Here To Inspire

Commemorations, screenings, and other observances are planned for Thursday's World AIDS Day. Here's a small sampling of some of the events to check out — if you know of a happening in your city or town that's not listed, please add it to our comments board. 

November 29 2011 8:10 PM

Secretary of State Hillary Clinton will discuss the future of the AIDS epidemic in a speech on Tuesday at the National Institute of Health.

November 06 2011 12:30 PM

A year — 365 days, the passing of 12 months, four seasons, a birthday, holidays of our choice, each a quantifiable measure of the passing of time. I have for years used these markers to essentially measure the year in question or whatever arbitrary schedule I was on. From grade school to college, the first to the next, relationship to being single, each evaluated through a year, perhaps over many, sometimes only one. The questions were “What was I doing then?” and “What job did I have?” and “Where did I live?” and the respective answers were often the measure of success, failure, or simply progress. December 1 came so quickly, but it has felt like 10 years since I pressed “share” to update my status on Facebook and told the world I had HIV. And here I am 365 days later thinking, How do I measure this year?

I chose World AIDS Day for obvious reasons. It’s a time when many mark all things related to HIV or AIDS. For some, that is remembering those who have been lost — nearly 25 million to date. For others, it’s a renewed charge to end the stigma and prejudices that still accompany this disease. There are those who focus on the research, the science that has in 20 years taken this illness from a death sentence to manageable for most. My measure of success was simply to start a conversation, one that has no doubt been carried on and supported by others for nearly 30 years. But when I found myself unexpectedly thrust into this community, I grew painfully aware that while World AIDS Day is no doubt a call to action, the other 364 days of the year seem awfully quiet ... too quiet. I had already lived with this reality for nearly two and a half years, and with a simple update on Facebook about my real status, a short narrative of my story, and pictures to put faces with the support I had been given privately, I would attempt to start a conversation in places it didn’t exist before.

The reality is, most people likely have not thought much about AIDS since we talked. A few have been reminded, perhaps through AIDS Walk New York or this column. But we all have our own lives — the expectation that even those close to me would live my conversation day in and day out would be ridiculous.

But my reality was just that — each morning, day and night, I have been living with HIV, now for nearly four years. This year I lived it publicly.

November 30 2010 7:35 PM

November 23 2010 4:00 AM

 Whether it’s the eight cases of Karposi’s sarcoma noted among gay men in New York City in March 1981 or the five cases of Pneumocystis pneumonia among gay men in Los Angeles in June that same year, it’s been three decades since AIDS began ravaging our readers’ lives, decimating this magazine’s staff, and teaching all of us to live more carefully, love more fervently, and lead by example. These 30 quotes—all taken from Advocate archives—are just a small sampling of the fear, fight, and feats that got us to where we are today.

“We are seeing the beginning of a major epidemic of cancer. The disease happens to be occurring in the gay community, but what is really relevant is whatever conditions are causing Kaposi’s [sarcoma]. We are very concerned to head off a panic.”
Alvin Friedman-Kien, MD, of the New York University Medical Center. August 20, 1981

“So far, no one knows with certainty what causes the fatal ‘new’ diseases. Heterosexuals, one person in a monogamous relationship and not the other, even infants have succumbed. Yet many cases are centered in the gay men’s community, especially in New York City. Most of us who know a lot of gay men also know one or more who have died. Living with this situation feels a bit like it must have felt to be alive when the plague was decimating the population of Europe.”
David Goodstein, president of Liberation Publications, publisher of The Advocate, in a letter to readers. January 20, 1983

“Two and a half years ago, my friends wondered why I was doing this.”
Lynn Paleo, who worked with the San Francisco AIDS Foundation, in a feature about lesbians’ involvement in AIDS activism. October 14, 1986

“My volunteer life at this point is limited exclusively to health education against contracting AIDS. We’ve been deluged with threats and the worst possible hype—media hype—about the dangers of AIDS. Yet there have been very few sound voices coming through saying, ‘Yes, times are tough and they may get worse, but we can do something about it.’ That’s what I’m trying to do.”
Actress Zelda Rubinstein on her involvement in an early AIDS awareness ad campaign. June 10, 1986

“When confronted with our own mortality, it has become common in our community to have our bodies cremated and our ashes thrown to the four winds. But with the wind goes an important part of our history. And also an important part of our future. I ask you to consider the ramifications of this action on tomorrow’s generation of lesbians and gays as they search for self-esteem. As a person with AIDS, I have thought about this a great deal. I believe that we must be the same activists in our deaths that we were in our lives. I urge those of you who are facing death to find a method of leaving a lasting record of our accomplishments—including the acknowledgmet that you were lesbian or gay.”
Activist and former Air Force sergeant Leonard Matlovich. June 23, 1987 

November 19 2010 4:00 AM

 Sex happens in Technicolor when a person is on crystal meth. Or so people say. Mark S. King knows the answer for sure. After an uneven five years of recovery from addiction, which only recently scored him a full year of uninterrupted sobriety, King says he finally knows now that all the wild fun he had when he was high was just a mirage: "I had this chemical, fake view that (a) this is what real sex is like and (b) it was enjoyable. It's a lie that it's enjoyable. And the lie is being told by this disease of addiction that I have."

