A&U February 2014 by A&U: America's AIDS Magazine

FEBRUARY 2014 • ISSUE 232 • AMERICA’S AIDS MAGAZINE

HIV EQUAL WANTS YOU TO PERSONALIZE YOUR STATUS

A NEW DOC CHAMPIONS ADVOCACY & ABILITY

KHAFRE KUJICHAGULIA ABIF OFFERS AIDS-AWARE AFFIRMATIONS

HIV ERADICATION STRATEGIES: WHAT’S THE LATEST RESEARCH?

phill philL

WILSON

THE STATE OF AIDS IN BLACK AMERICA

plus

Actor Erik Stein • Artist Carmine Santaniello • Essay by Amy Peters

AIDS WALK

LOS ANGELES OCT. 13, 2013 A fundraising walk starting and ending in West Hollywood Benefiting

and more than 20 other L.A. County AIDS service organizations.

aidswalk.net

213.201.WALK Text WALKLA to 292929 to register! A Special Thank You to

A&U Magazine

AIDSWalkLA

Created and produced by MZA Events. AIDS Walk Founder/Producer: Craig R. Miller. ÂŠ MZA Events, 2013

c o n t e n t s February 2014

34 Cover Phill Wilson, AIDS Advocate & Black AIDS Institute Founder & CEO, Talks with A&U’s Sean Black About Getting Strategic About Protecting the Health of Black Communities

Departments

Features 26 Gallery Artist Carmine Santaniello Promotes AIDS Awareness & Playing Smart 40 The Fierce Language of Self-Determination In a New Anthology of Poems, Prayers & Affirmations, Khafre Kujichagulia Abif Gathers Words to Live By 44 Status: Equal HIV Equal, a New Campaign Helmed by Thomas Evans & Jack Mackenroth, Thinks Outside of the Serostatus Box 48 A Walk to Remember Walk On Highlights the Empowerment Forged by Perseverance 50 Nonfiction Next Season by Karin McKie cover by Sean Black

Frontdesk

Mailbox

NewsBreak

Ruby’s Rap

Erik Stein

viewfinder 15

Essay

First Generation

Just*in Time

lifeguide 52

Treatment Horizons

Hep Talk

My Turn

The Culture of AIDS

Lifelines

Survival Guide

A&U Frontdesk

Silent Movie

ilms have played a large part in the history of AIDS—from the seminal Longtime Companion (1989) to Philadelphia (1993) to this year’s Oscar favorite, Dallas Buyers Club (released in 2013), Hollywood has made movie magic out of an oftentimes ignored and even silent epidemic. Certainly famous film directors have played an important part in the evolution of this magazine—Mike Nichols, Ismail Merchant, and Peter Hall are just a few who have spoken to A&U about their personal relationship to the AIDS pandemic. And dozens of film actors from the A-list have graced our cover as well (Elizabeth Taylor, Dustin Hoffman, Shirley MacLaine, Ann Magnuson, Rita Moreno, and Queen Latifah are some of my favorite A&U interviews). As you can tell, the movies are in our blood. But when a movie’s stars seem to overlook the obviously right moment to connect to the audience about a disease that has killed nearly a million Americans, then it’s time to become a film critic rather than just a fan/editor. In their acceptance speeches at the 71st Golden Globe Awards last month, both stars of Dallas Buyers Club—Matthew McConaughey and Jared Leto—failed to mention the disease (or those living with it) that inspired their well-awarded performances. Maybe it was assumed all Americans know what a buyers club is. (I doubt it.) Or that AIDS doesn’t need to be brought up in the first place because Hollywood is, after all, a community of actors who have already lost so many colleagues to AIDS. But that’s not my point in discussing the omission of the words “AIDS” or “HIV” in front of a global audience of millions. Granted we don’t expect our actors to discuss the plot lines of the movies they win for. But we do hope that the subject matter of a film so important to the HIV community might elicit a few words of support for those still fighting for their lives. If you were a director wouldn’t you mention the Vietnam War if you had just won for Platoon? (Oliver Stone did.) Wouldn’t you mention the fight against terrorism if you had just won for Zero Dark Thirty? (Jessica Chastain did.) It just goes to underscore how “AIDS” today is being written out of the script of our lives.

A M E R I C A’ S A I D S M A G A Z I N E issue 232 vol. 23 no. 2 February 2014 editorial offices: (518) 426-9010 fax: (518) 436-5354

