A&U October 2016 by A&U: America's AIDS Magazine

OCTOBER 2016 • ISSUE 264 • AMERICA’S AIDS MAGAZINE

PICKING HIS BATTLE

A&U ’S CHIP ALFRED TALKS WITH KEN PINKELA ABOUT SEEKING JUSTICE FOR A CONVICTION BASED ON HIV STIGMA

BUILDING STORIES JOHN FRANCIS LEONARD CHATS WITH TIM MURPHY ABOUT HIS NEW NOVEL, CHRISTODORA

*plus Artist Ghee Phua • Actor Cole Doman • Advocate Paul Margolis

timothy ray BROWN

ADVOCATES FOR HIV CURE RESEARCH TO MAKE THE END OF AIDS A REALITY FOR EVERYONE

WHAT IS ODEFSEY®? ODEFSEY is a 1-pill, once-a-day prescription medicine used to treat HIV-1 in people 12 years and older. It can either be used in people who are starting HIV-1 treatment, have never taken HIV-1 medicines before, and have an amount of HIV-1 in their blood (“viral load”) that is no more than 100,000 copies/mL; or in people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements. These include having an undetectable viral load (less than 50 copies/mL) for 6 months or more on their current HIV-1 treatment. ODEFSEY combines 3 medicines into 1 pill taken once a day with a meal. ODEFSEY is a complete HIV-1 treatment and should not be used with other HIV-1 medicines. ODEFSEY does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses, you must keep taking ODEFSEY. 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 EJCPEG QH UGZWCN EQPVCEV YKVJ DQF[ ƃ WKFU 0GXGT TGWUG QT UJCTG PGGFNGU QT QVJGT KVGOU VJCV JCXG DQF[ ƃ WKFU QP VJGO

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about ODEFSEY? ODEFSEY may cause serious side effects:

• Buildup of an acid in your blood (lactic acidosis), which

is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold (especially in your arms and legs), feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. • Serious liver problems. The liver may become large and fatty. Symptoms of liver problems include your skin or the white part of your eyes turning yellow (jaundice); dark “tea-colored” urine; loss of appetite; light-colored bowel movements (stools); nausea; and/or pain, aching, or tenderness on the right side of your stomach area. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight, or have been taking ODEFSEY or a similar medicine for a long time. In some cases, lactic acidosis and serious liver problems have led to death. Call your healthcare provider right away if you have any symptoms of these conditions.

• Worsening of hepatitis B virus (HBV) infection. ODEFSEY

is not approved to treat HBV. If you have both HIV-1 and HBV and stop taking ODEFSEY, your HBV may suddenly get worse. &Q PQV UVQR VCMKPI 1&'(5'; YKVJQWV Ƃ TUV VCNMKPI VQ [QWT healthcare provider, as they will need to monitor your health.

Who should not take ODEFSEY?

Do not take ODEFSEY if you take: • Certain prescription medicines for other conditions. It is important to ask your healthcare provider or pharmacist about medicines that should not be taken with ODEFSEY. Do not start a new medicine without telling your healthcare provider. • The herbal supplement St. John’s wort. • Any other medicines to treat HIV-1 infection.

What are the other possible side effects of ODEFSEY?

Serious side effects of ODEFSEY may also include: • Severe skin rash and allergic reactions. Skin rash is a common side effect of ODEFSEY. Call your healthcare provider right away if you get a rash, as some rashes and allergic reactions may need to be treated in a hospital. Stop taking ODEFSEY and get medical help right away if you get a rash with any of the following symptoms: fever, skin blisters, mouth sores, redness or swelling of the eyes (conjunctivitis), swelling of the face, lips, mouth, or throat, trouble breathing or swallowing, pain on the right side of the stomach (abdominal) area, and/or dark “tea-colored” urine. • Depression or mood changes. Tell your healthcare provider right away if you: feel sad or hopeless, feel anxious or restless, have thoughts of hurting yourself (suicide) or have tried to hurt yourself. • Changes in liver enzymes. People who have had hepatitis B or C or who have certain liver enzyme changes may have a higher risk for new or worse liver problems while taking ODEFSEY. Liver problems can also happen in people who have not had liver disease. Your healthcare provider may do tests to check your liver enzymes before and during treatment with ODEFSEY. • Changes in body fat, which can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system OC[ IGV UVTQPIGT CPF DGIKP VQ Ƃ IJV KPHGEVKQPU 6GNN [QWT healthcare provider if you have any new symptoms after you start taking ODEFSEY. • 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 ODEFSEY if you develop new or worse kidney problems. • Bone problems, such as bone pain, softening, or thinning, which may lead to fractures. Your healthcare provider may do tests to check your bones. The most common side effects of rilpivirine, one of the medicines in ODEFSEY, are depression, trouble sleeping (insomnia), and headache. The most common side effect of emtricitabine and tenofovir alafenamide, two of the medicines in ODEFSEY, is nausea. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What should I tell my healthcare provider before taking ODEFSEY?

• All your health problems. Be sure to tell your healthcare

provider if you have or have had any kidney, bone, mental health (depression or suicidal thoughts), or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and overthe-counter medicines, vitamins, and herbal supplements. Other medicines may affect how ODEFSEY 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 ODEFSEY with all of your other medicines. • If you are pregnant or plan to become pregnant. It is not known if ODEFSEY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking ODEFSEY. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

Ask your healthcare provider if ODEFSEY is right for you, and visit ODEFSEY.com to learn more. 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 ODEFSEY including important warnings on the following page.

ODEFSEY does not cure HIV-1 or AIDS.

SHOW YOUR

RADIANCE

ODEFSEY is a complete, 1-pill, once-a-day HIV-1 treatment for people 12 years and older who are either new to treatment and have less than 100,000 copies/mL of virus in their blood or people whose healthcare provider determines they can replace their current HIV-1 medicines with ODEFSEY.

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

(oh-DEF-see) MOST IMPORTANT INFORMATION ABOUT ODEFSEY

POSSIBLE SIDE EFFECTS OF ODEFSEY

ODEFSEY may cause serious side effects, including:

ODEFSEY can cause serious side effects, including:

•

Buildup of lactic acid in your blood (lactic acidosis), which is a serious medical emergency that can lead to death. Call your healthcare provider right away if you have any of these symptoms: feeling very weak or tired, unusual muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold (especially in your arms and legs), feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. Severe liver problems, which in some cases can lead to death. Call your healthcare provider right away if you have any of these symptoms: your skin or the white part of your eyes turns yellow (jaundice); dark “tea-colored” urine; loss of appetite; light-colored bowel movements (stools); nausea; and/ or pain, aching, or tenderness on the right side of your stomach area. Worsening of hepatitis B (HBV) infection. ODEFSEY is not approved to treat HBV. If you have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking ODEFSEY. Do not stop taking ODEFSEY without ﬁrst talking to your healthcare provider, as they will need to check your health regularly for several months.

You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight, or have been taking ODEFSEY or a similar medicine for a long time.

•

• • • • • • •

Those in the “Most Important Information About ODEFSEY” section. Severe skin rash and allergic reactions. Depression or mood changes. Changes in liver enzymes. Changes in body fat. Changes in your immune system. New or worse kidney problems, including kidney failure. Bone problems.

The most common side effects of rilpivirine, one of the medicines in ODEFSEY, are depression, trouble sleeping (insomnia), and headache. The most common side effect of emtricitabine and tenofovir alafenamide, two of the medicines in ODEFSEY, is nausea. These are not all the possible side effects of ODEFSEY. Tell your healthcare provider right away if you have any new symptoms while taking ODEFSEY. Your healthcare provider will need to do tests to monitor your health before and during treatment with ODEFSEY.

BEFORE TAKING ODEFSEY

ABOUT ODEFSEY •

•

ODEFSEY is a prescription medicine used to treat HIV-1 in people 12 years of age and older who have never taken HIV-1 medicines before and who have an amount of HIV-1 in their blood (“viral load”) that is no more than 100,000 copies/mL. ODEFSEY can also be used to replace current HIV-1 medicines for some people who have an undetectable viral load (less than 50 copies/ mL), have been on the same HIV-1 medicines for at least 6 months, have never failed HIV-1 treatment, and whose healthcare provider determines that they meet certain other requirements. ODEFSEY does not cure HIV-1 or AIDS. Ask your healthcare provider about how to prevent passing HIV-1 to others.

Do NOT take ODEFSEY if you: • Take a medicine that contains: carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®, Tegretol-XR®, Teril®), dexamethasone (Ozurdex®, Maxidex®, Decadron®, Baycadron™), dexlansoprazole (Dexilant®), esomeprazole (Nexium®, Vimovo®), lansoprazole (Prevacid®), omeprazole (Prilosec®, Zegerid®), oxcarbazepine (Trileptal®), pantoprazole sodium (Protonix®), phenobarbital (Luminal®), phenytoin (Dilantin®, Dilantin-125®, Phenytek®), rabeprazole (Aciphex®), rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®), or rifapentine (Priftin®). •

Take the herbal supplement St. John’s wort.

•

Take any other HIV-1 medicines at the same time.

Tell your healthcare provider if you: • Have or have had any kidney, bone, mental health (depression or suicidal thoughts), 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 ODEFSEY.

HOW TO TAKE ODEFSEY • •

ODEFSEY is a complete 1-pill, once-a-day HIV-1 medicine. Take ODEFSEY with a meal.

GET MORE INFORMATION •

• •

This is only a brief summary of important information about ODEFSEY. Talk to your healthcare provider or pharmacist to learn more. Go to ODEFSEY.com or call 1-800-GILEAD-5 If you need help paying for your medicine, visit ODEFSEY.com for program information.

ODEFSEY, the ODEFSEY Logo, 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: March 2016 © 2016 Gilead Sciences, Inc. All rights reserved. ODEC0026 06/16

“

We need to throw away the stigma and fear about HIV testing. It’s time we make HIV testing a part of our health routine. — Jay Ellis, Actor

”

I’M

DOING IT Testing for HIV

#DoingIt Testing is Fast, Free, and Confidential cdc.gov/DoingIt

c o n t e n t s October 2016

32 Cover Cured of HIV, Timothy Ray Brown Talks with A&U’s Alina Oswald About His Journey from a Berlin Hospital to the Worldwide Stage as an Advocate for Research Focused on Eradicating AIDS

Departments

Features 24 Gallery San Francisco-Based Artist Ghee Phua Cuts Deep in a New Portrait Series of Long-Term Survivors 28 One Building, Many Stories Writer & Activist Tim Murphy Takes Readers Back to New York City in the Early Days of AIDS in His Brilliant New Novel, Christodora 38 Military Injustice After Years of Dedicated & Decorated Service in the Army, Ken Pinkela Fights Against HIV Criminalization and a Stigmatizing Court Case That Cost Him His Legacy, His Livelihood & His Benefits 14 Ruby’s Rap Ruby raps with Actor Cole Doman cover photo by Sean Black

Frontdesk

Mailbox

NewsBreak

viewfinder 18

Just*in Time

Our Story, Our Time

Second Acts

TYing It All Together

Bright Lights, Small City

lifeguide 42

Under Reported

Destination: Cure

The Culture of AIDS

Lifelines

Survival Guide

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AMERICA’S AIDS MAGAZINE issue 264 vol. 25 no. 10 October 2016 editorial offices: (518) 426-9010 fax: (518) 436-5354 Editor in Chief & Publisher David Waggoner Managing Editor: Chael Needle Senior Editors: Dann Dulin, Sean Black Editor at Large: Chip Alfred Special Projects Editor: Lester Strong Literary Editor: Brent Calderwood Arts Editor: Alina Oswald Consulting Editor: Nick Steele Copy Editor: Maureen Hunter Contributing Editors: Sarah Churchill Downes, Reed Massengill, Kelly McQuain, Lesléa Newman, Robert E. Penn Contributing Writers: Tyeshia Alston, Noël Alumit, T.J. Banks, Larry Buhl, Ruby Comer, Diane Goettel, Sally Hessney, George M. Johnson, John Francis Leonard, Angela Leroux-Lindsey, Dale Reynolds, Connie Rose, David Rosenberg, Corey Saucier, Stevie St. John, Justin B. Terry-Smith, Hank Trout, Patricia Nell Warren, Chuck Willman, Jeannie Wraight, Rob Zukowski Art Director: Timothy J. Haines Contributing Photographers: Jordan Ancel, Davidd Batalon, Mark Bennington, Tom Bianchi, Sean Black, Adam Bouska, Brian Bowen Smith, Tim Courtney, Duane Cramer, Stephen Churchill Downes, Greg Gorman, Francis Hills, Renée Jacobs, Michael Kerner, Tara Lessard, Tom McGovern, Nancy Perry, Annie Tritt National Advertising Director: Harold Burdick, Jr. Sales & Marketing: David L. Bonitatibus Advertising Sales Office: (518) 426-9010 National Advertising Representative: Rivendell Media (212) 242-6863 Subscription Info: (518) 426-9010 Circulation Manager: Robert Schelepanow Bookkeeper: Richard Garcia Board of Directors President: David Waggoner Vice President: Harold Burdick, Jr. Secretary: Richard Garcia Founding Board Members: Mark S. Labrecque, 1961–1992, Christopher Hewitt, 1946–2004, Mark Galbraith, 1962–2011 In Memoriam: Bill Jacobson, 1939–2005 Rhomylly B. Forbes, 1963–2011 • Chris Companik, 1957–2012 Nancy Ellegate, 1959–2015 A&U (ISSN 1074-0872) is published by Art & Understanding, Inc., 25 Monroe St., Suite 205, Albany, NY 12210-2743, USA. For A&U advertising information please call 518-426-9010; for subscriptions and address changes please call 518-426-9010; for letters to the editor and unsolicited manuscripts write A&U Magazine, 25 Monroe Street, Albany, New York 12210; fax 518-436-5354; or e-mail: mailbox@ aumag.org. All unsolicited manuscripts that do not have a S.A.S.E. cannot be returned and will not be acknowledged. ©2016 Art & Understanding, Inc. ALL RIGHTS RESERVED. A&U may not be reproduced in any manner, either in whole or in part, without written permission of the publisher. A&U and the graphic representations thereof are the registered trademarks of Art & Understanding, Inc., a 501 (c) (3) nonprofit organization. Individual Subscription rates: $24.95 (12 issues). Institutional rates: $80.00 (12 issues). For subscriptions outside the USA and possessions, $30.95/Canada, $49.95/international, payable in advance in U.S. currency. First North American serial rights revert to contributors upon publication. A&U retains the right to anthologize work in further issues, as well as in microform or reprinting on the Internet within the context of each issue. Statements of writers, artists and advertisers are not necessarily those of the publisher. Readers note: subjects and contributors to A&U are both HIV-positive and HIV-negative. In the absence of a specific statement herein concerning the serostatus of any individual mentioned in, or contributing material to, this publication, no inference is made with respect thereto and none should be implied. Letters written to A&U or its contributors are assumed intended for publication. Art & Understanding, Inc. assumes no responsibility or liability for unsolicited submissions and does not guarantee the return thereof. PostMaster: Please send address corrections to A&U Magazine, 25 Monroe Street, Suite 205, Albany NY 12210-2743, USA

