FRIDAY, JUNE 3, 2005

While casually channel surfing onWednesday night—yes, the Wizard does live like ordinary HIV mortalswhen down-timing from the AIDS crusade—your beloved blogger suddenlyhad the bizarre experience of shock and horror at a condom ad, as if the Wizard of POZwere a card-carrying member of the American Family Association (AFA).It’s a pity, too, because we would like nothing better than to cheer Trojan for having the guts to court controversy from the  abstinence-onlycrazies by pioneering prime-time TV pitches for rubbers. But thislong-overdue breakthrough from “America’s Most Trusted Condom” left usfeeling like “America’s Most Hated.”
     The 30-second MTV-vid-like spot opens with cool rock music and whitefadeout type against a black screen: “40 percent of people…who knowthey are…HIV positive…do not tell their partners.” Cut to: A cute youngcouple at a train station sharing an iPod, snuggling, smiling and intune with the lyrics: “This is your love, this is your life, this isthe perfect chance to get it right.”
     Well, this was Trojan’s perfect chance, and they got it all wrong. Notnecessarily the stat—which may reflect reality (69 percent of the 1,371 POZ readers who answered our sex survey last year say they do disclose before sex)—buteverything else, as far as HIVers go. The problem is, by reducing us tothat single chiding stat, the ad portrays us to the millions of neggieviewers in middle America as, once again, diseased pariahs and moralmonsters.
      There’s no mention of howmany people who know their HIV status practice safe sex—even when theydon’t fess up. No mention of last month’s CDC report that people whoknow they are positive are 53 to 68 percent less likely to havehigh-risk sex than those who do not know they are positive. No mentionof the Emory University study tracking the sexual behavior of HIVersfor full-on 22 years that has found that 95 percent of us never infect anyone else.And, of course, no mention of the number of times we get rejected,insulted, beaten and even killed when we…do…tell…our…partners.
     “The unfortunate reality is that some people with HIV are notforthcoming about their status,” a Trojan rep told POZ. But if thecompany wants to scare people out of their HIV fatigue and into buyingtheir products with a dose of the truth, the Wizard suggests thisinstead: “One third of people with HIV don’t know they’re positive.”And what ever happened to asking your partner about his or her statusbefore busting out the jimmy hat?
      The Wizard isn’t the only onewho’s whining. In our corner, the ever-awesome Terje Anderson, National Association of People With AIDS head,slammed the ad as “irresponsible,” “incendiary,” “deeply disturbing”and likely to “heighten the stigma and discrimination against peoplewith HIV.” He even called on the condom manufacturer to withdraw thead—a bold, risky move that no AIDS advocate we know of has dared tosecond.
      In the other corner, ofcourse, the AFA came out swinging. “Condoms are the line in the sand,”an AFA rep warned. “We oppose condom ads because they promotepromiscuity.” Then the ever-awful Donald Wildmon, AFA founder, pennedan Action Alertto the group’s faithful to contact their legislators to force thenetworks to stop “abusing the use of public airwaves to air offensiveand inappropriate material.”
      Trojan, welcome to the culture wars.Let’s hope these Trojans are more successful than the ancient ones intheir head-butting with the Greeks. The Wizard will join Anderson’sarmy—and, yes, “America’s Most Trusted Condom”—against the wild manWildmon’s murderous anti-condom missives. It turns out that a pair ofAfrican-American sweethearts are spot ad No. 2 on Trojan’s prime-timehighway, all the better to reach one half of the market hardest hit bynew infections. But the Wizard is none too happy to report that prime-time TV (or is it Trojan?) isnot yet rising to the challenge of including both gaymen and condoms in the same 30 seconds.