But it wasn’t always so. In his acceptance speech for Philadelphia, Denzel Washington wasn’t afraid of the word. How come McConaughey or Leto are so disconnected from their roles that it didn’t dawn on them to talk about it at the podium? That’s why it pleases me that Phill Wilson, founder and CEO of the L.A.-based Black AIDS Institute, is gracing our cover this month—as a longtime activist, he has been a steadfast voice in our national, and now global, dialogue about HIV/AIDS. Wilson has led the charge in bringing attention to how AIDS impacts Black communities. Importantly, the Institute isn’t interested in being the single voice; through such initiatives as the Black Treatment Advocates Network, the organization actively nurtures advocates who can communicate the importance of testing and treatment to the people with whom they engage. This aim is shared by campaigns such as HIV Equal, featured in this issue. HIV Equal seeks to destigmatize disclosure by reminding us that we all have a serostatus and that we are all more than our serostatuses. Artist Carmine Santaniello, featured in this month’s Gallery, is helping to get the word out about prevention as a participant in Visual AIDS’ Play Smart series of HIV-basics trading cards. Also featured is an interview with Khafre Kujichagulia Abif, an advocate who has edited a new 600-page anthology of poems, essays, and affirmations—I hope these hundreds of voices will inspire thousands of readers to raise awareness. There is still hope for McConaughey and Leto. Both of them are nominated for the highest honor of entertainment awards— the Oscar. If they get another chance to talk about a disease that still afflicts tens of millions around the globe, I simply ask of them to give a shout out to those living with the virus as well as to their families, loved ones, and even those who haven’t spoken the word “AIDS” lately. It would help amplify the struggles and triumphs of living with HIV/ AIDS that we and others experience “offscreen,” away from the klieg lights.

DAVID WAGGONER

Editor in Chief & Publisher David Waggoner Managing Editor: Michael Needle Senior Editor: Dann Dulin Editors at Large: Chip Alfred, Sean Black Special Projects Editor: Lester Strong Literary Editor: Brent Calderwood Consulting Editor: Nick Steele Copy Editor: Maureen Hunter Contributing Editors: Sarah Churchill Downes, Reed Massengill, Kelly McQuain, Lesléa Newman, Robert E. Penn Contributing Writers: Noël Alumit, V. Anderson, Annie Buckley, Larry Buhl, Ruby Comer, Nancy Ellegate, LaMont “Montee” Evans, Diane Goettel, Sally Hessney, Angela Leroux-Lindsey, Sherri Lewis, Alina Oswald, Mark Rebernik, Dale Reynolds, Elizabeth Rodgers, Mariel Selbovitz, Justin B. Terry-Smith, Patricia Nell Warren, Chuck Willman, Jeannie Wraight Art Director: Timothy J. Haines Contributing Photographers: Jordan Ancel, Davidd Batalon, Mark Bennington, Tom Bianchi, Sean Black, Adam Bouska, Brian Bowen Smith, Fred Brashear, Jr., Tim Courtney, Stephen Churchill Downes, Greg Gorman, Francis Hills, Renée Jacobs, 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 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. ©2014 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

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A&U Mailbox

“I was really impressed by George Takei’s comments about the internment of Japanese-Americans during World War II. It was really criminal what happened to them. Their Constitutional rights were taken away from them and they were basically sent to prison. A different but no less urgent type of abuse is happening to those living with HIV/ AIDS who find themselves oppressed by our laws.”

Talkin’ ’Bout My Generation

Sulu was interesting in that greatest sci-fi TV program of all time, Star Trek. Now he is interesting as George Takei here on earth [cover story, “Helming Allegiance,” by Dann Dulin, December 2013]. Boy, this man is very smart and intelligent. Referring to kids, parents and AIDS, he says, “‘Oh those boring people, always lecturing—my parents, grandparents, my uncle…I’m invincible. I’m immortal. I won’t get AIDS.’ The attitude of young people is the barrier. It’s very difficult to connect with them. I know, I was one of them.” So, can we save kids from themselves? How do we connect with them? —Larry Quintero St. Petersburg, Florida

Fabulous interview with Ari Gold in A&U Magazine [Ruby’s Rap, December 2013]. You brought out his spirit and humanity; as a fan of Sir Ari Gold, I thank you for that. He is my hero, as a human being, as an artist, and a musician and songwriter; and for using his creativity, humanity and spirit to inspire strength and courage. Again, I thank you for your fabulous interview. —Michael Geneva Lakewood, Ohio

I was really impressed by George Takei’s comments about the internment of Japanese-Americans during World War II. It was really criminal what happened to them. Their Constitutional rights were taken away from them and they were basically sent to prison. A different but no less urgent type of abuse is happening to those living with HIV/AIDS who find themselves oppressed by our laws. —Mary Rozarro Evansville, Indiana

Your profiles of two great musicians and singers, Ari Gold and Levi Kreis [“Playing to Strengths,” by Chael Needle, December 2013], were very touching. Both of them made some interesting comments. Ari said, in part, “We are now all survivors whether or not we are living with [HIV] in our bodies. The generation that did not see their friends die has no idea how their lives have been affected by AIDS.” Levi’s comment on AIDS was: “From a personal standpoint, I would inspire all of us in that position to do the work internally, to make a concerted effort to affirm and love who we are, and to realize that our biggest challenge sometimes is our biggest ministry to the world.” Each

singer has such wisdom about the past and the present. Such wonderful comments. —Lou Anne Ferringer New York, New York

Swing Out Sister Reading your article, “Sister Act” [by Larry Buhl, December 2013] I found the statistics very sobering; that twenty-five percent of new cases in the United States of AIDS are in women, and that fifty-percent of cases of HIV infection are in women of child-bearing age. Our country and other countries need to do a lot more about HIV and AIDS. Let’s stop treating women as second-class citizens. —Marge Farrantino Baton Rouge, Louisiana

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.

