By Lee Loving 11/10/09
HIV/AIDS prevention is a new field, only 25 years old, and it is arguably one of the most important professions out there. Preventing sickness is as important as any treatment. The prevention of this disease with a 100% mortality rate is desperately important in all communities. HIV is not a “Gay Disease”, but a human disease. If you are human, no matter who you are or where you come from you can get this disease. Explaining it like that, but I want you the reader to understand the gravity of this issue. This statement is not meant to evoke fear but instill understanding of the importance of HIV Prevention.
In the last 25 years, newer and better drugs have been produced that extend the lives of those living with HIV. But drugs are not a cure, they come with side effects, compounding costs, and their effectiveness will always fade with time. The immune system eventually falls to the virus, and the illness is renamed when B and T lymphocyte counts drop below 200 to AIDS. This virus does not kill directly, but allows a whole horror house of other infections in. Viruses and bacteria that the body normally fends off with ease can cause life threatening results. The common cold can be fatal.
Education is the most important aspect of HIV prevention, a lot of stigma surrounds this disease. People who are infected can be shunned and driven out of their homes, jobs and relationships. Understanding that HIV+ people are still people regardless of their status and should still be included in society greatly helps reduce the risk of HIV+ people participating in high risk behaviors, like having unprotected sex, out of fear of rejection. HIV is not spread through casual touching, like shaking hands, hugging, or kissing.
How the virus does enter the body is through sex, via ejaculate, vaginal and anal secretions and blood to blood contact .For example when a person has unprotected sex; if a HIV+ woman breast feeds her baby. The virus can also pass from a pregnant woman to her unborn child; if an Intravenous-Drug-User shares a needle with someone who is positive; if blood from a positive person gets on an open wound. These are the major ways HIV is spread from one person to another.
According to the CDC database, HIV may be an offshoot of another similar virus that affected primates like chimpanzees called SIV (Simian Immunodeficiency Virus). This virus most likely made the jump from chimps to humans due to the bush meat trade, Due to little or no food, tribes would sometimes eat chimps and other primates. During the butchering process, small nicks and cut would allow an infected chimp’s blood to mingle with a humans, a person would get sick and possibly die. Over time it is possible that the virus adapted to our physiology and began to pass from human to human, becoming HIV. This is the best theory that has been offered about the origins of HIV.
Unfortunately, silence has surrounded this virus. In 1981 the first case diagnosed in a gay man, leading doctor to incorrectly naming it GRID (Gay Related Immune Deficiency). It was later proven that the virus did not originate due to homosexual behavior, however despite the evidence given to uphold this fact, it is still known as a “gay disease” in some parts of this country.
I am talking to Javier Rios, MPower Coordinator and New Mexico AIDS Services Tester. Javier has been the coordinator for ABQ MPower for the past four years. He is also a former Spanish professor of UNM. He is openly gay, 32 years old and has a partner which has been with for the past year. Due to confidentiality restraints I am not allowed to watch Javier as he is testing, so I visit him at his office at MPower.
That is where I held my interview, trying to better understand how an organization like MPower gets organized and understand the true impact of AIDS prevention and counseling.
MPower is a group targeted at preventing the spread of HIV and other STD’s in young gay men between the ages of 18-29, through education and building a since of community and self-esteem. This chapter is one of many in the country, and is one of the best in the nation. ABQ MPower has been around since 1997. ABQ MPower is a peer lead and volunteer run group.
How did you get into HIV prevention?
I had seen an ad in the Alibi for a job at NMAS, while I was in graduate school at UNM, I applied and was hired.
How did the Empowerment project get its start in Albuquerque?
The Empowerment project, a prevention based program, which started out of the University of San Francisco in California. ABQ MPower was part of a one year pilot program that was targeted at young gay men 18-29, who are at high risk of infection. There were empowerment pilot programs in Austin, TX and Phoenix, AZ that started around the same time. A year later, MPower was adopted by New Mexico AIDS Services, where it receives its funding today.
Are there any government sponsored HIV programs?