Printed in USA • Visit our Web site at www.aumag.org

Blood Simple

ne day there won’t be a virus known as HIV and the last person living with AIDS will have died, not from the disease itself, but from old age. You ask, how can I be so sure of the accuracy of my crystal ball? With early treatment and the community viral load falling, with South Africa fully committed to having every one of its HIV-positive citizens receiving adequate antiretroviral therapy, with UNAIDS stating goals of having every nation on the planet reaching undetectable status by the year 2030, it could become a reality. But a slow-paced reality, as political skirmishes, dire poverty, poorly distributed resources, and even outright war and refugee crises exploding across the Middle East, cloud up the crystal ball. Forecasting the end of AIDS is ultimately vague in a complex world with so many barriers to access. The HIV-free horizon is going to shift farther away, and then shift again. In the eighties, researchers gave up promising an AIDS vaccine by a certain date, realizing in part that hope was not going to solve the puzzle, and, although we have a vaster amount of scientific knowledge in 2016 than we did then, it may be better to keep the goal of ending AIDS untethered to any fixed deadline and focus on clear-thinking initiatives in the here and now. We will get where we need to be if we stay on track and if we build on our strengths and overcome our challenges. For example, the UN has dedicated its efforts to provide HIV-related services to women and girls, building on programs to eradicate mother-to-child transmission but also committing to halting key drivers of HV risk—gender inequalities and violence against this population. Women were forgotten in the early days of the epidemic here in the U.S. They were misdiagnosed and excluded from clinical trials, to name two of the most egregious errors in judgment. In this issue, A&U columnist John Francis Leonard interviews Tim Murphy about his new novel, Christodora, which creates a portrait of a woman battling HIV in 1980s’

New York City. It’s a sharp corrective of representations that too often focus on white gay men. While the federal and state governments here in the U.S. have steadfastly supported the Ryan White CARE Act, which in turn fuels innovation in HIV healthcare delivery, our government is not up to speed on reforming or revoking HIV criminalization laws, and justice is not being distributed equally across serostatus. The unjust laws, based on outdated science and fear and stigma, are being slowly changed thanks to the work of groups like Positive Women’s Network—USA and The Sero Project. This work is much needed—just read A&U Editor at Large Chip Alfred’s interview with Ken Pinkela, whose positive status became the focal point of a military witch hunt, in this issue. Alongside addressing barriers to access globally and HIV criminalization, initiatives to support HIV cure research have also gained steam. A&U’s Alina Oswald, in this month’s cover story interview with Timothy Ray Brown, the first HIV-positive individual to be cured, examines the advocate’s efforts to support research. With The Cure for AIDS Coalition, Brown hopes to create a hub of knowledge and action: “I’m proof that HIV can be cured. But we have to find out better ways to do it, because nobody wants to go through what I went through....” He is referring to his stem-cell transplants, which were a costly and difficult success that has not yet been reproduced in others, though it is being studied as part of the EPISTEM Project, for example. If we stay on top of healthcare access and health justice, as well as cure research, we will direct our own destinies. We still do not know the how and when of the end of AIDS, but we will always know the why.

DAVID WAGGONER

x o b l i ma Profile in Courage I found Mary Bowman to be very interesting and fascinating [cover story, “Spoken Words,” by Chael Needle, August 2016]. She

—Rendra Fawcett Compton, California

Reading about Mary Bowman, I really liked her poetry. I liked “I Know What HIV Looks Like,” and I liked “ “My Mother, My Thought.” I could tell that Mary really misses her mother; she says in the poem: “Like It Doesn’t Hurt Cuz It Does.” I feel that Mary Bowman’s poetry is going to help her

AUGUST 2016 • ISSUE 262 • AMERICA’S AIDS MAGAZINE

LONG-TERM THRIVING Marianne Williamson • Jesús Guillén • Rob Quinn

plus

A&U’s Summer Reading Issue featuring Christopher Hewitt Award Winners Marie Esposito • Jennifer Semble • Benjamin S. Grossberg

“I feel that Mary Bowman’s poetry is going to help her in dealing with her mother’s death. I think she has a lot of courage in her.”

mary BOWMAN Poet & Advocate

photo by Sean Black

RAISES AWARENESS ABOUT PERINATAL HIV INFECTION & THE NEED FOR SELF-CARE

is very young and focused on AIDS advocacy already. Her commitment to various organizations is very commendable. As for her poetry I really can’t comment since I am not into that. It is interesting that you don’t seem to hear about perinatal AIDS anymore. I know it was big news years ago, but no more. I guess the statistics are improving for mother-to-child transmission. This is a problem that UNAIDS has made great strides, especially in South Africa. It is still sad what Mary had to say about that: “We are long term survivors and are probably more valid [as such] because we don’t know anything other than HIV.” Wow, to have to live your life in this way. OCTOBER 2016 • A&U

Louise Hay [A&U, April 2010], who to me is the mother goddess of spirituality for the world. Yes, Marianne was there in the beginning of AIDS and she helped so many gay men infected with HIV make it to the other side of life. Many suffered with the horrors of death approaching but Marianne held steady and guided them to a greater spiritual horizon. Working with Project Angel Food, she has shown all of us what kind of human being she really is. Spirituality will solve the problem of AIDS. You must Believe. —Jane Debellville Morency Port Jervis, New York

in dealing with her mother’s death. I think she has a lot of courage in her. —Marsha Jay Colbert Panama City, Florida

Angels Among Us I can’t believe that you had Marianne Williamson in your magazine [“Emerging Enlightenment,” by Dann Dulin, August 2016]! She should have been a cover story. Marianne is a true blessing to all of us; she is a true spiritual guide into the future. To me she is another great guide just like

Feel the Love You can just feel the love and spirituality and power coming out of Jesús Guillén [“Surviving Still, by Hank Trout, August 2016]. The man just glows with all the good things in life. Jesus’s work with longterm survivors is very important because these people have gone through a lot in their lives. I just love that picture of him holding his hands in that sort of Buddhist way. I am so happy that he created AGUILAS for Latino men who are survivors. This is the kind of man who through love will make things happen. Jesus is a true godsend. Bless you. —Manuel Sorto-Evarista San Jose, California

Send e-mail to: mailbox@aumag.org Send letters to: Mailbox, A&U, 25 Monroe Street, Suite 205, Albany, NY 12210 Or click on “Mailbox” on our Web site’s home page: www.aumag.org Tweet Us @au_magazine Facebook: http://on.fb.me/AUFANPAGE All correspondence requires name, address, and daytime phone number for confirmation. Letters may be edited for length and clarity.

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NEWSBREAK DIFFA DESIGNS 2016 DIFFA DESIGNS 2016 presented by DIFFA San Francisco is a party not to be missed. On Wednesday, October 12, the San Francisco chapter of DIFFA: Design Industries Foundation Fighting AIDS will bring together shining stars from the world of interior design, architecture, fashion, industrial design, and visual arts to offer a glittering showcase and silent auction of unique, exclusive, and one-of-a-kind objects and exciting experiences. The event benefits DIFFA, one of the largest providers of funding to HIV/AIDS service and education programs in the U.S., and USCF Positive Health Program at Zuckerberg San Francisco General Hospital (SFGH) and Trauma Center. Ward 86 at SFGH was the first HIV/AIDS-specialized clinic to open its doors to patients, and quickly became an international leader in care and research. It provides primary care, offers vital support services, and administers dozens of clinical trials, among its other services. Attendees can expect live entertainment, live art, wines and cocktails, hors d’oeuvres, as well as works from top designers and design studios, such as Herman Miller, Gensler, Marmol Radziner, Julie Turner, and Sherry Williamson, among many others. The event will take place at THE NWBLK, an applied arts gallery in San Francisco’s Mission Gulch, from 6–9 p.m. Tickets are $125 (purchased between September 15 and October 11) or $150 (purchased on October 12, Untitled (Swimmer), a photograph printed on canvas the day of the event). created by Thomas Heiser for the event, playing off its A&U spoke to DIFFA volunteer Julie Blakenship, a curator and visual artist who has exhibited her work internationally. She is the former Execu- theme of “shine” tive Director of Visual Aid in San Francisco. A&U: Why did you decide to volunteer at this DIFFA chapter? Julie Blankenship: I decided to volunteer for DIFFA SF because I’m passionate about supporting Ward 86 at San Francisco General Hospital, the first HIV/AIDS-specialized clinic, and an international leader in testing, care, and research. They evolved a standard of care that addressed the whole needs of patient wellbeing: medical, social, psychological and often economic. Among their many firsts were non-traditional definitions of family and next of kin, social support groups, and transitional housing programs. DIFFA SF is part of an ongoing response to the HIV/AIDS epidemic by the art and design communities in San Francisco. What makes a DIFFA event different than other events? What can attendees expect if they have never gone to a DIFFA event? DIFFA DESIGNS celebrates the worlds of design and the creative spirit. Attendees can expect a festive party with an urban vibe, camaraderie, and community. This year’s silent auction features unique culinary, entertainment and wellness experiences plus twenty-five one-of-a-kind, limited edition or new-to-market objects of design desire—from the wonderful and whimsical to the wacky. At what other event can attendees see and bid on a “flicker of hope,” a “The Disco-Tech Jukebox,” or “The Bejeweled Banana”? Our suggested attire is either “business fabulous,” or in a nod to this year’s theme, “creative shine + sparkle.” So attendees can express their own creativity, sartorially. What are the most pressing needs of people living with HIV/AIDS in SF, particularly those who use the services at Ward 86? Ward 86 provides state-of-the-art primary care to more than 3,000 patients in San Francisco, many of whom are uninsured. The funds raised through DIFFA DESIGNS enables immediate basic services like bus fare, so patients can make their appointments. For more information and to purchase tickets, log on to: www.diffasf.org. For general information about DIFFA, log on to: www.diffa. org. For more information about the USCF Positive Health Program. visit: https://hiv.ucsf.edu. OCTOBER 2016 • A&U

NewsBreak

Global Fund Replenishment The Global Fund to Fight AIDS, Tuberculosis and Malaria relies on donor governments for ninety-five percent of its funding. These contributions are organized into three-year cycles, or “replenishments,” to help countries who implement Global Fund-financed programs to plan effectively. As a new cycle is set to begin, the Fund’s board sees what pledges and contributions have been made and decides what amount of funding can be allocated to countries for the upcoming three years. In September, the Global Fund Fifth Replenishment Conference took place in Montréal, Canada, to formalize this assessment for 2017–2019. The United States pledged $4.3 billion, a seven-percent increase from the last replenishment; the pledge is conditional on funding from other countries and donors coming in. Other major pledges came from the United Kingdom, France, and Germany. Foundations such as the Bill & Melinda Gates Foundation and (RED) made signficant pledges, as well. Some countries, like Italy and Japan, increased their pledges compared to the last replenishment. Additionally, the Fund saw new donors, such as Togo and Qatar. In all the Fund fell $100 million short of its fundraising goal of $13 billion. It needs an additional $20 billion to meet the funding needs of this three-year cycle. Advocates have pointed out that the funding, however, does not measure up to what is needed to improve healthcare access for underrepresented and vulnerable groups, such as sex workers and injection-drug users, among other key populations, nor to provide widespread access to new health technologies and affordable gold-standard antiretrovirals. Health GAP (Global Access Project), an “organization of U.S.-based AIDS and human rights activists, people living with HIV/AIDS, public health experts, fair trade advocates and concerned individuals who campaign against policies of neglect and avarice that deny treatment to millions and fuel the spread of HIV,” released a statement in response to the pledge from the United States, which was revealed before the conference. The coalition called on the United States to do more, and specifically President Obama to step-up investments, especially in relation to its “AIDS-Free Generation” commitments and its commitments to expand access to women and girls, and gay men, in the hardest-hit countries: “This pledge translates to the U.S. increasing its contribution to the Global Fund by roughly $80 million per year at a time when $7 billion per year in additional funding is what UNAIDS estimates is needed to put the world on track toward ending the AIDS crisis. This comes as the U.S. has flat-lined funding to the PEPFAR program for three years, although increased investments are urgently needed. UNAIDS projects that failure to scale up the global HIV response considerably between now and 2020 will result in 17.6 million more new infections and 10.8 million more deaths—increasing the long-term need for HIV treatment and future costs to health systems.” For more information, log on to: www.theglobalfund.org and www.healthgap.org.

