Saturday, December 1, 2012

World AIDS Day, Truvada...And Why We Can't Ignore HIV


Today is December 1st, and that makes today World AIDS Day. On this day we take a moment to educate people on the current reality of the HIV/AIDS and to reflect on it's history and those we have lost...and those we are still losing. I sometimes can't believe it, but here we are over thirty years after I first ever heard about HIV, still fighting this disease. And...we are not only fighting the disease itself but also still battling to educate the world about who gets HIV and how. For me, coming up in the 90's, the conversation about HIV and AIDS was pretty unavoidable. It was everywhere. There were commercials aimed at teens and young adults, movies and t.v. shows with HIV/AIDS themes, and of course...the news. Now, to be honest, I am not the most media aware person...but I grew up with a crystal clear idea of what HIV/AIDS was...how it was transmitted...and how to avoid it. I understood that a condom was an important thing to have even before I had any idea what sex really was.

But here we are in a whole different millennium and still needing to have the same conversations. Many still consider HIV to be primarily a gay disease as opposed to a disease that ravages the lives of heterosexual men, women and children around the world...worst in nations that still refuse to acknowledge it's existence and who can often not afford treatment. Over time, new medications changed what a diagnosis of HIV meant such that what used to be an automatic death sentence now holds a ray of hope...if not an end to the disease.

But that thirty years has taken a toll on our perceptions of HIV/AIDS. What used to be a terrifying killer to nearly everyone has become something to be managed and in some cases ignored...for example, for World AIDS Day the online hook up sight Manhunt is sending out emails to its members promoting Truvada...a recently approved pill that can reduce the chances of being infected with HIV...as a solution when "condoms get in the way".

Really?......I was shocked when I read this and had to stop and take a deeper look at it. After thirty plus years of living with HIV as an ever present possibility...and that sex still comes with risk, I questioned how this was helping people stay healthy?....  and was it sending completely the wrong message?
After a little Googling, this is what I learned a little more about Truvada....The recently FDA approved Truvada is being prescribed as a treatment for those already diagnosed with HIV/AIDS as well as being billed by it's creator, Gilead Sciences, as a preventative measure for those at "high risk" of exposure to HIV. The pill is actually a combination of two drugs that work together to reduce the amount of the HIV virus that is circulating through the blood stream thus reducing the chance that an individual will be exposed to the HIV virus. In order to be effective as a preventative measure, it is recommended that Truvada be taken daily both before and after potential exposure. PS....it's not cheap. At the last report it cost $14,000 a year. Taken daily, that's about $40 per dose. And nowhere did I find a hard number for exactly how much Truvada reduces your chances of infection.


Now...I wondered where Manhunt was coming from when they chose to offer this drug as an alternative to condoms....which is what I took "when condoms are in the way" to mean. My immediate and gut reaction was that it was incredibly irresponsible choice of language on their part. The choice for "When condoms get in the way" sends the message that they are merely an inconvenience and not something that can save your life or the life of your partner. Going back to my first paragraph above, I was shocked that it was 2012. Thousands of people have died from this disease in my lifetime and here we were still encouraging unprotected sex. I began to wonder if we had lived with HIV/AIDS so long that no one gave a sh*t anymore.

But there was a flipside that I was forced to consider.

Manhunt has to know their clientele and the realities that some of them choose to go without safe sex even knowing the risks. They do so perhaps because they believe HIV will never happen to them or for a variety of reasons that we may not agree with but are going to happen anyway. You can educate, beg, cajole, and plead and a certain amount of people are still not going to do it. Perhaps sex with condoms doesn't feel like real sex to them or they are married and afraid to be busted with condoms and lube....whatever. It still happens and Manhunt knows this. So...In a world were safe sex education only goes so far...can promoting a drug like Truvada be perceived as still helping people remain healthy, even if it is far less effective than simply wearing the dam condom?

