What type of immunity is lost when a client develops human immunodeficiency virus (HIV)?
a) Active immunity
b) Passive immunity
c) Humoral immunity
d) Cellular immunity
Answer: d
Cellular immunity, which occurs through the T-cell system, is lost with HIV. Active immunity occurs in response to an infection or vaccines. Passive immunity occurs through an injection of immune serum, or, for an infant, from breastfeeding. Antibodies produced by B cells mediate humoral immunity.
It takes a lot for a woman to push all the way to the top in a male-dominated industry like rap. Her 1994 Grammy Award winning song “U.N.I.T.Y.” reminded listeners that “I bring wrath to those who disrespect me like a dame.” She empowers women and girls with her music and life story, helping them take the reins in their own hands. She also supports charities like HIV/AIDS groups and women’s organi
zations. All in a day’s work for this Push Girl!
Tell your friend she’s got a little Queen Latifah in her. Reblog now to give her a little push.
In advance of World AIDS Day 2018, Secretary of State Michael R. Pompeo will deliver keynote remarks at the PEPFAR Faith Communities and HIV Technical Summit at the Department of State at 9:00 a.m. Eastern Time on Tuesday, November 27, 2018. Watch the event live on www.state.gov.
The Secretary will announce the latest lifesaving results achieved under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), including additional progress that is being made under the PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020). Visit www.pepfar.gov to learn more.
“Victims of the disease AIDS argue, with no qualms of inconsistency about rights, for crash research programs (to be paid for by people who don’t have AIDS), demanding a cure. And it’s done in the name of rights. The victims demand health care and scream ‘discrimination’ if insurance companies claim they have the right to refuse to issue a policy to someone already infected with the AIDS virus. The rights of the insurance company owners are not considered, while legislation is passed forcing insurance companies to provide insurance demanded by the victims. The individual suffering from AIDS certainly is a victim - frequently a victim of his own lifestyle - but this same individual victimizes innocent citizens by forcing them to pay for his care.” -From Ron Paul’s 1987 book Freedom Under Siege (pages 22-23).
Paul defended these comments on Fox News in January of 2012. You can see that video here (starting at around 3:30).
Researchers say they have found a second patient whose body seemingly had rid itself of the human immunodeficiency virus (HIV) that causes AIDS — supporting hope that it may be possible someday to find a way to cure more people of the virus.
The folks over at transhousingnetwork asked me to write something about how to be a good roommmate to someone living with HIV, so I did!
As has previously been noted on this blog, I am a trans woman who has been living with HIV/AIDS for eight years, which puts me somewhere between “treatment naive” (as they say) and “long term survivor.” Still, I live in New York City, which is one of the most competitive housing markets in the US, and I think eight years is long enough to have learned a thing or two about this stuff. This is extra-long for a Tumblr post, but if I may be so bold, I think it is full of good info for anyone who cares about someone living with HIV.
When I mentioned writing this article before to a friend, they were like, “Being a good housemate to someone living with HIV/AIDS? That sounds like a no-brainer. Just like, don’t be weird about stuff.” Were it that simple! Often, people with HIV/AIDS have special housing needs that you might not realize at first glance, so PartyBottom is here to tell you all about ‘em. Of course, this is not an exhaustive list, merely a start to an ongoing conversation, so if there’s anyone out there who has anything to add, please do message me and let’s keep the ball rolling. (Also, most of my knowledge comes from a US perspective – I am interested to hear what it’s like in other countries, too.)
HIV+ PEOPLE ARE MORE LIKELY THAN HIV- PEOPLE TO RECEIVE SOME KIND OF GOVERNMENT FINANCIAL ASSISTANCE. THIS MAY IMPACT HOW THEY PAY THEIR RENT, AND HOW THEIR LIVES ARE STRUCTURED OVERALL. YOU SHOULD BE OKAY WITH THAT AND PREPARED TO DEAL WITH THE REALITIES THAT COME WITH IT. I cannot stress how this changes a person’s life, your shelter and other basic needs being tied to the whims of various state apparatuses. The #1 thing that people living with HIV/AIDS need help from the state with is paying for their medicines, which can *easily* cost between $30-50k per year. Many people living with HIV/AIDS (hereafter in this article abbreviated with the common but unpronounceable acronym PLWHA) receive help with meds through a federal program called ADAP (the AIDS Drug Assistance Program) which may cover the cost of meds (maybe only HIV-related meds, maybe most meds, and maybe some doctor’s appointments. Where I live in NYC, it has even covered my hormones.) Many PLWHA are on Medicaid, Medicare, food stamps/EBT, pubic assistance/welfare, Social Security Insurance/Social Security Disability Insurance (SSI/SSDI) or may receive some shelter grant through a federal, state, or municipal program.
(And of course, some PLHWA have “normal” jobs with “normal” benefits and “normal” incomes and do not have to deal with these institutions – or may not, for now. More on that later.)
HOW DOES THIS ALL SHAKE OUT IN A ROOMMATE SITUATION? WELL, LET ME TELL YOU. Say you post a housing ad on Craigslist. $400 room available, must like cats, queer/trans friendly house! And say you get half a dozen replies, and narrow it down to two candidates whom you like. The first one says, “Oh, you know, I’ve been working and saving up money, I can put down a deposit and pay you three months rent in advance.” The second one says, “Here’s the deal. I am trusting you enough to tell you that I am HIV+, and enrolled in a program that pays my rent. We will need to fill out several forms together – maybe several rounds of forms together – and I will need utility bills with your actual names on them, and we may need to get the landlord involved and get a utility bill with her name on it, oh, and by the way, these programs are slow and bureaucratic, and I may not be able to pay rent for the first month (or two), but I can petition for arrears, and I am sure, absolutely positive (ha ha) that I can pay that back rent and all future rents and pay it on time, and one this all gets rolling, you will be issued a check in your name every month like clockwork, and at least in that regard I will be the best roommate ever. Oh, and by the way, a government social worker will be stopping by to snoop around a bit every two months, but she is actually not so bad and it will be nbd, I promise.”
WHO WOULD YOU CHOOSE? This is where the social justice rubber hits the road.
Now, say you did a good thing (moreover, a *legal* thing, as – in New York City anyway – it is technically illegal to practice housing discrimination against someone based on their source of income, though in reality people do it all the time) and have decided to join up and be roommates with someone living with HIV, and who, for the sake of the narrative, is enrolled in a housing program and other forms of government assistance. What are some sticky situations you might expect? Well, here are a couple:
IT IS NO ONE’S RIGHT TO DISCLOSE ANYONE’S HIV STATUS BUT THEIR OWN. There is a real parallel here with being trans. Some trans people are OUT OUT OUT about being trans – and that’s great! – and other people are super stealth and don’t want anyone to know about it. It is sort of the same with HIV.
