’re glad to see global leaders of the highest level reaching consensus on what’s needed to stop AIDS.

The war on drugs isn’t helping stop the AIDS pandemic.

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WHAT MATTERS TO YOU

BY CRISTINA GONZÁLEZ

FINDING AN HIV VACCINE While HIV meds can keep positive people healthy and simultaneously lower their risk of spreading the virus, too few people have access to treatment for it alone to stop the epidemic. Of the 34 million people with HIV on the planet, only 8 million are taking life-sustaining antiretrovirals. What’s more, the rate at which people become infected is outpacing the rate at which people access care. For each person who starts treatment, two more become positive. Every day, more than 7,000 people globally contract HIV. Clearly, an effective strategy to end AIDS must include a preventive vaccine. Therapeutic vaccines could also play a role for people living with HIV. Such vaccines could help their bodies control the virus, meaning they wouldn’t have to take daily meds. So for everyone, vaccines are an essential ingredient in the end of AIDS. Since the virus that causes AIDS was discovered in 1983, only three major

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vaccine trials have been completed. The first trial, called AIDSVAX, failed to prevent or control the virus. The second trial, MRKAd5, was discontinued because it possibly increased infection risk. The last trial, RV144, was mildly successful, lowering the rate of HIV infection by about 31 percent. Since then, significant scientific progress has been made, especially in the area of discovering HIV-neutralizing antibodies and developing vaccines to prompt the immune system to produce more of them, but further research is needed. Vaccine development takes time. Focused efforts to develop an HIV vaccine have only been under way since the mid-’90s. By comparison, the polio vaccine took nearly 50 years to develop. Vaccine research also requires money. The more funding we invest, the faster we’ll make progress.

2. WHY THIS MATTERS TO YOU From chicken pox to polio, vaccines

have become one of the most powerful public health interventions available, eradicating or lowering instances of an infection. They are effective, easy to administer and require no long-term commitments from individuals. And vaccines offer an equal opportunity for self-protection among disenfranchised groups (like women, gay men, people of color, children and sex workers).

3. WHAT YOU CAN DO ABOUT IT

Support vaccine research. Volunteer your time, donate money and use your voice. Call your AIDS service organizations and members of Congress and ask them to support initiatives for vaccine research. Do it loudly, and do it often. And talk to your doctor about volunteering for a clinical trial or study. Finally, if you can, spare a few dollars for vaccine efforts. Find out more about vaccine research at the International AIDS Vaccine Initiative’s web site iavi.org.

GETTY IMAGES/MARIA TOUTOUDAKI

1. THE ISSUE

COMFORT ZONE

BY CRISTINA GONZÁLEZ

STAY ON SCHEDULE

“It takes 30 days to create a new habit,” Conner says. So to make your journaling as healthy and powerful as it can be, make it deliberate. First, choose a journal that speaks to you. (Do you prefer blank pages, or the structure of ruled lines? Maybe you’re more modern and prefer typing on laptops or even your smartphone.) Next, choose a peaceful place to write—one that makes you feel free and safe. Finally, carve out a chunk of time that’s available to you every day. This is your journaling ritual: same vessel, same spot, same time, every day.

HOW TO OVERCOME WRITER’S BLOCK

Writing daily in a journal can help you feel better.

GETTY IMAGES/ZERO CREATIVES

Dear Diary

Whether you’re grappling with a temporary frustration or an ongoing sense of anger or sadness, the act of writing about your negative feelings can help you turn them around. In fact, journaling can be an integral part of a holistic health regimen. Through journaling, you can focus on a problem, define it and explore why it’s happening. This releases stress, which research shows can have a positive effect on both the mind and body. Freeing your mind can also strengthen your immune system. But to gain the maximum benefits of journaling, you have to let go of the “Dear diary” middle-school version of writing. Instead, write with honesty, intention, purpose, process and commitment, says Janet Conner, author of Writing Down Your Soul. Here’s how you can write your way to a healthier you.

Don’t let a blank page or screen intimidate you. Your journal is a safe and private space; it’s OK to be griefstricken, foul-mouthed or romantic. If you’re having trouble getting started, write about why you think you can’t write. The key is to write as much as you can, as fast as you can in the time you have set aside and to keep writing until you are spent. “Write quickly and allow anything to come through,” Conner says. “No editing, no judging, just write.” You’ll spew out the negative feelings and distractions and ultimately get to what’s really on your mind.