In my own opinion, and after some hard thought I think it can, for the reasons I gave above. But...if only Manhunt had not phrased it the way they did. Regardless of their intentions in promoting the drug, the reality is that they have painted condom use as unnecessary and inconvenient. We don't remotely live in a world in which we can afford to look at sex that way. I know that we don't see faces like this one of Pedro Zamora who passed away in 1994. For many, he became the first gay person they had ever known and when came out about his HIV status...he became the first HIV positive man many people may ever have had the opportunity to know. When he died in 1994, he was far from the first person to pass from the disease.....but he made personal to so many for whom AIDS had simply been a  a blurb in the news. Something that happened to someone else....not someone you cared about. Not something that could happen to you. But it did...all to often and to too many people. This is what HIV had come to mean to me...


It's a hard image to see. But we forget how common they used to be and how many people died alone because everyone was too scared to get sick. We may not see them so often anymore, but the reality is that people are still getting sick. New infections continue to grow among teens and young adults. Are we still getting out the message? Have we dropped the ball when we have stopped telling kids that HIV is real and can happen to them? Are Manhunts choice of words indicative of a larger fatigue in talking about and educating people about HIV as it exists today? Condoms may not be 100% effective in preventing the transmission of HIV...but it beats the hell out of the odds you get with Truvada. And while Truvada may be active against HIV, it is NOT against any of the other common stds like gonorrhea and syphilis that now are almost completely resistant to antibiotics.

We can't take it for granted that HIV is not still a risk to everyones lives. It is a conversation we still need to have society wide. It needs to filter out to everyone regardless of age, sexuality, and race. We need to reach those who still think of this as something that happens to someone else. The very first time I ever heard about HIV/AIDs was when Rock Hudson was diagnosed with it back in the early eighties. It has been an ever present part of life since then...and while we have celebrated the fact that we don't see so many deaths here anymore....I am now an adult, a man of 40....and this disease is still here and still making people sick...and still claiming lives. We haven't gotten so far passed the specter of those first days that we can afford to stop talking about it and educating people of all ages about what AIDS is, how you get it, who gets it, the importance of knowing your status....and taking precautions when having sex.

We are tired of taking precautions....I get it. We want sex to just be hot and spontaneous. We want to be passionate again, not fearful. We don't want to think about death and disease when we are in the throws of what can be a celebration of what it means to live. Those are real feelings and I think to some degree all of us feel them....I know I do. After being afraid of sex for so long I guess it's only natural to want to take it back....but we can't close our eyes to the reality that HIV is still out there and that safe sex is the best solution out there currently though new treatments like Truvada are providing hope that one day there will be another solution. Until then, we can not ignore that HIV is still here....as it has been for most of my life.

It's now  thirty years later(for me at least) and breakthroughs in treatment have come offering so much promise and then faded into obscurity...yet HIV is still here. As long as it remains, we have to keep being cautious, keep educating, keep fighting...for our own lives and the lives of those who will come after us. All of us are going to make mistakes...slip up...have moments of passion.....sh*t happens. None of us are perfect. That's also a part of the world we live in. But we can not throw away all we know about HIV/AIDS because it is inconvenient or in the way. Until HIV goes the way of polio...or drugs like Truvada work 100% of the time...we can't tell people that condoms are "getting in they way". We can tell them not to be afraid of sex...that it can be hot and spontaneous and passionate...and not pass on a life threatening disease...with one simple step. Until that day comes when a patient zero provides the antibodies to beat the disease or a magic pill makes new infections a thing of the past...we can't stop caring about it...we can't stop talking about it or we will keep seeing images like the one of Pedro above. The only thing a condom is getting in the way of, is seeing more of that. I don't know about you, but I  have seen enough.

Until next time dear readers....




(P.S.....I chose this is how I choose to remember Pedro. To remember those who lived...and still live in our hearts....)


7 comments:

  1. I agree Truvada is being marketing with an irresponsible message and basically panders to the habitually careless. Even if the drug works as advertised, condoms still provide greater protection. While condoms don’t provide the level of sensation of raw sex, you still can have good sensitivity even with a condom and it’s far more dependent on your technique in putting one on than the condom itself. If you put one on and feel almost nothing, it’s your fault and not the condoms. I not about to run a condom tutorial here :-D , because my talents for tastelessness are much better applied to something funny. There is one video on Jasun Mark’s channel where he gives tips which go beyond what standard condom instructions are and the results are greatly improved sensitivity. Following only package instructions without additional steps almost guarantees that horrible “raincoat in the shower” feeling. The video is called “Shut up Jasun: slow on the draw edition. Here’s the link: http://www.youtube.com/watch?v=si_2lxEkeV4 .