The Department of Health is a government funded program and NMAS receives money from them and through NMAS MPower receives its funding.
What are some of the strategies that have been successful in HIV prevention?
The one that I think that has been the most successful is peer led education. When you come to MPower and sit in on a meeting, you begin learning how to protect yourself. Then you take what you learned from MPower out in to the world and share it with others.
What things have inhibited success of prevention programs?
Mainly homophobia and a lack of awareness and ignorance.
What is it like to have to tell someone they are HIV+?
It’s sad. I also try to give people hope. Explain that being HIV positive isn’t’ a death sentence and make it into a positive experience, by helping them own their status. NMAS offers programs that help them in making lifestyle changes, through different community education workshops.
What is the syringe exchange program?
This is a program design to reduce the rate of HIV infection in IDU’s or Intravenous Drug Users 18 and older. People come in with their used syringes and exchange for clean ones, for a one to one ratio. People are also given information about safer injection, better vein care, risk and harm reduction practices, information on HIV/STD’s and hepatitis, abscess and wounds care, drug reactions, better nutrition, drug treatment options, safer sex practices, and other health issues are also available.
How important do you feel programs like this one?
Very important, but I feel we should be able to start educating kids while they are still in middle school.
It is a very important time in their lives. Some people have told me that have had sex even before they have reached high school.
How does HIV affect different communities, is the same for every community or is one group affected more than others?
Even though HIV isn’t a gay disease, it is still widespread in the gay community.
It’s the same for minorities, if you are gay an a minority your risk for infection also increases
I was able to tour the NMAS facility after business hours and I was able to get a firsthand look at where the organization of HIV prevention meets the public. HIV prevention is not only about condom, but also encouraging those living with HIV to learn to be responsible for their health and to want to protect the health of others as well.
Tools of the Trade
There are many tools at the disposal of HIV prevention, the first are the tests that help keep track of the virus and which communities most affected. There are two main test performed to detect the presence of HIV. The first is the blood test. A small sample of blood is taken from the individual, and then cultured in a lab, searching for the HIV antibody. Blood tests can also give information about viral load; how much virus is in your body at a given time. The test can also tell you which viral strain you are infected with, because different strains can require different treatments, as well as can give you a white blood cell count
The second test is the OraSure HIV-1 Specimen Collection Device. This is the test preformed most often at NMAS. The test consists of a cotton pad with a ractive substance on the end. The pad is rubbed against the sides of the mouth for 15 seconds, then left to sit inside the mouth, between the cheek and gum for 2 minutes and 45 seconds. It requires no blood and is painless. After the test the pad is inserted into a preservative fluid and sent to the lab and results takes two weeks. This test is designed to react to the presence of the HIV-1 Antibody. You are given a number that is matched to the test, so you can find you results. And it is completely anonymous and confidential. Both tests are 97% effective.
The OraSure Western Blot is the confirmatory test for the OraSure test; it takes materials from the other test and also detects the antibodies for HIV-1. If an Orasure test comes back with a positive result, but the western blot comes back negative, the status is also negative, but the individual is encouraged to retest in 3 months time. Retest is also encouraged if the western blot comes back inconclusive. If the Orasure comes back positive and Western Blot also comes back positive, a HIV+ is given the person ethnicity and sexual orientation and other factors are recorded to keep track of the virus as it moves through communities.
Another very important tool is the condom. Condoms are 98.6% effective in not only preventing pregnancy, but also preventing the spread of HIV. There are five bodily fluids that can transmit HIV; breast milk, semen, vaginal/anal secretions and blood. Four of these can be prevented from entering the body via sexual intercourse with a condom. Teaching correct usage, storage and disposal are very effective in reducing HIV infection rates.
Lastly the people involved are really instrumental in HIV prevention. The doctors, nurses, preventionist, caseworkers, counselors and volunteers; people who take the time to educate the general public and works to prevent the spread of HIV and other diseases in their communities.
Prevention continues to be very important even among those living with HIV, teaching them how to protect themselves and to care about the health of others. NMAS offers Community education programs for people who are positive like:
A workshop for those living with HIV and their partners, families and friends. Topics include:
How HIV affects the body, HIV transmission, safer sex, universal precautions and sharing a household, how HIV medications work and why adherence is important.
