Plus 133 November December 2019

BECAUSE YOU’RE MORE THAN YOUR STATUS

WHICH PRESIDENTIAL CANDIDATES CARE ABOUT YOU & HIV?

U N F O R G E T TA B L E HOW DRAG STAR JADE ELEKTRA TURNED A RENDITION OF THE CLASSIC SONG INTO A VIRAL HIT ABOUT UNDETECTABILITY

NOVEMBER/DECEMBER 2019 www.hivplusmag.com

00_PLUS133_Cover_FINAL.indd 1

9/24/19 9:35 AM

IMPORTANT FACTS FOR BIKTARVY® This is only a brief summary of important information about BIKTARVY and does not replace talking to your healthcare provider about your condition and your treatment.

(bik-TAR-vee)

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side effects, including:

BIKTARVY may cause serious side effects, including: } Those in the “Most Important Information About BIKTARVY” section. } Changes in your immune system. Your immune system may get stronger and begin to fight infections.

Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY. } Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY. } Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat. } Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain. } The most common side effects of BIKTARVY in clinical studies were diarrhea (6%), nausea (6%), and headache (5%).

} Worsening of Hepatitis B (HBV) infection. If you

have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to check your health regularly for several months.

ABOUT BIKTARVY BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults. It can either be used in people who have never taken HIV-1 medicines before, or people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements.

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS. Do NOT take BIKTARVY if you also take a medicine that contains: } dofetilide } rifampin } any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY Tell your healthcare provider if you: } Have or have had any kidney or liver problems,

These are not all the possible side effects of BIKTARVY. Tell your healthcare provider right away if you have any new symptoms while taking BIKTARVY.

including hepatitis infection. } Have any other health problems. } Are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby.

Tell your healthcare provider if you become pregnant while taking BIKTARVY. } Are breastfeeding (nursing) or plan to breastfeed.

Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088.

Your healthcare provider will need to do tests to monitor your health before and during treatment with BIKTARVY.

HOW TO TAKE BIKTARVY

Tell your healthcare provider about all the medicines you take:

Take BIKTARVY 1 time each day with or without food.

} Keep a list that includes all prescription and over-the-

GET MORE INFORMATION

counter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist. } BIKTARVY and other medicines may affect each other.

Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

Get HIV support by downloading a free app at

MyDailyCharge.com

BVYC0102_BIKTARVY_A_7-875x10-5_Plus_KeepPushing1_C1_r1v1jl.indd All Pages 18945 Plus 133 Biktarvy.indd 2

} This is only a brief summary of important information

about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more. } Go to BIKTARVY.com or call 1-800-GILEAD-5. } If you need help paying for your medicine,

visit BIKTARVY.com for program information.

BIKTARVY, the BIKTARVY Logo, DAILY CHARGE, the DAILY CHARGE Logo, KEEP PUSHING, LOVE WHAT’S INSIDE, GILEAD, and the GILEAD Logo are trademarks of Gilead Sciences, Inc., or its related companies.

Version date: December 2018 © 2019 Gilead Sciences, Inc. All rights reserved. BVYC0102 01/19

9/3/19 9:05 AM

KEEP PUSHING. Because HIV doesn’t change who you are.

BIKTARVY® is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in certain adults. BIKTARVY does not cure HIV-1 or AIDS.

Ask your healthcare provider if BIKTARVY is right for you.

To learn more, visit BIKTARVY.com.

Please see Important Facts about BIKTARVY, including important warnings, on the previous page and visit BIKTARVY.com.

18945 Plus 133 Biktarvy.indd 3

8/27/19 2:33 PM 9/3/19 9:05 AM

IN THIS ISSUE NOVEMBER / DECEMBER 2019

42

14 ON THE COVER 42 UNFORGETTABLE MOMENT Drag performer Jade Elektra sparks a global conversation about U=U with a stigma-smashing song.

FEATURES 14 THE ART OF LOVE Don Bachardy used his art to document the tragedy of the AIDS epidemic—and the death of his famed true love.

24 PRESIDENTIAL PLATFORMS Top 2020 Democratic presidential candidates reveal their plans to address the needs of people living with HIV.

2

NOVEMBER / DECEMBER 2019

02-03_PLUS133_TOC_FINAL.indd 2

9/24/19 9:34 AM

24

38 48 BUZZWORTHY 6 HIV-FREE CITY Some metros are even closer to eradicating HIV. 8 NOT WITHOUT US HIV activists confront Trump's national strategy.

9 READ UP Great books focusing on the history of the epidemic.

DAILY DOSE 23 AGING GRACEFULLY? The peril of living in a youth-obsessed world.

I AM THE FIRST 38 TEACHER OF LIFE This HIV-positive professor has had an amazing journey.

TREATMENT 12 JUST THE TWO OF US A two-drug regimen continues to impress.

13 BABY MONITORING Are poz moms getting the care they need?

13 SKIN DEEP These HIV-related conditions could spell trouble.

OPINION 46 BUTT SERIOUSLY A cheeky campaign for LGBTQ-friendly docs.

VINDICATED 48 AN INNOCENT MAN Michael Johnson walks free 25 years early in HIV criminalization case.

COVER (AND FAR LEFT): Drag performer Jade Elektra photographed by Krys Cee ABOVE AND LEFT (CLOCKWISE FROM TOP): Andrew Spieldenner by Emoticon Productions; Presidential candidate Kamala Harris by Josh Edelson/AFP/Getty Images; Michael Johnson courtesy Facebook; Don Bachardy by Sean Black

02-03_PLUS133_TOC_FINAL.indd 3

9/24/19 9:34 AM

editor in chief DIANE ANDERSON-MINSHALL • svp, group publisher GREG BROSSIA

creative director RAINE BASCOS deputy editor JACOB ANDERSON-MINSHALL editor at large TYLER CURRY managing editor DAVID ARTAVIA copy chief TRUDY RING associate editor DESIRÉE GUERRERO assistant to the editor DONALD PADGETT contributing editors KHAFRE ABIF, DIMITRI MOISE, MARK S. KING, ZACHARY ZANE mental health editor GARY MCCLAIN contributing writers JEANNIE WRAIGHT, MICHAEL SCHREIBER interactive art director CHRISTOPHER HARRITY front end developer MAYRA URRUTIA manager, digital media LAURA VILLELA assistant vp, integrated sales STUART BROCKINGTON executive directors, integrated sales EZRA ALVAREZ, MICHAEL RIGGIO, PATTY AGUAYO senior director, ad operations STEWART NACHT manager, ad operations TIFFANY KESDEN designer, branded partnerships MICHAEL LOMBARDO director, branded partnerships JAMIE TREDWELL associate director, branded partnerships ERIC JAMES senior manager, branded partnerships TIM SNOW editor, social media DANIEL REYNOLDS branded content writer IAN MARTELLA director of circulation ARGUS GALINDO office manager HEIDI MEDINA print production director JOHN LEWIS

PRIDE MEDIA chief executive officer ORLANDO REECE chief finance officer JANELLE MITCHELL evp, advertising and branded partnerships GREG BROSSIA corporate executive vice president BERNARD ROOK vice president ERIC BUI human resources ANTIOUSE BOARDRAYE ADVERTISING & SUBSCRIPTIONS Phone (212) 242-8100 • Advertising Fax (212) 242-8338 Subscriptions Fax (212) 242-8338 LOS ANGELES EDITORIAL Phone (310) 806-4288 • Fax (310) 806-4268 • Email editor@HIVPlusMag.com SOUTHWEST EDITORIAL OFFICES Retrograde Communications • Phone (951) 927-8727 Email editor@HIVPlusMag.com FREE BULK SUBSCRIPTIONS FOR YOUR OFFICE OR GROUP Any organization, community-based group, pharmacy, physicians’ office, support group, or other agency can request bulk copies for free distribution at your office, meeting, or facility. To subscribe, visit HIVPlusMag.com/signup.

There is a 10-copy minimum.

FREE DIGITAL SUBSCRIPTIONS Plus magazine is available free to individual subscribers—a digital copy of each issue can be delivered to the privacy of your computer or reader six times per year. We require only your email address to initiate delivery. You may also share your digital copies with friends.

To subscribe, visit HIVPlusMag.com/signup.

NEED SUBSCRIPTION HELP? If you have any questions or problems with your bulk or individual magazine delivery, please email our circulation department at Argus.Galindo@pridemedia.com.

Plus (ISSN 1522-3086) is published bimonthly by Pride Publishing Inc. Plus is a registered trademark of Pride Publishing Inc. Entire contents © 2019 by Pride Publishing Inc. All rights reserved. Printed in the U.S.A. Unless otherwise noted, all stock images are of posed models.

FOLLOW US ON FACEBOOK AND TWITTER

Facebook.com/ HIVPlusMag

4

Twitter.com/ HIVPlusMag

NOVEMBER / DECEMBER 2019

04_PLUS133_Masthead_FINAL_REVISED.indd 4

9/24/19 4:41 PM

EDITOR’S LETTER

LUKE FONTANA (ANDERSON-MINSHALL); FACEBOOK (JOHNSON); CHRIS WOOD (WARREN); JAMIE TREDWELL (DIANE, HERNANDO, ANDREW)

AT THE END of

the year, we usually mark World AIDS Day on December 1 and reflect both on where the epidemic has been (and those we’ve lost to it) and on where we are today. In many ways we’ve progressed to astonishing heights with treatment.

Earlier this year, we launched U=U & U, Pride Media’s yearlong initiative getting the word out about the groundbreaking consensus that people living with HIV with undetectable viral loads have zero risk of transmitting HIV to a sexual partner.

I’m sure when the Prevention Access Campaign launched its U=U campaign three years ago, the org had no idea how quickly the scientific world would back it up. But 2019 was really a watershed year. The very slowto-change Centers for Disease Control and Prevention issued a statement saying that “for persons taking ART [antiretroviral therapy] as prescribed and achieving and maintaining viral suppression, there is effectively no risk of transmitting HIV through sex.” Got it? That means it’s impossible to transmit the virus to anyone so long as you have it under control.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, a division of the National Institutes of Health, reiterated in an HIV.gov Facebook Live interview this summer, “U=U is the hallmark of what we’re doing because if you can get the infection level—the viral load—in any individual to below detectable, that person cannot transmit.

That means U=U. If we accomplish U=U, if you think for a moment, what does that mean? That means we don’t have anybody transmitting infection.

That’s what I mean when I say the concept of U=U is the foundation of being able to end the epidemic.”

Had more people understood this U=U concept, student athlete Michael Johnson could have graduated from college instead of spending the last five years in prison (see page 48). Both poz men we featured in our recent “I Am the First” series—actor and cannabis entrepreneur Hernando Umana (last issue) and professor and HIV leader Andrew Spieldenner (see page 38)—spoke on the issue. (That’s me with the guys above right!) And the U=U message is finally getting to people who need it most.

We also learned in the first HIV presidential survey (see page 24) that many of the Democratic presidential candidates understand U=U as well.

Publishing this historic survey, a week before our sister magazine The Advocate hosted an equally historic LGBTQ forum for the candidates, made me feel confident that many of the contenders have a grasp on the complex health inequities that those living with HIV—and the fight to end the epidemic—still face. (Note: President Trump and other presidential candidates were also sent the survey but as of press time have not responded.)

Many candidates have good policy proposals and impressive stigmabusting initiatives. Pete Buttigieg, the first out gay man to make it to a major debate, is particularly well-versed on HIV as you’d expect he’d be.

Some candidates believe their policies will lead to massive change (Bernie Sanders’s Medicare for All plan, for example); others have more nuanced ideas, some of which don’t go as far as we’d like. Beto O’Rourke, Kamala Harris, Cory Booker, Elizabeth Warren, Joe Sestak, and Steve Bullock all took time to think about their positions on HIV—and that’s saying something.

What stuck with me, however, was Warren’s quote, which I keep mulling over: “There is no single answer to ending this epidemic—we must use every tool at our disposal,” she said. “That includes Medicare for All, expanding

HIV research and treatment, ensuring everyone has access to PrEP and HIV testing, holding drug companies accountable and lowering drug prices, ending the opioid crisis, ensuring that community health centers receive robust funding, and reinstating our position as a global leader in public health. It also means expanding economic opportunities, tackling the housing crisis, banning private prisons and exploitative contractors, overturning HIV status criminalization and discrimination laws and regulations, and ensuring comprehensive, inclusive reproductive and sexual health education and services.”

Her statement was the one in this survey that made me think she really understands how complex tackling HIV is going to be as president. The truth is we have no idea who the Democratic presidential nominee will be, but simply knowing that folks like Warren have spent time compartmentalizing the impact HIV has on communities of color, on gay and bi men and trans women, on teenagers, on drug users and sex workers, and on your average suburban moms and dads living with HIV should give us hope.

This is still a Herculean effort getting people tested, on treatment, and undetectable—or to practice PrEP if negative. But it’s the closest we’ve ever been to an end. Here’s to what 2020 brings.

Happy holidays!

DIANE ANDERSON-MINSHALL EDITOR IN CHIEF EDITOR@HIVPLUSMAG.COM

HIVPLUSMAG.COM

05_PLUS133_ED Letter_FINAL_REVISED_da.indd 5

5

9/25/19 6:55 AM

buzzworthy

ARE WE REALLY ON THE FAST TRACK TO END HIV?

RESEARCH SHOWS THAT SOME CITIES MAY SEE AN END TO THE EPIDEMIC IN THE NEXT DECADE.

