Millions of people live in fear and isolation because of their sexual orientation and gender identity. via @unaids
Sometimes it’s wonderful to wake up gay and some days, well, not so much. My perfectly Instagrammed breakfast of eggs benedict was seriously spoiled on reading the Guardian and the Independent’s latest overwrought articles about ‘gay sex parties’ being linked to a rise in HIV diagnoses.
This story is trotted out in some form or another every few months or so, usually illustrated with a microscopic selfie of HIV itself or a blurry picture of a heaving Vauxhall club. For the uninitiated, here’s how these pieces usually roll: a ‘study’ is done on HIV rates, a journalist will trawl the sexual health clinics or ask charities for statements until something is said that will make a good headline. Usually a finger points firmly at a supposed increase in gay sex parties, a Roman orgy remixed for the Vauxhall generation.
The piece is printed, society safely compartmentalises HIV as a…
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The Dark Ages of HIV/AIDS History
The history of HIV/AIDS in the United States is rife with contention and controversy. During the very early years of public awareness, before any robust knowledge base on the virus existed, HIV was grossly misnamed as “GRID” – Gay Related Immune Deficiency. What motivated the use of this biased terminology was the prevalence of the virus in various urban gay communities in the 1980’s, which only fueled rampant homophobia and violence towards such enclaves. Not until the virus was discovered in recipients of tainted blood transfers, injection drug users, and persons of every identity did the massive push towards public and federal advocacy gain momentum. Today, celebrities and high profile public leaders are involved in outreach and education efforts regarding research, treatment, and prevention.
According to the CDC, MSM (men who have sex with men) and communities of color are adversely affected by the HIV/AIDS epidemic. However, it is mistakenly believed that being a member of such groups is deterministic of negative characteristics and behaviors that transmit the virus – vitriolic language and attitudes detract from the structural causes and socioeconomic contexts that fuel public health issues. The stigma and violence directed towards the gay community in the early years of the epidemic discouraged individuals from seeking treatment and hindered the proliferation of organized prevention efforts. Moreover, systemic poverty and the lack of robust health infrastructure widened the gap between those seeking treatment and information from those who could provide it. In the recent years, there has been a paradigm shift in discussion of HIV/AIDS to treating it as a tragic byproduct of societal oppression and inequality.
Fighting Stigma with Information
Though advocacy has progressed far from the state of affairs of 20 years ago, there needs to be greater solidarity among all communities across the lines of sexual orientation, race, and socioeconomic status. Awareness and prevention are the highest points on the agenda when it comes to fighting any disease. Especially for those who identify or interact with groups that are considered to be at a higher risk for contracting HIV, or participate in activities that spread the virus, regular testing is essential for harm reduction and early intervention. Testing remains one of the important personal initiative for individuals to take when preventing the spread of HIV. Empower yourself and those close to you by seeking help and knowledge, rather than taking your chances.
Find an HIV Testing Center Today! Click the FindTheBest logo below to access a great data driven tool to find a quality, free HIV test near you.
Or if you’re in Portland join CHATpdx’s Youth Exclusive drop in and testing night! Monday (6/24) from 3:00 – 7:00 PM at Pivot! http://pivotpdx.org/
– Susan Li
FindTheBest is a company based in Santa Barbara, CA that builds unbiased, data-driven comparison engines. Their Health Division is committed to creating innovative tools for navigating the important decisions regarding your health, including an STD testing clinic locator and a treatment center comparison tool. Susan joins the Health team from Columbia University in the city that never sleeps, ever. As an Economics and Asian American Studies major, she is dedicated to advancing social justice in all areas related to public health.
It’s important for people of every community and identification to get tested for HIV. Testing can really be a nerve wracking experience – getting tested with a friend or in a space you trust can give a huge sense of security.
After decades of study the FDA has made a ruling that makes that community experience less likely to happen. There are some benefits to approving the at home HIV test but I disagree with their decision. When a person goes to a safe space in their community to get tested there is less of a chance for them to commit an act of self harm or take other drastic measures if their test comes back positive. When someone uses an at home test the responsibility is on them to call the HIV Hotline to confirm their results and connect to counseling and care. It’s hard to ensure people will even follow through a referral for a confirmatory test.
These tests leave dramatically more room for error than traditional methods. Clinical trials found 8% of those who are truly HIV+ will not receive a positive result when using the at home HIV test. Getting an accurate answer means so much – I believe this 8% rate is too great a risk to allow these tests on the market.
The price for at home testing is prohibitive. Each test can cost between $40 and $60. To me that’s ridiculous – seeing as there are so many places to go and get tested for free. The cost of this test is nothing but a convenience fee. So the next time you are getting ready to take an HIV test I hope that my personal views can open your eyes to making the right decision for your health. Whether you buy an at home test or go in to get tested, the important thing is that your getting tested.
Find a free HIV test near you: http://hivtest.cdc.gov/
– STEFHANNIE J CALHOUN
Male Birth Control that can also kill HIV?
More often than not, the responsibility of preventing pregnancy falls on female-bodied individuals – birth control pills, the patch, IUDs, insertive condoms, etc. But what about guys who want to take responsibility too? Or women for whom a lot of the standard options don’t work?
Enter a new option: for years, researchers in India have been looking at a technique called RISUGTM (reversible inhibition of sperm under guidance). Basically, a doctor injects a gel into the vas deferens, which are the tubes that the sperm flows through on the way to ejaculation. The gel hardens as it coats the walls of the tubes, and tears apart the sperm as they pass by so that they can’t cause pregnancy. It’s a non-surgical procedure that can last for twenty or more years, and is easily reversible by injecting a solution that dissolves the gel. Within a few months of reversal, fertility should return to normal.