    It’s not only full-blown a**l sex that’s unsafe when unprotected. A number of activities in bed can be done in an unsafe manner too. There’s an Australian doctor with a YouTube channel, healthybear I believe, who has a video on oral sex and he says gay men who have mouth or some other cancers in that area at very high percentages test positive for the human papilloma virus (HPV). He advises gay men who engage in unprotected oral sex to get the Gardasil vaccination, even though it’s expensive and might not be covered by health insurance. Gardasil is more commonly given to young women. Here’s a link to that video: http://www.youtube.com/watch?v=TjQZ8FH1nUI .

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  2. i love jasun mark...hes my first fellow gay pagan. he talks very deprecatingly about his 'bad advice' but if you *understand* the perspective he has on things its not bad at all. {as a darkly amusing aside, i have misspelled this word repeatedly lately - and the dark powers are laughing hysterically.}

    the first time i got tested was in the former gay bar, now gay friendly, my bfam todd literally grabbed my shoulders from behind and pushed me towards the table with some comment like 'especially this guy'(because we were discussing the fact that i thought it was cool that the dhs was out like they were) or some such....i will punch him in the throat for that too eventually its just a matter of time now, hes forgotten. he was right i did need to be tested and i just had not worked up the nerve to go do it myself yet. i will get tested again, but by the grace of he that made all things and blind stupid luck i am clean of both hiv/aids and syphilis. i still remember the scene in life goes on where that straight teenager got in a fight at school and his then girlfriend in the main family wanted to stop the fight to the point that she outed him as being positive. sex ed here is a bit of a joke in terms of the school version but we had something- and i still remember both the stupid video and the fact that the 20-30 something male teacher they made teach the class was so nervous about it that he did not understand the 'anonymous' question i asked. (im reasonably certain that i made a point of telling him he did not understand/answer my question- im an ass that way). by the time i got into high school it had changed dramatically and my semester long health class was taught by the girls volleyball coach and she was awesome, she kept it real-probably more real than many parents would have liked but it was good.

    you bring up the point of discussing getting tested, the knowing portion(which is half the battle, G.I. JOOEE!! GO JOE!!) as part of that discussion the fear of 'what if' needs to be addressed because that fear keeps many from getting tested in the first place. it is not an unfounded fear either, between the marginalization we put ill people into and the discrimination for that illness (regardless of any stupidity involved on the part of the person in question) it is a huge hurdle for anyone to overcome for their own knowledge even.

    another point is that we as a species are adapting to the hiv virus. their are people who can carry the virus with no ill effects to themselves at all, ever. i believe they have a peptide chain that binds with the bonding chains on the virus preventing the virus from bonding with their cells or some such- or at the sites that the virus bonds to the cell they have a chain that tells the virus the cell is already infected (i dont recall the specifics- i know it has to do with the shape of the bonding chain). this doesnt help the people lacking that adaptation and these carriers can spread the virus to others normally. last i recall they were trying to figure out how to build those peptides and then deliver them as a treatment.

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  3. so im guessing the question becomes how much of a barometer is the lack of response? i know its only tuesday am but still...not even the usual 'well saids' so far.

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    1. Maybe a lot of our usual commenters live on the west coast. Late week last week and into the weekend, they were getting their asses kicked by a severe storm--severe quantities of rain and probable flooding too. Who knows what property damage and survival issues they may face now--stuff that makes blog posting seem quite trivial.

      For all we know, as an example, the Leffew's house has a moat in the front yard and Jay has to jet ski to work now.

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    2. lol, life happens.
      that may be fun....the jet ski to work that is.

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  4. Thank You! That is all I can muster at the moment, through the tears...and the memories.

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