SHAG (Sexy Healthy and Gay—Men’s group)
(Sexy Healthy and Glamorous—Women’s group)
(Sexy Healthy and Great—Men and Women’s group)
A workshop for men and women living with HIV. A three day workshop for developing skills to reduce stress associated with disclosure of HIV status to friends, family and sexual partners.
These skills help participants’ decide if, when,
Do It Right
Dating and relationship workshops with barbeques, potlucks, guest speakers and more for HIV+ gay, bisexual, questioning men and transgender individuals over 30.
According to the CDC, there are only 33 states with active status reporting, leaving 17 others, mainly in the south, without any kind of government assistance and many with people living with HIV without the care and support they need.
Reports given since ’01 – ’06 Show that while there are people are living longer and HIV/AIDS related deaths are declining, but infection rates are still on the rise in the U.S.
Red Ribbons and Politics
“When one of our fellow citizens becomes infected with HIV every nine-and-a-half minutes, the epidemic affects all Americans. That is why I have pledged to develop and implement a comprehensive National HIV/AIDS strategy (NHAS) that will focus on reducing incidence, increasing access to care, reducing HIV-related health disparities. The Nation HIV/AIDS Strategy will also increase awareness, and promote greater investment in prevention and treating HIV/AIDS in the U.S.”
President Barack Obama
June 27th 2009
National HIV Testing Day
The Obama Administration has put out a “Call to Action”. The White house has held town hall meetings all over the country, asking citizens how best to implement this plan. Everyone who wanted to speak, were given two minutes to make their recommendations and voice their concerns.
The thing that kept being brought up was the complete lack of a universal, comprehensive and inclusive Sex Education program. Many parts of this country, there are abstinence programs that continue to operate. These programs do not talk about condom use or harm reduction. Some of the HIV+ people that spoke at the town hall meeting said that if they had received proper understanding of the risks and given ways to protect themselves when they were younger, they might not be positive today.
REMARKS BY THE PRESIDENT
AT SIGNING OF THE RYAN WHITE HIV/AIDS
TREATMENT EXTENSION ACT OF 2009
Diplomatic Reception Room Excerpt
“We often speak about AIDS as if it’s going on somewhere else. And for good reason — this is a virus that has touched lives and decimated communities around the world, particularly in Africa. But often overlooked is the fact that we face a serious HIV/AIDS epidemic of our own — right here in Washington, D.C., and right here in the United States of America. And today, we are taking two important steps forward in the fight that we face here at home.
It has been nearly three decades since this virus first became known. But for years, we refused to recognize it for what it was. It was coined a “gay disease.” Those who had it were viewed with suspicion. There was a sense among some that people afflicted by AIDS somehow deserved their fate and that it was acceptable for our nation to look the other way.
This fight is long from over, but we have learned much in the last 25 years, but as new therapies are developed the virus continues to evolve new resistance against them. Silence is this diseases greatest ally. Education is the only weapon we have so we can face it without fear. We must face it, because ignoring it won’t make it go away.”
The president has cut Abstinence Only programs by over $160 million for more comprehensive sex education, and has signed the fourth extension of the Ryan White CARE act. This law was named after a 13 year old Indiana boy who contracted AIDS through a blood transfusion. This bill helps people in the hardest hit communities, who cannot afford the cost of their life sustaining medications, get the treatment they need. Among the hardest hit include the homeless, African Americans and the GLBT community. This bill was co-sponsored by the late Senator Ted Kennedy (D-Mass) and Senator Orrin Hatch.
Center for Disease Control and Prevention HIV database
New Mexico AIDS Services Home Page
New Mexico Department of Health HIV Prevention Planning
THE CAUSES AND CONSEQUENCES OF HIV EVOLUTION pdf
The White house homepage
Javier Rios; MPower coordinator, NMAS Tester
The first step toward change is awareness.
The second step is acceptance.
-- A fortune cookie that I once ate.