READ WHAT YOU WRITE After you’ve accumulated a few pages, go back and look for themes, trends or subjects worth exploring further. “You want to capture the wisdom and blessings that come through,” Conner says. She suggests circling passages that contain special meaning so you can go back and review them later. Also look for lessons you’ve learned. You’ll see an evolution of thoughts and emotions that hopefully leads to healing and health.

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CREDIT

THE SHOW MUST GO ON The funds raised by Broadway Cares/Equity Fights AIDS support nearly 400 HIV and family service programs nationwide, as well as AIDS research and advocacy. Their assistance helps The Actors Fund, LGBT health clinics—and even pets in need of loving homes. To date, the organization has raised more than $230 million—their performance is deﬁnitely more than showbiz as usual.

BY TRENTON STRAUBE

COURTESY OF BROADWAY CARES/EQUITY FIGHTS AIDS

T’S MERE DAYS BEFORE THE CURTAIN GOES UP FOR BROADWAY BARES XXII: Happy Endings, the one-night-only saucy vaudeville in which the best (and many of the best-looking) performers of the Great White Way expose their prodigious talents to raise money for Broadway Cares/Equity Fights AIDS (BC/EFA). With 227 dancers, 17 choreographers, 32 stage managers and hundreds of additional volunteers—plus 1,076 pasties, G-strings, jockstraps and assorted bits of costume (yes, someone keeps track of that sort of thing)—the annual fundraiser is a mammoth undertaking. Prior to the show, Tom Viola, executive director of BC/EFA, writes an email for everyone involved in the fundraiser. Only this isn’t the usual “let’s put on a show,” “break-a-leg” pep talk. Viola has something much more important to say. His letter starts off with the history of the Broadway Bares show—and the history of the AIDS epidemic. Then it continues: “Whether you know it or not, or even believe it, look around rehearsal or the dressing room on Sunday. Someone right next to you and many across the room are living with HIV. Some quietly, perhaps well; others in deep denial or shame. But my point is the AIDS virus continues to be passed. And it doesn’t have to be. “Now mistakes are made. Accidents happen. Foolish decisions of one type or another occur when we’re high, drunk, feeling bad, feeling invincible, too young to think it can happen, too ‘old’ to think we matter any more. There is no blame. And truly there should be no shame. We are all human and imperfect. “What we do have, however, is the information to keep ourselves safe.… There are two pieces that I want everyone receiving this email to read. One is ‘Safer Sex’ information…. The second is about PEP [post-exposure prophylaxis] that can, if a mistake is Signed, made, possibly help you to avoid seroconversion.… oversized “Please review them both.… Please take care of yourselves.… Have fun. Playbills at the annual But be kind, even when it seems a flippant, careless or harsh word might Broadway Flea Market seem screamingly funny or well-deserved by someone else.

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irst, a bit of backstory. In the mid-1800s, much of proper society and the religious hierarchy viewed actors as people of dubious character. Because of the shame From left: Angela Lansbury and stigma associated with the at Broadway craft, would-be thespians were often Barks; the Broadway Flea forced to run away from home and change Market; Wicked cast members their names. They were outcasts. Many during Audience churches wouldn’t even bury actors in Appeals; Kristin Chenoweth, consecrated ground. But the entertainSean Hayes and ment community banded together to take Adam Riegler at Gypsy; and Daniel care of their own. In 1882, they formed Radcliffe at The Actors Fund. One of its first orders Broadway Bears