NICOLAS HOIZEY ON UNSPLASH

B Y D AV I D A R T AV I A

6

NOVEMBER / DECEMBER 2019

06-09_PLUS133_Buzzworthy_FINAL.indd 6

9/24/19 9:49 AM

I

t’s been five years since the Fast-Track Cities initiative was launched in Paris on World AIDS Day 2014, when 26 mayors from cities around the world signed a bold declaration to address the HIV epidemic.

Since then, that number has expanded to over 300 cities and municipalities—all vowing to continue the fight against HIV and aiming to achieve the UNAIDS 90-90-90 targets by 2020: 90 percent of people living with HIV knowing their status, 90 percent of people who know they’re HIV-positive being on treatment, and 90 percent of those on treatment reaching suppressed viral loads.

London, which accounts for 38 percent of all people living with HIV in the United Kingdom, was one of the first cities to exceed the 90-90-90 targets, having achieved 95-9897 in 2017—much sooner than the proposed target year.

At this year’s Fast-Track conference, London mayor Sadiq Khan confirmed his commitment to ending the epidemic entirely: “I am proud of what we have achieved, but we need to go further,” Khan said. “I wholeheartedly support the United Kingdom’s bold ambition to get to zero new HIV infections, zero AIDS-related deaths, and zero discrimination.”

Sindhu Ravishankar, senior director of technical programs at the International Association of Providers of AIDS Care, presented data showing that 14 cities have surpassed the first 90 target (awareness of HIV status), 16 cities have surpassed the second 90 (treatment initiation), and 23 cities have surpassed the third 90 (sustained viral suppression). In total, four cities have surpassed all 90-90-90 targets: Amsterdam and the U.K. cities Brighton (including Hove),

Manchester, and London. One of those, London, has also surpassed 95-95-95.

While other cities have seen massive improvements, Ravishankar argued that they could do more to end HIV sooner than expected— some as quickly as next year. According to IAPAC models, Zambia’s capital city of Lusaka (not yet hitting the 90-90-90 goals) could actually end its local HIV epidemic (defined as fewer than one new HIV infection and one AIDS-related death per 1,000 adults each year) as early as 2020 rather than its original projection of 2050 if it instituted an aggressive antiretroviral therapy scale-up.

Ravishankar noted in a statement to the press, “implementing aggressive ART scale-up, including annual testing for anyone at risk and immediate ART initiation, has the potential to end urban HIV epidemics many years sooner compared to business as usual, contributing to the global goal of ending the HIV epidemic as a public health threat by 2030.”

Adding to the global efforts to stop HIV is RADIAN, a groundbreaking initiative by the Elton John AIDS Foundation and Gilead Sciences aimed at parts of Eastern Europe and Central Asia (EECA).

Building on the existing collaboration between EJAF and Gilead, RADIAN seeks to help create a greater understanding of the region’s needs to build solid action and address specific challenges.

“Every day, more than 400 people in EECA become infected with HIV and 100 die from AIDS,” Elton John said in a statement. “My Foundation’s work in establishing the Eastern Europe and Central Asia Key populations fund with Gilead and others a couple of years ago forcefully underscored for us the need to drastically expand our efforts in the region. So, I’m delighted that the Foundation is once again working with Gilead through RADIAN to provide much-needed support and funding to reverse trends and reach some of the world’s most vulnerable people. Together, we can create change, save lives, and ensure no one is left behind in the fight to end the epidemic.”

By World AIDS Day 2020, we could be living in a world where a major city has ended its local epidemic. Here’s hoping!

HIVPLUSMAG.COM

06-09_PLUS133_Buzzworthy_FINAL.indd 7

7

9/24/19 9:49 AM

James Krellenstein and other HIV activists storm the stage to confront CDC director Robert Redfield about his history of not including poz people in policy decisions

WE WON’T BE IGNORED

ACTIVISTS STORM THE STAGE AT THE USCA, PROTESTING NEGLECT FROM THE CDC. Protesters from various HIV organizations across the country stormed the stage at the 2019 United States Conference on AIDS in Washington, D.C., in September, soon after the Centers for Disease Control and Prevention director, Robert Redfield, spoke with MSNBC’s Joy Reid about the agency’s new plan to end HIV by 2030.

Redfield, a Trump appointee, stood behind the plan to reduce new diagnoses by 75 percent in the next five years (and 90 percent in the next 10 years). The plan is particularly focused on 48 counties that the CDC has determined are most vulnerable to HIV outbreaks. Activists point out that the CDC’s determination of risk is flawed. For example, Cabell County, W.Va, which was not on that list, recently had an outbreak of its own.

The new plan will alter how money is allocated by directing resources to locations that represent the highest number of new diagnoses. By definition, that could take funding from locations that have already been successful in reducing transmission rates but may represent large communities of people living with HIV with significant needs.

The Trump administration believes it can end the HIV epidemic by building programs to deliver treatment and care where those at risk are—rather than having people travel to treatment centers, which can be miles away. This could also redirect funds from urban locations to more suburban or rural locations. Some argue that could benefit rural Trump supporters more than city-based Democrats. Redfield explained that making this change is going to “require innovation in care delivery systems,” but argued that

8

“allowing [at-risk] communities to develop their own individual community plans” rather than having “a set plan for everybody” is a key focus moving forward.

While that could make it sound like more local HIV activists would be involved in determining how those funds are used, critics claim the CDC isn’t including those most impacted by these decisions in the conversation.

“We are here today to say that it is impossible [to end the epidemic] without meaningful partnership with the [HIVpositive] community,” said protest organizer Ronald Johnson, chair of the United States People Living With HIV Caucus. “We are here to demand that the community will have actual decision-making power and oversight in the national, state, and local implementation of the new initiative.”

Naina Khanna, executive director of Positive Women’s Network-USA, a network of women living with HIV advocating on issues that impact them most, touched on the plan’s practice of molecular HIV surveillance.

“One of the things Dr. Redfield didn’t talk about today is the fourth pillar known as molecular HIV surveillance,” she explained to the crowd. “When we get tested or when we get new meds, our HIV virus is sequenced.

It goes into a national database that is being used and scaled up in order to track what they call ‘HIV outbreaks.’”

“This all sounds good, right?” Khanna asked rhetorically, before noting some issues.

“Number one,” she continued. “People living with HIV didn’t know this was happening and we did not consent to this. Number two, over 20 states have laws that criminalize people living with HIV. That means when they trace these clusters, they are tracing people at risk of prosecution—and we are not confused about who is most impacted by this epidemic.

They are the communities that are most surveilled and policed.”

James Krellenstein, cofounder of PrEP4All, a grassroots initiative advocating for wider access to the HIV prevention drug Truvada, also spoke. “The CDC owns patents on PrEP that could have prevented a drug company from charging over $1,600 a month for a drug that costs less than $6 a month to produce,” he said. “Dr. Redfield, our community didn’t know about these patents [because] your agency hid it from us. If you’re serious about ending this epidemic, you cannot continue to mislead and ignore the very communities that are most impacted.”

“We need more transgender protections put on the table,” added Arianna Lint, founder and CEO of Arianna’s Center, an organization linking trans people to care. “We are not a problem, we are part of the solution….

Nothing is developed for us. We have us, the transgender community. When you’re looking for data, hire us.” —DA

DAVID ARTAVIA

buzzworthy

NOVEMBER / DECEMBER 2019

06-09_PLUS133_Buzzworthy_FINAL.indd 8

9/24/19 9:49 AM

This year the literary world is ripe with fascinating fiction and nonfiction HIV narratives, many focusing on the emotional history of the epidemic. B Y D E S I R É E G U E R R E R O

So Lucky by Nicola Griffith, the award-winning author of Hild, is a fascinatingly intense, semiautobiographical novel about a woman facing down her demons. The profoundly personal narrative reads much like a memoir, and readers can’t help but empathize with protagonist Mara Tagarelli. In the space of a single week, her wife leaves her and she is diagnosed with multiple sclerosis.

In the professional world, Mara is the head of a multimillion-dollar AIDS foundation (a career inspired by someone very close to her living with HIV) and in her personal life, she is a committed martial artist. But when her life is turned upside down overnight, Mara finds herself feeling completely lost and alone. She can’t rely on family, her body is letting her down, and friends and colleagues are distancing themselves, treating her like a victim. Just when all seems lost, she finds an inner strength to fight back against a system that often savagely mistreats the disabled and chronically ill— though her actions unleash new enemies. (Farrar, Straus, and Giroux)

In the Shadow of the Bridge, a memoir by novelist Joseph Caldwell, is at its core a love story. But this is a love story that is bittersweet as it comes to fruition in the shadow of the AIDS epidemic.

Much of the memoir focuses on the young bohemian’s life in 1950s-’60s New York, a place he migrated to in order to live freely as an out gay man.

Living on a street and neighborhood under the Brooklyn Bridge that would soon cease to exist, Caldwell rubs elbows with greats like James Baldwin, finds moderate success as a playwright, and ends up writing for TV soap operas like Dark Shadows and The Secret Storm. Amid it all, he also falls madly in love. However, the fiery affair quickly fizzles and Gale, the man he loves, leaves Caldwell heartbroken and longing. Years later, through a serendipitous twist of fate, the author is reunited with Gale in the darkness of the AIDS epidemic, where Caldwell has become a caretaker for the dying.

(Delphinium Books)

Bloodflowers by W. Ian Bourland examines the photography of Rotimi Fani-Kayode (1955–1989), an artist whose work created a cultural touchstone for conversation around gender and queerness, race and diaspora, and the enduring legacy of slavery and colonialism. Born in Nigeria, FaniKayode migrated through the art and culture scenes of Washington, D.C., New York, and London, where he produced much of his overall body of work—the majority of which consisted of his provocative, often surrealist, homoerotic photographs of Black men.

Bourland brilliantly describes FaniKayode’s work in a period of global transition, and how it created and responded to profound social, cultural, and political change.

In addition to his expert analysis of Fani-Kayode’s portraits, Bourland ties together the unique intersecting elements that made the art of this era incredibly original: surrealism, neo-Romanticism, Yoruban religion, the AIDS crisis, experimental film, loft culture, and house and punk music. (Duke University Press)

Illuminations on Market Street by Benjamin Heim Shepard covers the AIDS epidemic, nothing new for the author. As the writer and editor of six books, including White Nights and Ascending Shadows: An Oral History of the San Francisco AIDS Epidemic and From ACT UP to the WTO: Urban Protest and Community Building in the Era of Globalization, Shepard is wellversed on the topic.

But what is new to the Ph.D.-holder and former social worker is writing fiction—which he does brilliantly with his first novel, Illuminations on Market Street, “a story about sex and estrangement, AIDS and loss, and other preoccupations in San Francisco.”

Shepard expertly uses his real-life experience to fuel this exciting tale of a recent college grad and budding activist in early ’90s San Francisco.

Between punk shows and protests, protagonist Cab learns how to navigate life, love—and loss.

(Ibidem Press)

The Journalist of Castro Street: The Life of Randy Shilts by Andrew E. Stoner is the new biography of one of the most iconic— and controversial— figures of the AIDS epidemic. After Shilts penned the best-selling exposé And the Band Played On, which revealed uncomfortable truths on why HIV was allowed to spread unchecked during the early ’80s, he was considered the voice of the movement.

But his success was not without controversy. It was later discovered that the idea of a “Patient Zero” was bunk. The book focused on a promiscuous Dutch flight attendant who supposedly brought AIDS to the U.S. and infected thousands—a theory now thoroughly discredited via scientific analysis.

Behind the scenes, Shilts struggled with alcohol and substance abuse— partly in order to cope with the secret HIV diagnosis that had begun to take his own life.

(University of Illinois Press)

I’ve Seen the Future and I’m Not Going: The Art Scene and Downtown New York in the 1980s

by Peter McGough is a must-read for the modern art lover—or anyone who wants to learn more about the fascinating, and often tragic, life experiences of queer Baby Boomers.

From growing up gay in the rigid and sexually repressed American 1950s, to the frolicking freedom of the Studio 54 1970s, and finally, to the heartbreak and loss of the ’80s AIDS epidemic, McGough vividly takes you on a journey through time. The author is half of McDermott & McGough, a talented art duo known for their paintings, photography, sculpture, and film work—as well as for choosing to live, right down to their clothes, as though they were in the Victorian era (even living without electricity and other modern conveniences). I’ve Seen the Future and I’m Not Going is also a poignant peek into the wondrous lives of many queer artists, including Keith Haring, Basquiat, Andy Warhol, and Jeff Koons, whose lives were cut short.

(Pantheon Books)

Viral by Ann Bausum, the awardwinning author of Stonewall: Breaking Out for Gay Rights, is the first history of the AIDS pandemic created just for teen readers.

Bausum beautifully captivates this demographic with her exciting narrative style— while never insulting the politically savvy generation’s intelligence.

Viral is told with compassion yet unflinching honesty through the stories of the activists, allies, loved ones, longterm survivors, and even those who lost their lives during the early years of the AIDS epidemic.

But offering more than a history of that particular era, the book brings readers through the ’90s, 2000s, today, and beyond in efforts to share the message that the fight against HIV continues.

Already adopted as a vital history text in classrooms across the country, Viral is a must-read for anyone, especially teens, wanting to educate themselves on a crisis that affects us all.