“Tree hugger” took on a whole new meaning at the United States Conference on AIDS 2016, which convened in late September in Hollywood, Florida. Mondo Guerra [A&U, January 2013], fashion designer and winner of the debut season of Project Runway All Stars, installed a series of Pozitivitrees in the conference space to express the interconnections between all parts of our lives, and among our relationships, personal and professional, with each other. The HIV advocate “planted” the Pozitivitrees as part of his contribution to I Design, an HIV education campaign created by Merck to encourage individuals living with HIV/ AIDS to take a proactive, empowered approach to their health by seeking information and nurturing engaged and honest dialogues with their physicians and other members of their healthcare team about HIV and other health conditions. Music industry professional and HIV advocate Maria Davis [A&U, January 2016] also works on the campaign. Guerra used the Pozitivity design he introduced on a Project Runway Season 8 challenge, where he disclosed his positive status in response to a query about the use of fabric covered with plus signs. Since then, he has become a public spokesperson in the fight against AIDS—continuing to show how living with HIV can work with, not against, the creative spirit to transform one’s life for the better. The Pozitivitrees link this expressivity to the collaborative approach championed by I Design. In his artistic statement, he stated: “I approached this installation artistically in the same way that I approach working together with my healthcare providers. This project is rooted in the importance of having an ongoing dialogue: with my work, with project collaborators, with my doctors.” The yarn-wrapped outer trees start with a foundational white with only a few black lines, representing questions and connections not yet made, and lead to the middle trees, where the color red, saturated by its symbolic association with the HIV/AIDS community, adds more information and scientific progress in the healthcare field. Finally, the innermost trees show the Pozitivity design in full bloom, interlacing red, white, and black together. States Guerra: “It reflects bringing a community of people infected and affected by HIV from the outside-in, and applying all that we are and all that we know to the structure, which gives us added strength while creating a strong sense of balance. I hope that those who view this project will not only see the inherent beauty that embraces these trees, but also hear and feel so many stories of Pozitivity that it tells. Stories of love, faith, character, strength and beyond all else, stories of hope.” For more information, log on to: www.ProjectIDesign.com.

A&U • OCTOBER 2016

photo by Corporate Image Photography

Pozitivitrees

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by Ruby Comer

Cole Doman Bye Bye Birdie!” I scream with frenzy to myself as I scan over Cole Doman’s resume after viewing his performance in the thoughtful coming-of-age film, Henry Gamble’s Birthday Party. Yours truly was also in Bye Bye Birdie! When I was fifteen, I auditioned for a summer stock troupe, Kenley Players, in my hometown of Columbus, Ohio. I landed the part of a Sweet Apple, Ohio kid— joining the supporting cast of dancers and singers—and the stars Gene Barry and Totie Fields. Now I know you youngsters have no idea who these iconic entertainers were, so Google ’em! My god, doing the show was a blast, but demanding. It was then that I decided not to pursue an acting career. Lordie, actors work hard! I tip my hat to Cole Doman. His portrayal of Henry Gamble is honest and poignant. A native of Philly, Cole started acting as a kid. Now living in Chicago (but by the time you read this, Cole’s new home will be Los Angeles), he graduated from the School at Steppenwolf, and received his BFA from the Chicago

College of Performing Arts at Roosevelt University. In 2014, The Chicago Tribune named him one of the 10 Hot Faces of Chicago Theatre. Cole’s wholesome apple pie looks have been on display in the television series Shameless and American Gods. He’s presently on location with the film, Midnights at the Sad Captain. The young thespian generously supports Broadway Cares and he’s participated in the Chicago AIDS Run & Walk. Ms. Ruby is in Chicago visiting TPAN (Test Positive Aware Network), an all-encompassing AIDS organization, which was founded by seventeen gay guys in 1989. Next month, don’t miss their annual event, Barlesque—a strip-athon for businesses (read more about it). The proceeds support AIDS services. One evening, Cole takes me to Big Star for fish tacos. Afterwards, we walk across the street to Blue Line and have a dirty vodka martini, his favorite. Ruby Comer: [Biting into my fish taco] You know, I like the name Cole. Were you named after anyone? Cole Doman: I was named after Nat King Cole. My mom was a huge fan. His music was a big part of my childhood, along with listening to cast

recordings of Cabaret and Rent and a lot of Andrew Lloyd Webber, too. Your mom has excellent taste! Love Nat and his daughter, Natalie, too, who passed way too quickly. [A fan as well, Cole nods in agreement.] My mom used to be an actress, so theater was always part of my childhood. My sister and I are both actors now, and we did our first professional show together called Peter Pan & Wendy at the Prince Music Theatre. I was nine; she was ten. Did your mom influence you to pursue acting? My mom has always been my hero. I look at anything she does with serious admiration and awe. Her energy and charisma light up any room she’s in. Who wouldn’t want to be like her? Indeed. You have an uber mom there…. She’s my biggest fan, Ruby, but also keeps me grounded. She understands the discipline involved [in acting]. She chal-

Cole Doman stars in Henry Gamble’s Birthday Party (Wolfe Video)

A&U • OCTOBER 2016

Ruby illustration by Davidd Batalon; Henry photo courtesy Wolfe Video; portrait by Brandon Shade

“OMG

, he was in the stage show,

SOMETIMES, OUR HIGHEST HEIGHTS HAPPEN

LONG BEFORE TAKEOFF. Proud Partner of the Elizabeth Taylor AIDS Foundation.

blazing the sky.] Earlier you told me you were single. When you date, how do you bring up the issue of STDs? Honestly, I don’t date often. But it’s something that always needs to be addressed. Living as a queer person today, it’s not something that can be ignored. We don’t have the luxury of not knowing. You said a mouthful, boy! Have you ever dated anyone who was HIV-positive? No, but it’s not a deal breaker for me. Now your character, Henry, was raised Evangelical Christian. What religion were you brought up? Although I was raised Catholic, I wouldn’t identify myself as a Christian today, but I’m very open to spirituality.

lenges me—which is a gift. You two have a special relationship, how lovely. I’m curious, what do you do in your spare time, Cole? I love shopping for and sporting eighties and nineties vintage clothing.

Me too. Went to parochial school but don’t profess any religion now. What was your favorite scene to shoot in Henry Gamble’s Birthday Party? It was the opening scene with [actor] Joe Keery. It was also the scene I was the most nervous to shoot. [Close camera work.] It was probably my longest scene

Getting back to the epidemic, do you and your friends ever discuss the disease? It’s a sensitive subject, but we’re all comfortable talking about it. Being positive becomes a huge part of a person’s identity, so it makes sense to address it. Plus, the more it’s swept under the rug, the more shame and ignorance grows. Can you address the rise of HIV infection in your generation…? People my age have never lived in a world without HIV and AIDS [he says quietly then adds] That’s…crazy…to… think… about, Ruby. Because of this, there are a lot of LGBTQ youths who think that it’s a controllable disease and they assume they’re less at risk. Of course, all the stats and numbers prove them wrong. Right! It’s a myth. [I sternly say with a staccato pitch.] Once we remove the stigma from HIV, the less likely it will be ignored. Ignorant people who don’t know the realities of the disease have placed it on the LGBTQ com-

Tell me what spurred you to participate in Chicago’s AIDS Run & Walk? I have a few friends who are HIV-positive and I wanted to help them and serve my community, and so I got a bunch of friends together to walk. (I applaud.) When did you first get tested? I was around eighteen. Oh, Ruby, I was incredibly anxious, even though I knew what the results were going to be. It takes courage [to get tested], but everyone needs to do it.

in the movie, so there was a lot of room for error. Not to mention, by the end of the scene I was going to be masturbating into a sock on camera.

Have you always played safe? Yes, definitely! [He answers abruptly, his baby blues wide-eyed.]

OMIGOSH, that’s right. I forgot about that scene…. That terrified me, but Stephen [Cone, director] and Joe made it comfortable. We had a few laughs, and got the job done— no pun intended. [He leans against the bar.] Many of us [from the cast] still stay in touch.

[Walking across the street to Blue Line, the sun sets, there’s streaks of neon pink

I’m sure you all became “family” for several weeks while you were shooting the film.

munity. [He takes a hardy inhale.] This kind of thinking leads to self-destruction within our community and helps spread the disease. [He takes a sip of his drink.] Ruby, these people need to be made aware! Let’s you and I spread awareness together…. [We clink our glasses together in a toast.] I’ll hold you to that toast, Cole! Ruby Comer is an independent journalist from the Midwest who is happy to call Hollywood her home away from home. Reach her by e-mail at MsRubyComer@aol.com. A&U • OCTOBER 2016

photo & poster courtesy Wolfe Video

Eighties and nineties….vintage??! Lordie Lu, that makes me feel ancient! Vintage to me means fifties or sixties—oy! [He smiles.] Say, how did you first hear about the epidemic? When my mother was working as an actress in New York City in the 1980s, she lost a lot of loved ones to the disease. It was a large part of my mother’s life and so she was vocal about it while I was growing up. [He looks down for a moment.] For me the epidemic means loss.

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Hi Justin— Greetings from Accra. I cannot stop admiring your online posts and pictures and your positive attitude toward life. This makes me wonder if you are really HIV-positive because you do not fit the popular image of a person living with HIV as melancholy and lonely. Most people here do not disclose and are living in silence because of stigma. This brings me to the question: How did you find out you are positive—of course it was by testing but what led you to go and test for HIV? Did you have symptoms? What were they? How long after your exposure to the virus did you get tested? These appear to be personal questions. It’s okay if you do not wish to answer any of them. Thanks and regards. Good health and blessings to you. —Kaya I hope all is well and thank you for writing in. I also want to thank you for reading my articles and posts; it really helps me to know that people out there are really reading and listening to what I have to say. Let’s talk about the image of a person living with HIV. In the 1980s and ’90s living with HIV was very hard. On top of having a life expectancy of five years, give or take, one’s view on life could some-

times become altered. Knowing that you’re HIV-positive can lead someone to depression, to become isolated and can lead others to discriminate against them, etc. These negative factors can become overwhelming and can affect how a person treats themselves as far as living healthfully—physically, mentally, spiritually, and emotionally. When there was no medication that could effectively help someone with HIV, the complications of HIV were a lot worse. But today, because of medications called antiretroviral treatments, people with HIV are able to live healthier lives, to the point where someone with HIV can live nearly as long as someone who doesn’t have HIV. The images of HIV in the 1980s and ’90s are very different than they are today, at least in the U.S. To address your other questions about my symptoms and testing: One day I woke up and my satin sheets were soaking wet. I then began to throw up five times in my bed and realized that something was wrong. I had never felt so sick before, except for when I had the flu. I found out that I was HIV-positive because of an HIV test that I took at a local nonprofit in Washington, D.C. I was tested in 2006, but I believe I was infected in 2005. I’ve been living with HIV for eleven years but diagnosed ten years ago, in other words. I know there are

people out there that would say HIV doesn’t exist. Those people are called HIV Denialists or Dissidents. Do not believe them because HIV does exist; it’s a scientific fact and no legitimate/ethical doctor will tell you that there is a cure. Many doctors that say they have the cure for HIV are fraudulent and, in my opinion, they have the blood of people who believed them on their hands. Many cultures still have HIV stigma and, today, because of stigma, people don’t disclose their HIV status and are living in silence. The image of people living with HIV in some cultures is that they deserved getting HIV. They blame the victim of the infection and not the infection itself. This directly affects an HIV-positive person living in that same culture. They do not want to be associated with HIV for fear of what family or friends might think of them. Sometimes this can lead to them not seeking treatment and not disclosing to their sexual partners, thus leading to more infections and more deaths. From my experience with friends who have died in the past, there is still stigma. I went to a funeral of a friend and nobody wanted to say what he died of, even years later. That is what stigma does. Speaking out helps others accept what HIV is and helps them to combat it. ◊ A&U • OCTOBER 2016

Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal. blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.

viewfinder

Ready? Diclose Everything! no one reveals personal information at the drop of a hat, so why should we?

illustration by Timothy J. Haines

’ve recently had conversations and interviews where the question around “disclosure” is always the biggest hot button issue that comes up. When I talk about sexual responsibility, I always make sure that people understand that it is the responsibility of both parties involved. Unfortunately, the disclosure of one’s HIV status is a criminalized, stigmatizing part of the epidemic that has stood for far too long. In an age of the epidemic where treatments exist that have all but eradicated the original “death sentence” diagnosis, it is now time to defuse the fear around HIV in an effort to create better sexual conversations and experience. However, I am always brought back to this conversation around disclosure. Interestingly enough, the most frequent thing I hear is how people feel that someone who is HIV-positive should disclose whether they are asked or not. That got me thinking. How many people just quickly disclose things that others would see as “deal breakers” or “risky” or just private. What if some of your private truth required disclosure? Bad Credit Could you imagine if every time you went on a date you had to disclose your credit score? If you had to tell about the time you put a bill in someone else’s name, or got your car repossessed, or your house was foreclosed on? Could you imagine if you had to talk about how you filed bankruptcy and still paid Sallie Mae even though you’ve been out of college for twenty years? The same way that you don’t want to disclose your credit history or feel that people should not have that type of information is how people living with the virus feel. For most it is a personal thing that is only shared with the most trusted, so afford people who are positive some power and dignity in that process when making that decision to disclose their most personal business. Other STIs So let’s be clear. If every STI required disclosure, you wouldn’t have as much

OCTOBER 2016 • A&U

shame around those who are HIV-positive. But could you imagine if you had to tell about that one time you were dripping all over the place? Or how you had to wear a hoodie and give a fake identity when you went to go and pick up that prescription or ointment? It is interesting when those who have had other STIs in the past are so hypocritical in their judgment of people with HIV and the requirement around disclosure that is expected. Although HIV can have much more serious health implications, STIs like syphillis, herpes, gonorrhea and chlamydia also pose some serious health risks including death when gone untreated. So this notion that all HIV-positive people should have such a burden on them when people with other STIs have no obligation to say anything is tantamount to violence against people living with the virus. This is not an endorsement that all should disclose, but that we should start to have more healthy conversations on the topic. Penis Size and Body Count LMMFAO. I actually laughed when writing this section. If folks had to disclose how big they are or in this case, what they are lacking, there would be a worldwide movement to stop such a requirement. Could you imagine being criminalized for having a penis less than six inches? Or having to go to court when that body count hits numbers that the Golden State Warriors put up per game? For many these things are deal breakers just like the way folks treat people who live with HIV. We gotta grow up and educate ourselves better. I get it, HIV is still scary to some, especially in areas where the education around the virus is lacking or void. However we need to have more conversations and less condemnation.