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was to procure burial plots; another was to set up financial resources to assist those who fell on bad times or illness. Then and now, the term “actor” refers to anyone employed in the entertainment business, from writers and directors to stagehands and makeup artists. As the industry advanced across the nation and encompassed entertainment on the radio, then film, TV and the Internet, The Actors Fund grew, too. So has the need for its safety net. “People working in the arts have incomes that are seasonal at best, and modest,” says the fund’s president and CEO, Joe Benincasa, pointing out that most actors don’t work enough hours to qualify for health insurance. In response to AIDS, The Actors Fund started the HIV/AIDS Initiative in 1987, a service for entertainers living with the virus. Motivated by a fellow cast member dying of the disease, actress Colleen Dewhurst spearheaded the formation of Equity Fights AIDS to raise money for the HIV/AIDS Initiative. Viola, who was Dewhurst’s assistant, became its front man. Around the same time, an unrelated group formed in the theater world with the goal of raising money for AIDS organizations. It was called Broadway Cares, and in 1992, the two merged as Broadway Cares/Equity Fights AIDS. As the epidemic changed, so did The Actors Fund and BC/ EFA. “In 1988, people were dropping dead in front of each other,” Viola recalls. “You could enter a rehearsal period and before that six-week period was over, two, three or any number of folks in that group of 30 or 40 people could have dropped out because of AIDS. We all saw it.” Then, in 1996 came the arrival of antiretrovirals for HIV, and BC/EFA began to expand the scope of its funding, supporting every type of social service at The Actors Fund. To date, BC/EFA has awarded more than $65 million—including $4.5 million this year—to various programs at The Actors Fund. These include non-HIV specific programs such as the Al Hirschfeld Free Health Clinic, The Actors Fund Work Program (to retrain actors for other fields), The Dancers’ Resource and

COURTESY OF BROADWAY CARES/EQUITY FIGHTS AIDS

“Most of all, I hope you will arm yourselves with two things: Information and the self-esteem to access it.” The letter exemplifies Viola’s leadership style—informed and educational, honest, uplifting and accessible. For Viola, his job isn’t simply to raise money to help people with HIV. He sincerely cares about the health and well-being of the entire Broadway community. The email was a smashing success (search “letter from the executive director” on broadwaycares.org to read its entirety). It sparked a series of conversations, Viola says. People pulled him aside to talk about fears of disclosing their own serostatus—performers want to appear 110 percent fit 24/7—and to ask about HIV testing and PEP. Others wanted to thank him for having such a specific conversation about safe sex and HIV. And Broadway Bares? The event raised $1.25 million. A very happy ending indeed. And that’s just one night, and one of BC/EFA’s many iconic events. From 1987 through today, the organization has raised more than $230 million. Where does all that money go? How, exactly, is it put to use? As most performers in any hit production can tell you, the real story and drama take place off stage.

the Phyllis Newman Women’s Health Initiative. Of the latter, Viola says: “It seemed not only fair but also our responsibility to step up for the women in the community as they had rallied for us around the issue of HIV/AIDS.” Expanding the safety net under the umbrella of HIV/AIDS, Viola says, enables him to connect to thousands of folks in the community who aren’t directly impacted by the virus. “It allows me to talk about HIV/AIDS to the entire theatrical community.” Keeping HIV/AIDS on people’s minds is no small feat during a time of AIDS fatigue, when many people think the virus is a manageable disease—if they think of it at all. Plus Viola says, “It keeps people engaged. The more people who are assisted by the safety net of social services provided by The Actors Fund, the more people will want to be a part of our continued fundraising activities. This ensures we can continue to honor our mission of outreach to people living with HIV/AIDS.” The HIV/AIDS Initiative remains a central focus and beneficiary of BC/EFA; it received $2.1 million in 2012 alone. “There are as many people assisted annually in the HIV/ AIDS Initiative in 2012 as there were in 1995,” Viola says— Benincasa puts the number between 650 and 700—“but today not as many are dying; they’re provided with a different type of service.” It’s a holistic approach, says Benincasa of The Actors Fund. “If someone comes to you with HIV, they have a medical need, but they might also have a financial need, a housing need, an employment training need, a financial planning need.” Caseworkers help clients navigate these issues. Addiction and mental health services are available, as are nursing homes and supportive housing for people with HIV/AIDS, including the 30-story Dorothy Ross Friedman Residence in Manhattan, the Schermerhorn in Brooklyn and the Palm View Residence in West Hollywood—all supported, in part, from those dollar bills stuffed into G-strings at Broadway Bares.