(Viking)

HIVPLUSMAG.COM

06-09_PLUS133_Buzzworthy_FINAL.indd 9

9

9/24/19 9:49 AM

TREATMENT A SINGLE TABLET CONTAINING TWO DRUGS—DOLUTEGRAVIR AND LAMIVUDINE—CONTINUES TO SHOW LONG-TERM EFFICACY.

BY DAVID ARTAVIA

Findings presented at the International AIDS Society 2019 Conference on HIV Science in Mexico City found that Dovato, a two-drug regimen of dolutegravir and lamivudine, suppresses HIV just as well as three-drug regimens— and with fewer side effects and zero drug resistance. The drug from ViiV Healthcare received Food and Drug Administration approval earlier this year for the treatment of people newly diagnosed with HIV. The results of two landmark studies, GEMINI 1 and GEMINI 2, showed that after 96 weeks, Dovato continued to suppress HIV in the more than 1,400 study participants.

Dovato uses dolutegravir to inhibit HIV replication by preventing the viral DNA from integrating into the genetic material of T cells. This is key to HIV replication and also establishes chronic infection.

Meanwhile, lamivudine interferes with viral RNA’s conversion into DNA, so the virus cannot multiply.

These results further add to the consensus that two-drug regimens can be as effective and safe as multi-

drug regimens without raising drug resistance concerns. Previously, all HIV treatments included at least three medications so that if the virus developed resistance to one or two of the components it still couldn’t rebound. Now that newer drugs have proven less susceptible to drug resistance, researchers are demonstrating that these two-drug regimens can replace three-drug cocktails.

Bene fits of reducing the number of drugs one takes go beyond improving adherence.

It also raises hopes for fewer side effects and reduces risks of drug toxicity in long-term treatment.

Plus, it opens the door for further improvements in HIV treatment.

12

AITOF/PIXABAY

IT TAKES TWO

NOVEMBER / DECEMBER 2019

12-13_PLUS133_Treatment_FINAL.indd 12

9/24/19 9:48 AM

IS THAT RASH A SIGN YOUR TREATMENT ISN’T WORKING?

BABYSITTER TIME

MILLI LU/PIXABAY; CHEZBEATE/PIXABAY

Doctors recommend even more monitoring for pregnant women living with HIV.

Treating women who are pregnant and living with HIV has always been challenging for researchers. Given that pregnancy alters a person’s physiological makeup, it can significantly reduce maternal drug plasma concentration, which is the driving force for a fetus to absorb drugs.

According to a study published in the Journal of Medical Case Reports, researchers examined the case of a 26-year-old pregnant woman living with HIV who had an unusually low concentration of maternal drug plasma—even when doctors intensified HIV treatment.

The unnamed woman became pregnant several months after she was diagnosed with HIV. After one month of pregnancy, her viral load was still detectable (53 copies/mL). Even when doctors continued to intensify her treatment regimen, the woman remained detectable and never attained viral load undetectability on follow-ups. Regardless, the mother gave birth to a healthy baby via cesarean, which was recommended by physicians.

Ten weeks later, the woman’s treatment was de-intensified and her T cells rose back up. The baby’s T and B cells were normal and HIV was undetectable.

As of press time, the baby remains HIV-free.

Given that physiological changes can reduce a mother’s bioavaiability of ARTs, researchers recommend that pregnant women living with HIV receive more personalized treatment and careful follow-ups. —DA

There are a wide variety of skin conditions that can occur in people living with HIV. It could be something as simple as a reaction to one of your meds, but it could also be a sign of a weakened or nonfunctioning immune system— also known as immunosuppression. You should talk to your doctor right away about any significant skin changes or skin issues, as it could be a sign your medication isn’t working properly. Here are the seven most common skin issues associated with HIV: MOLLUSCUM CONTAGIOSUM: A highly contagious viral skin infection that causes pink or flesh-colored bumps on the skin.

HERPES VIRUSES: An outbreak of sores around the genital area or the mouth.

KAPOSI SARCOMA: A type of cancer that causes dark brown, purple, or red lesions on the skin, which often occurs in people with very low T cell counts.

ORAL HAIRY LEUKOPLAKIA: A viral infection that affects the mouth and can cause thick white lesions on the tongue that appear hairy.

THRUSH: Also called oral candidiasis, thrush is a fungal infection that causes a thick white layer to form on the tongue or inner cheeks.

PHOTODERMATITIS: A condition in which the skin reacts to sun exposure by turning darker (much more so than a normal tan) and is most common in people of color.

(Note: This is a common medication side effect and is not typically a sign of immunosuppression.)

PRURIGO NODULARIS: Outbreaks of itchy, crusted lumps on the skin most common in those with extremely weakened immune systems as well as people of color living with HIV. —DG HIVPLUSMAG.COM

12-13_PLUS133_Treatment_FINAL.indd 13

13

9/24/19 9:48 AM

ARTIST DON BACHARDY CHRONICLED A LOST GENERATION WHILE FACING HIS OWN GREATEST LOSS.

BY MICHAEL SCHREIBER PHOTOGRAPHY BY SEAN BL ACK

14

NOVEMBER / DECEMBER 2019

14-19_PLUS133_FEA_Bachardy_FINAL.indd 14

9/24/19 9:48 AM

I am a camera with its shutter open, quite passive, recording, not thinking,” observes the eponymous protagonist of Christopher Isherwood’s semi-autobiographical 1939 novel, Goodbye to Berlin. “Some day, all this will have to be developed, carefully printed, fixed.”

Eighty years later, this famous quotation comes to mind as Isherwood’s life partner, the artist Don Bachardy, discusses his own long and celebrated career drawing and painting extraordinary portraits he channels through his skilled eye and hand. Through a remarkable talent and an economy of brushstrokes, he is able to capture in his artwork both the physicality and the energetic imprint of his subjects, whether they be celebrities or everyday people.

14-19_PLUS133_FEA_Bachardy_FINAL.indd 15

9/24/19 9:48 AM

16

NOVEMBER / DECEMBER 2019

14-19_PLUS133_FEA_Bachardy_FINAL.indd 16

9/24/19 9:48 AM

With a stroke of his brush, Don Bachardy paints visuals of life and love that will be immortal

Bachardy readily attributes his success as an artist to the early and continuing encouragement he received from Isherwood, whom he fatefully met on a beach in Santa Monica, Calif., in 1952. Although Bachardy was 18 and Isherwood 30 years his senior, the unlikely pairing not only survived, but thrived both domestically and creatively over the next three decades.

Recently, their love story was chronicled in the awardwinning documentary film Chris & Don: A Love Story, and revealed through the publication of Isherwood’s diaries as well as The Animals: Love Letters Between Christopher Isherwood and Don Bachardy. The latter was adapted into a podcast series starring Simon Callow and Alan Cumming, along with the Isherwood-Bachardy play A Meeting by the River. The novel A Single Man, arguably Isherwood’s masterwork, was adapted by designer-director Tom Ford into a critically acclaimed 2009 film starring Colin Firth.

Isherwood’s 1976 memoir Christopher and His Kind was adapted into a BBC television film featuring Matt Smith.

Bachardy’s artwork, meanwhile, continues to be widely exhibited, and is in the permanent collections of the National Portrait Gallery in London, the Metropolitan Museum of Art, and the the Smithsonian, among many other institutions. His hundreds of celebrity subjects have included fellow artists, literary greats, movie stars, and politicians. His entire body of work, however, encompasses thousands of portraits that reveal the extraordinary in even the most ordinary of faces.

Isherwood succumbed to prostate cancer in 1986, just as friends of the pair as well as many of the young models with whom Bachardy was working, were being diagnosed with HIV. Bachardy has survived Isherwood and many of these friends by 30 years, as have two expansive portfolios of his work from that period: one collecting his poignant last drawings of Isherwood, and the other an extensive series of male nudes created in the immediate aftermath of Isherwood’s passing. Among these young men were several models who bravely encouraged Bachardy to document their decline due to AIDS complications—work the artist unflinchingly embraced and executed.

At age 85, Bachardy is still a prodigious artist, painting and working several days a week in the studio adjacent to the home he once shared with Isherwood in the Santa Monica Canyon. Two collections of his portraitures, Hollywood and Nudes, have recently been published. The life and love he and Isherwood shared have also been recounted and celebrated in exhibitions in Berlin, and a comprehensive new biography of Isherwood by Katherine Bucknell is forthcoming.

Plus recently sat down with the legendary artist to discuss the impact of love and loss on his work: Although distinctively expressed, you and Chris shared a gift of observation. Does his “I am a camera” hold any particular resonance for you as a portrait artist?

Without realizing it, Chris and I were perfect for each other because we both were fascinated by people. He had a literary interest: he heard. He heard how they talked, how they expressed themselves. And I looked at them. And it got to the point where, when Chris was writing about somebody we both knew, he would ask me how would I describe that person? And so it was a perfect balance.

Yours was a highly collaborative relationship, with Chris consulting you on his writing while continually encouraging you with your own work.

Of course in Chris, I had the ideal encourager. He was always there when I came home from art school, asking, “Let me see what you did.”

And we would go through all the work together. He would pick out his favorites, and we would really share them. That was just golden. Without him, I could have never made it. I had to find Chris to bring it out…. I was just bursting with a need for a vocation, without really knowing where it might be. Unconsciously, I had been developing the accuracy of my eye by copying movie magazine portraits of actors. When I applied that to real-life people, I instantly made advancements in all of my classes. The other students my age were eventually standing behind me, watching me draw, asking to see the pictures I was doing. And that was exactly what I needed—that kind of encouragement to be regarded as special, not only by Chris, but by people my own age. I couldn’t get enough of that.

You nursed Chris through his final months, and, with his encouragement, you also approached this deeply personal experience as an artist would.

Being alone with him, day after day, and concentrating on him in that way I only do when I’m working—I mean, not only looking at him, but identifying with him, it really did seem like we were doing it together.

So the last six months of his life, I was HIVPLUSMAG.COM

14-19_PLUS133_FEA_Bachardy_FINAL_REVISED.indd 17

17

9/24/19 4:41 PM

WITHOUT HIM, I COULD HAVE NEVER MADE IT. I HAD TO FIND CHRIS TO BRING IT OUT… drawing him. And of course I knew he was slipping away. And as ruthless as I am when I am working, it was also the most intense way of being with him, of looking at him. That’s really what I needed: that intense closeness, being with him. That was my farewell to him.

Just getting him in my head so that I could never get him out. And I never will.

As his life partner and as an artist, that must have been incredibly challenging.

Oh, yes. He was always a perfect sitter for me, but in those last months, last weeks, he was restless, moody; he was unfocused; he was sleeping. I was really doing it by his presence. I knew the face, the head, so well, that I only needed a second, as it were, to do each feature, because I knew him in my mind.

But his presence was still powerful. I think it’s certainly the best work I’ve ever done, and in a way, it had to be, because it was he who had made me an artist. He had made it possible.

I would never even have gone to art school without him.

What was it like trying to navigate a life on your own?

Well, I’ll tell you exactly how I handled it. He died in early ’86, and ’86 is by far the year with the most and fattest portfolios of my work. I literally worked seven days a week, almost every week. Long days, and sometimes working at night, if I had a really staunch model. They were all male nudes, because a 18

patron was sending me beautiful young men.

I was working, doing almost nothing but male nudes for almost three years. And a real intensity of work that isn’t matched in any other part of my life. It was real dedication to the work in the studio, and then to reading Chris’s journals at night. While we were living together, I never read any of his diaries, even though he never hid them from me. But without any acknowledgment to myself what I was going to do, at the end of the day he died, after his body had been taken out of the house, I went to where I always knew the journals were, and began first with latest volume. I worked back in time. And it was an amazing experience for me, as he’d guessed it would be, as many of the entries in the late journals were addressed, “Don, I know you’re going to be reading this after I’m dead.” And indeed, I was. And reading and rereading; getting it really into my head. It was so intimate, and I read slowly, savored every detail, and that’s what really got me through that first year without him.

During that same period, you also lost a number of dear friends to AIDS, the imprints of so many of whom still vibrantly live on in your portraits. Do any in particular come to mind?

Oh, yes. There was a pretty young boy who’d sat for me several times at the height of his beauty, and he was an early victim of AIDS, and he called me up especially to offer himself as a sitter, knowing that his beauty had already been ravaged. And so that was an invitation to me not to do any soft-pedaling.

He encouraged me to put in everything I could see, and I did. It was anyway a part of my basic attitude to my work, but he was saying, don’t be ashamed to tell everything.

And so I took him up on it, and it’s a shocking comparison. And there was only a year or two at the most between our sittings when he was so beautiful, and once he got AIDS, it was just all downhill. I think we did these two sittings, so I probably have at least four or five late pictures of him.

Do you know what his intention was in requesting that?

He wasn’t somebody who even suggested I only ever show one of the beautiful pictures I did of him. I think he was intelligent enough to know his beauty wouldn’t last, and he wanted it recorded. And instead of being ashamed of what AIDS did to him physically, he was intelligent enough to know there was a value in recording his decline. I guess he perceived he knew me well enough as an artist to know that I wouldn’t shrink from it. Given that license, I would make full use of it—and did.

Whereas most young men, that was the last thing they would have thought of doing. And

NOVEMBER / DECEMBER 2019

14-19_PLUS133_FEA_Bachardy_FINAL.indd 18

9/24/19 9:48 AM

I thought it was so protective of him to know that telling me I had license would make it all the more irresistible to work with him. I didn’t have to worry about shocking him by my own recording of what he truly looked like. And he was devastated, physically, by the comparison: you would hardly know it was the same young man.