Cancer, Mental Health, Past Sexual Abuse Could you imagine telling someone the status of your mental health? Having to give the details of past sexual trauma? That you are predisposed to cancer, or in remission with a chance to have it come back? Where does disclosure stop? Who makes the rules on when disclosure is too much? Here is the thing, the problem isn’t disclosure as much as it is the lack of navigation we have in our community around conversations about sex. If people were more confident in their own sexual agency, they would feel more empowered when having these tough discussions. Furthermore, when you discuss statuses, it is important to know that, even when you ask for someone’s HIV status, you still don’t have the right to know. If a person tells you “they don’t wish to answer,” you then have to make a decision on whether you want to proceed, sexually or otherwise. The point is that it is necessary to not be afraid to ask. As we are in what we hope to be the final days of the epidemic, it will be important that we are not afraid to simply talk to one another. You never know. It might just turn out positive. George M. Johnson is an HIV advocate who works for Us Helping Us, People into Living. Inc., located in Washington, D.C. He has written for Pride.com, Musedmagonline.com, Blavity. com, Rolereboot.org, and Ebony.com. Follow him on Twitter @IamGMJohnson.

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ne week after graduating high school, I escaped my small Ohio town for college. Upon coming out, my family rejected me, which fired up my determination to succeed and I graduated with a master’s degree in hospital administration at the age of twenty-three. However, I was unaware of the homophobia and discrimination I would experience in both Miami and Houston, cities where I found work. I once more escaped and began a new life and career in San Francisco in 1979. In January 2000, I lost my third partner in seven years to AIDS. Diagnosed with HIV in 1985, I began disability in 2002 after a long career at AT&T. My primary enemy was fatigue and I fell into severe depression. I chose to volunteer since nonprofits are forgiving of their employees when side effects from HIV medications keep them from showing up on time. Volunteering was fun and these interactions brought me new acquaintances. In 2011, a volunteer position reserving space in windows provided by Walgreens to San Francisco LGBT nonprofits at 18th and Castro Streets became available. These windows are set aside for nonprofits to display posters, etc., to raise awareness and promote their upcoming fundraising events at this very busy intersection in the gayborhood. Soon after taking over this position, I realized that since reservations for the windows only last a short period of time, it was necessary to create an online resource to promote multiple events simultaneously. Meanwhile, in Los Angeles, someone I would meet and work with on this project, David Hatcher, was working through his own particular struggles with living with HIV. David had been diagnosed with HIV in 2000. In 2012 he was diagnosed with HAND (HIV Associated Neurological Disorders), with symptoms including shortterm memory loss, decline in executive reasoning (decision making), and difficulties with spatial awareness. About two years in as Director of Global Digital Operations at SONY (David has degrees in computer science and artificial intelligence), the HAND symptoms began to manifest. With the assistance of doctors and staff at the

Paul Margolis

A Fight for Community Connections how a desire to fight depression led to nurturing information-sharing online

Jeffery Goodman Clinic the progression of symptoms stopped but were irreversible. In 2013 David went on permanent disability. In February 2015 I met David on a gay cruise. Over dinner I told him about OurTownSF.org, the resource guide I started, and David tells me now, “it checked all the boxes for me since I had been wanting to volunteer my time and give something back.” Later that year, he launched OurTownLA.org. The site itself was easy to set up since the gay-owned hosting company, www.Localon. com, used OurTownSF.org as a template. David says “putting together the nonprofit listings was interesting and very informative. As a gay man we mostly concern ourselves with the G in the LGBT. The LBT

have communities, needs, gatherings and organizations that I never knew about.” Now approaching its third year, OurTownSF.org continues to be a resource guide with connections to over 300 San Francisco LGBT nonprofit service agencies, arts and athletic groups, all organized under twenty categories. Visitors find vital services as well as volunteer and donor opportunities. Under the Wellbeing tab, fifty groups are listed serving those with HIV/AIDS. The site receives over 2,000 visitors per month and continues to grow.

I have heard several success stories including those newly diagnosed HIV-positive finding services on the site. At the suggestion of my friends, I’ve developed my skills in photography, which supplements attracting users to the website. I attend three to four events per week and most times receive an extra press pass. I bring my volunteers from the website or my new domestic partner. My photographs are especially popular since I post them within a few hours of the event on the website plus Facebook and Twitter. Recently I became a contributing photographer at a local gay newspaper, the San Francisco Bay Times, with photographs taken for OurTownSF. org. While the website I created provides a service, I enjoy my photography and attending events celebrating all the hues of the LGBT rainbow. I meet passionate and talented people who dedicate their time, many as volunteers, to serve those in need. What began as a desire to fight depression and loneliness has helped me connect my community, brought me new computer and photography skills and a sense of self-worth and a love life. For more information, log on to: www.OurTownSF.org and www.OurTownLA.org. Paul Margolis is a long-time San Francisco resident who is formerly a member of the HIV Planning Council, a founding member of Rainbow Toastmasters, and a current Castro Ambassador. His dedication to the LGBT community is demonstrated by his founding and full-time volunteer position at OurTownSF.org. Several of his photographs for the website were among those chosen for a retrospective of San Francisco LGBT life at the Harvey Milk Photo Center in June 2016. A&U • OCTOBER 2016

photo courtesy P. Margolis

Bringing hearts together since 1998

P zMatch.c m

Family, Love & Violence

raising our voices at the intersection of intimate partner violence & hiv

merica! The land of the free and the home of the brave. America the Beautiful should be outraged in knowing that our strong and brave troops, who went to foreign countries, stepped behind enemy lines and battled many wars, had more soldiers return home alive from war than women escape their homes alive. Now, please don’t get me wrong. I’m thankful that our troops made it safely home because they represent the strength of America and they are the reason Americans can proclaim their strength. However, my heart dropped when I read this statistic in a 2014 Huffington Post article: “The number of American troops killed in Afghanistan and Iraq between 2001 and 2012 was 6,488. The number of American women who were murdered by current or ex-male partners during that time was 11,766. That’s nearly double the amount of casualties lost during the war.” This statement filled my heart with sorrow because it’s almost as if it’s safer and easier to dodge bullets and bombs on foreign land than to just show the simple action of love in the place that you call home. What makes a man or a woman lift his or her hand to hurt the ones they love, I truly don’t know and it’s not my place or anyone else’s place to judge. However, my heart breaks for all those involved because everyone is hurting. I’m sure the need for control may be a factor behind the abuse but there’s no way that I can say that it is the only reason; nevertheless, I must humbly say that everyone needs to seek professional help. That same article, written by Alanna Vagianos, went on to state: “Worldwide, men who were exposed to domestic violence as children are three to four times more likely to perpetrate intimate partner violence as adults than men who did not experience domestic abuse as children.” Therefore, without professional help, the abuse can continue on. In my opinion, people with disabilities should not have to endure any more

pain than they have to. However, as the article states, “women with disabilities are 40% more likely to experience intimate partner violence—especially severe violence—than women without disabilities.” As a young woman, I grew up with my own disability. I was constantly in and out of, back and forth to the hospital because I was born with heart problems. Nevertheless, I was determined to never let it hold me back or keep me from keeping up with my peers. Yes, I had my own challenges and one of them was that everyone in my environment, particularly all the children at school, knew that I could not run fast before becoming short of breath. Therefore, they would always hit me and take off running—but they underestimated that I always had a strategy plan. I’m saying this because it is extremely important that the victim creates a strategic and effective safety plan. A safety plan will help guide you to safely flee from danger into a confidential environment where you and your children can be safe. It does not matter if the victim is male or female. Yes, men are being abused by their partners, too, and we need to shed light on this issue as well. It’s time that we stop sweeping everything under the rug and start uniting to fix the problem. If you do not know how to write a safety plan, contact a local domestic violence agency and they will be more than willing to assist you because your safety is a priority and your children deserve to be safe and they need for you to remain safe and healthy. “Domestic violence is the third leading cause of homelessness among families....” and no child should have to experience being homeless. People who are in abusive relationships are fearful of being hit again by their partner. Therefore, they tend to do all they can to keep him/her calm and satisfied. Trying so hard to please their mate, they never take into consideration the risk that they bring to themselves. It’s no secret that violence is painful but many people are clueless to the fact that

violence can also lead to HIV infection. Let me make myself clear here: A person who is involved in a relationship that has fear attached to it is less likely to ask their abuser (primarily male) to use protection, such as a condom. Many victims are not only physically abused, they are also sexually abused, and when forced sex takes place it tends to cause cuts and bruises which allow HIV to have an easier access for transmission. Additionally, women with HIV are more likely to become victims of domestic violence for multiple reasons, with one being they fear that their mate will reveal their HIV status. Men and women of the LGBT community are “2.6 times (more likely a transgender person of color) likely to become a victim of intimate partner violence than a non-LGBT person.” There is so much to be said about this subject but I cannot tell it all. Therefore, I am encouraging everyone reading that if they are in an intimate partner violence relationship, please seek help. Don’t Hide! For more information, visit: www.opdv.ny.gov/ professionals/health/hivaids.html. To learn more about the Don’t Hide campaign please visit: http://www.recoveryfirstcdc.com/. Tyeshia Alston is an HIV-positive AIDS activist and educator living in Dallas, Texas. Ms. Alston strives to build hope, increase faith, and encourage others to live their best life. Ms. Alston is a mother of a handsome two-year-old boy. She is driven to educate others about HIV/AIDS by creating community awareness programs and providing HIV/AIDS services through her organization, SAAVED INC. Ms. Alston has traveled to Washington, D.C., to speak with legislators about better healthcare access and how the disease has impacted communities which she serves and has served on panels for National Minority AIDS Council and other local organizations. Lastly, she is known to others by bringing her message to local talk shows and radio stations, working to do her part in ending AIDS. To learn more about Ms. Alston’s work, go to www.saaved.org and if you have any questions or comments, please feel free to email her at saaved2heal@gmail.com. A&U • OCTOBER 2016

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I’ll Always Have Paris coming to terms with one’s own seroconversion

illustration by Timothy J. Haines

’d been so careful for so long. Safe sex was being marketed and promoted heavily when I arrived in New York in 1987 at the age of seventeen. All the cool kids were doing it. But, as the nineties were drawing to a close, I and many of my gay male peers were ceasing to be as careful. I’ve heard it referred to as condom fatigue. It felt better, we told ourselves; it felt different. Coupled with recreational drug use, particularly my own, it was a dangerous combination. Drug and alcohol abuse lowers inhibitions and increases the likelihood of unsafe sex greatly. According to the NIH, one in four people living with HIV/AIDS has sought treatment for substance abuse. That statistic holds regardless of sex, sexual orientation, or ethnicity. In ’98, I had my first opportunity to see the City of Light. My former partner, Stephen, surprised me and his business partner, Bruce, with an early Christmas gift, tickets to Paris. We all lived and ran a successful business together and we knew that Bruce would never make the trip alone. The only traveling he did was domestic and to the dog shows he loved. He needed a break, and would be comfortable traveling with me. I would be able to visit museums and sightsee during the day with him and could see what trouble I could make for myself at night with Bruce tucked safely in his bed. I had a high tolerance for risk in those days and managed to secret a supply of liquid ketamine and some crystal meth among my toiletries. I indulged in the Special K as more of an an enhancement to sightseeing. I mean, what are the glories of Versailles without a little animal tranquilizer, right? The meth was more for my nocturnal wanderings. If one were to talk about taking risks sexually when under the influence, I was a poster boy. I was warned by friends that the city wasn’t necessarily a hotbed of after-hours fun, especially for the uninitiated, but I wasn’t thwarted. I found one-stop shopping in a notorious establishment along the picturesque right bank of the Seine. Downstairs, a hot leather and Levi bar, upstairs a very busy sex club with lots of private and public areas to indulge. OCTOBER 2016 • A&U

I’d struck gold! The same Frenchmen who looked so disdainful in other situations trailed around me like lemmings. I was back the next night for more, high as a kite and ready to go. I met a really handsome guy the next night. After I happily played bottom, the role I usually played and which is the riskiest, we both surprised each other by speaking English. He’s was a Texan in Paris for a friend’s wedding. We repaired to the bar downstairs and shared some beers. So went the pattern. We’d share a few beers and talk; we got along great in fact. He was a very nice guy. Then, when the mood struck, we’d head back upstairs for another session. The man had the stamina of a bull. He never offered to put on a condom and I didn’t ask him to. This happened at least three times and I was always on the receiving end, so to speak. He was certainly not my only sexual contact that week, but most of my other activity had been oral in nature and relatively low-risk. We parted ways in the small hours of the morning. Neither of us was feeling any pain, and he walked me to my door. Not only was he hot, he was kind—a trait sometimes rare in American gay men when it comes to sex. The next morning found me at the airport in large dark glasses feeling all the pain I hadn’t felt the night before. And who should I bump into? The Texan. He was boarding soon and we didn’t talk long, but he was giving me the strangest feeling. He wouldn’t look me in the eye and was very uncomfortable. I’m a great believer in instincts. They’re often right if you’ll only listen. Mine told me, screamed at me actually, that this guy is positive. And if unsafe sex were a baseball game, he’d hit at least three home runs the night before.

Some years later, I finally got tested. Yes, I hear my instincts but that doesn’t mean I always pay attention to what they’re saying. Through a genotype of my virus and a new knowledge of what seroconversion entails, I could narrow it down. Also, my sex-filled visit to Paris took place in the middle of a long and rare period of celibacy for me. So, I believe my gut was right and it was him. The thing people ask me when they hear this story (besides “did he really orgasm three times?”) is “am I angry? Do I blame him for my contraction of HIV?” My answer is no. I still believe firmly in what young gay men were taught in the New York City of the eighties. When you have sex with another man, you have to assume that he is positive. AIDS first came to be public knowledge when I was hitting puberty; it was hardly a shock. Now, do I blame myself? In a way, but I try not to judge myself too harshly. Yes I was having fun when it happened, but did I really love myself enough at the time? The answer is no. And again, I would have made some very different decisions that night had I been sober. For many people who become positive, it’s a similar story. We took risks that we normally would not have and came up short. John Francis Leonard is an advocate and writer, as well as a voracious reader of literature, which helps to feed his love of the English language. He has been living with HIV for thirteen years and he is currently at work on his first novel, Fools Rush In. Follow him on Twitter @JohnFrancisleo2.