he Bares burlesque is but one of several annual BC/EFA events that have grown over time and in scope to become beloved traditions. The Broadway Flea Market & Grand Auction started as two tables set up outside the Chorus Line stage door. Last year’s flea market, held in September, was a daylong bonanza that boasted 63 tables in the heart of the theater district; celebrities posed for photographs, and Broadway casts sold rare memorabilia, such as Spider-Man bracelets made of the web-slinging cables used in the show. There’s also the annual Fire Island Dance Festival—which is part of BC/EFA’s Dancers Responding to AIDS program— and Classical Action, a series of intimate performances (think: a private Tribeca home) by big-name classical artists such as mezzo-soprano Stephanie Blythe and pianist Warren Jones. Among other events, BC/EFA also produces Broadway Barks, a pet adopt-a-thon founded by Mary Tyler Moore and Bernadette Peters that raises money to help more than 26 local pet shelters and to cover vet costs. It also highlights the importance of spaying and neutering animals. What’s this have to do with HIV? “It creates good will for us as an organization,” Viola explains. “It’s a wonderful day for the entire community that fuels our fundraising efforts. Plus, I love dogs.” More than 600 animals have found homes through Broadway Barks, including a husky who spends time at the BC/EFA offices (that’s one lucky pooch; Viola and company enjoy an enviable view of Times Square). But the fundraising initiative that theatergoers are most likely familiar with is what BC/EFA calls its “Audience Appeals.” Twice a year, for six weeks, entire companies of Broadway, offBroadway and national touring productions volunteer their time so that their star talent—Hugh Jackman and his megawatt charm, Whoopi Goldberg and her intelligent humor—can return to the stage after the closing curtain and ask audiences to support BC/EFA by purchasing special merchandise, such as

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bout half the money BC/EFA raises each year goes to The Actors Fund, but the other half gets divided among nearly 400 programs that primarily serve AIDS and family service organizations; funds also go to 17 LGBT health clinics across the nation. Last year, the programs that received BC/EFA grants included 123 meal delivery programs in 34 states and 375 AIDS service organizations in 47 states, plus advocacy organizations and AIDS research groups such as the International AIDS Vaccine Initiative (IAVI) and the Foundation for AIDS Research (amfAR). Money went to harm reduction programs, case management and emergency financial assistance. BC/EFA also grants about a half a million dollars internationally, mostly to AIDS service centers in South Africa in acknowledgement of fundraising done by the actors in The Lion King. Twice each year, a BC/EFA national grants committee sifts through hundreds of applications. The committee is comprised of stage managers, performers and other industry professionals who helped raise the funds. Making them part

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of the process, Viola says, shows them how the money is put to use, which in turn engages them to help again. “It’s the most rewarding experience,” agrees Sherry Cohen, stage manager at Mamma Mia!, “to know that all these organizations are benefiting from what the Broadway community has done.” What’s more, says Kirsten Felix Burkhart, executive director of AIDS Resource in Williamsport, Pennsylvania, is that the grant application form is easy and quick to fill out—a rarity— which means caregivers don’t get mired in paperwork. Burkhart is a longtime Broadway buff, so once she started at AIDS Resource—she also oversees West House Personal Care Home, which caters to people with HIV—her first order of business was to call BC/EFA. That relationship, she says, has saved lives. “We would be out of business without their support,” Burkhart says. In addition to supplying tens of thousands of dollars in food for her clients, BC/EFA stepped in for emergency support. “A couple of years ago, our offices were broken into and vandalized, and someone stole $5,000 worth of our food cards,” Burkhart recalls. “Tom [Viola] heard about it from a friend and sent us a $5,000 check, just like that. West House would literally not be open if not for BC/EFA’s support.” Kevin Winge, executive director of Project Open Hand, a meal service program in San Francisco, points to another state of emergency: the national recession, which fuels job losses while depleting everyone’s ability to offer donations. “We’ve seen about a 10 percent increase in demand for services—and a 10 percent decrease in funding,” he says. “But Broadway Cares is still in the fight and still doing innovative fundraisers.” And BC/EFA is situated to respond to the HIV community’s unique needs. Regulations prevent the AIDS Foundation of Chicago from using government funds for advocacy work, explains David Munar, that group’s CEO and president. BC/EFA helps fill that financial gap. “They’ve supported our efforts to lobby [local politicians in Springfield, Illinois,] and impact state laws, the HIV budget and Medicaid reform.”

