Category Archives: Commentary

How Truvada helped propel the evolution of LGBT health

From The Advocate online

In light of the progress we’ve made over the past decades, it’s tempting to think that we are only steps away from a cure and that our previous advances will protect younger LGBTQ people for generations. While it’s empowering to feel confident in our current position, it is essential that we remember that all of this is fragile. According to a recent statistic from the Centers for Disease Control and Prevention, HIV and AIDS remain persistent problems globally. We’ve come a long way in preventing and treating HIV, but there is still much more to accomplish. Annual HIV infections and diagnoses are declining in the U.S., but progress has been uneven, and annual infections and diagnoses have increased among some groups. The declines can thankfully be attributed to targeted HIV prevention efforts, such as Truvada.

Read the full article.

Why don’t more Americans use PrEP?

From the New York Times

Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.

[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.

The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.

Read the full article on New York Times online.

Mental health care is key to ending AIDS

From Advocate.com

Research shows a strong correlation between mental health disorders and living with HIV or AIDS, a correlation that is often overlooked. According to the National Institutes of Health, people with HIV have an increased risk for developing mood, anxiety, and cognitive disorders and are twice as likely to live with depression as those who do not have HIV. A 2010 U.K. study showed that one-third of HIV-positive men who participated in the survey met the criteria for a post-traumatic stress disorder diagnosis.  

For those living with HIV or AIDS, depression is more than just mental hell — it can be a silent killer. Studies show that if people living with HIV feel stigmatized or suffer from mental illness, they are less likely to take their medication properly, which not only puts their own health at risk by not suppressing the individuals’ viral load, but also raises the likelihood that they will pass HIV on to others. Individuals living with HIV and depression are also more likely to think about suicide or even attempt to take their own lives. 

Despite what we know about the connection between mental health and HIV/AIDS, too few people living with HIV or AIDS, and those invested in their health and happiness, are getting the mental health support they need. That is why we are proud to announce the opening of the state-of-the-art GMHC Carl Jacobs Mental Health Clinic, which will allow us to incorporate innovative treatment and counseling into our service model. Services will be available to adult New Yorkers of all sexual orientations, gender identities, and income levels, regardless of HIV status.

Past traumas, stress, depression, reduced self-esteem, and other challenges can be grueling to deal with. We aim to offer holistic services that address not only our clients’ mental health issues, but their social, spiritual and health concerns as well. Meanwhile, the ability to reach more HIV-negative people with HIV-preventive interventions and mental health services will help us decrease new HIV infections. 

Read the full article.

The media can play an important role in helping to eliminate HIV stigma

From the HRC

by Diego Mora Bello, HRC Global Fellow

Stigma and discrimination continue to be common barriers for people living with HIV. Fortunately, the media can play an important role in helping to remove these and other barriers. In my own survey of Latin American news articles mentioning HIV and AIDS, and in meeting with media professionals and advocates, I found that Latin American Media has room to improve its use of correct and destigmatizing language when talking about people living with HIV. Covering HIV both correctly and responsibly is important, because doing so is an essential part of raising awareness, debunking common myths, and giving voice to an already marginalized group of people.

The importance of using correct and responsible language in journalistic coverage of HIV inspired me to research this topic and share my findings. The ultimate goal of HIV in the Media is to report on this subject in a scientifically accurate and responsible way that inspires others to follow suit.

Based on my research, here are the top three reasons why language is important when covering HIV and AIDS in the media.

Read the full article on the HRC Website.

An open letter by Tyler Curry

From Advocate.com

Before I sprouted out of the closet as a little gay sapling, my mother had never met a single homosexual person in her life. And in the suffocating Southern Christian confines of Texas, her limited perception was open to the most horrific creative interpretation. The nightmares of evil drag queens and insidious perverts quickly faded away, however, once her son told her that he liked boys.

The majority of gay men know how it feels to secretly live in the presence of someone who is blindly afraid of you, yet that blind fear is exactly what we inflict on HIV-positive men. It is because of this that I write an open letter to gay men young and old.

Your friend is living with HIV.

dear-gay-menx750It doesn’t matter who you are or where you hail from; if you are a man who kisses other men, someone you know is HIV-positive. Hopefully, this is already yesterday’s news because you live in a collective space where your friends are not afraid to discuss their love and sex lives, regardless of status. But if you care to argue that this is a false narrative, then you may be creating barriers for your HIV-positive friends without even knowing it. This isn’t just a hindrance to their mental health; it is also a risk to your own HIV-negative status. If you don’t acknowledge the reality that your friends may be living with HIV, you probably think that you’ve never slept with an HIV-positive person either.