COUNCIL of ELDERS With a Series of Portraits of Gay Men, Artist Ghee Phua Celebrates Long-Term HIV Survivors by Hank Trout

hese portraits of gay seniors are oddly unnerving. Individually, each of these portraits of older gay men draws the viewer in with its reverential softness and warm muted colors, making us wonder what stories lie waiting to be told behind those aging eyes, what scars life has left on the subjects. At the same time, each portrait also holds the viewer at bay with harsh slashing lines and abrupt angles, reminding us of the natural ravages of aging awaiting us all—a daunting mirror for some, a premonition for others. Arranged closely together in a row in the gallery at Strut, the San Francisco AIDS Foundation’s Castro Street building, the eleven portraits (and one self-portrait) seem to form a Council of Elders who, while not passing judgment, not exactly, are poised to share the lessons of a life lived fully, eager to instruct and nurture those to come after them, to mine their own past for nuggets of wisdom to pass on. One cannot help being awestruck

by the strength and dignity and intelligence in each of the faces painted here. Artist Ghee Phua, a native of Singapore who now lives in San Francisco, explained the genesis of this Portrait of Gay Elders series. A few years ago, the Bay Area Reporter, San Francisco’s long-published weekly LGBTQ newspaper, ran an article about the alarmingly high number of gay seniors who have contemplated or actually attempted suicide. The article highlighted the depression, invisibility, loneliness, and rejection that plague many LGBTQ seniors. Ghee was deeply moved by the article. “Despite being younger than the men in the article, I had experienced many of these same issues in the community,” Ghee said. “It occurred to me that here was an opportunity for me Harry Breaux, October 2015, oil on canvas, 11 by 14 inches

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A&U Gallery

Bartholomew Casimir, August 2015, oil on canvas, 11 by 14

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Ghee Phua (self-portrait), 2015, oil on canvas, 9 by 12 inches

to use my art as a positive force to address social issues.” During an appointment with his caseworker at the San Francisco AIDS Foundation, Ghee mentioned that he was thinking of painting a series of gay seniors and selling them as a fundraiser. His SFAF caseworker referred him to Vince Crisostomo, the Program Director of the Elizabeth Taylor 50-Plus Network [A&U, September 2016], SFAF’s social support group for men over fifty. Through 50-Plus, Ghee was able to recruit the eleven men

whose portraits make up the series. Like Ghee himself, most of these men—not all—are fellow long-term HIV/ AIDS survivors. Diagnosed as HIV-positive in 1991 at age 21, Ghee took his doctor’s advice six years later and went on fulltime disability in 1997. “I decided then to pursue my passion for art by taking classes at City College of San Francisco. When I moved to New York City with my lover, I also studied at the Art Students League for about a year and a half.” Since returning to

San Francisco, Ghee has continued painting at least a couple of hours every day. “I paint a lot of self-portraits, when no other models are available,” Ghee said. “Painting self-portraits allows me to experiment, to try new techniques.” One of the most striking aspects of these portraits of elders is Ghee’s use of sharp straight lines in each. These lines sometimes seem to be as soft as blades of grass, caressing the subject, like the green lines in the shirt worn by subject Mario Galande or what might be foliage in the background in the portrait of Joel Hoyer. Sometimes, though, they are more like angry red slashes, thumb-nail scratches that draw blood and leave scars on the faces and necks of subjects like Jack Bossard and Richard Jones. Often, the lines criss-cross, forming thorny barbed-wirelike borders between the subject and the background, as in the crossed lines along the shoulders in the portrait of Bartholomew Casimir. Ghee explained to me that his use of these lines developed from observations he made while painting self-portraits. “I was looking at many of the self-portraits that I’ve done over the years, and I noticed that the lines on my face, my wrinkles, especially on my forehead, had changed as I got older, the angles of my face changed. So I started paying more attention to those lines and angles. And I started incorporating sharp straight lines A&U • OCTOBER 2016

A&U Gallery more freely into my portraits. For me, each of those lines is a story, something the model has brought to the sitting, a story that I’m trying to tell.” Those lines fill the backgrounds of these portraits as well. “After thinking of each of those lines as a story I was painting, I realized that our stories don’t exist just inside us. We affect the environment we are in—our stories fill the space around us. So I started using the lines in the backgrounds of the portraits too. They are the stories we bring with us, the stories we share.” For many of the subjects in this series, those lines evoke stories of pain and grief. “I told Ghee when I sat for him, ‘You’re painting my pain,’” said activist Jesús Guillén, who sat for Ghee during the mornings, when his neuropathy strikes at its most vicious. That pain is indeed visible in each portrait— but so are the subjects’ strength and resilience. “I really learned respect for all of the models,” Ghee told me. “I learned that growing older does not mean that a person has nothing to contribute. Painting these portraits reinforced my Asian upbringing in the belief that my elders have a lot of life experiences and wisdom to share. I learned that while the physical aspects of aging are not easy, the attitude of the individual is most important.” If you think you detect the influence of Lucian Freud in these portraits—in their coloration, their angularity, their intensity, their refusal to be “pretty”—you’re not far off the mark. Ghee has listed Freud, along with Egon Schiele and van Gogh, as artists whose work he loves and has been influenced by. Acknowledging that painting is a very meticulous, painstaking process for him, Ghee Mario Galande, August 2015, oil on canvas, 11 by 14 inches

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Jack Bossard, July 2015, oil on canvas, 11 by 14 inches explained why the Portraits of Gay Elders series took three years to complete. Each sitting lasted three hours, and each portrait required at least fifteen sittings, quite a commitment of time and a potentially grueling schedule for both painter and models even with frequent breaks. The men who posed, though, were eager to cooperate with Ghee. “When I first heard about the project, I jumped at the chance to pose for Ghee,” seventy-oneyear-old activist and long-term survivor Harry Breaux said at the March 10 artist’s and models’ reception at Strut. “I know I’m going to go the way a lot of men have gone before me,” he explained. “It’s very important to me to leave something behind. Posing for this portrait was one way for me to do that and, importantly, to represent all those men who didn’t make it here to have their portraits painted.” The respect is mutual. “Given that most of the models are longterm HIV survivors, they are role models for me. I see them living healthy and productive lives as elders with a mostly manageable disease. That gives me hope.” Continuing his love of portraiture with a purpose, Ghee plans a new series of portraits of elder LGBTQ leather folk in San Francisco. The proceeds from the sale of paintings in the Portraits of Elder Gays series are shared equally among the Elizabeth Taylor 50-Plus Network, the model, and the artist; if a painting does not sell, Ghee will give it to the model. Ghee is available for commissioned portrait work. You may contact him at gheephua@gmail.com. Hank Trout edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/ AIDS (diagnosed in 1989), he is a thirty-six-year resident of San Francisco, where he lives with his fiancé Rick. Among other articles that he contributes to A&U, Hank Trout pens the For the Long Run column. Follow him on Twitter @HankTroutWriter.

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ctivism, journalism, advocacy, and novel writing, Tim Murphy’s career has run the gamut of the gay man’s experience from the late twentieth century up until today. AIDS treatment and services is where he got his start in the early nineties, writing for such storied organizations as GMHC and Housing Works. He’s dedicated over twenty years to writing about the HIV/AIDS crisis and LGBT issues from the front lines. His journalism has been featured prominently in Out, The Advocate, POZ, the New York Times, and Condé Nast Traveler. His groundbreaking cover story on PrEP for New York magazine was a finalist for a GLAAD Media Award for outstanding journalism. But Murphy isn’t only a “gay writer,” as evidenced in his skillfully written and highly readable new novel, Christodora (Grove Press). He transcends such labels, writing beautifully of the human condition and on issues that touch many of our lives. Modern-day struggles with addiction, mental illness, as well as the AIDS pandemic, are written about with skill and sensitivity. Recently, Tim took time to speak to me on the phone, answering my questions about

his new book and talking about his long and eventful career as a writer. John Francis Leonard: Christodora is a novel about New York City, in particular its East Village neighborhood, from the eighties on into the near future. What drew you to this neighborhood and why does it have meaning for you, personally? Tim Murphy: I guess a few reasons. The East Village has been the sight of so much bohemia, so much queer life, and so much activism over the decades. The ACT UP meetings actually started at the Cooper Union building. That was where Larry Kramer gave the first speech launching the movement. And then there’s Tompkins Square Park, where Wigstock was originally held. That was a seminal gay cultural event in its time. Then there were certain bars that were gathering places for gay men at the time like Boy Bar, The Boiler Room, and another placed just called The Bar. That was the best place. I spent so much of my time there when I first moved to New York. I always felt that, while the West Village was the “gay mainstream,” the East Village was the the center of alter-

In a New Novel, Writer & Activist Tim Murphy Revisits the Early Days of AIDS by John Francis Leonard

native gay life. It always had a kind of punk or political edge to it. I didn’t actually live in the neighborhood until much later, but I spent a lot of time there. I also associate it with groups like ACT UP, Queer Nation, Read My Lips, and so much queer radicalism of the late eighties and early nineties. Another thing is that when I started the book, I didn’t picture it set in the Christodora building, but in a similar building in the same neighborhood that a friend had lived in. It was maybe a third of the way through the book, that someone reminded me of the riots that took place in Tompkins Square Park in 1988 and how the Christodora was targeted. It made me look twice at the building. I was walking through the park one day, everything snowy and beautiful, and I looked up. I noticed how the building looms over the park like a silent witness, a silent sentinel to the passage of time. The building felt iconic, like it had a Godlike quiet, just silently witnessing these events and holding these lives as they play out for better or for worse. And I just like the name Christodora. It is so beautiful, so mysterious and romantic to me. A&U • OCTOBER 2016

photo by Edwin Pabon

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whom have died. Many of them are still alive and Above: Gays Against Guns protest in Washington, D.C. they’ve struggled, some Opposite page (top): Gays Against Guns honor those having a harder time than individuals killed in the Orlando massacre. others. A lot of them have been living with addicwomen with HIV that I’ve known and I just tion, depression, or both. love them all. There’s the women I worked Then there are financial troubles. There’s with at Housing Works, the aftermath of having where I worked for a the prime of your life while after I left POZ. interrupted by illness For a year and a half and the psychological I was the writer and fear that you’re not communications guy going to live that many for advocacy and activyears, then finding out ism. At Housing Works you are. That’s a real a lot of the clients later mind fuck. There are all became employees and of these layers of human volunteers and every experience that I drew day I worked alongfrom, some closer to me side women like Issy. than others. Wonderful women like Nancy Cotto and Julie We have so much inPeña. And lots more credible fiction and art that I met and interrepresenting the AIDS viewed working at POZ pandemic, but much and going all the way of it from the earlier back to GMHC in the days of the crisis comes early nineties. GMHC from a gay white urban had Lesbian AIDS middle-class male Project…[and] I interviewed Mary Fisher perspective. The central character in the back when I first started writing. From the book that has AIDS is Issy, a Latina. Why beginning I was writing about women with was her perspective as a woman of color HIV and AIDS. so important to you? Then there were the black poz women That character was inspired by so many A&U • OCTOBER 2016

GAG photos by Mark Leydorf

It’s always fascinating when reading fiction to wonder about what it was in the author’s own experience that inspired it. What inspired you to write Christodora? Were there any people in your life who inspired the characters? There’s quite a lot in my life that inspired the novel. I had my own personal struggles with mental illness and with addiction. I myself am HIV-positive. I was diagnosed positive in 2001. So a lot of that interior narrative of what all of that was like for me got played out amongst the different characters. I remember having a manic episode that was very similar to Eva’s in the book. It was very much like that, the rush of thoughts and feelings that escalated beyond my control. Then there are the various addiction narratives in the book. Some are taken from my own experience, some from talking to friends, and the hearing of countless people’s stories over the years as a journalist. Living in New York City for the past twenty-five years as a gay man through the AIDS crisis and all the changes it brought about had a lot of bearing. And there too, as a journalist, because I’ve written about AIDS for so long going back to being a volunteer writer for GMHC in the early nineties all the way through writing about more complicated treatment-related issues as in my writing for POZ Magazine. I still write for POZ sometimes. I came to know so many people through this, some of whom are gone, some of

in the South. The part that was different for them, amongst other things, from gay white urban men was that HIV had no context in their lives. It wasn’t like they knew anyone else who had it, who worked in [the AIDS field]….They just lived in shame and silence and stigma. Then ultimately, they couldn’t stand it anymore; they had to talk and connect, reach out to other women living with it and working in it….Once they found community, they often became very political. Once they saw how people need to agitate for their needs and their rights, they became some very fierce warriors. Issy was inspired by all of these women….I didn’t want to write a story only involving gay white men because that wasn’t my experience as a person, an activist, or a journalist.

book launch photo by Nicole Nyhan for Grove

With your character Hector, you speak to the ramifications of surviving the early days of AIDS. Hector eventually gives up on himself. Hector is a hero in the book, but a very flawed hero. Can you talk a bit about your perspective on “survivor’s guilt”? Did some of your own experiences inform the character? Hector has survivor’s guilt amongst other things. I think that also Hector experiences a delayed reaction to the crisis, to stress, to grief, and to loss. When [his lover] Ricky dies, he throws himself into activism, and then they win. He throws himself into working toward combination therapy and by ’96 they get it. I think that then, after the adrenaline surge ends, he crashes….There’s that time in ’96 where he says “I want out of this, I’m burnt out.” Those are all conditions—stress, trauma, and loss—are all triggers for some kind of addiction, something to medicate and numb….He finds the perfect drug in crystal meth and he becomes addicted. I think he’s broken. He pays a price for his activism and in a way, for not fully pro-