COURTESY OF BROADWAY CARES/EQUITY FIGHTS AIDS

posters autographed by the entire cast, and by dropping a cash donation in a bucket on their way out. The appeal lasts mere moments, but when you consider that the entire company— musicians in the pit, lighting technicians, everyone—must work later to navigate the extra demands, it is quite a commitment. The appeals season culminates with two events—the Easter Bonnet Competition each spring and Gypsy of the Year each fall—in which casts of shows participating in the appeals take to the stage for original songs, skits, dances and mind-blowing millinery. “You don’t want to get all mushy about show business people,” says show business legend Nathan Lane, “but they really do put their all into [BC/EFA productions], and they are some of the best shows in town.” In 2011, Gypsy and its appeals season brought in a record-breaking $4.9 million.

Munar adds: “They’ve also supported our work in HIV prevention technology.” BC/EFA was one of the first supporters of what is now called the International Rectal Microbicides Advocates, or IRMA, which explores anti-HIV gels, lubricants and douches that may curb infections. “[At first,] we got sneers and giggles, and people thought it was not a serious area of investigation,” Munar recalls. “But Broadway Cares understood that to make a difference in the epidemic, we have to deal with unprotected anal intercourse. Because Broadway Cares has an enormous reputation, [their support of IRMA was] a stamp of approval. Their early grants for IRMA helped open the door to other funders. Now, it’s a fledgling area of scientific inquiry, and it’s taken more seriously.”

undraising events themselves are opportunities for BC/EFA to educate and raise awareness, and those events aren’t confined to the ZIP codes of Times Square. When theatrical productions travel the country, they often bring their BC/EFA know-how on the road. The casts of Wicked and The Lion King held cabaretstyle fundraisers while in Charlotte, North Carolina, benefitting not only BC/EFA but also RAIN, the Regional AIDS Interfaith Network (grants from BC/EFA comprise RAIN’s Benevolence Fund, an emergency resource that in one instance helped an HIV-positive woman pay for copies of her children’s birth certificates, paperwork she needed in order far left: the to move her family out of a shelter and into From Broadway Bares secure housing). XXII ﬁnale, the BC/EFA banner, Local theaters, inspired by BC/EFA, have Alan Cumming in Broadway Backgotten in on the act as well, and Viola has wards 6, Judith worked to establish connections with thespian Light leads a Moment of Silence societies through colleges and high schools. in Gypsy of the “It does give us the opportunity,” he says, “to Year; Spider-Man cast members have conversations about safe sex and AIDS during Audience awareness—in a way different than someone Appeals

would have to approach it in health class.” In other words, minus the political and church-driven barricades. “One of the most important and beautiful aspects of what Broadway Cares/Equity Fights AIDS does, is that it’s a way for people to know that you have to take care of yourself,” says actress and participant Judith Light. “It’s there to keep reminding people [about HIV] and to keep people talking about it so that we don’t keep perpetuating the virus.” Viola takes this responsibility to heart, and he speaks openly about his own seroconversion in 1993. This makes him somewhat of a father figure—more like grandfather figure, he jokes—for the entertainers. “Any number of folks have walked in this office and asked, ‘Can I shut the door?’” Viola says. “I know what’s coming next: tears [and a disclosure that they’ve tested positive]. I let them know that they’re not, even in this tiny office, isolated in this experience. Because it’s the secrecy that keeps people from taking care of themselves. “The theater community’s extraordinary generosity of spirit is BC/EFA’s greatest resource. It is a rare blessing,” Viola says. “In turn, it’s my hope that BC/EFA will always be a haven for folks struggling or in crisis and [that it will always be] a home for those who want to do something about it.” As Viola illustrated in his Broadway Bares missive—and as those performers proved onstage that night—it is possible to educate and inspire, to look after one another, all while putting on one hell of a good show. “Broadway Bares celebrates the joys of sex and all sexuality safely and without exploitation,” Viola says. “In doing so, it has raised millions of dollars. But if, at the same time, it can prompt a dialogue, particularly among those involved in the production, about safe sex, the history of the epidemic and the need for us still to take very specific care of ourselves and each other, it will be worth doing for much more than any amount of money raised. “It can carry a message,” Viola concludes, “that hopefully will resonate long after the dancing is done.” ■

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CREDIT

A CAPITAL AFFAIR

Science suggests that it’s possible for us to start to end AIDS. This July, the XIX International AIDS Conference gathered nearly 24,000 members of the global HIV/AIDS community to discuss whether we can make that possibility a reality.