I was diagnosed sort of at the end of the era in which the common social work wisdom was to advise newly-diagnosed clients NOT to run out and disclose their status to everyone, even to their closest friends. “You cannot unring that bell,” was the common phrase, and frankly, it’s true. I have heard heartbreaking stories in which someone told her close friend that she was positive, who told her neighbor, who told the woman’s sister, and from then on, the HIV+ woman was never allowed to hold or touch her baby niece again, out of fear that she would somehow “contaminate” the child. People’s HIV+ status – not unlike the fact that someone is trans – makes good and potentially deadly gossip. It is not something that people easily keep to themselves.
FOR INSTANCE, say your roommate seems not to be doing much. Like, if they are caught up in the HIV/AIDS industrial complex, they are probably consigned to a life of subsistance poverty, so it is likey that they may have a little side hustle to afford things that most normal people have (like, say, a cell phone! or shoes that don’t hurt your feet! or whatever!) Maybe they cut hair for cash. Maybe they deal a little weed. Maybe they work under the table at a food truck. Maybe they play music and busk on the train. Odds are, they may have a life that appears improbable to the outside world.
What if someone is making chit chat with you at a BBQ and is like, “So, how’s living with PartyBottom working out? What does she, like, do all day exacty? Oh, really? Does she make enough money doing that?” A pretty naive answer might be, “Well, she does make some money, but she’s also enrolled in this city program called HASA that pays most of her bills.”
The thing is, if anyone knows what HASA stands for (the New York City welfare department’s HIV/AIDS Services Administration), then like, boom, they know that PartyBottom is positive. And if they don’t know and they Google it, same deal.
That is a casual, just kind of doofus-y goof. Things around disclosure get a little more tricky when you realize that HIV+ PEOPLE ARE SEXUALLY ACTIVE, AND IN GENERAL, THEY ARE RESPONSIBLE ABOUT IT. IT IS *NOT* YOUR RESPONSIBILITY TO “WARN” ANYONE ABOUT ANYONE ELSE’S SEROSTATUS.
Say your roommate brings home a hook-up from a party. You might hear all kinds of grunts and groans coming from their bedroom. Your HIV+ roommate may or may not choose to disclose their serostatus, based on the level of risk involved in the hookup. Maybe their new friend comes over three or four more times! It might be tempting to say something like, “Wow, it’s so cool of you not to stigmatize PartyBottom as a sexual partner for being HIV+,” or even something more innocuous, to that effect. But maybe all they were doing in there is like, sexydirtytalk brother-and-sister role-play with lots of mutual j/o (hottt, imho)! And as such, maybe someone like PartyBottom would feel like, since they barely knew the person, and this is just a no-high-risk-fluid-exchange nbd fwb sitch, that their new sexxin’ buddy really didn’t need to know all about sero status, have to have a loooong convo about health and feeling and etc etc etc.
People living with HIV know better than anyone else the right time and place and circumstance to disclose matters of their own health. This is not your job. On a number of instances, PartyBottom has started to date someone and a third party has inserted herself into the conversation, to let the object of her affection know about her serostatus before the time was right, out of “concern.” (Man, this is a whole other article.) Anyway, don’t do this.
PLWHA are often stigmatized as “AIDS monsters” who run around trying to infect people at every given opportunity, but both my IRL experience and all the public health data do not bear this out. (Most new infections are between people who do not know their status.) There *are* some (a very small minority) people who know they are HIV+ who intentionally infect others. Some of them are in very desperate circumstances and have had to make terrible choices. Some number of them may be practicing some form of sociopathy. But, if you are living with a sociopath, you’ve got bigger problems than this article can accomodate.
Moving right along,
PEOPLE LIVING WITH HIV/AIDS MAY HAVE SPECIAL PSYCHOSOCIAL NEEDS. AS A GOOD ROOMMATE, IT’S ALSO YOUR JOB TO BE A GOOD FRIEND. Drug companies love to showcase PLWHA as being superhuman – if you live in a city or a neighborhood or read magazines where HIV meds are advertised, it is not unusual to see depictions of PLWHA running marathons, raising families, being in modern dance troupes, and generally having the time of their lives. And sure, lots of PLWHA are out there living their dreams – even PartyBottom, in a various attempts to reassure worrisome people that she is OK, jokes that she has “the Magic Johnson AIDS” – i.e, on meds, low viral load, good CD4 count, low side-effect profile. And, to an extent, that is true. But there are not-so-good days as well.
Life with HIV can feel lonely and sad sometimes. Depression is always kind of knocking on your door. Lots of people – HIV+ and HIV- – feel this way, and everyone copes with this differently – and having nice friends around to shoot the shit with over a cup of tea or a beer is a great coping mechanism.
More specifically, depending on when a person was diagnosed, and what particular strain of HIV they have, they may be on meds that are hard to take, and which have physical or neurological side effects, or physical side effects that lead to emotional side effects. For instance, Atripla, the much-touted “one-a-day” pill for HIV, contains a compound called Sustiva/Efavirenz, which is notorious among treatment-experienced PLWHA for its neurological side effects: depression, nightmares, disorientation, hallucinations. But, it is often pushed on newly-diagnosed patients because physicians think we are all really dumb and cannot manage our lives and so a one-pill, once-a-day regimen is like, the most complicated thing we can handle. So, say you’re living with a housemate who is newly diagnosed, or a housemate who has been diagnosed for a while, and they have a meds switch-up: they might start acting weird. Be gentle, but talk to them about it. Encourage them to talk to their doctor about alternatives. They are out there.
(A brief counter-example of how to be a NOT good housemate to an HIV+ person: when I first started Atripla, a subletter was living in my house who did not know I was +. I had a SEVERE histamine reaction to Sustiva, and my entire body broke out in scaley red sores – like I had chicken pox or something. She was like, uh, what’s going on? And, because I thought I could trust her, I told her the deal: that I am HIV+, and that I was having a reaction to a new medication. She freaked out. She said, You know, this is the kind of thing you really should tell someone before they move in with you. This is all very triggering for me. You know, my uncle died of AIDS in the 80s and I really think it was the source of my family’s homophobia. This is just bringing up a lot of stuff for *me* right now. Meanwhile, my skin was on fire. So like, don’t say shit like that.)
(Also I think it would be irresponsible of me not to note this: if you have been prescribed Atripla, or any combination of drugs with Sustiva in them, don’t freak out. My doctor at the time sold it to me like this: “You know, some people kind of enjoy the neurological side effects. They say it’s kind of like smoking pot. They take it before bed and it helps them sleep better, and they like the dreams. Sometimes it means more sexy dreams!” And many people experience no side effect profile from this drug at all. The point is, if you (or your friend/roommate) is having trouble, talk to a doctor, sooner than later. And if they don’t take your experience seriously, find another doctor who will, if you can.)