A&U • FEBRUARY 2014

photo by Adam Bouska

The Final Frontier

NEWSBREAK

photo courtesy The Imperial Court of New York

Night of a Thousand Gowns If you have ever wanted to be received at court, the 28th Annual Night of a Thousand Gowns, taking place from 6 p.m. to midnight on March 29, is your chance to become a part of the royal “we.” Presented by Their Most Imperial Sovereign Majesties Emperor XXII Wen-D Bouvier Pinkhouse and Empress XXVII Gracie Steeles and the membership of the Imperial Court of New York, the benefit event invites participants to indulge in a majestic realm where compassion and community service rule the day. The Imperial Court of New York, a 501(c)3 not-for-profit, has a long track record of raising funds for the LGBT community, HIV/AIDS services organizations, social service organizations, and youth enrichment programs. It has raised over $2 million since its reign began in 1986. Creative formal, black tie festive, or dress uniform—whatever attire you choose, the Times Square charity ball is a glamourous chance to raise funds for the True Colors Fund, an organization devoted to ending homelessness among LGBT youth, and God’s Love We Deliver, a New York City-based non-profit that provides meal delivery and other nutrition services for individuals living with HIV/AIDS and other life-altering illnesses. God’s Love We Deliver has been working extra-hard this season as New York City has been hit with more than one snowstorm. Stephen Covello, Major Gifts Officer at God’s Love We Deliver, shares: “The Imperial Court has long been a dear friend and strong supporter of God’s Love We Deliver. In the more than two decades we have been working together, The Imperial Court has made a tremendous difference in not only our community, for those too sick to shop or cook for themselves, but the larger community as a whole in the NYC area. We deeply appreciate the support The Court has given God’s Love, through their volunteerism, their fundraising, their publicity, their amazing Night of a Thousand Gowns and their friendship. Every year we have been a beneficiary, it has been such an honor,” said Stephen Covello. “Our Thanksgiving and Winter Feast celebrations would not be the same without the Court presiding at our doors, welcoming volunteers. Over the course of our history together, the Court’s financial contributions have made a tremendous impact on our operations, helping us cook and deliver more meals, each year, with their help to those in the NYC metropolitan area who are too sick to shop or cook for themselves. Every year we stand by the Court and watch them support our organization and others, who need visibility, funds and love from such a Emperor XXII Wen-D Bouvier Pinkhouse and great group of people.” Empress XXVII Gracie Steeles The event will honor activist Edith Windsor; Cyndi Lauper [A&U, June 2010], Joan Rivers [A&U, October 1996], and Marsha Mason will act as honorary chairs. Martha Reeves, Exposé, and the cast of Pippin will perform. For more information, log on to www.icny.org and www.glwd.org.

World of Chocolate AIDS Foundation of Chicago (AFC) knows how to spice up a winter night, with chocolate both savory and sweet, cold and hot. World of Chocolate, an annual holiday celebration to mark World AIDS Day, brought together 1,200 guests and more than thirty of FEBRUARY 2014 • A&U

What is STRIBILD? STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. It combines 4 medicines into 1 pill to be taken once a day with food. STRIBILD is a complete single-tablet regimen and should not be used with other HIV-1 medicines. STRIBILD does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking STRIBILD. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about STRIBILD? STRIBILD can cause serious side effects: • Build-up 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 (not normal) 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 (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions.

• Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking STRIBILD, your hepatitis may suddenly get worse. Do not stop taking STRIBILD without first talking to your healthcare provider, as they will need to monitor your health. STRIBILD is not approved for the treatment of HBV. Who should not take STRIBILD? Do not take STRIBILD if you: • Take a medicine that contains: alfuzosin, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, pimozide, sildenafil when used for lung problems (Revatio®), triazolam, oral midazolam, rifampin or the herb St. John’s wort. • For a list of brand names for these medicines, please see the Brief Summary on the following pages. • Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera®). What are the other possible side effects of STRIBILD? Serious side effects of STRIBILD may also include: • New or worse kidney problems, including kidney failure. Your healthcare provider should do regular blood and urine tests to check your kidneys before and during treatment with STRIBILD. If you develop kidney problems, your healthcare provider may tell you to stop taking STRIBILD. • Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. • Changes in body fat can happen in people taking HIV-1 medicines. • Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking STRIBILD. The most common side effects of STRIBILD include nausea and diarrhea. Tell your healthcare provider if you have any side effects that bother you or don’t go away.

What should I tell my healthcare provider before taking STRIBILD? • All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, bone, or liver problems, including hepatitis virus infection. • All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking STRIBILD without first talking with your healthcare provider. • If you take hormone-based birth control (pills, patches, rings, shots, etc). • If you take antacids. Take antacids at least 2 hours before or after you take STRIBILD. • If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in STRIBILD can pass into breast milk, and it is not known if this can harm the baby. 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 Brief Summary of full Prescribing Information with important warnings on the following pages.