BY REGAN HOFMANN

JOAN LOBIS BROWN

N JULY, THE INTERNATIONAL AIDS CONFERence returned to the United States for the first time in 22 years. It gathered nearly 24,000 members of the global HIV/AIDS community in Washington, DC. The theme of this year’s conference—“Turning the Tide Together”—referenced the collective opportunity the world has to leverage scientific breakthroughs to begin to end AIDS. Advances in treatment and prevention options as well as headway made in cure, vaccine and microbicide research have all opened up exciting new possibilities. The phrases “AIDS-free generation” and “end of AIDS” were bantered around freely. But while hope was plentiful, those closest to the complexity of the science and the nuances of solving the problem of AIDS on the ground remained less optimistic. Rampant hope fueled by scientific possibilities was juxtaposed with a lack of specific strategies for actually ending AIDS, and that created an interesting dichotomy. “Which generation?” asked Peter Piot, MD, PhD, dean of the London School of Hygiene and Tropical Medicine, in an interview according to The New York Times. Others highlighted that the end of AIDS did not necessarily correlate with the end of HIV, hence the needs for vaccines, both preventive and therapeutic, and a cure, to really wipe HIV off the face of the earth. The essential questions remain unanswered: Who will pay to implement the solutions science suggests will work? And can we secure the political will to change health care systems, policies and laws so that we can apply the science? But the first step to fixing any problem is believing a solution is possible. In general, U.S. leadership embraced the notion of ending AIDS. Though President Obama did not appear at the conference, he pledged his ongoing commitment to the fight during a White House reception for leaders of the HIV/AIDS community. In her remarks at the opening plenary, Visitors Secretary of State Hillary Rodham Clinton called on at the AIDS U.S. Global AIDS Coordinator Eric Goosby to present Memorial by December 1, 2012 (World AIDS Day), a blueprint Quilt

for the U.S. government to achieve an AIDS-free generation. During the conference, Representatives Jim Himes (D–Conn.) and Barbara Lee (D–Calif.) introduced the Cure for AIDS Act, H.R. 6187, legislation that calls for $100 million over the next five years to be Congressionally directed to support cure research in the existing U.S. military’s medical research program. In the aftermath of the case of the Berlin Patient and the possibility that several others may have been functionally cured of HIV, there was much buzz and debate about whether, and when, a cure could be found. In a symposium before the conference, Francoise Barré-Sinoussi, the head of the International AIDS Society (the Geneva-based group that runs the conference), released “Towards an HIV Cure”—a strategy for coordinating AIDS cure research and funding around the world to increase collaboration and accelerate cure research. The plights of disenfranchised groups—men who have sex with men (MSM), African Americans, youth, women, sex workers and injection drug users—who have limited or compromised human rights and who often lack access to care loomed large on the conference agenda. So was the need to fight back against the criminalization of people with HIV and the need to bolster the fiscal health of global funding mechanisms like the Global Fund to Fight AIDS, TB and Malaria. (Activists dressed in Robin Hood suits called for a “Robin Hood tax” on financial transactions in order to garner fresh dollars for global health.) Also debated were the needs to find innovative funding solutions and to inspire more countries to commit funds inside and beyond their borders. The AIDS Memorial Quilt was there, stretching from the back of Capitol Hill to the Washington Monument. It was a powerful reminder that though we have come a long way in battling HIV/AIDS, our job is far from done. It would be impossible to begin to capture all that went down at the conference. For POZ’s exclusive coverage, check out poz.com/AIDS2012. Here, our visual recap of some of the highlights. See you in 2014 in Melbourne!

poz.com OCTOBER/NOVEMBER 2012 POZ 39

(1) Activists converge at Lafayette Square in front of the White House for the We Can End AIDS Mobilization for Economic Justice and Human Rights; (2) U.S. Global AIDS Coordinator and Ambassador Eric Goosby at a symposia session on improving the effectiveness and efficiency in the HIV response; (3) POZ deputy editor Oriol R. Gutierrez Jr. interviews Rep. Barbara Lee (Dâ&#x20AC;&#x201C;Calif.) in the Global Village; (4) former U.S. President Bill Clinton speaks at the closing session; (5) AIDS 2012 volunteers stop to pose for a group photo