A few other short points:
QUIT MOVING SO MUCH. It has been noted that queers tend to occupy dwellings for shorter times than “traditional” families, seniors, etc. This is bad for neighborhoods in general (rapid real estate turn over makes it easier for landlords to jack up rents, gentrification happens, etc) and it is particularly bad for people living with HIV, because often their shelter needs are often tied to state bureacracy, which does not respond well to quick change. Deciding to move because you “need a change” or “don’t like the energy” of a place could very well leave someone living with HIV in a serious housing crisis, or even homeless. When you decide to make a home somewhere, ask yourself: can I see myself living here for five years? Ten years? The rest of my life, maybe, even?
CONTEMPORARY HIV IS AN EPISODIC ILLNESS. SOME DAYS WILL BE BETTER THAN OTHERS. For PartyBottom, personally, there are days (and, occasionally, weeks) when the fatigue hits and it is overwhelming. I have gotten and lost “real jobs” because of this. Most people with HIV – and most people in general – will not be able to work at some point in their lives because of illness or disability.
For me, I know the fatigue will pass eventually, and there are things I can do to alleviate it/keep it at bay, but mostly, I worry about worrying my roommates. I worry that they’re thinking, “Is she okay? Is everything alright? Do we need to do something?” The worry that my roommates think something is wrong with me is sometimes worse than whatever is actually wrong with me.
And sure, sometimes people get more seriously sick. Occasionally people end up in the hospital. But just realize that there will be ups and downs, and that it is your roommate’s responsibility to be honest with herself and you about how sick she or he is in fact feeling, and that no matter what happens, you will all get through it, together. (And maybe, if they request it, be prepared to be your roommate’s emergency contact.)
PEOPLE LIVING WITH HIV HAVE A LOT OF APPOINTMENTS TO KEEP. MAYBE BE A BUDDY AND OFFER TO GO WITH THEM! Doctor’s appointments, social security appointments, welfare office appointments, holistic health appointments, mental health/therapy appointments, etc etc etc. If you have time, and the inclination, going with someone to their appointments is a nice thing and will more likey than not help keep the household running smoothly. If you are a pal and go with your friend/roommate to the welfare office, it is more likely that they will keep those appointments and the checks will keep coming and the house will run smoothly. Speaking of which,
BE PREPARED TO DEAL WITH CERTAIN FEELINGS OF RESENTMENT THAT COME FROM LIVING WITH SOMEONE WHO RECEIVES PUBLIC ASSISTANCE. In certain cities, the benefits package offered to people living with HIV (slang term: “the kitty”) might at first glance seem quite generous. It is easy to look at someone in this situation and have surprising feelings of envy! Especially if you are scrambling to make ends meet. “Man, it’d be nice to be able to do anything I wanted all day, and not have to worry about rent or health care,” you might find yourself thinking. It’s easy for resentment to build up, and for that to start expressing itself in subtle ways. “Well, PartyBottom is on EBT, so maybe she can start buying more of the groceries we share, since she’s not, like, *actually* paying for them.” This kind will start stressing everyone out very quickly. Try to deal with these feelings, either by talking to a friend or therapist, or meditating on them, or – if you are very emotionally close to an HIV+ person – expressing them in the context of, “I know this might seem unfair, but I am having this feeling. I need to talk about it.” Having feelings is okay. Being mean to people because of them are not.
(Also, realize that your feelings have been manipulated by a decades-long US corporate anti-welfare mass media campaign. You have been programmed to hate welfare. It’s kind of your job to do the work to deprogram yourself of this, but again, this is another article.)
UNDOCUMENTED PEOPLE’S STRUGGLES WITH HIV ARE EXPONENTIALLY HARDER, but in certain cities there are certain programs that will help them at least have access to meds and basic health care. This is an extra-tough situation, but people live it every day. Somehow, people make it work. Some people (documented and undocumented) sell their meds in order to make money to survive. This is an intensely personal decision that you cannot judge unless you have walked this path, so reserve your fucking judgement.
This might be a good example of when communal living structures where everyone contributes a fixed percentage of their monthly income to the entire rent, instead of everyone paying evenly or by square footage, might be a good and humane way to live. If you have more, offer to pick up the slack for those who have less – maybe one day they will do the same for you. (There are models of these kinds of living structures buried in trans history: STAR house and Transy House, both here in New York, worked this way to one degree or other and Reina at thespiritwas has done some excellent research on this.)
IF YOU ARE A LOW-INCOME PERSON, AND YOU ALSO QUALIFY FOR PUBLIC BENEFITS, GET THEM. There are all kinds of reasons why people put off getting benefits who need them: shame, guilt, fear of interacting with the state, general flakiness. But if you find yourself running short of cash each month, or not having enough to eat, or needing health care but being unable to access it, AND you qualify for programs to help you alleviate any or all of the above, please do everyone a favor and buckle down and make it happen. It will make the house run smoother, it will take the burden off of your (quite likely already impoverished) HIV+ roommate to save your ass. And, hmm, how to put this: when whether you live or die is tied to the state and its bureacratic machinations and your ability to navigate them, it is somewhat frustrating to hear your roommates make excuses as to why they cannot get their act together to figure out how to get fucking food stamps. Maybe that’s unfair. But also, I look around me and think, okay. This is not rocket science. You can do it, and I will help you, but you have to take it seriously and roll your ass out of bed and get to the welfare office. We can even do it together! And it will make our lives together so much easier! But you have to kind of be like a pit bull to get some of these services: sink your teeth in and never let up.
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I know this has been a long article, but if I had to tl;dr it (which I am hesitant to do but it’s tumblr so w/e), the main take away is this: as queers, we need to take seriously our commitments to caring for one another. It is not always easy. It *can* be fun. But it is crucial.
inthis post i said i have had a couple of really bad experiences with mental health practitioners. i would like to talk about some of them. this first one is not très tragique or anything, but i do think it impacted the course of my life in some significant way.
less than a year after i came out as trans, the apartment where i was living burned down. i was on technically-illegal hormones at the time, with no medical supervision. (where i was living at the time, it was very difficult and super $$$$$ to go the legal route.) i figured out my name change stuff by filling out legal forms i found on the internet. because my house had burned down, i was like, well, shit. i don’t want to have to buy all boy clothes that i will just have to throw/give away after a while, so i might as well just go ahead and “go full time” (ugh, the early 2000s.) i was, at the time, enrolled at an enormous public state college, studying social work.
i was stressed out, to say the least. i had a lot of normal problems that 22 year-old college girls have: body image issues, self-esteem problems, boys, blah. i went to the college mental health clinic to make an appointment with a therapist.
i told her basically ^^^ (minus illegal hormones part) and this is what she said to me:
i don’t feel competent to treat you because i have never met a transgender person before. it would be like if someone came in requesting a letter of psychiatric recommendation for gastric bypass surgery, and i had never met a fat person before. i’m sorry, but i can’t help you.
i tried to explain to her that i was not looking for her to sign off on any letters – there was no way (i thought at the time) i would be able to afford any surgery at any time in the then-near future. i just wanted to talk about being depressed and anxious.
still, she refused to treat me.
eventually, the anxiety and stuff got so bad that i stopped going to classes and dropped out of school and got a job (which paid $7/hour.) to this day, i have never finished college.
i am not blaming this counseling lady for my dropping out. but it’s like, when trans people reach out for help – help that they really need – and are smacked down, there can be serious consequences, that range from mild set-backs to the heart-breakingly tragic. i mean i guess in a way it’s good that she admitted her incompetence? but in a way i wish she had not just dismissed me, especially after i had admitted all the deeply personal things that i had admitted to her during a psych intake (anyone who has ever been through one of these will know what I mean.)