Meantime over onChannel Myth-Busters, this just in: African-American drug users withHIV are cheating death by means of combo therapy about as successfullyas HIVers in general—news that may help soften up not only HIV docs’tough-love approach to treating druggies (“junkies can’t adhere todaily dosing”) but also the deep-rooted doubt about the safety andbenefits of HIV meds in much of black America (“HIV meds are poison”).
      Here’s the deal. According to a new report from the New York Academy ofMedicine (NYAM), death rates among IV-drug users and crack smokers inthe Baltimore African-American HIV community have fallen a full 90percent since HAART became available in 1996. The studyof some 665 HIVers over 14 yearsconcludes that “before HAART, 15.9 percent of study participants weredying each year. After 1996, when patients in the study received HAART,the annual mortality rate plunged to only 1.2 percent per year.”
     These data so wowed the wonky Wizard that we placed a call to thestudy’s own wizard, David Vlahov, PhD, of NYAM and Johns HopkinsUniversity (hence the Baltimore focus). How, the Wiz wondered, do youknow that these folks are actually proving all the experts wrong bysuccessfully taking their meds and keeping their virus suppressed?After all, the study admits that adherence wasn’t measured. Vlahov hadanswers—and they were plenty provocative: First, strict (95 percent)adherence may be less than it’s cracked up to be because the studyclearly shows that “even if people were only somewhat adherent, theystill had a tremendous benefit from HAART.”
     What’s more, he advised, his current research is revealing that thispopulation actually has less resistance than HIVers in general—astandard way to test for adherence. (In yet another of his studies,Vlahov said, “76 percent of 366 drug-using HIVers said they’d taken 90percent of their doses over the prior three days.”) The dutiful docalso downplayed the Wizard’s worries about African-Americans’ mistrustand myths about the meds, saying that it’s not nearly as widespread aswe might think—at least in his Baltimore community.
      Vlahov, who has devoted more than a decade to this issue, hopes hisresearch will encourage HIV doctors to do unto drug-using HIVers asthey do unto others: provide combo therapy and the best possibletreatment—without making getting clean and sober a qualification. “In astudy we did the year after HAART was introduced, of the drug userseligible for the meds, only 7 percent had been given them.” The reason,he says, is “not so much prejudice as ignorance. Doctors tend to besuspicious of drug users. If we think their lives are chaotic and theywon’t be adherent, we won’t give them meds.”
     Adherence is hard for everyone and for addicts most of all, whetheryou’re chasing a needle or a news story 24/7. (You want chaos? Spend aday slinging data and hot dish with the Wizard.) So how do you explainall these great findings and counter those doctor arguments? Again withthe answers: “Does a person take their HIV seriously? That’s theissue,” Vlahov said. “If they take it casually, adherence will be anissue for anyone. If they take it seriously, it doesn’t matter who theyare—they will attend to their health.”
      Of course, life as a drug user in downtown Baltimore or the Bronx isstill no bowl of cherries, even with once-a-day combos and all. Mostare coinfected with hep C and fear looming liver failure. That goes forformer users, too, who can be 12-stepping their way down the yellowbrick road, never missing a single dose of their HIV meds and headingstraight off the cliff of liver shutdown with no transplant in sight.Barbara Zeller, MD, who treats many drug users with HIV at ProjectSamaritan in Brooklyn and the Bronx, says, “Of the deaths we see now,one of three is from AIDS, and the other two are from organfailure—mostly liver, some kidney.” That’s why Jason Farrell of Positive Health Project arguesthat this study should influence doctors to test and treat theirjunkies for hep C, too. Let’s give the good doctor from Baltimore thelast word: “This study tells doctors that drug users can take HAART andhave positive benefits. Don’t exclude drug users from treatment.”

TheWizard’s favorite celebrity sighting this week was that new nudie picof  Victoria ‘Posh Spice’ Beckham, shot with just her Jimmy Choos along with43 of “the world’s [other] most beautiful women” and auctioned at anElton John AIDS Foundation fundraiser on Wednesday. London Daily Mailart critic Robin Simon called the former Spice Girl’s contribution“titillating totty snap.” But what the Wizard really wants to know isthis: Can Posh bend it like hubby David?… And this: With the GlobalFund starving to death and Asia hurtling after Africa into a black holeof disease and indifference, what do you do? Invite Madonna, the DalaiLama, Pink Floyd, Nelson Mandela, 50 Cent and Pope Benedict XVI to afive-city concert and protest event to kick-start a global salvation!Not quite. Bob Geldof’s Live Eight concert fundraiser on July 2 is to fight globalwarming and African poverty. Still, the millions raised will benefitHIVers—at least indirectly. A hell of a lot more helpful, in theWizard’s opinion, than the United States’ new tactic to skirt the Fund’s grassroots networks andgo unilateral.