STRIBILD is a prescription medicine used as a complete single-tablet regimen to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD does not cure HIV-1 or AIDS.

I started my personal revolution Talk to your healthcare provider about starting treatment. STRIBILD is a complete HIV-1 treatment in 1 pill, once a day.

Ask if itâ&#x20AC;&#x2122;s right for you.

Patient Information STRIBILDTM (STRY-bild) (elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/ tenofovir disoproxil fumarate 300 mg) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information, including Patient Information. What is STRIBILD? • STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD is a complete regimen and should not be used with other HIV-1 medicines. • STRIBILD does not cure HIV-1 or AIDS. You must stay on continuous HIV-1 therapy to control HIV-1 infection and decrease HIV-related illnesses. • Ask your healthcare provider about how to prevent passing HIV-1 to others. Do not share or reuse needles, injection equipment, or personal items that can have blood or body fluids on them. Do not have sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

• Do not stop taking STRIBILD without first talking to your healthcare provider • If you stop taking STRIBILD, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking STRIBILD Who should not take STRIBILD? Do not take STRIBILD if you also take a medicine that contains: • adefovir (Hepsera®) • alfuzosin hydrochloride (Uroxatral®) • cisapride (Propulsid®, Propulsid Quicksolv®) • ergot-containing medicines, including: dihydroergotamine mesylate (D.H.E. 45®, Migranal®), ergotamine tartrate (Cafergot®, Migergot®, Ergostat®, Medihaler Ergotamine®, Wigraine®, Wigrettes®), and methylergonovine maleate (Ergotrate®, Methergine®) • lovastatin (Advicor®, Altoprev®, Mevacor®) • oral midazolam

What is the most important information I should know about STRIBILD?

• pimozide (Orap®)

STRIBILD can cause serious side effects, including: 1. Build-up of lactic acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take STRIBILD or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: • feel very weak or tired • have unusual (not normal) muscle pain • have trouble breathing • have stomach pain with nausea or vomiting • feel cold, especially in your arms and legs • feel dizzy or lightheaded • have a fast or irregular heartbeat 2. Severe liver problems. Severe liver problems can happen in people who take STRIBILD. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems: • your skin or the white part of your eyes turns yellow (jaundice) • dark “tea-colored” urine • light-colored bowel movements (stools) • loss of appetite for several days or longer • nausea • stomach pain You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. 3. Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take STRIBILD, your HBV may get worse (flare-up) if you stop taking STRIBILD. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. • Do not run out of STRIBILD. Refill your prescription or talk to your healthcare provider before your STRIBILD is all gone

• sildenafil (Revatio®), when used for treating lung problems

• rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®) • simvastatin (Simcor®, Vytorin®, Zocor®) • triazolam (Halcion®) • the herb St. John’s wort Do not take STRIBILD if you also take any other HIV-1 medicines, including: • Other medicines that contain tenofovir (Atripla®, Complera®, Viread®, Truvada®) • Other medicines that contain emtricitabine, lamivudine, or ritonavir (Combivir®, Emtriva®, Epivir® or Epivir-HBV®, Epzicom®, Kaletra®, Norvir®, Trizivir®) STRIBILD is not for use in people who are less than 18 years old. What are the possible side effects of STRIBILD? STRIBILD may cause the following serious side effects: • See “What is the most important information I should know about STRIBILD?” • New or worse kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking STRIBILD. Your healthcare provider may tell you to stop taking STRIBILD if you develop new or worse kidney problems. • Bone problems can happen in some people who take STRIBILD. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. • Changes in body fat can happen in people who take HIV-1 medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the middle of your body (trunk). Loss of fat from the legs, arms and face may also happen. The exact cause and long-term health effects of these conditions are not known. • Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having any new symptoms after starting your HIV-1 medicine.

The most common side effects of STRIBILD include: • Nausea • Diarrhea Tell your healthcare provider if you have any side effect that bothers you or that does not go away. • These are not all the possible side effects of STRIBILD. For more information, ask your healthcare provider. • Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What should I tell my healthcare provider before taking STRIBILD? Tell your healthcare provider about all your medical conditions, including: • If you have or had any kidney, bone, or liver problems, including hepatitis B infection • If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD. – There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk with your healthcare provider about how you can take part in this registry. • If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed if you take STRIBILD. - You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. - Two of the medicines in STRIBILD can pass to your baby in your breast milk. It is not known if the other medicines in STRIBILD can pass into your breast milk. - Talk with your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements: • STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. • Be sure to tell your healthcare provider if you take any of the following medicines: - Hormone-based birth control (pills, patches, rings, shots, etc) - Antacid medicines that contains aluminum, magnesium hydroxide, or calcium carbonate. Take antacids at least 2 hours before or after you take STRIBILD - Medicines to treat depression, organ transplant rejection, or high blood pressure - amiodarone (Cordarone®, Pacerone®) - atorvastatin (Lipitor®, Caduet®) - bepridil hydrochloric (Vascor®, Bepadin®) - bosentan (Tracleer®) - buspirone - carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegreto®) - clarithromycin (Biaxin®, Prevpac®) - clonazepam (Klonopin®) - clorazepate (Gen-xene®, Tranxene®) - colchicine (Colcrys®) - medicines that contain dexamethasone - diazepam (Valium®)