BUT BECAUSE PARTYBOTTOM IS ALL ABOUT POSITIVITY, i will end on a nice note. unexpectedly, it wasn’t until i was diagnosed a few years later that i found a really good therapist who i was able to see through an ASO (AIDS service organization – like a nonprofit that provides services to HIV+ people.) here’s the weird thing: i was 25 at the time, and she was 23. she had just graduated from the very same program that i had dropped out of.
can i repeat, she was twenty-three years old? i remember, on our first visit, she leaned over to throw something away in the trash and she had, like, a full on tramp stamp on her lower back! i was was like, oh lord jesus.
but you know, even though she didn’t have that many trans clients and didn’t know a whole lot about trans stuff, she was just open-minded enough to be caring and warm. it was a very fruitful therapeutic relationship that lasted for three years. she helped give me the courage to publish my writing for the first time, and eventually to move to new york.
(i know i have complained about bright-eyed baby social workers before, but i will make a distinction here: her job was not to be my case manager, ie, someone who helps you navigate all the conflicting systems that control your life when you are living in poverty with a chronic illness, it was to be my therapist: to listen to my problems and feelings, to offer empathy and insight, and to help with the acquisition of the right set of emotional coping skills, whatever that looks like.)
in fact, us both being so young and so close in age really worked out well in some ways. i could be all like, okay, this will sound ridiculous, but kimora lee simmons said this thing on the style network the other day that really resonated with me, and she would be like actually, i saw that episode of LIFE IN THE FAB LANE and i know exactly what you mean by that.
and she really did, is the thing. sometimes i think that’s all it takes.
as i mentioned in this post, during my annual physical, i had a prostate exam. while i was bent over the table and my doctor had his finger up my ass (a sensation to which partybottom is certainly no stranger), he noticed a band-aid on my butt.
he said, it looks like somebody gave you a shot. who gave you a shot? and I said, oh, my boyfriend gave me my hormone shot the other day. and i added, fun fact: he’s transgender, too.
toward the end of the appointment, he was like, okay, so, now, i’m really sorry, but i’m going to have to ask you a bunch of annoying questions. and i was like, sure, ask away doctor! i will tell you anything you want to know, since you seem like a nice guy. (i was in a good mood.)
i realized very quickly that this was the “harm reduction counseling” part of the appointment. this kind of thing is mandated by the state – they have to do it to get funding, and i suppose it probably is a decent part of good health care, too. basically, he was asking a bunch of questions about substance use, med adherence (how often i take my meds and if i take them on time), and safer sex.
when we got to the sex questions, he starts out, have you had sex since i saw you last? and i enthusiastically answered, yes! then he was all, do you have a partner? and i was was like, yup. and then he was like, are you monogamous? and i was like, eh, yeah, more or less. and then he was like, do you guys use condoms? and i was like uuh, um, i mean, not really, i mean we don’t really need to because we don’t really have high-risk sex, i mean, the thing is, it’s like…
and he goes,
OOOooh i remember, you said your boyfriend is transgender! so, he uses a strap-on or something? and i was like YES, EXACTLY, TRUE, THAT IS EXACTLY HOW WE HAVE SEX.(actually, he uses a realdoe, but no need to split hairs here.) and then my doctor was like, psssh, you should have just said. this is APICHA, we hear everything. no judgement! what, you think i believe in abstinence or something? what, do i look like nancy reagan?
which is funny, because dr. tang does not look like nancy reagan. like, not even a little bit.
i spent three hours on the phone today (attempting to) make medical appointments
in particular i am having trouble finding a therapist. my medicaid HMO farms out its mental health services to ANOTHER sketchy “behavioral health” HMO. i called them and asked for mental health clinics not too far from my neighborhood that take my particular insurance.
she cheerfully gave me three referrals with three different phone numbers. all three phone numbers were incorrect – either i got a recorded answer saying “this is no longer the number for this service, please call this other number” or the number was disconnected entirely. i ended up googling the names of the clinics she listed, and after trying about five different numbers, eventually i found the correct phone number for all three clinics.
(it is worth noting here that this is far from the first time that having computer skills has supplemented my navigation of the welfare system. having internet access and literacy is something that many, many people in this system do not have. thus, even though most of the time i feel like a broke down bitch, i also recognize how lucky i am in many, many ways.)
the first clinic no longer takes my insurance, even though my insurance company says it does. the second clinic has recently restructured, and is “unsure” if they take my insurance, and said they’d get back to me. at the third, i only got a voice mailbox – however, it is at a hospital that i happen to know recently went bankrupt and may close basically any day now.
however, i still feel fortunate, and hopeful: to have insurance, to have access to health care, to have a gp that will manage my mental health meds on a casual basis until i can find a “real” psychiatrist (and let’s face it, most medicaid psychiatrists are like, 15-appointment, revolving-door medicine types) and hopefully (whoa boy i hope) a decent therapist.
PS i have NO IDEA if any of these places are “trans–friendly.” i am pretty much just jumping in feet first. i’m faaairly good at advocating for myself in the mental health system and generally therapists like me (i “display a high degree of insight into my problems” ie i have the language skills of someone who went to college for a while), and so unless something goes terribly wrong, i’m generally able to be nbd about mental health providers who are like ???? about trans stuff.
that said, i have had some experiences with being trans in the mental health system that range from merely facepalm-y to truly frightening, which i will blog about more some time later.
to cleanse the palate from that last nasty ask, i want to tell you about a good visit i had to the doctor:
i have never had a physical in my adult life. i had decent pediatric care as a kid (they knocked my knee with a little rubber mallet), but after age 15, i have never seen a doctor for a visit that took longer than 20 minutes.
the doctor’s appointments I used to have at Big Gay Health, Inc. were, like…. fine? I guess? As I said before, they generally consisted of reviewing my numbers (viral load and CD4) to see if I was taking my HIV meds. If there was a bounce in my viral load, they would lecture me about med adherence (my particular regimen must be taken every day, at the same time every day, with food).