Tim Murphy at the Christodora book launch at Housing Works OCTOBER 2016 • A&U

cessing or feeling the loss of Ricky, Issy, and other friends. I feel like that’s something we’ve seen in gay men for the past twenty years when the epidemic quieted down a little bit. It’s kind of a PTSD, a delayed reaction to grief, to loss, to anger, to unfairness about who lived and who didn’t. I think it’s understandable. There are a lot of gay young men for whom this was never a plague, or never took all of their friends and lovers. Suddenly the survivors are watching them all run around on PrEP having a blast like it’s the late seventies again when they, the survivors, have lived through a war. I think there’s a lot of really understandable grief, anger, and resentment that sometimes is more readily addressed or soothed through drugs than going to support groups or therapy. So Hector, to me, has a kind of PTSD. But I just love him, too. You can never take away from Hector what he accomplished and it was so important to me to show that Hector received compassion just as he gives it early on. What are you working on now? What’s up next for you? I was working on a new book with about a quarter of it finished but got involved in something else. I don’t know if you’ve heard of us, but I suddenly got very involved with Gays Against Guns. I was probably the fourth or fifth person to sign on in New York and since then, the movement has completely engulfed my life. If you simply Google Gays Against Guns and hit “news,” you’ll see the protests and campaigns that

have launched, not only in New York, but all around the country….It’s the three-month anniversary of the Orlando shooting….In just two months we had fully functioning chapters and have launched protests in D.C., L.A., Provincetown, Atlanta, Dallas, Chicago, and Orlando. It’s completely engulfed all our lives. I feel very strongly that the LGBT community should play a role in gun violence prevention. We want to start a fight against the gun lobby that hasn’t existed in that movement yet because it’s been a very polite, inside the beltway movement and we want to bring an ACT UP element of confrontation and anger to it. Do it in a public and theatrical way that hasn’t happened before. It’s very funny to me that the very kind of activism that I talk about in Christodora in a very nostalgic way, that I wish I had been more a part of, is now such a big part of my life. It’s a very tough nut to crack, the gun industry. Sadly, it does better with every massacre as people believe that Obama is going to take away their guns and they rush out and buy more. It’s a very scary cycle. John Francis Leonard writes the column Bright Lights, Small City for A&U.

strides & STRATEGIES TIMOTHY RAY BROWN HAS BEEN CURED OF HIV/AIDS—NOW HE’S COMMITTED TO HELPING FIND CURES FOR EVERYONE by Alina Oswald

photographed exclusively for A&U by Sean Black

uring the last century, scientists have been able to find a cure for a long line of deadly diseases, so many have wondered: When is it going to be HIV’s turn? To borrow a line from a statement defining the Undetectable flash collective [A&U, December 2014]: “Where is the cure?” Or, more pointedly: Where is the affordable, available-to-everyone cure? That’s exactly the question Timothy Ray Brown seeks to answer through his work with the Cure for AIDS Coalition. Until not that long ago, Timothy Ray Brown was only known in research circles and the media as the Berlin Patient, that is, the first (and so far only) known person ever to be cured of HIV. Nowadays, his name rings that proverbial bell throughout the country and the world. Occasionally, some people still call him “the Berlin Patient,” Brown shares with me over the phone. While it doesn’t seem to bother him, he adds, “I wanted to take back my name. I think that that would be the best way to get my story out there. And I think it’s appreciated by researchers, too, that I came out.” Brown is not your usual activist. Or at least, he doesn’t seem to be. He’s soft-spoken, calm. Not necessarily what many might associate with what an activist should or would sound like. And yet, Brown might just be the activist to help us reconsider how we

think in terms of finding a permanent solution (or solutions, as I find out from Brown) to HIV and AIDS. I remember reading about Berlin Patient’s story several years ago. It mentioned an American man living with HIV and leukemia and who underwent a stem cell transplant procedure in Berlin, Germany (hence the name, “the Berlin Patient”), where he was living at the time. But that media narrative might be a very simplistic way of trying to describe Brown’s challenging, and also compelling journey through the hazards of eliminating the virus from his body and, ultimately, to a life free of HIV. Many individuals living with HIV often look at their lives through a before-and-after filter, a transparent, yet impenetrable wall that might allow them to look back, but not go back to a life before an HIV diagnosis. Timothy Ray Brown has gone back to a life before an HIV diagnosis. He’s living proof that breaking that seemingly impenetrable wall is possible, and that going back to an HIV-negative status is, indeed, something that can actually be achieved. The story of Timothy Ray Brown doesn’t start with the Berlin Patient or with his being cured of HIV. His story starts in his native Seattle, Washington, a city that saw its first cases of AIDS in 1982. Two years later, when Brown graduated from high school, Seattle’s A&U • OCTOBER 2016

AIDS cases were in the dozens. Brown went on to take classes at Seattle University, and also, around 1989, joined ACT UP/ Seattle. Then, in 1990, he went on a trip to Europe, where he returned a few months later, and settled in Germany and took a job as a translator. He studied political science in Berlin. It was there, in 1995, that he was diagnosed with HIV. Brown’s diagnosis came at a time of promising changes and medical advances in HIV treatment, when the new medications conferred a Lazarus effect on many of those living with the virus. A few short months after his diagnosis, thanks to those new drugs, Brown’s engagement in HIV treatment became “an inconvenient” (having to take up to fourteen pills a day) but “manageable” task. But the story doesn’t end there; far from it. Fast-forward about ten years later to a time when Brown was diagnosed with acute myeloid leukemia (AML), a cancer that causes bone marrow to make abnormal cells. Right away, Brown started chemotherapy to treat the leukemia, under the care of Dr. Gero Hütter, a hematologist, the doctor whose treatment of Brown would cure him of both leukemia and HIV. Dr. Hütter took Brown’s blood samples and sent some of them to the German Red Cross. His idea was to try curing his patient’s leukemia—and maybe even HIV— by performing a stem cell transplant from a donor with a gene mutation, one that makes someone resistant to HIV infection. HIV attacks the immune system by connecting to and then invading a certain type of immune system cell, called a T cell. Most strains of HIV use a T-cell protein, called CCR5 (or C-C chemokine receptor type 5) as a co-receptor to invade the host cell. Scientists have discovered that some individuals living mainly in northern Europe carry a mutation in their CCR5 gene, called a CCR5-delta32 mutation that, in turn, protects them from getting infected with the strains of HIV using CCR5 protein as an entry door into the host cell. (A class of antiretrovirals called entry inhibitors disrupts this or other coreceptors and proteins.) In order to ensure that he had the best chances to cure his patient of HIV, Dr. Hütter didn’t look just for any kind of stem cell donor, but for a donor with this particular CCR5-delta32 mutation. And he found the right donor, also referred to by experts as “donor #61 homozygous for the CCR5-delta32 deletion.” The procedure was far from a walk in the park. “I’d done a lot of soul searching,” Brown says, recalling his decision to go

ahead with the stem cell transplant procedure. “My leukemia was in remission, and I thought, if it doesn’t come back, I don’t want to [go through with it].” But by the end of 2006, Brown’s leukemia did come back. Shortly after that, it became clear that he was going to have to go through with the stem cell transplant after all. “They took me off the chemo,” Brown says, explaining that that in itself could mean an increased risk of infection. “[Doctors] did a full body radiation, on my body, to [kill] my immune system and prepare me [for the transplant]. “I ended up having a second transplant, because after the first one, the leukemia came back in 2007. [After the second transplant] I went back to work, and I also went [back] to the gym. And I did notice that before the transplant I could not develop muscle; [after the procedure] I was actually able to regain muscle. That was kind of funny. I don’t think there was any discussion about me having a long term remission from HIV or being cured until [after] the second transplant.” Doctors checked their patient thoroughly, looking for traces of HIV anywhere and everywhere in his body, ending up finding none. And still, months after that second transplant, Dr. Hütter and his team were very careful not to use the term “cured,” when referring to their patient, and so they called it “long-term remission” instead. “In fact,” Brown underlines, speaking of Dr. Hütter, “in his paper that he wrote after the second transplant, and that was published in the New England Journal of Medicine, he used the term ‘long term remission.’ And so, actually, I didn’t believe that I was cured until that paper was released.” He laughs. “It took the New England Journal of Medicine [article, for me] to believe [that I was cured of HIV].” Brown shares his amazing story, carefully using scientific and lay terms. Listening to his story, I wonder how it feels to be cured of HIV. “It feels very good not [having] to take the medication for HIV,” Brown says. “Not to worry about that.” He goes on, “I don’t mean to say that it controlled my life, because that was something I’d do every day, I’d take my medications, but it felt very good not to have to do that anymore.” Brown’s answer seems simple, but it’s profound for anyone who has taken antiretrovirals, switched regimens, and worried about viral loads, T-cell counts, and opportunistic infections. Maybe it gives a glimpse into what life would look like for many people, once we have an HIV cure—a sense of relief, breathing room. And that, A&U • OCTOBER 2016

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alone, is amazing. That’s why these days, Brown’s attention is focused on making an HIV cure—or cures—a reality for everybody in need of one. Timothy Ray Brown has been working on strategies to make that possible. In 2012, he founded the Timothy Ray AIDS Foundation. He also cofounded Cure for AIDS Coalition together with Dave Purdy, an HIV/AIDS activist who also serves as the Coalition’s CEO. (Recently, the Timothy Ray AIDS Foundation website has become one and the same with the Cure for AIDS Coalition, cureaidsreport.org.) “Originally we were working under the World AIDS Institute,” Purdy explains. “Then we quickly realized that the missions were different, and that we needed to focus all our attention on a cure for a lot of different reasons. So we thought about starting a foundation, and we’ve since decided to create the Cure for AIDS Coalition.” As mentioned on its website, “The Cure for AIDS Coalition is a first of its kind AIDS organization in the world, a public benefit corporation whose sole mission is to find a cure for HIV and AIDS.…The Cure for AIDS Coalition seeks to unite, educate, raise awareness and advocate for full funding for research for a Cure for AIDS. It will be made up of a network of organizations, corporations, institutions, governments, foundations and individuals all dedicated to the goal of finding a cure for HIV.” Brown has become a tireless advocate, bringing his message as a keynote speaker at conferences, colleges, and foundations, and has been featured in an episode of the HBO documentary, VICE. He went straight to the top to make cure research a priority by writing a letter to President Obama. In his letter, which is posted on the Cure for AIDS Report website, Brown mentions that, since he was cured in 2007, he has “given [his] mind, body and soul over to finding a cure for HIV.” The experience has taken him on a journey not only through being cured of HIV, but also through a more spiritual, transformational journey that, at least in part, turned him into the symbol of hope he is today, not only when it comes to an HIV cure, but also a cure for cancer. It turns out that Brown and Purdy did hear back from (now former) White House AIDS Czar, Douglas Brooks, saying that Brown will be receiving a letter from President Obama. “For the record,” Purdy says, “that’s the first time Timothy [Ray Brown] has actually written a letter like that; actually, anything like that. It’s kind of a big deal for us.” It seems that working together, Brown and Purdy have helped find solutions to problems seemingly impossible to solve. OCTOBER 2016 • A&U

“Working together [scientists, activists, researchers],” Purdy says, “is a very important part of making a cure come to fruition. And thinking outside the box,” he adds. “[Try] everything. And if it doesn’t work out then [try something else]. Don’t give up!” The Coalition offers primers on the need for a cure, research strategies, and the obstacles (scientific, cultural, and political) involved. Researchers are currently looking at two types of cures: a sterilizing cure (in which no trace of HIV can be found in the body, as in Timothy’s case) and a functional cure (in which HIV remains in the body, but the individual no longer has to take HIV meds). Dr. Hütter has tried to replicate the Berlin Patient’s success story with other patients. It did not work out. Doctors in the U.S. have tried similar potential HIV cures, to no avail. There’s the case of the two Boston Patients, who received bone marrow transplants from donors, in 2008 and 2010, respectively. Unlike the Berlin Patient, the Boston Patients received stem cells from donors who were not immune to HIV. Also, the patients were not taken off anti-HIV medications after the transplant procedure. While their doctors, HIV specialists Timothy Henrich and Daniel Kuritzkes, based in Boston, Massachusetts, made the announcement that their patients were free of HIV, they also mentioned that it was too soon to call it a cure. It was too soon. The virus rebounded, months after the patients were taken off their anti-HIV medications. Then there’s the case of the Mississippi toddler. The little girl was started on anti-HIV drugs right after birth, and the child appeared to be virus-free for the following two years. Her pediatrician, Dr. Hannah Gay, at the University of Mississippi Medical Center, in Jackson, Mississippi, later mentioned that HIV must have been dormant in the girl’s body for all those two years. “In general, I think that we’ve learned a lot from when I was a patient, from the Boston Patients [for example],” Brown says. In spite of the setbacks, scientists are not giving up. There are promises, but also obstacles along the way. “I’ve talked with one of the researchers working with a doctor performing these [procedures], and, unfortunately, it’s hard to find recipients,” Brown says. He explains that these procedures could be risky. Meanwhile, patients are doing well on their medications. So, there’s sometimes little incentive for them to enroll in studies, to help find a cure once and for all. “And that’s what we’re trying to do as well,” Purdy adds. “If you look on our Cure AIDS Report website, we listed clinical trials [available across the country and around the world] for people who might be interested.

Because a cure can come from different angles and different parts of the world.” Purdy continues, “It seems like, back in the day, when people were dying [of AIDS-related causes], they were [more willing] to take risks. I think people are [still] willing to take risks [when it comes to participating in clinical trials to possibly find a cure for HIV.] I hope that people realize that the research benefits them.” While some researchers are looking at sterilizing or functional cures, some are focused on preventative vaccines. “At first, I was very pro-cure, since no [preventative] vaccine has been found to be effective a hundred percent,” Brown says. “So, I was kind of for a cure. It would be nice [to have] both. In a way we sort of have a [preventative] vaccination in PrEP. I’m very pro-PrEP. I wish it were around before I became HIV-positive. It would have saved a lot of problems.” Brown says “sort of” because, unlike a vaccination, with its occasional boosters, PrEP is an ongoing daily regimen. Purdy notes, “I guess, arguing about vaccine versus cure, we know that cure gets so much attention, especially from the media. Timothy [Ray Brown] realized that right from the beginning. We actually support all avenues. Interestingly enough, the vaccine [research] group has started to merge somewhat with the cure group. [We] think it’s because they can share knowledge and resources. And they can help each other. Because I think everybody agrees that a vaccine is going to be critical for the long term. Treatment as prevention is critical as well.” Brown tends to believe that the cure strategy involving elimination or derailing of CCR5 protein might be a way to go. “I’m thinking that that’s going to be one of the keys to getting rid of HIV,” he says, while explaining that he’s also open to considering other strategies. “I’m proof that HIV can be cured,” Timothy Ray Brown says. “But we have to find out better ways to do it, because nobody wants to go through what I went through, [but] if you have tested positive, don’t give up! You can do very well on medications.” And, he adds, ever the caring advocate: “Also, and I’m saying this as a former smoker, people living with HIV live a usual lifespan, unless they smoke!” Find out more about Timothy Ray Brown and his work at www.cureaidsreport.org. Alina Oswald is Arts Editor of A&U. An accomplished photographer, she is also the author of Journeys Through Darkness, a biography of artist Kurt Weston. Visit her website at: www.alinaoswald.com.