- digoxin (Lanoxin®) - disopyramide (Norpace®) - estazolam - ethosuximide (Zarontin®) - flecainide (Tambocor®) - flurazepam - fluticasone (Flovent®, Flonase®, Flovent® Diskus, Flovent® HFA, Veramyst®) - itraconazole (Sporanox®) - ketoconazole (Nizoral®) - lidocaine (Xylocaine®) - mexiletine - oxcarbazepine (Trileptal®) - perphenazine - phenobarbital (Luminal®) - phenytoin (Dilantin®, Phenytek®) - propafenone (Rythmol®) - quinidine (Neudexta®) - rifabutin (Mycobutin®) - rifapentine (Priftin®) - risperidone (Risperdal®, Risperdal Consta®) - salmeterol (Serevent®) or salmeterol when taken in combination with fluticasone (Advair Diskus®, Advair HFA®) - sildenafil (Viagra®), tadalafil (Cialis®) or vardenafil (Levitra®, Staxyn®), for the treatment of erectile dysfunction (ED). If you get dizzy or faint (low blood pressure), have vision changes or have an erection that last longer than 4 hours, call your healthcare provider or get medical help right away. - tadalafil (Adcirca®), for the treatment of pulmonary arterial hypertension - telithromycin (Ketek®) - thioridazine - voriconazole (Vfend®) - warfarin (Coumadin®, Jantoven®) - zolpidem (Ambien®, Edlular®, Intermezzo®, Zolpimist®) Know the medicines you take. Keep a list of all your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. Do not start any new medicines while you are taking STRIBILD without first talking with your healthcare provider. Keep STRIBILD and all medicines out of reach of children. This Brief Summary summarizes the most important information about STRIBILD. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about STRIBILD that is written for health professionals, or call 1-800-445-3235 or go to www.STRIBILD.com. Issued: August 2012

COMPLERA, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, the STRIBILD Logo, TRUVADA, and VIREAD are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners. © 2013 Gilead Sciences, Inc. All rights reserved. QC14549 02/13

NewsBreak

Chicagoland’s top chocolatiers, restaurants, and caterers. The twelfth installment took place in the Union Station Great Hall and provided a seemingly endless assortment of goodies. Some of the top honors include: Chef Michael Frontier and co-owner Terry Opalek of Terry’s Toffee, People’s Choice Award; Uptown Brownie’s owner and Chef Sally Kenyon; Top Overall–Business Class I; Mercat a la Planxa, Best Savory Sample; and the team from Prasino team won Best Libation. The benefit raised a record-breaking $135,000. Proceeds will support AFC’s myriad services, including care, prevention, housing, grantmaking, as well as helping patients navigate insurance services under the Affordable Care Act and advocating for expanded healthcare access. For more information, log on to: www.aidschicago.org.

In partnership with Brooklyn-based non-profit Gay Men of African Descent (GMAD), AIDS Healthcare Foundation (AHF) has opened its newest Men’s Wellness Center. The center will provide accessible, convenient, and affordable STD testing to clients, particularly black gay men, in the community, as well as promote regular sexual health screenings as part of routine healthcare for all sexually active people. Free screening and treatment for chlamydia, gonorrhea, and syphilis, and free HIV testing will be made available. The center is also working toward healthcare services for meningitis as well. “This is one of the better opportunities to connect community resources with community needs that is very competent and compassion-driven,” Vaughn Taylor, executive director of GMAD, said in a prepared statement. “I have this fantasy of bringing back mobile [HIV testing] units and reintroducing the house call to the community. I’ve heard about how effective that has been for AHF in Florida and it’s something that I think could happen here.” The Men’s Wellness Center, located in the GMAD facility at 44 Court St., Suite 1000, Brooklyn, New York, seeks to address the HIV and healthcare needs of one of the hardest-hit regions in the country. Launched in 1986, GMAD has been providing services to the New York City black gay male community, offering sexual and mental health programs, support groups, treatment adherence assistance, education and training, and a food pantry. As the largest non-profit HIV/AIDS healthcare provider in the United States, and a substantial presence worldwide, AHF currently provides medical care and/or services to 270,000 individuals in thirty-two countries. AHF also operates Wellness Centers in California, Florida, Ohio, Mississippi, Louisiana and Texas, as well as in Mexico City. For more information, visit www.gmad.org or www.freeSTDcheck. org, or by calling (718) 222-6300.