4 40 POZ OCTOBER/NOVEMBER 2012 poz.com

(1,3) JENNIFER MORTON; (2) IAS/STEVE SHAPIRO; (4) IAS/RYAN RAYBURN; (5) IAS/DEBORAH W. CAMPOS

(1,2,6) JENNIFER MORTON; (3,5) IAS/RYAN RAYBURN; (4) JOAN LOBIS BROWN

(1) Bristol-Myers Squibb unveils its panel for the AIDS Memorial Quilt; (2) activists tie red ribbons to the gates of the White House; (3) U.S. Health and Human Services Secretary Kathleen Sebelius speaks at the opening ceremony; (4)Jeanne White-Ginder, Sir Elton John and David Furnish help unfold the AIDS Memorial Quilt; (5) Bill Gates and World Bank president Jim Kim, MD, PhD, at a symposia session; (6) Rep. Jim Himes (D–Conn.) and Rep. Maxine Waters (D–Calif.) read names and make remarks at the AIDS Memorial Quilt

6 poz.com OCTOBER/NOVEMBER 2012 POZ 41

(1) Performer Sheryl Lee Ralph on the Quilt stage with Merckâ&#x20AC;&#x2122;s Michael Seggev and Chirfi Guindo; (2) delegates highlight visa restrictions for those with a history of drug use or prostitution; (3) Margaret Cho at the AHF Keep the Promise rally; (4) U.S. Secretary of State Hillary Clinton speaks at the opening plenary; (5) delegates navigate the Walter E. Washington Convention Center; (6) Ross Zuckerman, Giovanni Vitacolonna and Peter Schmidt at the POZ booth; (7) amfAR chairman Kenneth Cole at the AIDS Memorial Quilt

6 42 POZ OCTOBER/NOVEMBER 2012 poz.com

(1) JOAN LOBIS BROWN; (2,3,4,5,7) JENNIFER MORTON; (6) IAS/RYAN RAYBURN

(1) IAS/DEBORAH W. CAMPOS (2,3,4) JENNIFER MORTON; (5,6) IAS/STEVE SHAPIRO; (7,8) IAS/RYAN RAYBURN

(1) Jamar Rogers in the Global Village; (2) UNAIDS executive director Michel Sidibe and Annie Lennox read names at the Quilt; (3) volunteers help stitch Quilt panels; (4) AIDS Foundation of Chicago’s David Munar at the We Can End AIDS march; (5) IAS president Françoise Barré-Sinoussi at the “Towards an HIV Cure” symposium; (6) NIAID director Anthony S. Fauci, MD; (7) former first lady Laura Bush at a special session for women and girls; (8) Linda Scruggs of AIDS Alliance for Children, Youth and Families at a plenary session

poz.com OCTOBER/NOVEMBER 2012 POZ 43

HEROES

BY TRENTON STRAUBE

Hip-Hop Soul Back in the day, hip-hop’s female emcees exuded power and self-respect (think Salt-N-Pepa, Queen Latifah and MC Lyte). But in 2007, when Kathleen Adams, a student at Fordham University in the Bronx, New York, surveyed the way women of color were portrayed in mainstream media, she didn’t like what she saw. In response, Adams teamed up with emcee Lah Tere to give birth to Momma’s Hip Hop Kitchen (mhhk.org). The organization offers workshops, community events and college tours that “educate and empower women of color on issues that impact their lives, including HIV/AIDS and reproductive justice,” says Adams, who is HIV negative. Their biggest event, held the first Saturday in March at Hostos Community College in the South Bronx, is an annual hip-hop showcase for female artists in which health facts flow as easily as the beats and rhymes. As she helps redefine how hip-hop can be a positive influence to woman of color, Adams and Momma’s Hip Hop Kitchen keep the battle against HIV/AIDS blazin’ on the front burner. What three adjectives best describe you? Savvy, determined, adventurous. What is your greatest achievement? Graduating from college and graduate school while balancing Momma’s Hip Hop Kitchen and everything else I do. If you could change one thing about living with HIV, what would it be? People think it is a death sentence, and it’s not. I have plenty of friends who are living healthy lives and thriving!

