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POZ’s (Abbreviated) Encyclopedia of AIDS
by Regan Hofmann
POZ has featured its share of adult film stars. Our Miss June 1998 cover featured Rebekka Armstrong, and "The XXX Files" cover in April 1999 featured Tricia Devereaux. Gay male porn icon Aiden Shaw guest edited our August 1997 issue. And just last December, we profiled ex-porn star Darren James (who is straight). We don’t do it to be salacious; rather, we wish to show that people with HIV can enjoy healthy, sexy lives. Unsafe sex has long been part of the adult film industry, largely because audiences prefer skin-on-skin sex and, as a result, porn stars are paid a premium to bareback. But as we have asked on our pages more than once: Why should porn stars risk their lives so we can have safe, virtual sex while watching them?
Post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) are two similar ways to possibly prevent HIV infection. PEP is administered to people who may have been exposed to the virus—think condom breaks and medical-setting needle sticks. Perhaps the 28-day course of drugs (they must be taken within 72 hours of exposure to HIV) could be standard fare in every home medical kit. PrEP is taken before a potential exposure; ongoing studies will prove whether it staves off infection. Another form of PEP/PrEP exists when HIV-positive mothers are given treatment before giving birth and their newborns receive meds post-birth. Given that, in certain cases, treatment can prevent infection, we ask: Could we already be in possession of a cure?
Today, about half of all new HIV cases are among African Americans and 18 percent are among Latinos; we’ve known for two decades that the disease was affecting communities of color. Now the epidemic is a crisis of unprecedented proportions in the Hispanic and black communities. In 2006, African Americans were 45 percent of new HIV infections, but 13 percent of the population. Those who could have allocated resources to prevent HIV infections in these communities are now wringing their hands. History shows that racism can spread HIV as effectively as sex without a condom.
Choosing only sexual partners who share your HIV status was once criticized as a viral apartheid. Today, safer-sex advocates encourage the practice and social networking sites facilitate it (and lessen disclosure trauma). Not that it is foolproof: Some people lie, are misinformed or make erroneous assumptions about their HIV status. And let’s not forget the “window period” when a person is infectious but does not yet test positive.
A slang term for some HIV meds administered (often sporadically) in jails and prisons. When will people realize that prisoners are our brothers and sisters? If we accept the denial of decent medical care behind the walls (remember that HIV rates in prison are two and a half times those on the street, and that about a quarter of positive people pass through lockup some time in their lives), we erode our community’s goal of human rights for all. And yesterday’s prisoner may be your future husband, wife or neighbor. So let’s not throw away the key to their health.
May be punishable by a fine, but it should not be a felony—even if you are HIV positive. The trace amounts of HIV in spit and the mechanisms by which the enzymes in saliva interact with HIV prevent spitting from transmitting HIV. Just think: If someone brandished a rubber knife with the intent to harm, would that “threat” warrant life in prison? Criminalization of people with HIV is the ultimate stigma, but it also furthers the spread of HIV by discouraging those at risk from getting tested. A member of the highest court in South Africa, Edwin Cameron, who has HIV, put it eloquently: “HIV is a virus, not a crime.” If nondisclosure of a potentially deadly, sexually transmitted virus can be grounds for criminalization, why not prosecute those who fail to disclose they carry human papillomavirus, which is a leading cause of cervical, anal and penile cancers?
It’s what stands between HIV and many of its solutions. Because people associate HIV with sex and drug use, they refuse to see that HIV is just like any other disease. Instead, HIV is enveloped in a haze of homophobia, fear, denial, disgust and indifference. Because of that, people living with HIV often fear rejection, feel shame and isolate themselves. They become afraid to disclose and seek medical care and the support of their loved ones and friends. Which, in turn, can lead to ill health—both physically and emotionally—for those living with the virus. Stigma also impedes preventing, testing and diagnosing HIV. People are afraid to talk about it and to find out their own status—which can lead them to unwittingly transmit the virus. And lots of people don’t get tested because they fear being “witch hunted” by government agencies.
Yes, you may safely share them with HIV-positive people—as we reminded the world on our April 2008 cover featuring Caleb Glover, an HIV-positive toddler who was banned from a swimming pool because of his status. Come on people, it’s 2009. Get it straight already. (And you may serve us on real dishes, not paper plates, if you please.)
The hot talk lately is of treatment as prevention, or the notion of testing, identifying and administering meds to all people with HIV whether they want it or not; this, the argument goes, would render their viral loads undetectable and the people themselves virtually noninfectious regardless of whether they practice safe sex or safe injecting. Is it feasible to identify all positive people and pay for their treatments? And what about the ethics of making population-based treatment decisions for entire classes of people—regardless of their individual need, desire or benefit from it—as opposed to administering individualized treatment? Then there is the issue of adherence (poor adherence can spike the viral load of a person who was virtually noninfectious, which could lead to spreading drug-resistant virus). However, studies have shown the strategy can be effective, and Julio Montaner, head of the International AIDS Society, is red hot on the idea. The notion of treatment as prevention is guaranteed to engender a hearty debate.
This tiny stretch of tarmac in downtown Manhattan is not only ground zero for all things financial, and terrorist, on American soil, but also the site of many a profound protest by AIDS activists lobbying for affordable treatment. Dying in—the staging of activists’ faux deaths—was intended to get the attention of the pharmaceutical companies that price gouged people living with HIV (remember when the price of Norvir skyrocketted an unmitigated 400 percent?). The money that we, our employers, our health insurance companies and the government pay for AIDS medicines could have financed rebuilding the World Trade Center—in solid gold. And while the pharmaceutical companies get larger and richer, they become more risk adverse. They barely, and tentatively, pump money into the many small, independent biotech companies that lack the funds to do the research and development necessary to bring their products to clinical trials and, if they work, to market. Makes you wonder: Does it pay to cure AIDS? We hope and think so. And governments, relief organizations and foundations around the world would also like to see a change. They’re burdened with the ever-rising costs of keeping people with AIDS alive—both for humanitarian and their own economic reasons. The price to not cure AIDS has always outweighed the profit to be made by failing to produce a cure.
Jelly. Lube. The slippery stuff. A good partner for condoms, helping them stay intact and in place. A necessity for the ever-increasing number of people older than 50—many of them armed with Viagra—who are getting more action than they did in college. Older people are inclined to have multiple partners and not use protection, which is contributing to a spike in HIV infection among eldersexuals (as some ASOs call them). It’s time to turn around the safe-sex talk: Do preach to Papa.
From children born with HIV (though this number in the United States is fewer and fewer these days) to the increasing number of kids who only discover what HIV is after they are diagnosed, AIDS is rampant among America’s youth. In 2006, 34 percent of all new HIV infections were among people younger than 30. This is largely due to the eight years of abstinence-only sex education that the federal government funded under the Bush (No. 2) administration. We have a dire need to reach our young ones with accurate and complete messages about sexual health. Given the cyber nature of their lives, we will need to wield well the new technology. Twitter, anyone?
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