(The other reason for these visits is frankly, kind of a policing one. If you are being prescribed meds but your bloodwork shows that you are not responding to them – your CD4 count stays the same, and your viral load does not decrease – it is assumed that you are selling your meds, probably to undocumented people, and there is the possibility that you will get in big trouble.)
ANYWAY, this was my first full physical in many years. Like, the nurse telling me to strip down to a little paper gown and everything. Speaking as a trans woman, this is normally something that would freak me the fuck out, but my nurse and doctor had such good bedside manner and gave me plenty of time and privacy to change that it felt like nbd.
And can I tell you, they checked EVERYTHING out? The whole thing took an hour and a half, and they checked out everything they possibly could, both in person and via the results of my bloodwork. Eyes, ears, nose, thoat, abdomen, and even — oh Lord my Lord! GENITALS, BREASTS, and PROSTATE.
Again, as someone who is often very private about my body, particularly in medical contexts and particularly around strangers and particularly around male authority figure medical strangers, this normally would have sent me into a panic attack. But the doctor was just so kind, so sweet, so funny and made the whole thing seem so normal that I was totally okay with it.
(I also got an anal pap while I as there. I have mixed feelings and general unresolved questions about the effectiveness/alarmist/overall public health value of the anal pap, but that’s a post for another time.)
The last thing I want to say about this nice visit to the doctor was this: learning to do a breast exam felt like a big fucking deal. He asked me if I do self-breast exams every month, and I like, uhhh, I have seen like pamphlets about how to do it, but I honestly don’t even know what I’m feeling for. Which is true! I have dated men all my life, thus I have not gone around feeling a lot of titties, so I don’t even know what “normal” breast tissue is supposed to feel like.
(Especially because, you know how when trans girls’ breasts are developing, it can feel kind of hard and fibrous right under the nipple? I’m all like, is that that “normal”? Who fucking knows?)
Anyway, what he told me was that what you’re looking for is any breast tissue that feels different from the rest of the breast tissue. Like anything fibrous or lumpy or w/e. Idk, if you can find a compassionate medical provider, please please do yourself a favor and have him or her show you how to do this, it is so easy and knowing that you’re doing it correctly is (or at least, has been for me) a major weight off my mind.
tl;dr: went to the Dr., got poked and prodded a lot, feel good about it
As I mentioned in my last post, I have been receiving all my health care from Big Gay Health, Inc., NYC (many of you know where I am talking about) for the last six years.
During the time I was there, they hired a case manager specifically to work with trans clients. Here’s the thing: I have known this person for several (12+?) years and am really not trying to shade them. I believe their heart is in the right place, but there are some institutional problems that lead to trans women getting bad care at places like this.
The trans care coordinator they hired at Big Gay Health, Inc was a white, female-assigned (FAAB, I believe, as the kids say these days) genderqueer with an advanced degree in divinity studies from an Ivy League university. They were friendly. They were overworked. They had had several social-work type jobs before, but never (AFAIK) stayed with the same organization for more than two or three years. (Turnover in social services is a BIG PROBLEM for people who depend on these services, but that is a blog post for another time.) (They have since left this position to go to div school. Again. This time, for a different religion.)
As part of their job, a few years ago it was this coordinator’s job to compile and release a “comprehensive” guide to trans health and wellness resources in the New York area. It was downloadable as a .pdf, so I perused it. I noticed that though it contained no resources for electrolysis, laser providers, or hair removal specialists of any kind, it listed no less than six birth doulas. I sent a FB message to the coordinator (again, we were/are friends) to say “Hey, um… did you notice..?” and the answer I got back was like, herp derp, we’re still searching, it’s a work in progress, non-pology.
(The resource guide has since been updated to include hair removal, but IDK anything about the practitioners in it.)
INCONTRAST, I recently switched health care providers to a smaller clinic whose main populations are men of color who have sex with men, HIV+ people, lesbians (LOTS of studs & AGs in the waiting room always), sex workers, undocumented patients, and trans people. I was able to get an appointment there very quickly.
The intake was nbd, but one of the best parts was getting to meet the trans care coordinator there. She is a bilingual Argentine immigrant trans woman (I learned this from her bio on a workshop flyer). She is so smart and friendly and awesome. Here is what she said to me:
Girl! You look good! And it looks like you got your name changed, your ID changed, your Medicaid straight, your hormones. (She looks at my chart) Oh and it looks like you got the orchiectomy too! That must be why you look so soft. I’ve been thinking about doing that too. So, what do you need from me?
I told her, well, sometimes I’m a little self-conscious about the facial hair I have left. Do you know any good electrologists? She said,
You know I get a little bit of this-this (points to her face) sometimes, too. Did you know there’s an electrology school way out in Queens? The girls that work there have had like 700 hours of training, they just need to get their last 300 clinical hours so they need people to work on. It’s free, or maybe $20 an hour or something like that. Hey, here’s my personal email - email me sometime and we’ll go together and make a day of it.
I was fucking agog.I have never had a provider be so sweet, kind, and real with me – not to mention giving me such USEFUL INFORMATION. (Speaking of which, I will be posting about that referral shortly.)
Point is, I think it all comes down to hiring practices. If you prioritize education and being able to speak a certain kind of social-work-y, tenderqueer vernacular, you will get providers who can provide services for white, FAAB, transmasculine people. If you prioritize hiring people from the communities you hope to serve – people who have lived the life – you will serve those communities, and, hopefully, serve them well.
(Nota bene: I did not invent these ideas, I just happen to be living them. Activist and artist Mirha Soleil-Ross has been talking about this kind of thing for years, and academic Viviane Namaste lays down the extended remix in her book Invisible Lives. Canadians, I tell you what.)
ACT UP was successful because it tolerated difference. You have to have coalitions in order to make change in America. If we love and identity people with HIV and other oppressed people, we can help transform the epidemic.— Sarah Schulman
There’s fairly explicit sex in The Normal Heart, but what you won’t see is condoms. That much, at least***, is historically accurate.
But in 1981, almost no gay men were using condoms. They weren’t worried about getting a girl pregnant, after all, and though STDs such as gonorrhea or the crabs were a fairly common experience, they were almost entirely viewed as a short-term, easily-treated consequence of sexual liberation. It was an inconvenience and maybe a cautionary tale, but unlikely to change the entire way you went about having sex.
AIDS—especially not knowing what it really was, how it could be transmitted, and how long it would be until there was a cure—changed that. There’s one scene in the film where Julia Roberts’ character, a doctor, tries to persuade a room full of gay men that they should stop having sex. Just stop. Having. Sex.
It goes badly. Take that one meeting’s explosive outrage and frustration and fear that both fleeting encounters or longterm relationships were now possibly deadly and multiply it by about 10 years—because that’s how long it took before there was something of a (still debated) consensus that sexually active people should use condoms every time they have sex.