You’ve become a longtime supporter of various AIDS charities, and have donated your work to fundraising efforts.

Yes, always to that cause. Oh, certainly. Glad to. And I still do.

You’ve previously cited Chris’s illness as the reason you yourself didn’t contract HIV. Can you explain why you’ve thought this?

Yes, because I was home taking care of him.

I mean, for the last six months he was alive we hardly saw anybody else. I felt that looking after him was my responsibility, and one that I really wanted to fulfill, because he had allowed me to have a wonderful life. And without him, I would never have become an artist. I’d never have had the courage to believe in myself. But I didn’t even really feel it was an obligation to take care of him. It was really something I wanted to do, and I knew how to do. And if it hadn’t been for my devotion to Chris, and if he hadn’t been in need of my attention to him personally, I would certainly have died of

AIDS because I never took precautions. And once the epidemic started, it would have been too late, anyway.

Were you surprised at all to find that Chris didn’t mention much about HIV or AIDS in his later diaries, even though you were both losing friends and were non-monogamous as a couple?

Oh, we certainly talked about it. I mean, everybody, all of us talked about it, of course, but I think he was too close to his own death to want to get into it. It was difficult enough coping, because he was somebody who had such an appetite for life, for experience, like very few people I’ve known. And also, he was beyond it, and I didn’t realize to what extent until after he was dead, when I read his diaries.

It’s remarkable that in so many ways, you were able to carry on a dialogue with Chris, just in going back through the diaries.

Yes, exactly. And that, of course, had not only occurred to me—as I just said, he addressed entries to me. It was like he was still holding my hand.

Michael Schreiber’s first book, One-Man Show: The Life and Art of Bernard Perlin, was named a Stonewall Honor Book by the American Library Association, and is being adapted into a featurelength documentary film. His next book, This American House, a collaboration with his husband, Jason Loper, about their Frank Lloyd Wright-designed home in Iowa, is due out in 2020.

HIVPLUSMAG.COM

14-19_PLUS133_FEA_Bachardy_FINAL.indd 19

19

9/24/19 9:48 AM

YOU MATTER AND SO DOES YOUR HEALTH That’s why starting and staying on HIV-1 treatment is so important.

WHAT IS DESCOVY®?

DESCOVY is a prescription medicine that is used together with other HIV-1 medicines to treat HIV-1 in people who weigh at least 77 lbs (35kg). DESCOVY is not for use to help reduce the risk of getting HIV-1 infection. DESCOVY combines 2 medicines into 1 pill taken once a day. Because DESCOVY by itself is not a complete treatment for HIV-1, it must be used together with other HIV-1 medicines.

DESCOVY does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses, you must keep taking DESCOVY. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about DESCOVY? DESCOVY may cause serious side effects: • Worsening of hepatitis B (HBV) infection. DESCOVY is not approved to treat HBV. If you have both HIV-1 and HBV and stop taking DESCOVY, your HBV may suddenly get worse. Do not stop taking DESCOVY without first talking to your healthcare provider, as they will need to monitor your health.

What are the other possible side effects of DESCOVY? Serious side effects of DESCOVY may also include: • Changes in your immune system. Your immune system may get stronger and begin to fight infections.

Tell your healthcare provider if you have any new symptoms after you start taking DESCOVY. • Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. Your healthcare provider may tell you to stop taking DESCOVY if you develop new or worse kidney problems.

• Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that

can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.

• Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.

The most common side effect of DESCOVY is nausea.

Tell your healthcare provider if you have any side effects that bother you or don’t go away.

What should I tell my healthcare provider before taking DESCOVY? • All your health problems. Be sure to tell your healthcare provider if you have or have had any kidney or liver problems, including hepatitis virus infection.

• All the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Other medicines may affect how DESCOVY works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist.

Ask your healthcare provider if it is safe to take DESCOVY with all of your other medicines.

• If you are pregnant or plan to become pregnant.

It is not known if DESCOVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking DESCOVY. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Important Facts about DESCOVY, including important warnings, on the following page.

Ask your healthcare provider if an HIV-1 treatment that contains DESCOVY® is right for you.

DVYC0085_A_7-875x10-5_Plus_Drew_r1v2jl.indd Custom V 2 18504 Descovy Drew.indd 2

11/14/17 11:42 AM

11/13/17 1:26 PM 18504 Descovy Drew.indd 3

11/14/17 11:42 AM

IMPORTANT FACTS This is only a brief summary of important information about DESCOVY and does not replace talking to your healthcare provider about your condition and your treatment. ®

(des-KOH-vee) MOST IMPORTANT INFORMATION ABOUT DESCOVY

POSSIBLE SIDE EFFECTS OF DESCOVY

DESCOVY may cause serious side effects, including: • Worsening of hepatitis B (HBV) infection. DESCOVY is not approved to treat HBV. If you have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking DESCOVY. Do not stop taking DESCOVY without first talking to your healthcare provider, as they will need to check your health regularly for several months.

DESCOVY can cause serious side effects, including: • Those in the “Most Important Information About DESCOVY” section.

• Changes in your immune system.

• New or worse kidney problems, including kidney failure.

• Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.

• Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.

The most common side effect of DESCOVY is nausea.

These are not all the possible side effects of DESCOVY. Tell your healthcare provider right away if you have any new symptoms while taking DESCOVY. Your healthcare provider will need to do tests to monitor your health before and during treatment with DESCOVY.

ABOUT DESCOVY • DESCOVY is a prescription medicine that is used together with other HIV-1 medicines to treat HIV-1 in people who weigh at least 77 lbs (35kg). DESCOVY is not for use to help reduce the risk of getting HIV-1 infection.

• DESCOVY does not cure HIV-1 or AIDS. Ask your healthcare provider about how to prevent passing HIV-1 to others.

BEFORE TAKING DESCOVY Tell your healthcare provider if you: • Have or had any kidney or liver problems, including hepatitis infection.

• Have any other medical condition.

• Are pregnant or plan to become pregnant.

• Are breastfeeding (nursing) or plan to breastfeed.

Do not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby.

Tell your healthcare provider about all the medicines you take: • Keep a list that includes all prescription and over-the-counter medicines, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

• Ask your healthcare provider or pharmacist about medicines that should not be taken with DESCOVY.

GET MORE INFORMATION • This is only a brief summary of important information about DESCOVY. Talk to your healthcare provider or pharmacist to learn more.

• Go to DESCOVY.com or call 1-800-GILEAD-5 • If you need help paying for your medicine, visit DESCOVY.com for program information.

HOW TO TAKE DESCOVY • DESCOVY is a one pill, once a day HIV-1 medicine that is taken with other HIV-1 medicines.

• Take DESCOVY with or without food.

DESCOVY, the DESCOVY Logo, LOVE WHAT’S INSIDE, GILEAD, and the GILEAD Logo are trademarks of Gilead Sciences, Inc., or its related companies. All other marks referenced herein are the property of their respective owners. Version date: September 2017 © 2017 Gilead Sciences, Inc. All rights reserved. DVYC0085 11/17

DVYC0085_A_7-875x10-5_Plus_Drew_r1v2jl.indd 5 18505 Descovy Drew.indd 1

11/13/17 1:26 PM 11/14/17 11:42 AM

D A I LY D O S E

BY TYLER CURRY

WRINKLES IN TIME I MAY ONLY BE 36, BUT THE PRESSURE OF TURNING TO MEDICAL INTERVENTIONS TO LOOK YOUNGER IS ALREADY IMMENSE.

JONNY LINDNER/PIXABAY (MAN); COURTESY TYLER CURRY (CURRY)

HERE IS A little secret about me. Before I even

turned 30, I had my first Botox injection. Living in Dallas, a city consumed by a plastic-perfect aesthetic, it seemed like a harmless rite of passage into my life as a gay man. Little did I know, it was also the first step into the ocean of aging, where the tide keeps rising and it becomes harder and harder to keep your head above water.

You may be asking yourself why a 36-year-old man is writing about the difficulty of aging. I admit I am surprised to find myself doing it.

But this year, I moved back to the city where I gave the first piece of my soul to the plastic surgery devil, and I quickly learned that I am in a little bit of debt.

Maybe it’s a regional thing. I had spent the last three years in a liberal hippie bubble where “healthy” wasn’t tied to how few wrinkles you had or the circumference of your biceps. It was just long enough for me to let my forehead unfreeze, cut out the creatine powder, and allow my face and body to (gasp!) return to a more human form.

As much as I hate to admit it, it only took three months after my return to the land of plastic surgery to book an appointment with the needle. After joining a few social groups of men my own age, I found myself surrounded by men whose biceps were bulging, whose pecs were exploding, whose waists were microscopic, and who were all on some pretty serious steroids. As you can imagine, my healthy body image quickly morphed into a house of a thousand horrors.

This column isn’t about how steroids are bad.

If you aren’t hurting anyone else, you are free to

do with your body what you will. The temptation of steroids for me might be the pressure to get liposuction or breast implants for others. It is simply the pressure to conform or contort yourself to stay valuable. I know I am not the only person who continuously battles with whether to resist what my insecurities would have me do or give in and chase the dragon.

It is a struggle of many, and it will only get harder with age.

No matter how much I want to strive to stay relevant in a culture that worships youth, my one absolute is that I also want to live—and live well—for as long as I possibly can. For me, a person who is living with HIV, doing things like taking steroids is in absolute contrast with the one thing I never waiver on: my health. Not how close I look to a Men’s Health magazine cover— but my actual health, which is more important than my insecurities would have me believe.

This has become something I have to constantly remind myself of. Now it is also something I try to bring up in conversation with the wonderful, thoughtful, and amazing people whom I have met this year in the city where I had my first injection. We are all struggling with the pressures of Insta-society, so sometimes the best therapy we can do is to laugh about it and take the air out of the room as much as possible.

Regardless of the pressures you may face, aging is inevitable and the alternative is a literal buzzkill. Hopefully, we can do it while damaging ourselves as little as possible.

Editor at large TYLER CURRY is also a contributing editor at The Advocate magazine and the author of A Peacock Among Pigeons. (@IamTylerCurry)

HIVPLUSMAG.COM

23_PLUS133_Daily Dose_FINAL.indd 23

23

9/24/19 9:50 AM

WILL THEY LEAD US TO AN HIV-FREE FUTURE?

the 2020 presidential candidates were asked about hiv policy and stigma. here’s how they responded.

ELEMENT5 DIGITAL/PEXELS

by jacob anderson-minshall

24

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 24

9/24/19 9:56 AM

THE NEXT PRE SIDENT

of the United States will represent over a million Americans living with HIV, and their administration will fund resources for the 40,000 people newly diagnosed with the virus each year. They’ll be trying to live up to some states’ aggressive (but some say attainable) HIV goals, as well, like ending AIDS by 2030.

HIV activists have long requested that presidential candidates share their HIV policy plans, though they haven’t always gotten a response.

But things have begun to change, and

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 25

six of the top 2020 Democratic nominee hopefuls responded to an HIV-focused survey spearheaded by AIDS United, along with other members of the ACT Now: End AIDS Coalition (which is made up of Gay Men’s Health Crisis, Housing Works, Positive Women’s Network-USA, Prevention Access Campaign, Sero Project, Transgender Law Center, U.S. People Living With HIV Caucus, and over 40 other community-based organizations).

The survey was sent to every major presidential candidate, including reelection-seeking President Trump. So far, responses have been returned from several Democratic candidates: Cory Booker, Steve Bullock, Pete Buttigieg, Kamala Harris, Beto O’Rourke, Bernie Sanders, Joe Sestak, and Elizabeth Warren.

Not surprisingly, many of the candidates’ responses are similar. They all support the Equality Act, as well as providing more services for those living with or at risk of contracting HIV who are incarcerated; more funding for HIV research, programs like PEPFAR, and specific HIV prevention efforts like PrEP; and returning the nation to a leadership role on the world stage when it comes to HIV. Each condemns HIV and LGBTQ discrimination, the ban on those living with HIV enlisting or deploying in the armed forces, and barriers to reproductive health care. Most wouldn’t deny health care to people based on their immigration status. Many specifically call health care (and housing) “a human right.”

Where the candidates differ is in specific proposals and their grasp of the issues facing those living with HIV (not all of them are well-versed in U=U or TasP, for example). There was also a difference in language. For example, both the Sanders and O’Rourke campaigns answered questions in the third person (“As president, Beto will…”) while the others answered in the first person (“As president, I will…”).

Some seem to think maintaining current funding levels is enough, while others argue for dramatic increases for programs impacting those living with HIV. Here are summaries of each candidate’s responses:

9/24/19 9:56 AM

26

SEAN RAYFORD/GETTY IMAGES

C ORY B OOKE R pledges to “beat this epidemic” by increasing funding, removing barriers to PrEP, passing comprehensive sex education legislation, halting all administration attacks on the Affordable Care Act and Medicaid, rescinding Trump’s rules that enable LGBTQ discrimination, and increasing access to health coverage.

The senator from New Jersey argues, “We need to use Medicare’s bargaining power to drive down the costs of prescription drugs and import drugs from Canada and other countries. We also need to pass the ​Prescription Drug Price Relief Act, which would lower drug prices in the U.S. by 50 percent and take patents away from drug companies that sell the same medication for less in other countries. And we need to impose a tax on prescription drug companies that unfairly raise the price of their drugs.”