In the first six months after my diagnosis, I was petrified to tell my best friend about my status. As much as I knew he wouldn’t judge me or toss our friendship aside, something he had previously said kept ringing in my ears:

“I would never date someone with HIV. I just don’t think I could get over it.”

A world where my best buddy would reject someone just like me was a world I could live without. Yet I tucked it inside and hid something from my friend to avoid any stigma from someone I loved. When I did tell him my status and the reason for my hesitation, he was immediately overcome with unquestionable support and complete remorse. And just as happens with anyone who made a judgment before getting to know someone, his benign HIV stigma has become undetectable.

Although most days I do feel like a rainbow unicorn, my story and my status are nothing unique. If you are a gay man, or any other person who knows more than a handful of gays, then you know a person with HIV. Instead of trying to figure out who it could be, think about how you would feel if one of your closest friends were judged, rejected, and ridiculed for his status.

Or worse: How do you feel if one of your friends is remaining silent because he feels you might judge and reject him as well?

HIV isn’t exclusive to the LGBT community, but it is the backbone of its legacy of tragedy and strength. Today, HIV doesn’t have to rob a person of anything in their life, but only if they are surrounded by an educated and loving community that understands a disease is not a characteristic or a flaw. It’s just another thing to overcome, and the LGBT community overcomes its struggles together.

Be a part of that community. Be a friend, a lover, and an ally to people with HIV.

Why the HIV battle continues for gay men

From the Huffington Post

Ace Robinson
Global Health Policy Analyst

September 27th was National Gay Men’s HIV/AIDS Awareness Day. It’s the day that approximately 80 gay and bisexual men will become infected with HIV. Thirty (30) of those men will be Black. Twenty-five (25) will be White and twenty-one (21) will be Latino. Some of those men will find out about their status very early, will be engaged in competent healthcare, and will live a full productive life while managing this chronic illness. But to this day, that will be the exception and not the rule.

Ace Robinson Global Health Advocate

Like just about all viral illnesses life the flu, treating HIV right away and staying on treatment will not only stop you from getting sicker, but stop you from being able to transmit that virus to others. The same is true for HIV. Last month, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Health confirmed what global experts had been saying for years: “Once you begin therapy and you stay on therapy…you are NOT capable of transmitting HIV to a sexual partner.” It is called Treatment as Prevention (TasP). That is excellent news. But that is only true for 30% of Americans. The vast majority of People Living with HIV (PLWH) are not benefitting from the advances in treatment due to not knowing their HIV status, lacking access to care and treatment, lacking social support, or a mix of all the above.

Of those infected each day in the United States, two-thirds are gay and bisexual men. In vast parts of the USA, gay and bisexual men do not receive the type of needed support to access and stay on treatment which puts them at risk for HIV progression and potentially transmitting the virus to another person. Due to homophobia, some men do not have support from their families, have reduced access to jobs and housing, and have had poor experiences in healthcare settings. That creates the perfect storm for the continued epidemic that has gripped this globe for over 35 years.

Today, we live in an age that PLWH can live nearly their entire expected life span IF they receive sustained treatment. We also live in an age that people can take a daily pill (PrEP) that can prevent HIV infection before exposure. And if that is not enough, we also live in an age that people can take a course of treatment that can prevent HIV infection after exposure(PEP).

But what good does TasP, PrEP, and PEP do if people most at-risk for infection are not aware of it. They are really just a jumble of letters. In my circles, it seems that everyone know about these things. But that’s not the norm. For so many, there is nearly no knowledge of these ways to treat and prevent HIV. A couple of weeks ago, I was in southern Georgia visiting my mother and we went on a mini-vacation to Jekyll Island. I was chatting with a young Black gay man who worked at the local hotel. Eventually, we started chatting about what I do and I off-handedly starting rambling on about PrEP and PEP. If you could have seen the look on his face, you would have thought that I had told him that aliens had landed in Times Square. For that young man, we had failed him. He should have known sooner.

The HIV prevention and treatment toolbox is filling faster today than ever before. But not everyone knows what is in it. Awareness, advocacy, and access will be the ultimate tools in the HIV toolbox to ultimately end HIV in mine and others’ communities. We must strive to continue not only raising awareness, but also advocating for access for gay men who have been disproportionately impacted by HIV for far too long.