Here’s a little more context from POZ magazine founder Sean Strub’s memoir, Body Counts:
Following decades of shame, the Stonewall riots had presaged an unprecedented explosion of gay male sexuality, which was the environment in which I came out as a gay man. Men who, only a few years earlier, might have committed suicide or stayed closeted in their hometowns had flocked to the safety and privacy of gay urban ghettos. Sex itself had become synonymous with liberation; it was the antidote to oppression, with some men seeking validation and pleasure in the arms of hundreds or thousands of partners.
By the time the first cases of disease were reported, we had elected a handful of openly gay and lesbian candidates to local offices and passed a few municipal nondiscrimination ordinances. We felt like we were on a path toward somewhere better, although there was no sense of inevitability to our struggle, particularly as the religious right emerged to push us back.
Despite the political gains, there were woefully few public venues for gay men to meet except those that were sex-oriented, such as bathhouses, bookstores, and backroom bars. These venues were defended fiercely; they were the only places where many closeted gay men could socialize safely. When public health authorities in some cities sought to have them closed as the epidemic grew, it drove numerous gay men to activism. They were protecting spaces they valued for themselves, as well as the only places where many gay men could be reached for education about HIV and safer sex.
While the post-Stonewall generation of gay men embraced their sexual liberation with gusto, most had been taught little or nothing about sexual health. The relationship between gay people and the medical profession, historically, had been contentious, mistrustful, and highly politicized. It was less than a decade before that homosexuality was declassified as a mental disorder, yet many doctors clung to the idea that homosexuality required professional intervention to “cure.”
Systematic oppression, a hostile culture, and self-hatred damaged gay men, and when the ’70s presented a sexual liberation unimagined only a few years before, it resulted in sexual behaviors and environments that created the perfect storm for a sexually transmitted virus to spread rapidly. The lack of knowledge about gay men’s sexual health and access to health care that respected gay sexuality compounded the problem.
In 1983, two NYC gay activists and their doctor published a small booklet called How to Have Sex in an Epidemic, which controversially did not encourage abstinence but rather celebrated all of the emotional reasons that sex plays such a huge part in anyone’s life. And though there was debate still about whether there was a single virus or multiple factors that could lead to infection, recommended condom use (and negotiation/discussion about risk).
That’s the modern foundation of “safe® sex"—the idea that sex is such a powerful and eternal part of human expression that simply telling huge groups of people NOT to do it is likely to be less effective than educating them and arming them with a way to do so that helps prevent new infections.
It wasn’t until 1986 that the US Surgeon General C. Everett Koop would tackle a similar concept for all Americans. At a time when there were serious suggestions that everyone with HIV be tattooed or quarantined in order to contain spread of the disease, Koop advised:
"Many people, especially our youth, are not receiving information that is vital to their future health and well-being because of our reticence in dealing with the subjects of sex, sexual practices and homosexuality. This silence must end. We can no longer afford to sidestep frank, open discussions about sexual practices -homosexual and heterosexual. Education about AIDS should start at an early age so that children can grow up knowing the behaviors to avoid to protect themselves from exposure to the AIDS virus.”
But the next year, when Congress finally appropriated $30 million in emergency funding so states could help provide AZT, they also passed an amendment from Jesse Helms, which banned funding any educational materials about AIDS that “promote or encourage, directly or indirectly, homosexual activities.”
Irony alert: Here’s what then-NYC Mayor Ed Koch wrote in the NYT about the Helms Amendment:
“We have got to call a spade a spade,” said Senator Jesse Helms in offering an amendment to the fiscal 1988 appropriations bill for the Departments of Labor, Health and Human Services, and Education, “and a perverted human being a perverted human being.” Ironic comments, indeed, given the profound perversity of the policy his amendment advances….
Senator Helms may not like homosexuals. But he and those who voted for the amendment should remember that homosexuals - and intravenous drug users - are the sons and daughters of families who love them. They too deserve protection against the gravest public health threat our nation faces.
But Helms’ “no promo homo” rules had a devastating impact on American sex ed, as right wing activists on local school boards routinely attacked any teacher or organization they deemed in violation. The result in most school districts was a sex ed program that may have discussed AIDS but rarely in any meaningful or helpful way.
*
Got a story about sex ed or safer sex to share? Submit a post, send us an ask, or post your own tagged #normalheart-history.
***Unless I was particularly bleary-eyed with tears during that part, this poster appears in the background of a scene in the HBO film that should be set in 1983 or so, despite the fact that the poster wasn’t created by the activist art collective GRAN FURY until 1988, and was part of a larger campaign bringing attention to the growing number of infections among women. The film does not exactly have Mad Men-level attention to historical detail.
Since 1992, IN THE LIFE has been at the forefront of HIV/AIDS coverage. At times, we’ve been the only journalists covering the changing face of the disease. We take a look back at the stories behind the evolving pandemic.
The bookshelves in my workplace contain an expansive printed history of the AIDS crisis. There are internal medicine journals from 1985, needle exchange sharps-handling instructions, and decades of legal writings on HIV stigma and criminalization.
I was only 9 or so in the mid 80’s when AIDS came home. Tommy, my mom’s live-in bff and my gay uncle of sorts, and all his boyfriends began showing symptoms, getting diagnosed, and in some cases, quickly dying. His artist friend Jim was the first to die, leaving a room full of my favorite fantasy paintings of unicorns and castles unfinished. I would give anything to have one of those today.
What I got instead were pamphlets. Pamphlets and booklets and standards of care, provided by our local health crisis group. They felt important, and, being a know-it-all kid anyway, I obsessed over them. I read over and over in every medical article I could find that it was ok to hug a person with AIDS, to hold their hand, to kiss them on the cheek. I got in fights at Catholic school over it, yelled at kids for making AIDS jokes, snapped at thoughtless, ignorant adults I heard spreading misinformation. I was That AIDS Kid.
One of the books I found in the shelves is called Strip AIDS USA, a collection of comics about and in reaction to AIDS, from 1988. The back cover is a panel by Will Eisner, featuring his most famous comic character, The Spirit.
Stigma, discrimination, and attempts at criminalization of HIV are still happening. The people in my office work very hard to fight these things, but spreading basic, good information about transmission and how to treat people with HIV or AIDS can start anywhere - in a comic strip, on Tumblr, from a know-it-all kid like me. Or you.
On November 7, 1991, Magic Johnson, superstar basketball player, held a press conference to announce that he was HIV-positive and would be retiring from basketball immediately. Some of the sports writers in the audience wept openly at the news.
The news is so shocking and so unexpected, it is difficult to absorb it even as we report it. Magic Johnson has tested positive for the HIV virus: that’s the first step to AIDS. Magic Johnson, basketball superstar so beloved, so well-known, that his first name was all he needed well beyond the world of sports.