MJ MILITARY INJUSTICE

Years After Being Wrongly Convicted in an HIV Criminalization Case, Decorated Army Officer Ken Pinkela Is Still Seeking Justice. Now, in an A&U Exclusive, a Key Witness Opens Up About Recanting His Testimony and the Army’s Chief JAG Officer Weighs In for the First Time by Chip Alfred photographed exclusively for A&U by Alina Oswald

ieutenant Colonel Ken Pinkela had an impeccable record in the U.S. Army. The twenty-six-year veteran completed tours of duty in Desert Storm, Desert Shield, Bosnia and Kosovo, and served a stint as the Army’s legislative liaison to the U.S. House of Representatives. Now, he is fighting the toughest battle of his career—seeking acquittal for a crime he insists he didn’t commit. “They went after me because I was gay and I was HIV-positive,” he tells A&U. After a grueling eight-year legal ordeal, Pinkela says, “I lost everything. I was dismissed from the Army. They literally erased me like I never served a day in my life.” Pinkela, forty-nine, has no job, no pension, and no VA benefits. “I don’t even get a flag on my coffin when I die.” Now, he speaks out about all that went wrong with this case and why he’ll never give up trying to make it right. The nightmare began in 2009 when a fellow Army officer, identified by the Army as “C.H.,” told authorities that Pinkela did not disclose to him that he was HIV-positive before they had sex in Pinkela’s Arlington, Virginia, home. According to Pinkela, C.H. also claimed that while he was getting ready for sex by using a douche

hose, Pinkela offered to help him “clean out” and was forceful with the douche hose and made him bleed. Pinkela says C.H.’s story is a bunch of lies. After C.H. came forward, the case languished in the Judge Advocate General (JAG) system for a few years, until Captain Jordan Stapley was assigned to prosecute. Amid the rampant homophobia in the military, Pinkela says Stapley was ruthless in his quest to convict him. “It’s the Army and they had allegations of gay sex.” At trial, the only witness was Elliott Scott Henney, who had a consensual sexual relationship with Pinkela over several months before Pinkela was diagnosed with HIV on July 12, 2006. In an exclusive interview with A&U, Henney, thirty-four, shares the details of how he was tracked down by Stapley and coerced into giving false testimony against Pinkela. Henney says Stapley convinced him Pinkela was a deviant sexual predator, and that because he was HIV-positive, he must be guilty. “Where there’s smoke, there’s fire,” Stapley said. Henney recalls Stapley grilling him about the last time he had sex with Pinkela, ultimately pressuring Henney into saying it might have been 2007, when it was actually before Pinkela’s diagnosis

in 2006. In hindsight, Henney realizes he was a pawn in the Army’s manipulative scheme. Stapley assured him there were several other witnesses testifying against Pinkela, when in fact Henney was the only one. “I thought Stapley was my buddy,” he says with regret. “I was fooled by a con man.” After a week-long trial, Ken Pinkela was convicted on June 30, 2012 of abusive sexual contact, aggravated assault with a means likely to produce death or grievous bodily harm, and reckless endangerment. C.H. testified that Pinkela sexually assaulted him in November 2008 by inserting a metal shower enema into his anus against his will, then engaged in unprotected, consensual anal intercourse with him. On August 11, 2015, Henney wrote to then Secretary of the Army John McHugh, recanting his statements against Pinkela and asking that the case be dropped. In an excerpt from Henney’s letter, he writes: “This entire case is NOT what the United States military represents. This case should have NEVER made it to a courtroom, and the way in which the case was ‘put together’ with deceit and lies, is NOT the way any person, or officer, should ever suffer.” The day after Henney’s letter went A&U • OCTOBER 2016

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public, Pinkela updated a Change.org petition he established in 2014, which to date has garnered nearly 75,000 signatures supporting Pinkela’s request to have his case reviewed by President Obama and the Secretary of the Army. In the revised petition, Pinkela writes, “The prosecution’s only witness has recanted his testimony. He describes being threatened by Army prosecutors, being lied to and says that the prosecution led him in his testimony. This should be reason enough to have my case re-examined and get the charges against me dismissed.” It wasn’t reason enough to get the charges against Pinkela dismissed, but the Army did review the case. On November 4, 2015, the United States Court of Appeals for the Armed Forces (CAAF) set aside and dismissed the reckless endangerment conviction against Pinkela and reduced

the aggravated assault charge to assault and battery. The Court acknowledged that the government failed to prove that “engaging in unprotected anal intercourse while HIV-positive constitutes a means likely to produce death or grievous bodily harm.” The Court also noted the government offered no evidence at trial that “HIV infection was the ‘likely’ result of [LTC Pinkela’s] actions.” Ken Pinkela was sentenced to eleven months in military prison. He served 272 days in the Army prison in Fort Leavenworth, Kansas, and was released in April, 2013. Pinkela maintains that he was the victim of an unjust prosecution. “The Army did no investigation. No CID [Criminal Investigative Command] official was at trial to testify.” No physical evidence was presented at trial that an assault or a sex act of any kind occurred between Pinkela

and C.H. The Army also did not conduct phylogenetic testing, which would determine if C.H. and Pinkela have similar strains of HIV. On August 2, 2016, I started working on this article and sent a certified letter to Secretary of the Army Eric Fanning asking about the current status of the case and about Henney’s allegations of judicial misconduct. About two weeks later, I received a letter from Colonel Walter M. Hudson, Chief of the Army’s Criminal Law Division. The letter states, “On April 11, 2016, CAAF denied Pinkela’s renewed petition for grant of review, concluding his military appeals process.” With that, the Army affirmed that the case is officially closed, but Ken Pinkela isn’t giving up fighting for justice. “I will never stop,” he proclaims. He says he will appeal to Secretary Fanning, the first openly gay leader of any U.S. military service. At this point, only Fanning or President Obama has the authority to upgrade Pinkela’s dismissal so that he can further appeal his case. Fanning has not commented publicly about the Pinkela case and did not respond directly to my request or to Henney’s letter. According to Henney, he and Fanning were acquaintances when Henney was a bartender at the Duplex Diner, a bistro in Washington that Fanning frequented. After Fanning received Henney’s letter, Fanning sent a private message to Henney via Facebook Messenger. He wrote, “Elliott—received your letter today. I’m looking into it. Will get back to you. Best, Eric.” That was the last communication he ever received from Fanning. “It is disappointing that the Secretary of the Army—an openly gay man—would not have enough of an understanding of HIV-related stigma to at least order a review of the case,” remarks Sean Strub, executive director of Sero, a network of people with HIV and allies fighting for freedom from stigma and injustice. “The entire Department of Defense lacks leadA&U • OCTOBER 2016

ership to make their HIV-related policies consistent with contemporary science, so they are stuck with these prosecutions based on stigma and ignorance,” Strub explains. “Elliott Henney’s experience is critical to understanding what happened to Ken and how the Army prosecutor disregarded any real interest in the truth or justice in his handling of the case.” Strub describes the Army’s total disregard of Henney’s recanting as “astonishing and disheartening. With a total absence of physical evidence, Ken’s case is a prime example of how every person living with HIV is just one accusation away from a courtroom.” Ken Pinkela says his experience in the courtroom destroyed his life. “I had a great career and great opportunities,” he reflects. “Now I feel so naïve that the organization that I’ve given my life to could turn its back on me so blatantly.” With no steady source of income since 2012, Ken was forced to sell his Arlington home and move back home to live with his mother in Otisville, a small town in upstate New York. Last month, after a series of applications for public benefits, Pinkela finally qualified for public assistance with New York State’s ADAP (AIDS Drug Assistance Program). He has also secured basic healthcare insurance coverage. But his future isn’t exactly looking bright. “I can’t get a job,” he says. “Nobody wants to hire me at my age with a felony conviction.” He’s angry that he gets nothing from the Army, while his accuser got a sweet deal in exchange for his testimony. Pinkela says C.H. received immunity from being discharged from the Army under Don’t Ask Don’t Tell, which was in effect in 2009 when the case began. Pinkela tells A&U that C.H. receives a regular stipend check from the VA because he is considered a victim of sexual assault. Today, Pinkela often struggles just to get through the day. He has physical wounds, including a combat injury that left him with a metal plate on one side of his face. But it’s the emotional wounds that have taken the greatest toll on him. He suffers from anxiety and depression, which have gone untreated because he can’t afford psychiatric care. He spends a lot of time as an advocate and public speaker combating HIV criminalization and as a volunteer with Sero. His one saving grace is the support of his family and friends. “Their love every day is amazing,” he shares. “They have kept me alive.” I am concluding this article with no conclusions. Instead, I will offer some food for thought and a call to action. AfOCTOBER 2016 • A&U

ter trying for weeks to understand what it’s like to walk in Ken Pinkela’s Army boots, I am left with many more questions than answers. How could a man who devoted his life to serving his country be treated with such disrespect? Why hasn’t the Army responded to Elliott Scott Henney and launched an internal investigation about his allegations of prosecutorial misconduct? And the big question: Where does Eric Fanning stand on all of this? You can’t really stay above the fray, Mr. Secretary. It is your duty to do something, say something to address this injustice. No military service member should ever have to endure what Ken

Pinkela has been through. “I have lost the freedom which I fought to defend for nearly three decades,” Pinkela declares. “I want it back. I want my life back.” For more information: http://seroproject.com/; http://justiceforkenpinkela.blogspot.com/; and www.change.org/p/secretary-of-the-army-eric-fanning-review-an-innocent-soldier-s-wrongful-conviction. Chip Alfred, Editor at Large, is the author of Positive Justice, an A&U column about HIV criminalization reform. If you have a story idea or suggestion, please contact Chip at chip.alfred@ gmail.com.

PrEP Math by

PrEP

(pre-exposure prophylaxis) is fairly new, but the HIV prevention tool is not yet having a huge impact on public health. According to the CDC, one in three primary care physicians (PCPs) and nurses have not heard of PrEP. Adding to the slow uptake is the fact more clarity is needed about who might be a candidate for PrEP and what increased coverage of PrEP might mean for our comprehensive HIV prevention efforts. A new mathematical-modeling study, “Impact of the Centers for Disease Control’s HIV Preexposure Prophylaxis Guidelines for Men Who Have Sex With Men in the United States,” by Jenness et al and published recently in The Journal of Infectious Diseases, provides insight into the potential impact of PrEP among sexually active gay and bisexual men, and other men who have sex with men (MSM). Researchers assessed impact in relation to numbers of infections averted and the number needed to treat based on the behavioral indications of the CDC’s PrEP guidelines and the scaling-up of coverage. The results show that one-third of new infections in the U.S. could be prevented among MSM over the next ten years, with forty-percent PrEP coverage among at-risk individuals and sixty-two percent adherence. The study also showed that increased coverage and adherence together increases the percentage of infections averted. The number needed to treat, however, is only reduced through better adherence. The open-access article, which includes many more intricacies than can be covered here, concludes: “Implementation of CDC PrEP guidelines would result in strong and sustained reductions in HIV incidence among MSM in the United States.” These guidelines, which cover other population categories, such as heterosexuals and injection-drug users, define “substantial risk” for MSM as recent condomless anal sex (receptive or insertive) with a partner whose HIV serostatus is unknown within or outside of a monogamous relationship, or anal sex, with condoms or condomless, in an ongoing serodifferent relationship. Notes Samuel M. Jenness, PhD, Department of Epidemiology, Emory University, “It

Chael Needle

a study forecasts the difference a new prevention tool might make

seems like those who are [prescribing PrEP] have a number of different interpretations of who among their patient population, or client population, is going to be the best candidate for PrEP. And so that was really the motivation for the CDC and Health Services for releasing the clinical practice guidelines for how risk assessment should be conducted and how patients should be managed in terms of getting on PrEP, if there are indications for it. Our study was the first to date that looked at the future impact of HIV incidence and the number of infections that we can avert, or prevent, over the next decade if clinicians followed those guidelines. “We were specifically interested in the individual behaviorial components of those guidelines [analyzed through different scenarios involving monogamy and non-monogamy, and serodiscordancy]....So, our paper looked at the individual implications of how the behaviorial guidelines could be tied into PrEP indications and, if clinicians followed them, what sort of HIV prevention impact could be made.” Dr. Jenness and his team assessed how those guidelines might be interpreted in clinical practice, realizing that some interpretations might depart from a literal assessment and seeking “to understand whether there would be a differential impact of interpreting them one way versus the other.” He continues: “We saw some differences...[but] at the end of the day, we’re talking about a relatively small difference if they interpreted them literally or more realistically. “The main finding coming out of the study is that we can prevent up to a third of infections if the guidelines are followed. If they were interpreted in a different way that might fall down to roughly twenty percent, so it’s not a major difference,” he notes. As for whether, based on the CDC guidelines, PrEP would have a substantial impact, Dr. Jenness notes: “I think you could take it in either direction because, on the one hand, a third of new infections prevented would be a substantial gain, and drive the incidence down among MSM in quite a significant way, but, on the other hand, that means there are two-thirds of infections that are still going on....We know that somewhere around five to ten percent of men who are indicated [for PrEP] currently are using PrEP, and so that’s going to require significant scaled-up efforts

to close that gap between current use and what we’re using as our base scenario in the model. So, there’s been some discussion about whether there should be supplemental targeting techniques on top of the CDC guidelines and we’re interested in that too,” he says about the substance of a planned follow-up study “to understand ways that we might use other features of gay and bisexual men’s sexual risk histories or other sexual network charcteristics to identify other high-risk men who would be good candidates for PrEP but that aren’t being adequately identified under the current guidelines.” Dr. Jenness explains: “Currently the guidelines are focused on very specific anal intercourse acts and the types of partnerships that those occur in and the motivation for that is to cast a wide net to incorporate men who exhibit some of those risk behaviors. Still at the same time [assessments] may be missing out on broader community and partnership-level risk factors that aren’t captured at that individual level. Sexual trauma [as you mentioned] might be one of them. Demographics might be another. “We know that, for example, black men who have sex with men have a much higher risk of becoming infected compared to white men, and, although our study didn’t look at the racial disparities in PrEP uptake or do projections by race, there might be some utility down the road of doing supplemental targeting for populations or subgroups that have known higher incidence to begin with, regardless of whether they are exhibiting these particular behavioral indications.” Says Dr. Jenness about the article: “The key target group that we’re aiming for here is people who are working on designing PrEP scale-up programs because that’s for both clinicians and community members, MSM, who would benefit from PrEP, public health agencies, other AIDS service organizations who need to make decisions about how PrEP fits into their comprehensive HIV prevention plan. It’s very expensive and there’s a whole mix of coverage actions in terms of insurance and payment, and it’s not always the right choice for every man and he needs to make decisions about whether it is for himself.” Chael Needle wrote about the UN’s recent political declaration on HIV/AIDS in the July issue. A&U • OCTOBER 2016