Booker supports Medicare for All and sees health care as a human right, “regardless of someone’s immigration status,” age, income, whether they have a preexisting condition, or are/have been incarcerated. He believes, “Abortion care is health care, and health care is a human right.” And says he’ll “work with Congress to pass legislation that will codify the protections of ​Roe v. Wade.”

Booker also views housing as a human right and says, “Programs like HOPWA [Housing Opportunities for Persons with AIDS] aren’t just about housing—they are about health care and education and economic opportunity, among others. When housed, people living with HIV are far more likely to gain access to treatment and adhere to treatment.”

Booker is a cosponsor of the ​Equality Act, which would protect LGBTQ people from discrimination in housing, the workplace, and public accommodations. It has passed the House but is stalled under Mitch McConnell’s Senate leadership.

“Discrimination on the basis of HIV status has no place in our country,” Booker adds.

“As president, I would work to extend federal protection from discrimination based on HIV status and fight to provide the resources they need to be successful in our society. That’s why I am an original cosponsor of the ​Health Equity and Accountability (HEAP) Act, which would provide targeted approaches for improving awareness, health outcomes, early detection, linkage to care, and treatment for conditions that significantly impact racial and ethnic minorities.”

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 26

9/24/19 9:56 AM

WILLIAM CAMPBELL/CORBIS VIA GETTY IMAGES

STEV E BU L LO C K would battle the HIV epidemic by supporting the Repeal Existing Policies That Encourage and Allow Legal (REPEAL) HIV Discrimination Act aimed at eliminating federal, state, and local HIV criminalization laws (which Bullock argues “stigmatize HIV and deter people from getting the help they need”); working to ensure HIV testing and treatment information are available to all “with an increased focus on marginalized communities;” and lowering costs of HIV prevention and treatment drugs, “including PrEP and PEP, to ensure that all Americans have access.”

Bullock supports additional funding for HIV research, saying, “The U.S. spends $35 billion on HIV—but only 10 percent goes to domestic prevention and research. It’s clear we need to maintain and increase our focus on research and development. I would convene experts in the field, including activists who have been fighting for decades, to ensure that we devote the right level of funding for this important work.”

The governor of Montana plans to address the opioid drug epidemic by increasing funding “for state substance abuse grants and incentivize grants that go to the hardest-hit rural areas,” for “return to work” programs “for those who have struggled with addiction,” and for “proven substance misuse prevention and treatment programs.” And by working “with states that have yet to expand Medicaid” to do so.

Bullock believes “access to health care shouldn’t depend on the size of your paycheck. It should be a right for all. But with over 27 million Americans still uninsured, we have work to do.” But he does not advocate for Medicare for All, instead pledging “to ensure high quality, universal health care access” (in other words, everyone has access to health care—a far cry from the “free” health care some other candidates promise.)

Bullock adds we must “make care more affordable while

expanding access and improving existing coverage. This can be done by building on the success of the ACA.” For example, Bullock supports providing Americans a public health care option, allowing a Medicare buy-in for Americans 55 and over, increasing subsidies to defray the cost of health insurance, and automatic enrollment for those eligible for Medicaid.

Bullock supports the Equality Act and says, “It is frightening that millions of Americans can still be fired merely because of who they love. As president, I will sign an executive order ensuring that any federal contractor prohibits discrimination based on sexual orientation [and] racial and gender identity.”

To support the transgender community he would uphold Obama-era protections overturned by Trump.

Although he doesn’t offer specifics, Bullock says he would reduce drug costs by working “with Congress to take on the pharmaceutical industry and negotiate drug prices” and would create caps for Medicare drug costs.

He believes in comprehensive immigration reform (with a path to citizenship) but doesn’t suggest immigrants have a right to publicly funded health care (as other respondents did). However, Bullock does make clear, “Incarcerated Americans deserve health care access. Period.” He doesn’t suggest comprehensive reform of the correctional system, however instead saying he would “direct the Department of Justice to ensure that the Bureau of Prisons and state prison-health providers are providing health care that meets established standards.”

“There is no debate: a woman’s right to make her own health care decisions is under attack in America today,” says Bullock, arguing, “The government should not be deterring medical professionals from providing the best possible health care advice.”

HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 27

27

9/24/19 9:56 AM

time that those who are stably housed are more likely to have improved health outcomes once they enter care. This has been shown again and again for those living with HIV.” A gay man, Buttigieg was one of the candidates to specifically address HIV criminalization (rather than discrimination at large) and states, “I can assure you that my Department of Justice will not prosecute people (or seek enhanced sentencing) because of their HIV status.”

The majority of statutes criminalizing HIV are state-level and not the purview of the federal government, so such efforts may have limited impact.

When it comes to providing health care for immigrants, Buttigieg notes, “We will never end the AIDS epidemic if we push one segment of the at-risk population underground. It is morally wrong, and it is very bad public health practice. In a Buttigieg administration, we will reverse any public charge provisions that the Trump administration puts in place. We will clarify—through policy and a public education campaign—that all immigrants, regardless of status, are welcome to be served in all public health programs, including Ryan White, community health centers, and publicly funded family planning and STI clinics.”

Buttigieg also promises “a national strategy on reproductive health and wellness that strengthens access not only to abortion but to all aspects of reproductive health, from sex education to research, to coverage and clinical care.”

PARAS GRIFFIN/WIREIMAGE

PE T E B UT T IG IE G declares, “Within the first six months, the Office of National AIDS Policy will develop a revised National HIV/AIDS Strategy that truly embraces all elements of what it takes to end the epidemic.” Only a couple of candidates specifically mentioned revising the National HIV/ AIDS Strategy (although as president they will have the opportunity to do so).

The core principles of Buttigieg’s HIV strategy would be to improve access to PrEP, provide equitable and “culturally competent” health care to all at risk for HIV, including “men who have sex with men, trans people, injection drug users, women, [and] people of color,” to get “everyone with HIV” in treatment “so they can lead longer and higher-quality lives and so they won’t transmit HIV, since we know that U=U (undetectable equals untransmittable).” And finally, “we must address the stigma and other social determinants (poverty, lower income, housing insecurity, etc.) that often make accessing preventive and care services more challenging.”

Buttigieg does not promote universal health care (or Medicare for All/single-payer). Instead, he supports reversing the weakening of the Affordable Care Act and increasing funding for public health infrastructure, and the creation of and investment in Health Equity Zones to support local, multisector community solutions to reduce health disparities.

The mayor of South Bend, Ind., does not call housing or health care “a human right.” He notes, “Housing is one of the most critical social determinants of health. We have known for some

28

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 28

9/24/19 9:56 AM

HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 29

29

9/24/19 9:56 AM

KAMALA HARRIS says, “I strongly believe affordable health care should be a right, not a privilege.” She supports Medicare for All and increasing federal funding for HIV research, and would push for the passage of the PrEP Access and Coverage Act, which she recently introduced and would require public and private health insurers to cover PrEP. “Ensuring that PrEP, as well as the required tests and follow-up visits, are covered costfree as part of all insurance plans (including Medicare and Medicaid) will help make sure everyone who could benefit from the medication is able to take it and help increase awareness about steps we can take to prevent further transmissions.”

The California senator also says, “I will take executive action as president to hold pharmaceutical companies accountable if they engage in price gouging and fight to give the Department of Health and Human Services the authority to set ceilings for prescription drug prices to put them in line with countries such as Canada and Germany.”

Harris is a cosponsor of the Equality Act and says, “Fighting to pass it will be one of my top priorities as president.”

Addressing HIV criminalization, Harris says, “I support reversing outdated laws that continue to stigmatize individuals with HIV. Furthermore, we need to ensure that we are enforcing laws already on the books that prevent discrimination against individuals on the basis of their HIV status.”

Speaking about immigrants, Harris pledges, “As president, I will never support a proposal that denies people public education, public safety, or public health.” She adds, “We have to fight back against this all-out assault on reproductive rights.”

To do so, she says, “I will fight to make sure everyone who needs it has access to the full range of reproductive health care services, including safe and legal abortions. That’s why I will protect Planned Parenthood from Republican attempts to defund essential health services, fight to repeal the Hyde Amendment, and reverse the Trump administration’s attempts to cut evidence-based Teen Pregnancy Prevention Program grants. And I am calling for a Reproductive Rights Act that I will fight to sign into law as president. Under this plan, states with a history of unconstitutionally restricting access to abortion will be required to pre-clear any new law or practice with the Justice Department before it can be enacted.”

30

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 30

9/24/19 9:56 AM

DANIEL BOCZARSKI/GETTY IMAGES FOR SPOTIFY

HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 31

31

9/24/19 9:56 AM

32

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 32

9/24/19 9:56 AM

us that undetectable means untransmittable (U=U), and Beto understands that medications can allow a person living with HIV to achieve undetectable levels.”

He believes public education and “treating individuals with HIV with respect” are the best approaches to “destroying the stigma associated with HIV. That stigma, and the discrimination suffered by those with HIV, hinder discussions about HIV prevention and PrEP and drive people away from testing and treatment—and so do laws criminalizing HIV.” Pointing out that “science tells us“ such laws “do not achieve real health benefits,” O’Rourke supports the REPEAL HIV Discrimination Act. O’Rourke was the only candidate to specifically address the aging population, arguing the country must “recognize the discrimination facing older Americans who, despite having started to live openly and honestly, are forced to hide their sexual orientation as they try to access those assisted living facilities or nursing homes in which homophobia is still prevalent. Recognizing that nearly half of people living with HIV are more than 50 years old, we must ensure that these Americans are not forced to hide their health status or sexual orientation for fear of losing their access to nursing home facilities.”

O’Rourke also detailed how he would support the transgender community, including by “directing his Department of Justice to investigate the crimes against transgender people, specifically transgender women of color; by ensuring law enforcement agencies receive training related to implicit bias, use of force, and accurately reporting the gender of victims; by reinstating the Bureau of Prisons’ (BOP) Transgender Offender Manual to ensure safe housing for transgender people in BOP custody; and by modernizing federal law to allow transgender people to update their name and gender on identity documents.”

A cosponsor of the Equality Act, O’Rourke says he would also create an Interagency Task Force on LGBTQ+ Nondiscrimination.

JOSHUA LOTT/GETTY IMAGES

B E T O O’ ROUR KE believes that tackling the epidemic requires addressing “societal barriers and discrimination facing people with HIV. As president, Beto will ensure that health insurance and health care includes access to HIV prevention and treatment, by fully enforcing the nondiscrimination protections in the ACA and by including protections in any new system of universal health insurance.”

Arguing that “health care is a right and not a privilege,” he believes that “reproductive health care services and the right to control one’s own body is a fundamental part of health care,” and “we must ensure all Americans have access to universal, guaranteed, high-quality health care.”

Until then, he supports increased funding for “the demonstrably effective Ryan White Program and for networks of people living with HIV that provide peer support and combat stigma.”

O’Rourke also wants to see more funding for PrEP, and calls “failing to educate our families and communities about it ” both a “moral failure and a public health failure of the highest magnitude.”

The former congressman from Texas promises to tackle “price gouging by drug companies so critical and effective treatments like PrEP are accessible and affordable.” And as president, he pledges to lower the cost of prescription drugs, by “allowing drug importation from Europe and Canada; modifying regulations that get generic drugs on the market faster; ensuring universal, guaranteed, high-quality health care for all Americans through Medicare for America.”

He supports increased funding for the Housing Opportunities for Persons with AIDS program and says, “We know that people living with HIV who are homeless—like other homeless Americans—are less likely to have access to health care, are less likely to have access to and adhere to their prescriptions, and are more likely to use the emergency room as their health care provider.”

Stating, “Our HIV policies must be based on science and not fear or discrimination,” O’Rourke’s campaign says, “Medical science tells

HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 33

33

9/24/19 9:56 AM

34

JUSTIN SULLIVAN/GETTY IMAGES

B ER N I E SA N D E RS believes we can set and reach a national goal of ending the HIV epidemic in the U.S. by the year 2025 “so that HIV is no longer a public health threat to any community in the U.S. and that people with HIV are able to live long healthy lives.” He does not yet have a plan for achieving that goal, but argues, “We must also appoint people living with HIV, community and public health experts, and government officials to the HIV/AIDS Task Force to develop specific recommendations.”

He believes health providers, social services, law enforcement, and all other entities must have the “proper resources and training to handle the varying needs of the communities they serve—especially the community living with and affected by HIV/AIDS—without discrimination.”

Sanders supports Medicare for All, “which will guarantee health care as a human right to everyone in America, free at the point of service.” He believes this plan will “address the racial disparities we still see in the epidemic—people of color are disproportionately uninsured.” The senator from

Vermont also says it will “address the need for more Black doctors, more Black dentists, more Black nurses, more Black psychologists. We are talking about guaranteeing health care to all as a right, but at the same time ending the long-standing disparities which exist within the health care system.”

To address high prescription drug prices, Sanders says he will create “a multibillion-dollar prize fund to reward medical researchers and developers of medicines who create lifesaving drugs for HIV and AIDS treatment and prevention based primarily upon the added therapeutic value a new treatment offers and the number of people it benefits—instead of a system where the market is manipulated to keep out all competition.

Under Bernie’s plan, drugs would have generic competition immediately after FDA approval.”

To “address the social determinants of health, Bernie will guarantee all Americans economic rights. These include the right to a complete quality education, a decent job with good pay, affordable housing, quality health care, a clean environment, and a secure retirement.” He does not explain how to fund or enforce such guarantees.