A&U • FEBRUARY 2014

photo by Ed Negron

A Wellness Center Grows in Brooklyn

Essay

The Messenger by Amy Peters

t was 1994. I was a nineteen-year-old college sophomore in Florida; I was also a member of the local ACT UP chapter, and freshly certified by the Red Cross as a pre- and post-HIV test counselor. This was in the days when HIV tests were done by blood draw, and you had to come back a week later to get your results. I volunteered at a local clinic that offered anonymous testing. Confidential testing, the alternative, meant that you were “in the system”; someone, somewhere, would know your identity, to a certain extent. With anonymous, you could be virtually invisible. Many people preferred anonymous, so that they could know for themselves what their status was, before deciding whom else should know. Our goal as counselors was to get people to come back. After all, with a week between the blood draw and the results, cold feet could happen. If they came back for their results, we could give them resources, and maybe even hope. The mid-90s were a transition time in society’s understanding of the virus. Some people were still unclear on the basic concepts of transmission. One of my clients, when I asked him about his sexual history, said he was a virgin, but he had kissed someone. It made him nervous—he wasn’t sure if kissing could spread AIDS, he said—so that’s why he had come to get tested. If someone tested positive, they were sent home with a large packet of information. To prevent them from standing out while making their way back through the waiting room and out of the building, we gave everyone the same-sized envelope to carry out with them. If the person tested negative, the envelope had a smaller amount of information. I think it may have been a brochure on staying negative, and some condoms. When a client arrived to get tested, he—they were almost all men; I don’t remember a single woman—was assigned to one of us counselors. He talked to one of us first, and then went down the hall to see the phlebotomist. The following week, if someone tested positive, that person would be connected with their original counselor, who would deliver the news. If someone tested negative, they might get assigned to see any counselor, although, whenever possible, the clinic tried to maintain continuity. One day, I had a client who tested positive. The clinic staff sat down with me to prepare me to give the results. I was told I could give the positive result and be done with my volunteer shift for the

day. Others would handle my negatives. I’m a black woman, and my client was a white man. In my nineteen years, growing up as I had in the South, it was probably the first time I had ever given a white man bad news. He arrived, and I brought him to my office. We had been trained to encourage those who tested positive to get retested, in case of a false positive. Out of all the things I told him in the minutes that followed, that’s the only thing I remember now. “It could be a false positive. That happens.” His face was so still, but his eyes were moving, bewildered. It’s been two decades since that day, and for many years after, I remembered the details of what he looked like: hair color, eye color, what he wore. But over time, those details have faded and washed away. I only remember the bewilderment, the shock, the not knowing what to do next, even as I told him my scripted, memorized Red Cross trained info: get re-tested, see your doctor, use these condoms, take this envelope and read the contents, etc., etc. We were both in a daze as we made our way back to the waiting room. I walked him out of the building entirely and said good-bye and never saw him again. I came back into the building, my face a mask to hide the reality of what had just transpired from other clients in the waiting room. Once inside the inner offices, I debriefed with clinic staff, collected my belongings, and left for home. I never volunteered there again. I was still a child, and, in my fight to learn how to be an adult, I realized: I wasn’t cut out to be a messenger. Amy Peters is the pen name of a former HIV test counselor and current LGBT rights activist and healthcare advocate. She lives in Florida.

A&U • FEBRUARY 2014

lifeguide

Just Being Human how do we survive surviving the plague?

irst of all, I hope everyone was able to enjoy the holiday season, no matter what or if you celebrate anything. We all know that what’s supposed to be one of the “happiest” times of the year—all filled with hope and cheer—can actually be the loneliest times for so many. I won’t dwell on that. My guess is we’ve all been there at some point, especially if we’re forced to deal with family members who aren’t terribly supportive or understanding. But it’s a brand new year, and we can (to some extent, anyway), make it whatever we want it to be. And my wish for all of us is that 2014 is filled with laughter, friendship, love, and always good health! I did something rather unexpected, but necessary for myself over the break. I watched the outstanding documentary How to Survive a Plague— three times. Nominated for an Academy Award, the film chronicles the first few years of how the virus held the world, especially the gay community, hostage, changing the lives of millions seemingly overnight. I watched the film three times in an effort to understand and, in a way, study those first horrid years of AIDS and how it felt to be thrust smack dab in the middle of it all at the age of twenty-seven: all of the terror and hatred, the wretched government officials’ faces, not to mention those dropping around me. I found out I was HIV-positive in a

small town in Indiana and, like many of you probably felt no matter where you lived, I feared that’s where I would exist in my final days, but where I had to begin my own fight. Living in the “buckle” of the Bible Belt I wasn’t even able to find a doctor knowledgeable enough about the virus to prescribe anything, let alone the only drug I had heard of: AZT. As a “returning adult student” at Indiana University, even-