King, a boyish and muscular 49-year-old blond who lives in Atlanta and blogs about HIV for, is now taking baby steps out of what he describes as a "sexual Peter Pan thing for most of my adult life, thinking that sex was apples being picked from a tree and that it was an inexhaustible resource." A relationship with another HIV-positive man in Fort Lauderdale that imploded a few years back because of King's drug use has shown promising signs of new life, though, and King is planning to move back to Florida to give it another shot -- ever mindful, he says, that clean and sober sex is a strange yet potentially many-splendored thing.

"Sex is really important for a whole lot of reasons: establishing emotional intimacy with partners, experiencing physical pleasure, relieving negative feelings such as distress or loneliness, and also affirming your identity," says Robert Kertzner, a Columbia University psychiatrist with a large number of HIV-positive clients in his private psychotherapy practice. "And all the reasons for sex being important for someone's well-being remain true for people who are HIV-positive -- and probably are even more compelling for them."

But sex is often a thorny issue for HIVers, to say the least. The reality of life with the virus rears its ugly head in the very place where most people want to let it all hang out and forget their troubles. Many, instead of experiencing orgasmic bliss, end up dealing with a laundry list of anxieties: worries about disclosure, transmitting the virus, or potential superinfection; concerns about body image caused by lipodystrophy or aging (King woefully cites his "flat butt" issues); feelings of shame over getting the virus in the first place; and for people like King, ripple effects from current or past drug use.

To that list add performance anxiety or just plain disinterest in sex. Although studies vary in their findings, it is clear that at least half of all HIVers suffer some kind of sexual dysfunction, including low sex drive, problems with getting an erection or with vaginal engorgement and lubrication, or difficulty achieving orgasm. Researchers believe the psychological strain of living with HIV is largely to blame. But, particularly for men, many antiretroviral medications can also cause sexual problems. Other medical culprits, such as low testosterone, diabetes, or cardiovascular disease, can throw their wrenches into the works as well.

Sometimes, though, it's the place where we expect to get help that can be a problem or at least contribute to existing ones. Julianne Serovich, a professor of human development and family science at Ohio State University who studies the psychology of HIV-positive women, says medical professionals in particular tend to overlook HIVers' sexual needs. "I think we are more concerned about how [HIV-positive] people are having sex -- what they're doing -- not necessarily whether they're enjoying it, whether it's healthy for them," she says. "We all have the right to have a healthy sexual existence."

Fortunately, though, there are caregivers who specialize in helping people turn their not-so-steamy sex lives around. "HIV affects people's sex drives for lots of reasons," says David McDowell, a psychiatrist in private practice in Manhattan. "But there are good remedies. It's amazing. You give somebody the right amount of testosterone, they all of a sudden perk up." That's all the more reason to talk to your doctor or a mental health specialist about possible solutions for your problems.

As for people recovering from addiction, like King, McDowell says there's a good deal of hope -- as long as recovering addicts can do the work to recalibrate their expectations of sex. "Sex then becomes a much more sensual, romantic, fun, balanced experience rather than this hyperkinetic overdrive," he explains. "It's going from an incredible, driving disco beat to a nice symphony. But it's in some ways much more enjoyable because it's about connection, not just in a very animalistic driving, predatory way."

November 18 2010 4:00 AM

 Having lived with HIV for well over a decade, Carlos Hernandez had pretty much resigned himself to not having a future. He eventually “ran out of T cells altogether,” he says, but he still refused to take antiretroviral medications. He’d tried them a couple of times in the early days of the newly formulated drug cocktails and was adamant that he’d never face the side effects again. The fact that more tolerable medications had been rolling out of the pipeline over the years since his last attempt at treatment in 1999 escaped him.

“I told myself, Screw it! My days are numbered,” he recalls. “I quit paying my taxes. I just quit paying attention. I didn’t plan on being around. To me, my only future was that I was just going to have a slow death from AIDS.”

After two bouts of meningitis, he wound up in the hospital for what seemed like the third and final time — so ill that the 5-foot-8 Hernandez dwindled from his usual 170 pounds to 85. It was finally time, he felt, to tell his family that he was HIV-positive.

Similarly apathetic, heroin addict Samuel Morales, who tested HIV-positive and was given six months to live in 1985, blazed through the go-go decade on a spree of theft and drug dealing, bouncing back and forth between prison and the streets of Philadelphia. “That was my thing: drugs and stickups,” the 53-year-old preacher’s son and one-time honors student says. “I didn’t really care about life. My life was like… I walked in the streets and felt like people knew who I was. I would stick them up and tell them, “It’s not me. It’s the drugs.” I guess I was looking for somebody to kill me, or I was trying to kill myself. I ain’t care about life.”

In 1990, facing a bundle of charges, including attempted murder and skipping out on bail, Morales pleaded no contest and was sent to prison for eight to 20 years. There, continuing to deal and use drugs on the inside, he faced the dismal medical care typical of U.S. prisons throughout much of the early days of the AIDS epidemic, extended stays in solitary confinement, and the apparent certainty that he would die before ever getting out.