(emphasis ours.) At the time, there were far fewer treatment options, and many people still believed HIV infection meant an automatic death sentence. But even as late as 1991, many people didn’t understand that the risk of infection came from what you did, not who you were. To quote a Time retrospective on the 20th anniversary of Johnson’s announcement:
“It made people notice, for the first time, that you can get infected with HIV without being gay, without being a drug user, without being a sex worker,” says Kevin Frost, CEO of amfAR, the Foundation for AIDS Research. “A lot of people took notice, and that changed the perception of how people got infected, and who was at risk.”
The next day, there were four times as many calls as usual to the National AIDS hotline, and closer to Johnson’s home in LA, it was more like six times as many. The New York Times devoted 300 column inches to the story over the following three days, which by our back of the envelope calculations comes out to roughly four solid pages of text. That a healthy, heterosexual, black athlete was now HIV positive upset the image people had of the disease. It could even be argued that the announcement, coming just months before the start of clinical trials on combination antiretroviral therapy, marks the end of the early AIDS era.
Johnson’s announcement was met with outpourings of both affection and fear. In 1992, fans voted him on to the NBA All-Star team, but several of his former teammates said that he shouldn’t play, while others openly worried about the risk of infection if Johnson were wounded on the court. Johnson would go on to be voted the game’s MVP and also be part of the men’s Olympic “dream team” in 1992.
Johnson is still healthy, and the Magic Johnson Foundation, founded in the wake of his announcement, is still an active philanthropic organization, though its mission has grown. As the Foundation’s site says,
MJF was created to fight HIV/AIDS through grantmaking. Twenty-two years after its formation, the organization has evolved to address other powerful epidemics in urban communities, which include the lack of educational opportunity and the absence of empowerment.
1981: Dr. Michael Gottlieb and his colleagues at the University of California, Los Angeles, note five cases of a rare Pneumocystis pneumonia in gay men and alert the Centers for Disease Control (CDC), which publishes a noticein itsMorbidity and Mortality Weekly Report (MMWR) on June 5, 1981. This is the first publication of what would come to be known as AIDS. By the time the report is published, 250,000 Americans are already infected.
The report does not mention the race of the five men. “The first five patients were white,” remembered Gottlieb. “The next two were black. The sixth patient was a Haitian man. The 7th patient was a gay African-American man, here in Los Angeles. Most of those first patients died within months. We had no information and no treatment.”
Gottlieb told FRONTLINE that not mentioning the race of the first patient was “an omission on our part.”
Emphasis ours. From the same timeline:
In July [1982], the CDC publishes a notice in the MMWRof 34 cases of the new disease among male and female Haitians living in five states. An accompanying editorial says, “It is not clear whether this outbreak is related to similar outbreaks among homosexual males, IV drug abusers, and others, but the clinical and immunologic pictures appear quite similar.”
In a January [1983] MMWR notice, the CDC describes two cases of AIDS in females – one Black and the other Hispanic — who had no other risk factors except that they had been having sex with infected males.
In a second MMWR, the CDC details 16 cases of AIDS found in prisoners in New York and New Jersey. In New York, four of the men are black, four are white and two are Hispanic. In New Jersey, three are black and three are white. While most of the men report they are heterosexual, most have also used IV drugs.
The CDC and other health organizations’ shorthand for “risk factors” that might put someone at risk for AIDS was “the 4-H club”: homosexuals, heroin addicts, hemophiliacs and Haitians. This dangerous language set a precedent that was not only inherently homophobic, classist and racist but led to a widespread misunderstanding (still hampering prevention efforts today) that HIV transmission was based on “who you are, not what you do.”
*
Have stories to add? Submit a post, send us an ask, or post your own tagged #normalheart-history and #POC and hiv/aids
I just wanted to say what a fantastic idea this is and what a fantastic job you’re doing carrying it out. I work in public health (in training to become an epidemiologist), and was spurred to do so by learning about the AIDS epidemic and the failure to act by both the Canadian and American (and global, but I don’t work there) governments. I felt the need to do something, to dedicate my life to preventing something like this from ever happening again. Thank you so much for putting together such a wonderful resource and educational tool. It is truly inspiring to see this kind of dedication and work, and is sure to inspire more people the way Larry’s work inspired me.
Love,
Olivia
Thanks, Olivia, this means a lot.
In working on this Tumblr, I (shana) was reminded again how the entire idea of wanting to be an epidemiologist or to study immunology was pretty rare/obscure as a career path pre-AIDS, and how many friends (gay men especially) I had who have pursued those fields since. And how much better prepared (if still underfunded) public health is now as a result.
We’ve spent the last week putting up histories and resources on the context of the early AIDS epidemic.
Visit our archive for more information on women and AIDS, people of color and the HIV epidemic, the controversies around safe sex, how AIDS activism changed medical care, and just a few of the artists whose work was shaped by the epidemic. And more on Larry Kramer, activist and artist, as well.
Now that you’ve seen the movie, we want your input too. What are your questions? What can you add to the conversation?
We’ve already had some great discussion with knowledgeable commenters about AIDS activism and the disability rights movement, and learned the story of a Normal Heart performance 25 years ago in Missouri that led to local controversy and even arson.
We’d love to know what confused you, what enraged you, what you want to learn more about, and what you in turn can teach us.
HBO’s adaptation of The Normal Heart airs tonight. We’ll be watching, and we hope you will be too.
We’ve collected these resources over the last week—with lots of help—in hopes of providing more context to the story of the early AIDS epidemic than what we’ll see on the screen.
But it doesn’t stop there.
Please, help us spread the word about normalheart-history by reblogging this and our other posts.
Encourage anyone who’s watching the movie to ask us anything about the people and stories portrayed in the film.
And submit your own story about the epidemic so we can post that, too.
High resolution 12” x 18” poster of HIV/AIDS-related issues that affect Indigenous communities. This poster coincides with #WORLDAIDSDAY&#DAYWITHOUTART. As with all our posters, feel liberated to, share, print out, wheatpaste, and disseminate at will!
HIV/AIDS Among American Indians & Alaska Natives (CDC wedsite).
Fast Facts:
HIV affects AIs/ANs in ways that are not always obvious because of their small population sizes.
Over the last decade, annual diagnoses increased 63% among AI/AN gay and bisexual men.
AIs/ANs face HIV prevention challenges, including poverty, high rates of STIs, and stigma.
HIV is a public health issue among American Indians and Alaska Natives (AIs/ANs), who represent about 1.2%a of the U.S. population. Overall, diagnosed HIV infections among AIs/ANs are proportional to their population size. Compared with other racial/ethnic groups, AIs/ANs ranked fifth in rates of HIV diagnoses in 2015, with a lower rate than blacks/African Americans, Hispanics/Latinos,b Native Hawaiians/Other Pacific Islanders, and people reporting multiple races, but a higher rate than Asians and whites.
