September 3, 2008

Fight Club: Reflections on Mexico City

I think that even the new CDC numbers don’t give us a truly accurate picture of the U.S. epidemic. The data does not represent infections in all 50 states and, notably, leaves California and Puerto Rico off the list. Including new infection rates in this state and U.S. territory could really change what we understand, for example, about the spread of HIV among Latino/Hispanic people.

I have a theory that the numbers of who has HIV in the U.S. are skewed because who gets tested in America for HIV has a lot to do with erroneous assumptions on the part of doctors and people who worked in testing sites. If I had a dime for every time people told me a story of how they were talked out of getting an HIV test because they didn’t fit the “profile” of someone at high risk for HIV…

In many other countries around the world where HIV testing is even-handed and widespread, the virus is shown to have moved fairly quickly and evenly into every sector of the populace. This is because HIV doesn’t discriminate; only people do. We can talk all we want about certain factors that lead to higher risk for HIV, but the virus can and will go anywhere and everywhere nature allows it to go—which is clearly to every type of person on the planet. A lack of promiscuity or a certain color of skin or socioeconomic standing or gender has long been proved not to protect a person against HIV. In the United States, if you embody the inverse of factors people associate with HIV (say, you are monogamously married, as opposed to “promiscuous”; straight, rather than gay; a drinker, rather than an IV drug user) you are far less likely to get tested for HIV, but you are not necessarily proportionately at a much lower risk. While it’s true that certain factors and behaviors can increase your risk for HIV, not embodying a certain factor or avoiding certain behaviors is not insurance against getting HIV. Another way to put it is that while someone who has multiple acts of unprotected sex may have a higher risk for contracting HIV, a person who has unprotected sex once can also get HIV, so therefore everyone who has ever had unprotected sex should qualify for an AIDS test.

I wonder, what percent of America has had an HIV test? And if everyone in America got tested, would the CDC numbers look very different?

The XVII International Conference made me think about how strange it is that HIV appears to disproportionately affect certain sectors of the populace—only in America. In countries where testing is more common, the reported profile of who has HIV dovetails more closely with the composition of the general populace. The diversity of people living with HIV is a testament to the power of the virus’ ability to be an equal opportunity offender.

While there’s no question that the virus will infect any—and every—body it can, based on the best data we have to date, there is a clear skew to the concentration of infections and an indication that certain groups may be at elevated risk for contracting the disease at this point in America. It is of critical importance that we acknowledge that we have a real need to address the spread of HIV among MSM, African Americans, young people, women and Latino/Hispanic people in particular.

One of America’s most prominent AIDS journalists, Lawrence Altman, in his recap of the International Conference in the August 18 edition of The New York Times, did not mention the AIDS crisis in black America. Perhaps he did not attend the press conference in which Phill Wilson of the Black AIDS Institute (BAI) and a handful of the most powerful black American AIDS activists discussed the BAI’s new report “Left Behind,” which chronicles the chilling impact of AIDS on black America. I mean no disrespect towards Altman. But since there were precious few American media at IAC, I feel that those there had a responsibility to be tuned in to big news—like how AIDS is disproportionately affecting the black and MSM communities stateside. In his summary article about the conference, Altman did not reference the revised CDC incidence numbers, nor did he mention that hundreds of AIDS organizations and more than 1,000 individuals have signed on in support of the call for a National AIDS Strategy.

As an American HIV-positive journalist, I blame, in part, the media for perpetuating the myth that AIDS is under control in America. It may be a crime of omission, but it is time that we give the rest of the world—as well as our current and future governmental leaders—a clear picture of what it’s like to live with AIDS in America. If AIDS journalists in the United States aren’t reporting on the key news about the American AIDS community, how will the rest of the world see that our own fight is far from over?

Now that the travel ban for HIV-positive foreigners has been lifted, we can entertain the idea of hosting a future International AIDS Conference stateside (we hope the Department of Health and Human Services’ will soon remove “HIV” from its list of communicable diseases, a fact that means that an HIV-diagnosis can still prevent an HIV-positive foreigner from entering the United States). I would love to see the international AIDS community come to America. I would love to see those tens of thousands of people, positive and not, from all over the world, spend time in the old U. S. of A. Partially, I want the chance to return the hospitality the rest of the world has shown us, and partially, I want people to see the truth of AIDS in America, firsthand.

And I want to engage my country in the battle against AIDS. Remember the film Fight Club? It was a biting commentary on American culture, but one of the catch phrases from the movie was, “The first rule of Fight Club is that you don’t talk about Fight Club.” That seems to be the first rule of AIDS in America. We must change that. Unquestionably, we need to take our battle out in the open, to the mainstream—much like those fearless and wildly popular lucha libre warriors I encountered in Mexico.

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Previous Comments:

Vic R, San Jose CA, 2008-09-05 16:43:18
Why in the world won't any onhe stand up and say the numbers were so off in the states? Every dollar spent by ASO's come about based on numbers of infected living in a given area. Our president continued the lies about new infections to simply cut the funding available in thes country. Has any one seen a push to provide funding based on the "corrected" numbers? Face it, we'd rather through funds at corupt goverments outside our countries then face the prolem here at home. Sad, Vary Sad...

Dony Jauregui, Phoenix, 2008-09-05 11:25:52
I am studying to be a Journalist at a community college. Am too HIV positive and wanting to spread to know very much in this lifetime. I am 20 years old and people more than half of my age don't know much about this virus/disease and what it's doing everyday. I agree with this article. I'd like to see more said. Education is one of the keys here to stopping HIV.