Sanders details how his administration would tackle the opioid drug crisis (beyond free addiction treatment services as part of single-payer health care), including by “funding the State Opioid Response Grants program,” holding pharma companies accountable, and passing an Opioid Crisis Accountability Act. Beyond cosponsoring the Equality Act and pledging to pass “the Every Child Deserves a Family Act and other bills to prohibit discrimination against LGBTQ+ people,” Sanders added that his support for LGBTQ people would include opposing “any legislation that falsely purports to ‘protect’ religious liberty at the expense of others’ rights,” and supporting “police departments that adopt policies to ensure fairer interactions with transgender people, especially transgender women of color who are often targeted by police unfairly, and by instituting training programs to promote compliance with fair policies.”

Sanders says he will also work to pass a law that ends the criminalization of HIV status.

Sanders believes “Medicare for All means guaranteeing health care as a right for everyone in the United States, regardless of their immigration status.” And he supports reproductive rights, arguing that we must “defend the right to control your own body and ensure LGBTQ+ people are free from discrimination by providers.”

His Medicare for All program would repeal the Hyde Amendment; provide free comprehensive reproductive health coverage; fully fund Planned Parenthood, Title X, and other initiatives that protect health care, access to contraception, and the availability of a safe and legal abortion; and address the nation’s health-based racial disparities.

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 34

9/24/19 9:56 AM

BILL CLARK/ROLL CALL VIA GETTY IMAGES

JO E S ES TAK will fight the HIV epidemic by “the immediate creation of a public option to shore up the Affordable Care Act, followed by a gradual but deliberate transition of choice to a universal health care system.”

He says, “We need to ensure that all Americans have access to quality health care. That is the most important factor when it comes to increasing access to HIV prevention and treatment services.”

“As for the social determinants of health and promoting racial justice,” the former Pennsylvania congressman says, “I advocate a range of policies to deal with social and racial justice.”

Those include “addressing the crisis of homelessness and the lack of affordable housing; funding more and better addiction treatment; raising the minimum wage; increasing access to education from pre-K through to college; creating a national labor force ‘Training for a Lifetime’ program; improving living conditions and access to services in Native American communities; pursuing criminal justice reform to address injustices in policing, the courts, and prisons; and passing the Equality Act to prevent discrimination against LGBT people.”

“These policies and more,” Sestak explains, “will help create a more just America—and begin to deal with the root causes of poverty and addiction, which are the major drivers of the HIV/ AIDS epidemic.”

Sestak says he would increase funding for HIV programs, and “will

convene various stakeholders inside and outside government to create a new national strategy for dealing with the epidemic.”

Sestak calls health care “a right, not a privilege,” and says our health care system “should not be profit-driven, like any ordinary industry. It must be missiondriven.” While he isn’t promoting a Medicare for All platform, he argues that transitioning to “universal health care” should be the country’s eventual goal (and offers several examples of what it could look like), and says adding a public option to the ACA “is one part of a transition of choice to a universal health care system. Creating such a system will not be easy, but I know our country can rise to the challenge, particularly if there are milestones to measure the credibility of transitioning to a singlepayer system.”

Ultimately, he argues, “the key to reforming our health care system— and why a single-payer system is so attractive—is cutting out the middlemen of private insurance companies. It simply makes no sense to have a layer of bureaucracy between doctors and patients seeking to squeeze profits out of both.”

Calling the opioid epidemic a “life or death issue,” Sestak proclaims, “Looking away is not an option.”

His plan for combating it includes “fighting the corruption stemming from the revolving door between the DEA, Justice Department, and pharmaceutial companies and their lobbyists; and holding pharmaceutical

companies accountable for their role in the epidemic, not only with fines but criminal prosecutions.”

Furthermore, Sestak supports using federal funds “to implement evidencebased substance misuse prevention and treatment programs, including syringe exchange programs. I will also not stand in the way of other harm-reduction strategies, including supervised injection sites when states and municipalities wish to pursue them.”

To reduce drug costs, Sestak supports allowing the importation of cheaper meds from Canada, enabling Medicare to bargain directly with drugmakers, and prohibiting pharma companies from paying generic drug manufacturers “not to go to market after their brand-name drug patent expires.”

Long a supporter of LGBTQ rights, Sestak says he would oppose “laws that under the guise of ‘religious liberty,’ seek to maintain legalized discrimination against LGBTQ+ people in public accommodations.” He calls out the “shockingly high murder rate among transgender people of color” and says he will “shine a spotlight on individual LGBTQ+ victims to ensure that justice is served.”

“I support efforts to repeal or modernize HIV criminalization statutes,” Sestak states, “to end the inappropriate use of one’s HIV status in prosecutions under the Uniform Code of Military Justice.”

Sestak, a retired Navy officer, also states that he will consider hiring people living with HIV in his administration— including key executive positions in the White House—so that he can “lead by example,” saying that “education helps reduce stigma, and there is more we can do in that regard. But stigma is stubborn and [we] ultimately can’t just focus on educating those willing to learn and shaming the bigots and haters who stigmatize, but we also must focus on the stigmatized themselves and support the self-empowerment and agency of people living with HIV. All the billboards and social media anti-stigma campaigns in the world won’t matter if we don’t lift up the voices and respect the dignity of people living with HIV.” HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL_REVISED.indd 35

35

9/24/19 4:40 PM

EL I ZA B ETH WA RRE N says, “There is no single answer to ending this epidemic—we must use every tool at our disposal. That includes Medicare for All, expanding HIV research and treatment, ensuring everyone has access to PrEP and HIV testing, holding drug companies accountable and lowering drug prices, ending the opioid crisis, ensuring that community health centers receive robust funding, and reinstating our position as global leader in public health. It also means expanding economic opportunities, tackling the housing crisis, banning private prisons and exploitative contractors, overturning HIV-status criminalization and discrimination laws and regulations, and ensuring comprehensive, inclusive reproductive and sexual health education and services.”

Believing that health care is a human right, Warren supports Medicare for All, but also wants to see more funding for the National Institutes of Health to conduct research in treating HIV and finding a cure. She introduced the National Biomedical Research Act, a bill that would establish a reliable funding stream for the NIH by establishing a $5 billion Biomedical Innovation Fund at the NIH. Warren has also cosponsored the HOPE (HIV Organ Policy Equity) Act that has made it possible for people living with HIV to receive transplants from an HIV-positive organ donor.

To address the opioid crisis and fight substance abuse, Warren co-introduced the Comprehensive Addiction Resources Emergency (CARE) Act, which commits $100 billion over 10 years, including $2.7 billion to the hardest-hit communities and $1.1 billion for organizations working with underserved populations, such as those living with HIV. A cosponsor of the REPEAL HIV Discrimination Act (which would eliminate discriminatory federal and state laws and regulations that criminalize people living with HIV), Warren notes that “26 states still have laws on the books that criminalize HIV exposure, permitting discrimination against those living with and those believed to have HIV. These laws aren’t supported by science or evidence, discourage people from getting tested and treated, and result in increased stigmatization and discrimination against already marginalized populations.”

To bring down the cost of prescription drugs Warren introduced the Affordable Drug Manufacturing Act, “which would allow the government to manufacture a generic drug when no company is manufacturing a drug, where only one or two companies is manufacturing the drug and prices are spiking, where there is a shortage of the drug, or where the medicine is essential and faces limited competition and high prices.”

In addition, Warren has introduced the Capping Prescription Costs Act, which would 36

cap family prescription costs at $500/month. She cosponsored the Prescription Drug Price Relief Act, which would peg prescription drug prices to median prices of comparable countries, and the Affordable Medications Act, which would allow Medicare “to negotiate lower drug prices, block anticompetitive behavior, crack down on a range of practices that brand-name and generic drug manufacturers use to keep prices high, and support innovation.”

A cosponsor of the Equality Act, Warren believes “every person in the country should be treated with dignity and respect—and that includes having the right to live a healthy life.”

She notes that the majority of those living with HIV “are LGBTQ+, are from communities of color, and are contending with multiple barriers that prevent them from accessing the care they should have. We must demand more for them and for their futures.”

Her Housing Plan for America would expand the Fair Housing Act to prohibit discrimination on the basis of sexual orientation or gender identity. Warren calls discrimination against transgender Americans “unconstitutional” and in addition to fully upholding civil rights and nondiscrimination protections, she says she will “direct the CDC to collect accurate data on the health of transgender people.”

Warren also believes, “No person should be denied access to a doctor and critical health services because of their immigration status.”

And “everyone— no matter where they live, where they’re from, how much money they make, the color of their skin, their gender identity, or their sexual orientation— are entitled to access highquality, evidence-based reproductive and sexual health care. My Plan to Protect Choice calls on Congress to pass new federal laws that protect access to reproductive care. That includes creating federal, statutory rights that parallel the constitutional right in Roe v. Wade, and fully supporting Title X family planning funding. We must also repeal the Hyde Amendment, which blocks abortion coverage under federally funded health care programs like Medicaid, the VA, and the Indian Health Service.” (Warren was the only candidate to mention the health provider for Native Americans.)

Warren’s proposals for reforming the correctional system include “banning private prisons and detention facilities outright,” and supporting ​ gender-affirming surgeries in correctional facilities. She cosponsored the Solitary Confinement Reform Act, which would “reform the practice of solitary confinement and ban it as a practice to separate LGBTQ people and those living with HIV from the general population.” And she cosponsored the Youth Access to Sexual Health Services Act “to ensure marginalized young people, including those in juvenile detention, have access to sexual health services.”

You can read each candidate’s complete answers at HIVPlusMag.com and AIDSUnited.org, which will update the material if more responses come in.

NOVEMBER / DECEMBER 2019

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 36

9/24/19 9:56 AM

JOSH EDELSON/AFP/GETTY IMAGES

HIVPLUSMAG.COM

24-37_PLUS133_FEA_2020 Candidates_FINAL.indd 37

37

9/24/19 9:56 AM

I AM THE FIRST

BY DIANE ANDERSON-MINSHALL

AN OPEN BOOK

This college prof living with HIV is 100 percent real, even at the White House.

38

Photography by Lina Cherfas

NOVEMBER / DECEMBER 2019

38-41_PLUS133_I Am the First_FINAL.indd 38

9/24/19 10:03 AM

n the 1970s, millions of Vietnamese fled their country after the war ended.

So many immigrated by sea that the 2 million Vietnamese refugees who landed on America’s shores after 1975 were almost always generically referred to at the time as “boat people.”

No matter how refugees left Vietnam, the 8,500-mile voyage to America wasn’t an easy passage. Accidents, drownings, and pirate attacks stole innumerable lives, but at least the United States seemed willing to accept the survivors. Some even welcomed them with open arms. Churches and synagogues urged their congregations to offer assistance, and many Americans opened their homes to immigrant families to help them resettle.

Andrew Spieldenner was born in Texas to a family that was among those Vietnamese refugees, and he lived in multiple places (Texas, Ohio, and Florida) as they searched for a better life. His teen years were spent in California’s San Francisco Bay Area.

“My family’s mixed, so growing up was interesting,” Spieldenner recalls. “Half my family is white, and the other half is Vietnamese. So at one point in Ohio, we had more than 20 relatives living with us through refugee [placement], and it was actually featured in the newspaper.”

His was a far different experience than what’s happening on the U.S. border today, says Spieldenner, a professor of communication at California State University, San Marcos. He worries about the “enhanced militarization of the border, the rhetoric that’s going around about Latinx communities and immigrants and migrants” and its impact on his mostly Latinx students.

“I was talking to my mom the other day and we were saying how different that newspaper story would be today,” he admits, “because back in the ’70s it was like, ‘Look at this charming family in Ohio hosting 27 refugees.’ And today it would be like, ‘Investigate this home.’”

With a doctorate from Howard University, a historically Black university, as well as a master’s from University of California, Los Angeles, and a bachelor’s degree from U.C. Berkeley, Spieldenner seems an easy fit for academia. He’s the first person in his family with a Ph.D. But that career, or any career, wasn’t always a given for the man who has now been living with HIV for 20 years.

“It was funny,” Spieldenner jokes of his 2009 graduation from Howard. “Actually, when I graduated, my mother said to me, ‘Oh, I’m so proud of you. I’m so glad you didn’t become a crackhead.’ And I was thinking, That was the bar? [But] in fairness to my mom, I did have a serious drug issue. I have had serious drug issues in my life.”

Today, Spieldenner is a well-respected HIV activist. He serves as chair of the U.S. People Living With HIV Caucus, as well as research

director for the U.S. implementation of the People Living With HIV Stigma Index for the North America affiliate of the Global Network of People Living With HIV. He worked in the nonprofit HIV field before becoming a professor, and previously held senior positions at the Latino Commission on AIDS, the National Association of People with AIDS, and the Black AIDS Institute. And while he could sweep his past under the rug, he never does, especially not with students.

“I think it’s important to be transparent about identities, particularly stigmatized ones, particularly if we have the privilege and position to be able to speak openly,” Spieldenner insists.

“I think it’s important. I have had periods where I’ve done heavy drug use. Life is hard. Life sucks. I think drugs are one way of coping with the world.

People have different experiences using drugs.

People have different experiences with addiction.”

The activist professor says he’s a firm believer that drug users are people who are self-medicating.

“Every language, every culture has a word for pain and a word for healing,” Spieldenner says. “I think part of what we don’t really recognize with people who are using drugs is what is the pain and what is the healing that needs to happen.

And we don’t have a society that supports that.

We don’t have a society that supports harmreduction programs. We don’t have a society that sees substance use as a health condition. Instead, we pathologize people who use drugs.”