The Numbers: HIV and AIDS DiagnosescOf the 39,513 HIV diagnoses in the United States in 2015, 1% (209) were among AIs/ANs. Of those, 73% (152) were men and 26% (55) were women.Of the 152 HIV diagnoses among AI/AN men in 2015, most (79%; 120) were among gay and bisexual men.dMost of the 55 HIV diagnoses among AI/AN women in 2015 were attributed to heterosexual contact (73%; 40).From 2005 to 2014, the annual number of HIV diagnoses increased 19% (from 172 to 205) among AIs/ANs overall and 63% among AI/AN gay and bisexual men (from 81 to 132).In 2015, 96 AIs/ANs were diagnosed with AIDS. Of them, 59% (57) were men and 41% (39) were women.
Living With HIV and Deaths
Of the 3,600 AIs/ANs estimated to be living with HIV in 2013, 18% (630) were undiagnosed. By comparison, 13% of everyone living with HIV were undiagnosed.
Of AIs/ANs diagnosed with HIV in 2014, 78% were linked to medical care within 1 month.e
At the end of 2013, 53% of AIs/ANs who had been living with diagnosed HIV for at least a year were retained in care (receiving continuous HIV medical care), and 52% had achieved viral suppression.
During 2014, 51 AIs/ANs died from HIV or AIDS.
Prevention Challenges
Sexually transmitted diseases (STDs). From 2011 to 2015, AIs/ANs had the second highest rates of chlamydia and gonorrhea among all racial/ethnic groups. Having another STD increases a person’s risk for getting or transmitting HIV.
Lack of awareness of HIV status. Almost 1 in 5 AIs/ANs who were living with HIV at the end of 2013 were unaware of their status. People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others.
Stigma. AI/AN gay and bisexual men may face culturally based stigma and confidentiality concerns that could limit opportunities for education and HIV testing, especially among those who live in rural communities or on reservations.
Cultural diversity. There are over 560 federally recognized AI/AN tribes, whose members speak over 170 languages. Because each tribe has its own culture, beliefs, and practices, creating culturally appropriate prevention programs for each group can be challenging.
Socioeconomic issues. Poverty, including limited access to high-quality housing, directly and indirectly increases the risk for HIV infection and affects the health of people living with and at risk for HIV infection. Compared with other racial/ethnic groups, AIs/ANs have higher poverty rates, have completed fewer years of education, are younger, are less likely to be employed, and have lower rates of health insurance coverage.
Alcohol and illicit drug use. Alcohol and substance use can impair judgment and lead to behaviors that increase the risk of HIV. Injection drug use can directly increase the risk of HIV through sharing contaminated needles, syringes, and other equipment. Compared with other racial/ethnic groups, AIs/ANs tend to use alcohol and drugs at a younger age and use them more often and in higher quantities.
Data limitations. Racial misidentification of AIs/ANs may lead to the undercounting of this population in HIV surveillance systems and may contribute to the underfunding of targeted services for AI/AN.
What CDC Is Doing
CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy, maximize the effectiveness of current HIV prevention methods, and improve HIV data collection among AI/AN. Activities include:
Working with the Indian Health Service (IHS) and tribal leaders of the CDC Tribal Consultation Advisory Committee to discuss methods for developing and implementing scalable, effective prevention approaches that reach those at greatest risk for HIV, including young gay and bisexual AI/AN men.
Providing support and technical assistance to health departments and community-based organizations to deliver effective prevention interventions.
Ensuring that capacity-building assistance providers incorporate cultural competency, linguistics, and educational appropriateness into all services delivered.
Providing capacity building assistance directly to the IHS so it can strengthen its support for HIV activities, including HIV testing capacity; We R Native, a comprehensive health resource for Native youth; and the Red Talon Project, which works to achieve a more coordinated national and Northwest tribal response to STDs/HIV.
Raising awareness through the Act Against AIDS campaigns, including
Doing It, a national HIV testing and prevention campaign that encourages all adults to get tested for HIV and know their status;
Let’s Stop HIV Together, which raises HIV awareness and fights stigma among all Americans and provides many stories about people living with HIV; and
HIV Treatment Works, which highlights how men and women who are living with HIV have overcome barriers. The campaign provides resources and encourages people living with HIV to Get In Care,Stay In Care, and Live Well.
In addition, the Office for State, Tribal, Local, and Territorial Support (OSTLTS) serves as the primary link between CDC, the Agency for Toxic Substance and Disease Registry, and tribal governments. OSTLTS’s tribal support activities are focused on fulfilling CDC’s supportive role in ensuring that AI/AN communities receive public health services that keep them safe and healthy.
a Percentage of AI/AN reporting only one race. b Hispanics/Latinos can be of any race. c HIV and AIDS diagnoses indicate when a person is diagnosed with HIV infection or AIDS, but do not indicate when the person was infected. d The term gay and bisexual men, referred to as men who have sex with men in CDC surveillance systems, indicates how individuals self-identify in terms of their sexuality, not a behavior that transmits HIV infection. eIn 32 states and the District of Columbia (the areas with complete lab reporting by December 2015).
World AIDS Day Observed on December 1st of every year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection, and mourning those who have died of the disease. Government and health officials, non-governmental organizations and individuals around the world observe the day, often with education on AIDS prevention and control.
As of 2013, AIDS has killed more than 36 million people worldwide (1981-2012), and an estimated 35.3 million people are living with HIV,[2] making it one of the most important global public health issues in recorded history. Despite recent improved access to antiretroviral treatment in many regions of the world, the AIDS epidemic claims an estimated 2 million lives each year, of which about 270,000 are children.
Day With(out) Art Day Without Art (DWA) began on December 1st 1989 as the national day of action and mourning in response to the AIDS crisis. To make the public aware that AIDS can touch everyone, and inspire positive action, some 800 U.S. art and AIDS groups participated in the first Day Without Art, shutting down museums, sending staff to volunteer at AIDS services, or sponsoring special exhibitions of work about AIDS. Since then, Day With(out) Art has grown into a collaborative project in which an estimated 8,000 national and international museums, galleries, art centers, AIDS Service Organizations, libraries, high schools and colleges take part.
In the past, Visual AIDS initiated public actions and programs, published an annual poster and copyright-free broadsides, and acted as press coordinator and clearing house for projects for Day Without Art/World AIDS Day. In 1997 we suggested Day Without Art become a Day WITH Art, to recognize and promote increased programming of cultural events that draw attention to the continuing pandemic. Though “the name was retained as a metaphor for the chilling possibility of a future day without art or artists”, we added parentheses to the program title, Day With(out) Art, to highlight the proactive programming of art projects by artists living with HIV/AIDS, and art about AIDS, that were taking place around the world. It had become clear that active interventions within the annual program were far more effective than actions to negate or reduce the programs of cultural centers.
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