tually I was connected to one of the university’s medical clinics, and began receiving some care. In 1988!! (Upon my first visit, I was told to “get all of [my] affairs in order.”) I figured I’d be dead within a year. My story is similar to many of yours, especially if you didn’t live in or near one of the urban epicenters of the disaster. And yet, here we are today! The second viewing of the documentary was to wake me up a bit. I’ve been in some kind of slumber for several months—a funk, I guess—where I was beginning to really lose steam and the desire, well, for doing a lot of things. I’ve been tired and in great pain, spend-

ing far too much time in bed during the day napping with my Chihuahua, Buddy, resting his little head on my chest and staring at me as if he’s thinking, What is your problem? I want to go on a “real” walk! Get up, already!! I waited a couple of days after the second viewing to see it again; remembering the young face of Ryan White (happening practically in our back yard); getting involved in the little Indiana town’s Gay & Lesbian center with my partner; the support groups we participated in; fighting with my own doctors—when I finally got a couple—about the medications I wanted because I had read about them. I remembered helping my partner make a Quilt panel for his ex-lover when he died, and then going to the marches in Washington, D.C.—feeling that overwhelming camaraderie and power with thousands of other gays and lesbians and PWAs who didn’t have to feel embarrassed about our countless battle scars: the sores, marks, paper-thin bodies. Or thinking the next (birthday, Christmas, whatever) was going to be the last. And it made me realize that while we’ve made (I hesitate to use the word) tremendous advances in HIV/AIDS treatment and care, we have so much more work to do to get rid of the stigma attached to being poz. Bob Rafsky, an attorney who helped form ACT UP and who was featured in the film, continued on page 62 A&U • FEBRUARY 2014

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ERIK STEIN

Ruby Comer: What was the first Broadway show that you ever saw? Erik Stein: It was Three Penny Opera with Sting. I was eighteen years-old. Must have been spectacular. My first was Seesaw with Michele Lee, Ken Howard, and

Tommy Tune. I was mesmerized! What character are you dying to play? I would love to play Sweeny Todd, and I would like to be involved in any way with Sunday in the Park with George. Stephen Sondheim’s lyrics and music changed my life, and they continue to thrill me every time I hear them. I’d also like to play Shylock in Shakespeare’s The Merchant of Venice—it scares me to no end, but I work better when I push myself out of my comfort zone and leap into the unknown. I wish I had that kind of chutzpah! Tell me, when did you first hear about the epidemic? While in high school. I grew up in a small town in the middle of California so AIDS was not a part of our lives, though we were told to use condoms in sex-ed class. I graduated in 1988 and remember that summer I was working on a play outdoors and worried that I might be able to get AIDS from a mosquito. Holy mackerel! The myths back then were endless…. It wasn’t until I went to PCPA that I met someone who had actually encountered the disease. After my audition—I sang “Empty Chairs at Empty Tables” from Les Misérables—I met with the head of the Conservatory. He asked if I had any personal connection to the song. I was eighteen. Having lived a pretty sheltered life, I didn’t know how to answer. He explained that the song reminded him of the late seventies when he

was living in San Francisco where he and his friends had been working hard for gay rights. AIDS claimed many of his friend’s lives. When he hears this song, he told me, it called to mind the friends that he had lost. I was speechless. He made me realize that I could use something so personal in my art. This man became my mentor and not only did he help me become a better actor, he helped me become a better human being. Like him, I still think of those men [who died of AIDS] every time I sing that song now. ruby illustration by Davidd Batalon; photo by Lucas Blair

ast summer I was joyfully transported through time and space to Czarist Russia by Erik Stein’s boffo performance as Tevye the milkman in the classic musical, Fiddler on the Roof. I was entertained under the stars by the Pacific Conservatory of the Performing Arts (PCPA) Theaterfest production in Solvang, the heart of California’s Central Coast wine country. Months later during the holidays, Erik and I decided to meet in La Jolla, California, where I was camped out at the coastal resort’s Grande Dame, The Grande Colonial. At age 100, it’s steeped in a rich history. Its guests have included Hollywood royalty and during the Twenties the hotel even had a pharmacy that was managed by Gregory Peck’s father. My room has a majestic view of the Pacific Ocean and is spacious, superior, and casually elegant. Mr. Stein is an accomplished actor, director, teacher, and former company founder with credits ranging from Broadway to regional theater and film. Early in his career, he studied at PCPA and is presently coaching actors there (“I am honored to teach in the Conservatory that trained me.”) Over the years, he and his wife, Jacqueline Hildebrand, a fellow actor, have lost friends and peers to AIDS and have been involved with several HIV/AIDS organizations, including Broadway Cares. Cat lovers like moi, they are “devoted” to their two little ones, Pawsey and Zoe. On a cool evening, Erik and I convene near the cracklin’ fireplace in the hotel’s dashing lobby.

What a lovely tale. What do you think of when I say “AIDS?” It makes me anxious. It makes me sad. It makes me think of a generation of amazing artists who were wiped out, yet oddly enough, it also makes me think of community and hope. The theater community came together in force to take this disease down. They fought hard to help support and care for people who, in some ways, were considered untouchable. They also fought

A&U • FEBRUARY 2014

hard to prevent others from getting the disease. Their work is a shining example of what people can do together. Fortunately, AIDS is no longer a death sentence. [A sea of flashing light distracts us. It’s the paparazzi. I think, How did they know I was here? Alas, it was just another celebrity. Erik sums up.] A community came together, Ruby, and made a profound change relatively quickly. That gives me hope.