While using words like drug “user” instead of drug “addict” are simple adjustments that help destigmatize marginalized folks, being open, he says, is even more critical. “I want my college students to understand that lots of different people use drugs, that it’s not just those people over there, and that if they have issues they’re experiencing or they’re experimenting, that they can talk to somebody about it and that it’s not a weird thing.”

Spieldenner says that the more “we don’t talk about identities, when we keep them hidden, is when people start developing shame around perfectly normal things.”

Sure, he’s been told not to talk about being gay or living with HIV, but Spieldenner has wisely ignored that advice. “Masturbation should not be something people are ashamed about,” he adds. “And yet if I talk about masturbation in the classroom, which I do, people flip out like, ‘I can’t believe you talked about masturbation.’ It’s like, ‘Seriously, it’s like the first thing you learn to do.’

I’m just like, ‘What are you talking about?’”

It’s paid off at Cal State where his students report that they love the conversation his classes engage in.

“On the first day, I tell them that I have HIV, I tell them I’m a gay man of color, and I tell them that if they have problems with that they can leave and somebody else will take that spot. Every HIVPLUSMAG.COM

38-41_PLUS133_I Am the First_FINAL.indd 39

39

9/24/19 10:03 AM

semester people drop, which is good. I don’t want them in my class, and other people do.”

Talking with a counselor helps students cope with their own depression. Last semester, one of Spieldenner’s students told him, “You make us feel so welcome because you’re so out there.”

“Because I’m open about going to therapy,” he says, “she realized it wasn’t a weird thing to go to therapy, even though people in her family didn’t do that. I think that’s one of the reasons I’m out is because it filters out people that I don’t want around me, but I also think it’s important for people to see somebody with HIV in the classroom as a professor. I think it’s important for people living with HIV to know that we can still go to grad school, that these things are still part of what we can do in the world, that we can be professors.”

In a world where nearly half of all LGBTQ employees are closeted at work (according to a 2018 Human Rights Campaign workplace study), Spieldenner is still one of the few academics in the country who are out about living with HIV. “I know a couple other academics who are out about having HIV. I know a lot more that aren’t out about it and some of them say things like, ‘Well, then my students will know I’ve had sex.’ And I’m always like, ‘Well, if you tell them you’re gay, they assume you have sex—they assume you have sex if you’re an adult.’ I don’t quite get the logic.”

He says that unlike decades ago, when Magic Johnson was talking about HIV, and speakers went into classrooms and talked about living with HIV to high school students, “a lot of times people that are 20 might not have met anybody with HIV. [That is] one of the reasons I think it’s important to kind of center that experience in the classroom so they can’t go for the rest of their life saying, ‘I never met somebody with HIV.’” His students may also be at higher risk for acquiring HIV and not getting tested. Students at Cal State San Marcos are mostly firstgeneration Americans, and many are the first in their family to go to college.

“And we service a largely Latinx community at my university,” he explains. “We’re near the border, so there’s challenges that we have at this university that other universities might not have. I had a student ask for an extension on a paper because his mother had been deported over the weekend. I don’t have the kind of student that’s like, ‘Oh, what am I going to do?

I didn’t get asked out this weekend.’”

Spieldenner admits, “I love where I teach, I love the students. They make everything worthwhile. I have four students starting grad school that are all first-generation Latinx this fall. And it’s that capacity to really work with them and show them what else is out there. No one asks a queer person [about it], if we’re like, ‘Oh, I’m moving to L.A., or ‘I’m moving to New 40

York.’ People just say, ‘Yes queen, go.’ But for straight kids, they don’t get that. So if they say they’re moving to New York or L.A. or they’re following their dream someplace, people wonder why.”

Queer people are often asked why they would leave their families, he says. “We leave our families because they’re not always that safe. As loving as they try to be with us, sometimes the way they love us is damaging. And one of the things that I’ve been really happy about is being able to work with students and get them to see what else is out there in the world, what other kinds of people can they be so they don’t have to do the same job that their parents did or [live in] the same situation.”

That’s not to say there aren’t challenges, especially with students dealing with intense fear. Last semester, a young student gunman shot up a synagogue on Spieldenner’s campus. So while people were scared already of the enhanced rhetoric around immigration and the weaponized borders, the professor says, “Having somebody who was your student actually be a shooter changes the dynamic a lot on campus.

There’s a lot of fear that there’ll be a repeat. So it’s just fucking weird to be a teacher right now.”

But Spieldenner is nothing if not resilient. He proved that years ago after his boyfriend died of AIDS complications in the 1990s, “before treatment was

NOVEMBER / DECEMBER 2019

38-41_PLUS133_I Am the First_FINAL.indd 40

9/24/19 10:03 AM

really accessible. [And] the guy who diagnosed me told me I had seven to 10 years if I was lucky.”

So he left the country, spent a year in Vietnam (to see where his family came from) and visited Thailand (where he stayed for another year).

“I was supposed to only stay for a weekend.

Oops! One of the things that I learned was that the rules are different in other parts of the world, that people have different ways of interacting, that not everything has to be about what kind of job you have and what people can get out of you.”

Spieldenner returned to the U.S., dove into HIV activism, and eventually branched into academia to make “a different kind of impact” and ultimately decided his “voice would be freer than if I worked at an HIV organization. I always felt like, when I worked for an HIV organization, my advocacy voice was compromised somewhat. And since I joined academia, I can say what I want.”

The HIV advocacy work he does now offers even more meaning to him. “I’m able to help build community for other people living with HIV. I was part of a group of HIV advocates who met with the presidential candidates in 2016. So none of that would’ve happened if I still stayed working in HIV. Things changed when I went to academia. I think what we’re seeing now in the HIV space is a lot of people want to know how to work in a different arena. And I think globally we see an economy where people don’t keep the same job forever. And I’m fortunate enough to have been able to switch careers and been successful at it. And I think more and more people need to think of themselves that way. Like, What am I going to do for the next 10 years?”

When he was younger and “encountered James Baldwin,” Spieldenner says, “I thought, Wow, that’s the kind of life I want. He travels the world, he writes, he drinks. And I’ve succeeded.

So that’s been a good benchmark for me—that I actually am somebody who gets to travel, that gets to meet people, that gets to write and gets to build knowledge. I’m grateful about that and I’m proud of that. I’m also proud of some of the organizations that I’ve helped build, some of the community groups I’ve helped build like the U.S. People Living With HIV Caucus, my work with the Positive Women’s Network. I think that the work I’ve been able to do with other people living with HIV is really powerful. It definitely moves legislators.”

For a kid from an immigrant family, a gay man of color, and a self-described geek, Spieldenner is doing all right. He’s proud to have ended up “being a professor that gets to talk about health and the world and AIDS and cancer and dying and comic books and pornography.”

He’s not just the first in his family with a doctorate, he’s also the first person in his family to go to the White House as a guest—and the

first to protest at the White House. He’s spoken at the United Nations as well.

“It’s surreal to be the first person in your family to go the U.N. or go to the White House for meetings,” he admits. “And at the same time, after you start doing it, you take it for granted. I was actually talking to my sister and I was in a low point and I was like, ‘I don’t even know if what I do matters in the world.’ And she said, ‘You were at the White House on a meeting for stigma. How many Spieldenners do you think have been to the White House?’ And I went, ‘Oh, I guess I am doing something with my life.’ It’s been surreal doing HIV advocacy at the level I’ve been able to, partially because I think a lot of people don’t get those opportunities. I know a lot of people in my family don’t get the opportunities and don’t take advantage of being able to meet with their legislators.

A lot of people don’t know how easy that actually is to meet your local legislators. And that’s where change starts to happen.”

His work with the Joint United Nations Programme on HIV/AIDS forces him to “take the voice of civil society forward at a global stage and be able to make sure the HIV response at the U.N. level is human rights focused. I think we see a lot of countries that had very successful HIV responses turning more conservative and watching their HIV responses fall apart because they’re criminalizing gay men again or they’re criminalizing trans people or they’re criminalizing people with HIV and sex workers. You start to see these changes, politically, and how they affect on-the-ground work.”

While UNAIDS is working with nations around the globe to end the HIV epidemic by 2030, Spieldenner admits doubts. While he calls those goals “admirable” and necessary, he adds, “I’m not sure it’s realistic. There’s not enough treatment today in the world for all of us living with HIV, and part of that is capitalism. And there’s a huge disparity in what’s available in different countries, what is made available, what countries can afford. There’s been a huge withdrawal from the philanthropic field from HIV.… I [just] don’t see how it’s going to work.”

Some of the drop in HIV-related donations, he says, may be because “some of the philanthropic world has moved onto other issues, in part because the treatment is available and it’s not considered…a crisis the way it was. What saddens me about that is that as HIV got blacker and browner in the U.S., philanthropy left. And that to me is a sad statement because our lives are worth the investment.”

His task still is to “continue to keep our voices centered. My dreams for my future are to continue being able to make the changes, to continue to be part of an HIV movement that’s thriving. The one thing about HIV I wish I could teach the world is that we as people with HIV need to make our own communities. And we are able to support each other in ways that other people cannot. HIV, there is no cure for HIV. The best we have is each other.”

HIVPLUSMAG.COM

38-41_PLUS133_I Am the First_FINAL.indd 41

41

9/24/19 10:03 AM

42-45_PLUS133_FEA_Cover_FINAL.indd 42

9/24/19 10:05 AM

By Desirée Guerrero + photography by Krys Cee

Toronto drag queen Jade Elektra sparked a viral U=U lesson with an “Undetectable” remake of a Nat King Cole classic.

changing a single word, Toronto’s drag personality Jade Elektra delivered an iconic performance of the Nat King Cole song “Unforgettable” at the city’s 35th AIDS Candlelight Vigil this summer and ignited an important conversation about Undetectable Equals Untransmittable (U=U).

U=U is a globally accepted scientific consensus stating that when a person living with HIV is on treatment and lowers their viral load to undetectable levels, it becomes impossible for them to transmit the virus. As of press time, over 900 health organizations in 98 countries endorse U=U, and those numbers continue to rise.

HIVPLUSMAG.COM

42-45_PLUS133_FEA_Cover_FINAL.indd 43

43

9/24/19 10:05 AM

The talented singer, recording artist, DJ, and stage performer Alphonso King Jr.—whose offstage personality is far from the signature flamboyance that RuPaul’s Drag Race viewers associate with the genre—recently spoke with Plus about how the inspiring performance and song came about.

The queer and African-American King is a fiercely outspoken activist and admits that it hasn’t always made Jade Elektra the most popular queen in Toronto clubs.

“This is the weird thing about that video going viral. I’m not very well liked here [in Toronto],” King says with an unaffected frankness. “It’s because I’m very outspoken.

[Many] really believe that there’s no racism here. They spend a lot of time mocking the U.S…[but] they fuck up too.”

A lot of the stuff “that Trump is doing is seeping into their government here,” continues King, who was born in the U.S. but now lives in Toronto with his Canadian husband (and behind-the-scenes business partner), John Richard Allan.

King argues that the premier of Canada’s province Ontario, Doug Ford, “is basically trying to do exactly what Trump is doing. He is taking away funding from programs. He tried to scrap sex education and all kinds of stuff.”

Unfortunately, even within the area’s LGBTQ community, King says discrimination exists. In his experience at least, he says drag performers who play ethnic “caricatures” of people of color are often more popular, but, “I’m just not willing to play the game.”

The 52-year-old entertainer says he learned to balance his drag career with his work as a DJ, singer, and recording artist, all while holding true to his personal and political convictions.

He admits that although he has been doing drag for over 30 years, he’d become resigned to the fact that he might never become a household name.

Perhaps that’s why King says he was as surprised as anyone when the video of him performing “Undetectable” went viral. A simple word substitution transforms the Nat King Cole torch classic, “Unforgettable,” into a fun, flirty, and positive message about U=U and living with HIV. Though King himself is living with HIV, he says he was intially a bit reluctant to perform the song in front of a large crowd.

“I was nervous because in this climate that we’re living in, someone is always offended. I told the organizers of the event, ‘OK, if someone says something to me, I’m sending them to you because you asked me to do this song,’” he recalls with a laugh. “I do a cover of Carl Bean’s ‘I Was Born This Way,’ and I wanted to do that.

I thought it was upbeat, it had a good message to it. And they insisted on ‘Undetectable’ and I was just like, ‘OK.’” 44

King jokes that the “craziest thing about that performance, also which no one caught” was a wardrobe malfunction.

“There was a wig hair stuck in my eye during it that I could not fix. And my padding on my right side started sliding down my leg! All this is going on while I’m onstage and I’m trying not to freak out and keep in character.”

Since going viral, King has been asked to perform the song at various events and venues, including the 2019 United States Conference on AIDS in Washington, D.C. But King says one of the best and most rewarding parts of this entire journey is how the song has inspired others living with HIV. Beyond sharing the stigma-smashing message of U=U, the song also brings a humanity back to people living with HIV that has been noticeably lacking for some time.

“I’m thinking of all the things that were going wrong during the number, and I get

Alphonso King Jr. says the aesthetic of his sultry, torchsinging drag persona Jade Elektra is partly inspired by Jessica Rabbit. But the best part of his journey is less about glamour and more about inspiring other people living with HIV

NOVEMBER / DECEMBER 2019

42-45_PLUS133_FEA_Cover_FINAL.indd 44

9/24/19 10:05 AM

off stage and I’m walking through the crowd and this guy stopped me and he said, ‘Thank you for making me feel sexy again.’ I was like, Wow. It hadn’t registered to me that that was the message someone would get from it.