In contrast, 41-year-old Mexican native Gabriel Rocha says that he was desperate to live but was unable to find any help that would allow him to. In 1999 while living in Puerto Vallarta his health declined to a point as dire as Hernandez’s at its worst. “Doctors wouldn’t touch me,” he wrote earlier this year in his fund-raising pledge for the California AIDS/LifeCycle. “They told me I was going to die and there was nothing they could do for me. They condemned me to a death sentence and were unwilling to lift one little finger to help.”

Fortunately, Rocha had a patron saint of a friend in the United States who flew him to San Francisco. Cheating death, he would remain in the hospital there for the next four months. Eventually, he applied for and was granted political asylum in the States. But it wasn’t just the lack of proper medical care in Mexico that threatened his life; he was once abducted by a group of men and tortured over a two-day period because of his sexual orientation.

November 18 2010 4:00 AM

 Imagine if you could chuck your daily supply of anti-HIV meds and replace them with a monthly transfusion at your physician’s office or, if possible, even a single shot that you give yourself. A small but determined group of biotech companies are researching new therapies that would last in the body for weeks or longer.

TaiMed Biologics and Progenics Pharmaceuticals, for example, are each looking into drugs known as monoclonal antibodies; these have already revolutionized cancer treatment and have made some chemotherapy far more tolerable when it comes to possible side effects. TaiMed’s agent is an antibody that blocks HIV’s attachment to the CD4 coreceptors. It is made by injecting mice with those same coreceptors, harvesting the natural antibodies the mice produces as a reaction, and then altering the DNA of those antibodies so that they are 99% human. Infused into an HIV patient, these antibodies, it’s theorized, could last up to a month.

Progenics is in clinical trials of PRO 140, a monoclonal antibody that blocks the CCR5 coreceptor. Study results published this year indicated that once-weekly and every-other-week subcutaneous injections of the antibody both suppressed viral loads significantly, and patients could potentially administer the injections themselves. PRO 140 has received fast-track designation from the Food and Drug Administration.

Tibotec Pharmaceuticals, the antiviral division of Johnson & Johnson, is attempting to produce a long-acting version of one of its upcoming nonnukes, currently referred to as TMC278. The medication is processed to create a mixture of tiny particles of TMC278 with a liquid to create a solution called a nanosuspension. When injected into the body this solution works to extend the release of medication over the course of weeks.

Another compound, EFdA, a nucleoside reverse transcriptase inhibitor being developed in academic and National Institutes of Health labs, meanwhile, has shown itself to be extremely powerful in both test-tube and primate studies.

“This new compound is 60,000 times more potent than any other drug that is currently being used to treat HIV,” says Stefan Sarafianos, an assistant professor of microbiology and immunology at the University of Missouri school of medicine. “This compound has a different chemical makeup than other approved therapies and creates an exceptional amount of antiviral activity. It’s activated very quickly and stays long in the body to fight the virus and protect from infection.”

Curiously, the EFdA compound was discovered by a soy sauce manufacturer in Japan that was developing it as a flavor enhancer. The company’s product tests eventually found it had antiviral capabilities. With a half-life of three weeks, EFdA could be taken less often than currently available options. It also has shown potential for use in a microbicide.

But there’s a major question yet to be addressed: Can researchers develop enough of these long-lasting medications to piece together a viable full cocktail? After all, currently successful combination therapies contain at least three compounds -- whether in the form of three drugs taken together or combo pills taken with one or more additional meds -- since each attacks HIV in different points of the infection cycle.

That’s not to say, though, that they won’t have their benefit. “I see these long-acting drugs as a potential answer to adherence problems,” says Jeffrey Jacobson, the cochair of the long-acting drug task force for the AIDS Clinical Trials Group.

With this type of treatment breakthrough possibly becoming available in the next few years, HIV Plus decided to check in with experts to see what other advancements they think could be in store for HIVers over the decade ahead. And of course, we’re looking at the current traditional treatments that are working their way through clinical research.

November 18 2010 4:00 AM

 • An estimated 33.4 million people worldwide are now living with HIV. In the United States there are approximately 1.1 million people living with the virus.

• It’s estimated that 2.7 million people were newly infected with the virus in 2008, the most recent year for which statistics are available. That’s just under 7,400 people who contracted HIV every day. Roughly 56,300 of those new infections occur annually in the United States.

November 18 2010 4:00 AM

Ahead of World AIDS Day and the corresponding Day With(out) Art, HIV Plus takes a look at the art, in its variety of forms, that has been created in the name of this virus. From emotional and physical therapeutic efforts to the outright documentation of the AIDS crisis, we had no idea when we started this project of just how immense the body of works had grown. And while we were barely able to scratch the surface here in these pages, we are grateful—and awed—that there is not only a universe of creativity that speaks of the past three decades of struggle, of success, and yes, of loss, but also an army that is growing to preserve this history.

November 18 2010 4:00 AM