But it doesn’t stop there – now researchers are talking about ways to make the gel also prevent
ideas about how it would work – like inactivating HIV in spermor having the gel release drugs that would kill the HIV downstream (because some components of semen don’t pass through the vas deferens – they come from the seminal vesicles, prostate and bulbourethral glands).
Of course, it’s still in trials so we won’t be seeing it on the market any time soon, but if it works this could be huge! Not only would it be another option for preventing pregnancy, but it would also provide a new way for serodiscordant couples to prevent transmission of HIV to the negative partner.
What do you think? Would you try it? Would you trust your partner if they said they’d had it done?
I have never heard of the Banyan Tree Project nor National Asian & Pacific Islander HIV/AIDS Awareness Day, which falls next month on May 19. Each year A&PI Awareness day is sponsored by Banyan Tree Project. National Asian Pacific Islander HIV/AIDS Awareness Day goal is too highlight the negative stigma, lack of communication and general awareness of HIV/AIDS in the API community. The theme for 2012 is “Saving face can’t make you safe. Talk about HIV–for me, for you, for everyone.” An idea that is very important to highlight in our community.
Growing up as a Queer Chinese Asian American; I have seen the hush, hush of just talking about the queer community. It’s something you don’t acknowledge nor talk about subject. Heck, I didn’t even know that there are community groups out there dedicating themselves to informing and educating the Asian Pacific Islander Queer community. Over the years, I have to learn to embrace myself, my community and all those that are a part of it. It was recently that I became even deeper part of the queer community and making myself part of the local API group, Asian Pacific Islander Pride, which had made me aware locally of the Asian Pacific Islander community and events. This is step one of many steps in my life to make myself a more engaging part of the API community. I’m proud for simply reaching out and help to increase awareness, decrease negative stereotypes and providing information that helps keep people informed.
Just like the other National HIV/AIDS Awareness Days, it is very important to embrace awareness into the ethnic groups of all backgrounds as those are the ones who generally are looked over and forgotten. I am glad that we, the Queer Asian community, are standing up and putting a voice to bring education and awareness to help make HIV/AIDS less of an impact while ending the stigma of being Queer in API community. The motto this year is for you to make our issue, your issue. Go and simply Speak Up! Get yourself involved in an organization, like Asian Pacific Pride, that you feel strongly with. It’s all starts with YOU.
What does A&PI HIV/AIDS Awareness Day mean to you?
As one of the last fluids we think about when we think about HIV, I thought it might be helpful for us to learn a little more about the 4th fluid that transmits HIV. Since blood, semen and vaginal secretions have gotten all the attention, why not take a moment and learn a little more about how breast milk can transmit HIV.
What a brief review of the research shows:
- Infant feeding is estimated to be responsible for anywhere from 5-20% of mother to child transmission. If a child is born HIV-negative to a positive mother who is not on antiretroviral treatment, the risk associated with prolonged breastfeeding is estimated at 10-20%.
- HIV RNA is found in breast milk and the risk of transmission is directly related to the viral load in the mother’s milk. Some mothers may have a specific gene (SDF1 3’A allele) that causes increased viral replication in breast milk and therefore increases transmission risk.
- Although breastfeeding from an HIV-positive mother poses a risk of HIV transmission to the infant, there is also evidence that it provides better health outcomes for the child than formula feeding (protective against other infectious diseases)
- The World Health Organization promotes alternative (formula feeding) only when it is “affordable, feasible, acceptable, sustainable and safe.” When ARVs are widely available and breastfeeding is a social norm, they recommend that HIV-positive mothers breastfeed until 12 months of age.
- Women who are on antiretroviral treatment while breastfeeding have a lower risk of transmitting HIV to their infant. (about 3.5% in one study in Kenya)
- Exclusive breastfeeding has been associated with a reduced risk of late HIV transmission as compared to mixed feeding. Mixed feeding practices (breast milk plus other liquids or solids) and prolonged breastfeeding (more than 6 months) are associated with increased risk of mother-to-child transmission of HIV.
- Exclusive breastfeeding is hard. Barriers include low milk production, lack of control over the feeding situation, and both perceived and enacted stigma.
- Infants can develop resistance to HIV medications independent their mother’s resistance – that is, the mother is not necessarily passing on a resistant virus, but if the infant becomes infected while breastfeeding and the mother is on ARV, the infant is being exposed to small amounts of the drugs through breast milk and may therefore develop resistance to them.
The more we can inform women about the risks and benefits associated with breastfeeding, as well as things that can reduce the risk, the better able they will be to make the best decision for themselves and their infants.
A systematic review of a number of publications on HIV and breastfeeding:
Large Breastfeeding study in Kenya:
Difficulties of exclusive breastfeeding:
If anyone is still reading,
To kill HIV in breast milk, flash-heating breast milk can inactivate HIV without destroying too many of the vitamins or immunoglobulin in the milk that make it beneficial to the baby. The WHO recommends it as an option to reduce vertical HIV transmission in resource-poor regions. Of course, to do this the mother has to express the milk first, then heat it, then feed it via bottle – so it’s kind of a compromise between breastfeeding, which could transmit HIV, and bottle feeding formula, which has other nutritional/gastrointestinal risks.
What do you think? How has this changed how you think about HIV? Has it changed any of your thoughts?