I thought, Oh, they’ll get a chuckle off of me changing the name or changing the words. But yeah, it was really an eye-opening moment that was like, oh yeah, that’s right—we are sexual beings, and we deserve to feel sexy and have relationships.”

King says, looking back, he’s always been an activist at heart, though it took him time to fully embrace the role. Today the performer is confident and comfortable in his own skin, but he recalls dealing with internalized stigma and shame after his HIV diagnosis.

“When you start thinking that way, you start putting yourself in that box. So breaking that stigma—the self-stigma is what I call it— breaking that is one of the hardest things. You think, Well, I’m not worthy, and no one’s ever going to want me. And I went through that the first year or so, but then I met someone else who was HIV-positive and we had a really great relationship.”

That may be key, says King. “My husband’s also positive. One of the things that we encourage in our group—we’re not telling people what to do—but we encourage them to find someone else who is HIV-positive because then you don’t have to worry, you don’t have to feel like, Oh, they don’t understand what’s going on.”

He’s had a few serious relationships before he met his husband, King says, including one “where my partner kind of emotionally abused me because I was HIV-positive. We got into an argument, and he would tell me that I ruined my life with becoming positive, and we could never be a regular couple, and we can’t have sex the way he wanted, and all this other stuff.”

In the 1990s New York City, King met his “very out” future husband, which inspired him to open up about his own status and get more involved. Together, they have built an online HIV support group that offers social and romantic possibilities, not just 101 info.

“He started a thing online called Poz Planet, which is on Facebook, and we’ve worked on it really hard,” King explains. “It’s got over 10,000 members from all around the world….

There are plenty of HIV-positive groups online, but they don’t really encourage you to hook up or any of that kind of stuff. They’re just there for information…. We tried to create a support system and allow people just to be people. There are some people who post selfies all day. And I’m like, ‘We don’t care.

It’s fine.’ People comment or whatever and I know that it’s an ego boost if they’re in some small town or whatever, to have someone from someplace else go, ‘Oh, you’re cute.’”

Still, King says that even HIV activists, including him and his husband, don’t always agree. And his views are not always popular.

“I’m not a big fan of PrEP, and he is,” King confesses of his husband. “And the reason that I’m not a big fan of PrEP is because how it’s being used and where it’s being used.”

King feels like it’s largely accessed by white gay men, at least in North America, who take PrEP just to have condomless sex without worry. But access is limited for out gay and bi men of color who desperately need prevention techniques. And, he worries that Truvada as PrEP could have the same impact on the kidneys that some antiretrovirals have had after long-term use. “[Activists] are not really talking about that aspect of it,” he says. “I’m reminding people condoms haven’t gone anywhere and there’s no side effects with those…unless you have a latex allergy or something. So don’t forget about protecting yourself that way. You don’t have to take a pill to protect yourself.” (Though it should be noted that PrEP is considered to be 99 percent effective in preventing HIV, while condoms are about 90 to 95 percent effective.)

King is also quick to clarify he doesn’t necessarily think PrEP is a bad thing, just something people need to be properly educated about before taking it long-term. Still, though he may not be completely onboard the PrEP train, he respects the science behind it and why fellow HIV activists, like Plus contributing editor Mark S. King, advocate for it.

“Of course, Mark’s stance is that ‘This is a wonderful drug. This is helping people feel comfortable to have sex again,’ and all of this stuff,” King says. “I get that and I understand that.”

Another reason King doesn’t see PrEP as the panacea for HIV stigma is because he believes HIV organizations and campaigns often exclude queer poz folks of color from the conversation. That’s a mistake, he explains, if we truly want to end stigma and create a healthy environment for all.

More events “for HIV-positive people, where they can go and not have to worry about the stigma, and just go and have a good time” would help too.

Ultimately, King says he couldn’t be more pleased that his “Undetectable” is bringing awareness to U=U. “I’ve been a musician since the mid-’90s, working on music and everything, and nothing’s ever happened. Often, I feel down on myself because I was around when RuPaul was coming out, and nothing’s happened with my music.… You know, at some point, [you] start thinking, Oh, well, maybe it’s because I’m HIV-positive and that people just don’t want to deal with that—because I always bring that to the forefront in whatever I’m doing.”

The irony that now he’s being lauded for singing a song celebrating his positive diagnosis is not missed.

“It’s funny,” King reflects. “The thing I was afraid to tell everyone is the thing that’s helping me get my name out there.”

HIVPLUSMAG.COM

42-45_PLUS133_FEA_Cover_FINAL.indd 45

45

9/24/19 10:05 AM

OPINION

BY ZACHARY ZANE

INSTEAD OF HAVING FOLKS SIGN A PETITION, A NEW CAMPAIGN IS CALLING FOR BUTT SELFIES. 46

SHUTTERSTOCK

WHY I’M FEELING CHEEKY

that hard to find a health care professional who’s up-to-date and sensitive to specific needs of the LGBTQ and HIV-positive communities. Yet, for many, it still is.

In some smaller suburbs, it’s nearly impossible to find a doctor who is knowledgeable about issues like PrEP, hormone replacement therapy, anal pap smears, and other queer health care requirements. In fact, most people living with HIV have to specifically see an infectious disease specialist when, in theory, their primary care physician should know how to help them achieve and sustain an undetectable viral load.

These days, HIV is a manageable condition, similar to diabetes. It shouldn’t be the responsibility of HIV-positive and/or queer people to find a doctor adept at treating them. That’s why the #WeNeedAButton campaign is putting the responsibility on doctor-patient matching sites.

I’ve teamed up with DatingPositives.com, a dating site for poz people, and Waxoh.com, its sex-positive digital magazine, to promote the effort.

DatingPositives.com embraces those managing all STIs and takes their issues very seriously. Given that the LGBTQ community often overlaps with this community, the partnership was a perfect match—so to speak.

Together, we have a mission to improve our community’s health care experience and minimize stigmatization. Our simple solution? A single button to identify queer-friendly doctors.

IT SHOULDN’T BE

NOVEMBER / DECEMBER 2019

46-47_PLUS133_Opinion_FINAL.indd 46

9/24/19 10:05 AM

Instead of signing a petition, we’re asking everyone who is with us—members of the queer community, those living with HIV, and allies—to post a “belfie,” or butt selfie, in solidarity, using the hashtag #WeNeedAButton.

The #WeNeedAButton hashtag campaign launched on June 25, and we will continue until we’ve successfully convinced major patient matching sites, like Zocdoc, Yelp, and HealthGrades to include a button, or filter, that lets people know that a provider is queer-friendly.

That way, when you see a doctor you don’t have to worry they won’t believe you when you say you’re bisexual, or even more annoying, suggest you “pick a side,” which is something that still happens. The doctor will know what to do if, for some reason, they notice that your viral load has become

He’s not alone, and I’ve heard many similiar stories working with DatingPositives.com. Chris, 45, was diagnosed with HIV in 2007. The doctor not only shared his test results over the phone, which isn’t legal, he also provided Chris with zero resources, simply recommending that he “find another doctor.” He didn’t even provide any recommendations for other health care professionals.

“He absolutely did not want me as a patient,” Chris recalls. “I felt very discriminated against. Fortunately, my roommate at the time knew a great doctor at Fenway [Health], an HIV specialist and a gay man, who took me on as a patient when he heard my experience with my previous doctor.”

Chris says he was lucky that he contracted HIV in his 30s, when he was knowledgeable

COURTESY ZACHARY ZANE

POST A “BELFIE,” OR BUTT SELFIE, IN SOLIDARITY, USING THE HASHTAG #WENEEDABUTTON. detectable. They also won’t misgender you.

Neither will they judge you for not wearing condoms or for having casual sex.

In short, they’ll get you, and they’ll treat you with the respect that you—and for that matter, all patients—deserve.

Take my friend Isaac, 21, who came out as trans and started transitioning while he was in his late teens. When he brought up the idea of starting PrEP once he had begun sleeping with gay men, the doctor refused to prescribe him Truvada since she didn’t see trans men as being a high-risk group. The doctor wrongly believed that cisgender gay men wouldn’t sleep with a trans man, which simply isn’t true. Roughly a year later, Isaac contracted HIV. If the doctor had prescribed PrEP like Isaac requested, “I likely wouldn’t have gotten HIV, since I would have been on PrEP for that whole year,” Isaac tells Plus.

about the virus and also had numerous gay friends and support systems. But what if Chris wasn’t yet out when he contracted HIV and didn’t know what to do? What if he didn’t have a support group? What if his friend didn’t know of a gay HIV specialist who luckily had an open spot for a new patient?

The time for change is now. Join me, DatingPositives.com, and hundreds of others in sharing our booties! If we can get tens of thousands of folks to share their medical horror stories and butts, I think the campaign will make a massive impact.

The campaign will not only force patient matching sites to create this filter, but also let health care professionals know that they need to step up their game.

The level of care queer and positive folks receive is often horrendous—but we’re not going to take it anymore.

Contributing editor ZACHARY ZANE is also a writer focusing on (bi) sexuality, gender, dating, and relationships. Follow him on Twitter @ZacharyZane

HIVPLUSMAG.COM

46-47_PLUS133_Opinion_FINAL.indd 47

47

9/24/19 10:05 AM

V I N D I C AT E D B Y D AV I D A R TAV I A

Left: Johnson with a reporter

LONG WALK TO FREEDOM

AFTER BEING UNJUSTLY SENTENCED TO 30 YEARS FOR HIV “EXPOSURE,” MICHAEL JOHNSON WALKED OUT OF PRISON A FREE MAN 25 YEARS EARLY. IN 2015, MICHAEL JOHNSON (known online

as “Tiger Mandingo”) was convicted for one felony charge of “knowingly” transmitting HIV to one man, and four charges of exposing four other men to the virus who didn’t contract it. Four years later, in July, Johnson was set free after serving five years in prison—thanks to a plea deal.

“I feel great,” Johnson told BuzzFeed reporter Steven W. Thrasher, who’s been writing about the case since it began, as he left Boonville Correctional Center in Missouri. “Leaving prison is such a great feeling.”

He added, “It’s good I had the support of everyone who wrote me letters. There are times when you get down, and it helps that people knew why I was fighting the system.”

In one of the most highly publicized HIV nondisclosure cases in recent years, Johnson, a poz college wrestler, had been convicted and

48

sentenced to 30 years in a St. Charles County, Mo., court. After the verdict, his lawyers appealed, claiming that prosecutors failed to turn over significant evidence.

The appeals court ultimately overturned his conviction.

Prosecutors originally suggested they would take the case to another trial; instead Johnson’s legal team negotiated a plea deal that didn’t require him to admit guilt—and got him out of jail immediately.

As BuzzFeed explained, by taking what is known as an Alford plea, a defendant “doesn’t admit guilt to a crime itself, but admits that there is enough evidence that they may be found guilty if their case goes to trial.”

Furthermore, because the charges he pled to fell under health statutes, Johnson will no longer be required to register as a sex offender in the state of Missouri or Indiana (his home state).

Johnson is just one of many people living with HIV who’ve become victim to criminalization laws, which can make it legal to lock up HIV-positive people for failing to disclose their status to a sexual partner, even in situations where transmission neither occurred nor was scientifically possible.

These draconian laws were passed during a time when AIDS was believed to be a “gay man’s disease”—and a death sentence.

These local and state statutes were drenched with the widespread homophobia and stigma of their time, yet many states still have them on the books. Activists are currently advocating for these laws to be scrapped or at least updated to reflect current scientific consensus on HIV—especially in the U=U era.

The men Johnson allegedly “exposed” to HIV were predominantly white, and given that St. Charles County is a mostly white suburban area near St. Louis, his case was often reported with subtextual racism: photos highlighting his dark skin and shirtless body were featured by news outlets and showcased his physicality, playing on white fears of Black men as sexual predators.

In addition, the trial blatantly ignored scientific facts. One of the prosecutors, Philip Groenweghe, reading the charges out loud when Johnson appeared in court, included a description of Johnson ejaculating on the back of one of his sexual partners. As anyone with knowledge on HIV transmission knows, it is pretty much impossible to transmit the virus through such an act, making the salacious description gratuitous yet potentially influential on jurors.

Although Johnson allegedly failed to disclose his status to sexual partners, he was already receiving treatment for HIV, and it’s questionable as to whether he could actually have transmitted HIV at the time.

Johnson’s legal representation has also been scrutinized. His public defender opened the trial by saying, “You have to consider my client guilty until proven otherwise,” before the judge reportedly corrected him by saying, “I believe you meant to say ‘innocent.’”

Johnson had a new legal team at the time of his release.

COURTESY AKIL PATTERSON

Right: With friends and activists Akil Patterson and Meredith Rowen, moments after Johnson was released from jail.

NOVEMBER / DECEMBER 2019

48_PLUS133_Vindicated_FINAL_REVISED.indd 48

9/24/19 4:40 PM

callen-lorde.org

18946 callen Lorde Plus 133.indd 42

9/27/19 2:10 PM

HOW DO WE HELP STOP HIV? A. PREVENT IT. B. TEST FOR IT. C. TREAT IT. D. ALL OF THE ABOVE. Learn how it all works together at HelpStopTheVirus.com © 2015 Gilead Sciences, Inc. All rights reserved. UNBC1856 03/15

18642 gilead bonus plus red.indd 1

5/1/18 12:12 PM