edition 26

5-11 oct. 2016

Main event 9 oct. BBcM.org

lifeguide

Spectrum Analysis

he recent spread of emerging pandemic viruses such as Zika and Ebola has increased the urgency for the discovery and development of new antiviral agents. In the past, drug development has utilized the one drug-one pathogen model where for every virus a specific drug or drugs were developed. Researchers are now looking at a new model of drug development where drugs called broad spectrum antivirals (BSA) could be used to treat numerous viruses. BSAs are an issue that I touched on in a previous edition of Destination: Cure called One Drug, Many Possibilities [A&U, December 2015], which focused on one specific BSA, AR-12. In this two-part series, we’ll take a deeper look at BSAs and their broader application. In next month’s Part II, we’ll explore how BSAs work. But first let’s look at why they’re important. BSAs are drugs that can be used for the treatment of several different viruses at once. Unlike current ARVs that are designed specifically to work against one virus such as HIV or hepatitis C by targeting steps of the viral replication process, BSAs utilize common cellular factors and pathways that numerous viruses use. This would allow them to prevent viruses from taking hold, with little to no risk of the development of drug resistance. In addition to a higher barrier to drug resistance, BSAs would be beneficial in numerous ways. BSAs could be kept on hand, particularly in areas where viral outbreaks are more likely to occur, and quickly administered for fast, effective treatment of a wide range of viruses and genotypes. Early treatment would reduce the occurrence of viral transmission from one person to another, and could prevent a widespread outbreak from occurring. BSAs would also reduce the complexity of antiviral regimens where drug-drug interactions can occur. History is fraught with viral outbreaks that led to epidemics/pandemics that claimed the lives of hundreds of millions of people. Whether new pandemics will occur has never been in question: It’s simply a matter of when and how severe. In 1918–1919, an especially virulent

strain of influenza caused a catastrophic loss of life across the globe. Approximately 500 million people were infected with this strain of flu, most commonly known as the “Spanish Flu.” Estimates of the number of deaths range from 50–100 million individuals or three to five percent of the world’s population. Two of my great-grandparents were among those who died. The bubonic plague, or the “Black Death,” occurred from 1347 to 1351, killing at least 75 million of the world’s population of 450 million. Less deadly but more recent pandemic viruses include the H1N1 flu which claimed between 151,700 and 575,400 lives worldwide and 12,469 deaths in the U.S. between April 2009 and April 2010; a virus identified in the Far East killed approximately 69,800 people in the United States from September 1957 to March 1958 and the Ebola virus which caused the deaths of 11,316 people. HIV/AIDS has been responsible for the deaths of 35 million individuals since the beginning of the pandemic. Each year approximately 55,000 people in the United States die of the flu. Most recently, the Zika virus has generated fear throughout 70 countries and territories. Although no one who has been infected with Zika has died, the virus is strongly linked to microcephaly, which causes severe birth defects. As of this week in the U.S., 580 pregnant women have been diagnosed with Zika with a total of sixteen total liveborn infants with birth defects and five pregnancy losses with birth defects. With each viral outbreak, new funding must be found to research and develop treatments and vaccines. In 2009, Congress approved $1.85 billion to combat influenza, in 2014, $5.4 billion was provided to stop Ebola, and President Obama requested $1.9 billion dollars from Congress to combat Zika, the large majority of which

has yet to be approved. In such cases, funding is taken from other initiatives. New viral outbreaks can have a severe effect on other priorities such as HIV. A report by the United Nations Development Programme (UNDP) Global Fund Partnership team, found the Ebola epidemic in Sierra Leone had virtually halted national HIV efforts with many people having to stop their ARVs due to problems in the supply chain, caused by a redirection of resources such as transportation and manpower. New and emerging pandemics are consistently on the horizon. There is little ammunition to combat these viral outbreaks and prevent viruses from turning into epidemics or pandemics. The development and availability of broad spectrum antivirals, would allow us to quickly save lives and prevent new or reoccurring outbreaks from becoming deadly epidemics or pandemics such as those described above. In next month’s column, we’ll take a deeper look at how BSAs work and explore the moral aspects of the political and pharmaceutical support of this new class of drugs. Jeannie Wraight is the former editor-in-chief and co-founder of HIV and HCV Haven (www. hivhaven.com) and a blogger and writer for TheBody.com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in New York City. A&U • OCTOBER 2016

illustration by Timothy J. Haines

broad spectrum antivirals shift the drug model paradigm, part 1

E R U T L U C S THE

AID OF

BOOKS The Angel of History by Rabih Alameddine Atlantic Monthly Press

e are all haunted by our pasts to some degree, carry our sins and our demons on our backs. In Rabih Alameddine’s new book, The Angel of History, the protagonist, Jacob, not only carries that heavy load, he is squired through a turbulent and troubled life by Satan himself: “…Satan had made a bed in my ear and slept in it, and Satan said, This is not possession, if it were, you would do what I tell you and not refuse my counsel….” This is not your mother’s Satan, however. He’s a sartorially splendid, witty yet wicked man of sophistication. Jacob is a pet project of his and he’s determined to guide him through the turbulent waters of his life. He calls on his conspirator, Death, as well as a host of Saints to achieve this end. Jacob turns up one evening at a San Francisco psychiatric emergency room, out of mental and emotional exhaustion and hoping for admission for a threedays’ rest. He’s ready to end his non-stop conversation with the omnipresent Satan, who’s always whispering in his ear. He is literally exhausted by the AIDS-related deaths of his closest friends and the man he loves during the height of the pandemic in San Francisco: “AIDS was a river with no bed that ran soundlessly and inexorably through my life, flooded everything, drowned all I knew….” Jacob was born illegitimately to a Yemeni maid in a wealthy Beirut household and raised wandering Yemen, in a Cairo whorehouse, at a Lebanese Catholic boarding school, and finally landing in the City JULY 2016 •2016 A&U• A&U OCTOBER

by the Bay as an adult gay man: “…But each time you bid farewell to a place, voracious flesh-eating fish swim up from your depths, vultures circle your skies, and your city’s dead quiver with fury in their graves and bang on their coffins….” Jacob’s history is told from the perspective of this one desperate evening at the clinic. Satan’s interviews with the Saints that have also guided Jacob’s life give much insight into his character. Jacob’s own journals tell the tales of a painful childhood capped by the horrors of a modern-day plague which takes many of the men he loves. Jacob is a struggling poet and writer and his wonderful and unique short stories provide another perspective of his unique view of the world and lend more credence to the creative powers of Alameddine, who was a National Book Award finalist for An Unnecessary Woman. Alameddine’s greatest strength is his euphonious and lyrical prose. It reads like poetry, every word selected with a jeweler’s precision. The words have a rhythm and flow beautifully from the author’s creative and agile mind. The author’s signature erudition is displayed beautifully here with classical, religious, and artistic references that serve to inform and illustrate, and are never pedantic. All of these skilled devices serve to bring us a compelling tale of a complex man’s inner life and the loss and grief brought about by the AIDS crisis at its height. —John Francis Leonard

Gay Gotham Art and Underground Culture in New York by Donald Albrecht, with Stephen Vider Skira Rizzoli

onfession: I dearly love ex hibit-specific museum books. By their weight and heft, they promise hours of poring over exquisitely reproduced photographs and artwork, accompanied by insightful, contextualizing commentary. Thus, when

Gay Gotham: Art and Underground Culture in New York arrived in my mailbox—with Cecil Beaton’s 1969 photo of Andy Warhol and Candy Darling on the cover—I immediately wanted to immerse myself in it. The book does not disappoint. Produced by the Museum of the City of New York to accompany the exhibit of the same name, which runs through March 2017, Gay Gotham is a stimulating survey of LGBTQ artists who sought and found freedom, support, and inspiration in New York City during the twentieth century. Arranged chronologically, beginning with the laissez-faire bohemianism of Greenwich Village and Harlem in the 1910s and ’20s, through the more circumspect mid-century, to the post-Stonewall days of liberation and the sobering impact of the AIDS crisis on the arts, Gay Gotham explores the role of diverse LGBTQ theater, art, and literary communities in shaping twentieth-century art. The big-name heavy hitters are all represented, of course—Cadmus, Lynes, Beaton, Baldwin, Bernstein, Thompson, Stein, Warhol, Mapplethorpe, Haring—but the book is at its best when it introduces us to the less well-known, like Richard Bruce Nugent, a gay African-American artist, writer, and actor who figured prominently in the Harlem Renaissance, and transgender artist Greer Lankton. The text, by Donald Albrecht (the MCNY curator) and Stephen Vider, provides chronological and cultural context for appreciating the more than 350 images in the book. The text can seem a bit superficial in places, particularly in the too-brief references to the devastating impact of AIDS on the New York City arts scene, but that may be the inescapable fault of any survey of this scope. Besides, the sheer number and quality of the images reproduced more than compensate for the text’s shortcomings. The 1986 Mapplethorpe portrait of Warhol reproduced here would by itself justify the price of the book. —Hank Trout

ollywood Dine and Dish III lets you step up to the plate to support the much-needed food voucher program at AIDS Assistance Program–Food Samaritans (AAP). The event holds a lot in store—Tony nominee Sharon McNight, actor and comedian Alec Mapa [A&U, May 2011], and Emmy-winning comedy writer Bruce Vilanch [A&U, August 1998] will serve up saucy secrets of Hollywood stars. That’s the “dish” part. The “dine” includes hors d’oeuvres, premium cocktails, and an exquisite dinner. Created by producer and award-winning Hollywood photographer Michael Childers, who

continues to present the fun-filled evening, the event promises lots of laughter and love. Emmy-winnier Michael Corbett (Extra) will serve as master of ceremonies. As the AIDS Assistance Program of Palm Springs receives no federal or state funding, the non-profit relies on donations and events like this one to provide food-voucher services to 500 clients twice per month. It also has a waiting list and AAP would love to expand its capacity to make sure the residents of Coachella Valley living with HIV/AIDS and other chronic illnesses do not suffer from food insecurity. Date: October 29; time: 7 p.m.; location: a private estate in Palm Springs, California (address will be given upon RSVP); tickets: $500 (per person), $750 (per couple). For more information and to purchase tickets, contact the organization by phone at (760) 325-8481 or visit aidsassistance.org.

Clockwise, from top left: Bruce Vilanch, Sharon McNight, Michael Corbett, and Michael Childers

FILM Wilhemina’s War Directed by June Cross Secret Daughters Productions

hen we hear the words “woman warrior,” Joan of Arc or Boudicca comes to mind. We don’t necessarily think of a grandmother living in rural South Carolina. And that would be our mistake. Wilhemina Dixon, the subject of June Cross’s documentary Wilhemina’s War, is a sharecropper’s daughter. She does odd jobs like weeding, picking peas, and taking care of people’s cattle. She is also the primary caregiver for her fifteen-year-old HIV-positive granddaughter Dayshal. Although Mina has others dependent on her—a husband with cancer and a mother with Alzheimer’s disease—Dayshal is her main concern. She has mostly home-schooled the girl to protect her from bullying. She has educated herself about the disease, speaking out about it whenever possible and even organizing a local HIV-testing event. For Mina, the banner

she’s carrying into battle is a very simple, very personal one: “AIDS is in my family.” Dayshal was born with the virus. Her mother, Toni, is an individual with substance abuse problems dying of AIDS-related complications. “If it wasn’t for the Lord and my grandma, I don’t know what I would do in this life,” the teenager admits. “I call Mina ‘Mother’ because she raised me. My mama, Toni, I don’t feel comfortable calling her ‘Mother’ because she never did nothing for me.” Mina speaks matter-of-factly about the situation, saying that she hopes that her granddaughter never has children because she, Mina, won’t be there to help her with them. The film brings home the fact that AIDS is “killing African-American women in numbers you would not believe,” says Shernell “Toni” Sells of the South Carolina HIV/AIDS Council. In 2009, AIDS was listed as the leading cause of death among young black women. South Carolina ranks No. 1 in the U.S. in terms of heterosexual transmission, which makes its cutting of funds for HIV/ AIDS programs all the more unbelievable. Cross weaves all of this into Mina and Dayshal’s story. She also makes use of some

vintage photos and animation. The photos work—the animation doesn’t. Still, the latter plays a very small part in a film that hits you in the gut and leaves you questioning a state government that’s doing nothing…or less than nothing…for its HIV/AIDS population. —T.J. Banks John Francis Leonard writes the column Bright Lights, Small City for A&U. Hank Trout writes the column For the Long Run for A&U. T.J. Banks is the author of Sketch People, A Time for Shadows, Catsong, Houdini, and other books. Catsong was the winner of the 2007 Merial Human-Animal Bond Award. A&U • OCTOBER 2016

photo of M. Childers by Michael Childers; all other photos courtesy AIDS Assistance Program

A Calendar of Events

OCTOBER 2016 â&#x20AC;¢ A&U

Survival Guide

[a portrait by sean black]

Davina Conner

““Being a Black woman with HIV has helped me to realize that life is too short to not be happy. If those close to me can see the world through my eyes they would understand. We must love, inspire and make others smile—smiling brings light to so, so many. If we advocate for change, we must advocate for all so I say: Live well and Happy Day!” Davina Conner, aka Pozitively Dee, is an HIV advocate, speaker, radio personality for blog talk radio, and motivator diagnosed with HIV in 1997. Sean Black is a Senior Editor of A&U. 48

A&U • OCTOBER 2016

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