What person in the HIV/AIDS community do you most admire? It’s not a person. It’s the Young Women of Color Leadership Council. YWOCLC work in their communities, high schools and colleges to raise awareness of HIV/AIDS. What drives you to do what you do? I want to be able to listen to music and watch music videos that do not degrade female bodies of color. I want to actively work to lower the rates of HIV/AIDS within communities of color.

STEVE MORRISON

What is the best advice you ever received? My great-grandmother Charlie-Mae Walker told me, “Age doesn’t matter unless you are wine or cheese.”

SURVEY AIDS 2012 Review The XIX International AIDS Conference brought leading scientists, public-health experts, policy makers and the HIV-affected community together to discuss the global state of HIV/AIDS. Now that it’s over, POZ wants to know: What did you think of AIDS 2012?

MSM, sex workers, people who use drugs, migrants, etc.)

❑ Raise awareness of community, policy and/or scientific leaders

❑ Strengthen advocacy or policy work ❑ Share information/experience with new contacts met at AIDS 2012

❑ Develop new collaborations (e.g., creation of a partnership/

Did you attend in person or follow online or through other means, the XIX International AIDS Conference (AIDS 2012) held July 22 to 27 in Washington, DC?

network)

❑ Strengthen existing collaborations ❑ Join existing partnership(s)/network(s) ❑ Not sure ❑ Other (please specify): ______________________________________ ❑ I will not do anything differently

❑ Yes ❑ No (skip to question 6) 2

What benefits did you gain from attending/following AIDS 2012? (Check all that apply.)

❑ New knowledge ❑ New skills, including a better understanding of best practices ❑ Continuing Medical Education (CME) credits ❑ New contacts/opportunities for future collaboration,

Please tell us how you think AIDS 2012 may impact HIV research, policy, advocacy and programs at regional, national and/or global levels (100 words maximum). ____________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________

What did you most dislike about AIDS 2012 (or what disappointed you), and what would you like to see at the next International AIDS Conference? __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________

What year were you born?__ __ __ __

What is your gender?

What is your sexual orientation?

What is your ethnicity? (Check all that apply.)

including professional and career development

❑ Strengthening collaboration with existing contacts (i.e., people you already knew before the conference)

❑ Meeting friends ❑ Sharing experiences/lessons learned ❑ Affirmation/confirmation of current work/research direction, approach and/or practice

❑ Motivation/renewed energy and/or sense of purpose ❑ Opportunity to advocate on specific issue(s) ❑ Opportunity to raise funds ❑ Identification or clarification of my priority needs and the ways I can help meet them

❑ Other (please specify): ______________________________________ ❑ I did not gain anything from the conference (skip to question 4) 3

How will you use the benefits you gained from the conference? (Check all that apply.)

❑ Share information with colleagues, peers and/or partner organizations (e.g., through discussions, presentations,

dissemination/translation of materials, writing papers, etc.)

❑ Organize a hub (a screening of selected conference sessions followed by a moderated discussion) in my city/community

to share the knowledge gained at the conference with others in my community

❑ Build capacity within my organization/network through

training, development/update of guidelines, procedures, manuals, other materials, etc.

❑ Motivate my colleagues, peers and/or partners ❑ Influence work focus/approach of my organization ❑ Refine/improve existing work, research practice or methodology

❑ Start a new project/activity/research ❑ Expand/scale up existing programs/projects ❑ Raise awareness of key populations (e.g., women, youth,

❑ Male ❑ Female ❑ Transgender ❑ Other ❑ Straight ❑ Bisexual ❑ Gay/lesbian ❑ Other

❑ American Indian or Alaska Native ❑ Arab or Middle Eastern ❑ Asian ❑ Black or African American ❑ Hispanic or Latino ❑ Native Hawaiian or other Pacific Islander ❑ White ❑ Other (please specify):_____

Please fill out this confidential survey at poz.com/survey or mail it to: Smart + Strong, ATTN: POZ Survey #183, 462 Seventh Avenue, 19th Floor, New York, NY 10018-7424