Tevye photo by PCPA/Luis Escobar; hotel photos courtesy Grande Colonial

What was your first personal encounter with the epidemic? I was working at a dinner theater in Indiana. We learned that one of our company members had to drop out because he had just been diagnosed and he wanted to focus on his health. He left without saying goodbye. It seemed unreal to me and I pushed it out of my mind. It had a profound effect on me. I don’t know if he died, but later that year, a group of us from this theater were watching the Tonys where they presented a retrospective of dance numbers from the decade of the eighties. The dance number from The Best Little Whorehouse in Texas came on. When the number ended, an actor who was a bit older than the rest of us started to cry. We asked him what was wrong and he just said, “They’re all gone.” You see, most of the young men we had just watched dance had died of AIDS. It really affected me. Heartbreaking. Before we met you asked if I might tell you in advance a couple of questions I might ask. I said I might want you to comment on the current high rates of HIV infection in the younger generation, especially since you teach young people. Yes, I got together a few of my acting students and posed that question. Well, it seems that AIDS awareness is a part of their lives, that condoms are available, and they know they should get tested regularly. Do they get tested? Some more than others. They grew up with AIDS and it has been a part of their lives, but they don’t seem to be as scared as I was when I was their age. That’s not to say that the students are more reckless, they just talk about it a lot more easily. They don’t view AIDS as a death sentence. I asked them what scared them the most and they said that they are afraid of those who are actively trying to get the disease. That’s frightfully frightening, Erik [shaking my head and sneering, eyes darted upward]. FEBRUARY 2014 • A&U

Top: The Grande Colonial in La Jolla Bottom: Erik as Tevye in Fiddler on the Roof

I asked some gay students how we could reach the closeted community and they said TV is what made them comfortable about coming out, shows like Will & Grace and Glee. The more gay kids can learn that they are not alone, the more they will let go of their need to hide. One of my students told me he didn’t know that there was anyone else like him in the world until he saw an episode of Queer Eye for the Straight Guy. Another student told me that the sooner young people are comfortable with their sexuality the sooner they will stop defining themselves by their sexuality. Then they will no longer make risky decisions in order to define their sexuality. After all, life has so much more to offer. Well said, Erik. What motivates you to be so active? My motivation for volunteering is selfish. I like being around like-minded people. I like working with a community to create something positive. It’s what I do for a living. In the theater we come together as an ensemble to create a piece of work. We all know that the play is the thing, and we are all in service to the play. Life is about shared experiences. Some get on the phone and send money, and that is great. I like to be in the room with

other people and ride the wave of like-minded energy. Before I take my daily stroll along the picturesque cove and watch the lively seals, is there anything else you’d like to add Erik? When my wife and I were living on the Central Coast, we became a bit sheltered, and it started to seem as if the disease was going away. Yet in 2010, our close friend was

diagnosed with AIDS in April and dead by the end of June. He hadn’t gotten tested until a sore appeared on his face. By that time it was too late. This was a real wake-up call. The disease is still very real. We have made a lot of progress, but we can’t stop. People are still getting infected. People are still dying— not just in Africa—but here in this country. They’re our neighbors and our friends. 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.

ABOUT PREZISTA

PREZISTA® is always taken with and at the same time as ritonavir (Norvir ®), in combination with other HIV medicines for the treatment of HIV infection in adults. PREZISTA® should also be taken with food. • The use of other medicines active against HIV in combination with PREZISTA®/ritonavir (Norvir ®) may increase your ability to fight HIV. Your healthcare professional will work with you to find the right combination of HIV medicines • It is important that you remain under the care of your healthcare professional during treatment with PREZISTA® PREZISTA® does not cure HIV infection or AIDS and you may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. You should remain under the care of a doctor when using PREZISTA.® Please read Important Safety Information below, and talk to your healthcare professional to learn if PREZISTA® is right for you.

IMPORTANT SAFETY INFORMATION What is the most important information I should know about PREZISTA®? • PREZISTA® can interact with other medicines and cause serious side effects. See “Who should not take PREZISTA®?” • PREZISTA® may cause liver problems. Some people taking PREZISTA,® together with Norvir ® (ritonavir), have developed liver problems which may be life-threatening. Your healthcare professional should do blood tests before and during your combination treatment with PREZISTA.® If you have chronic hepatitis B or C infection, your healthcare professional should check your blood tests more often because you have an increased chance of developing liver problems • Tell your healthcare professional if you have any of these signs and symptoms of liver problems: dark (tea-colored) urine, yellowing of your skin or whites of your eyes, pale-colored stools (bowel movements), nausea, vomiting, pain or tenderness on your right side below your ribs, or loss of appetite • PREZISTA® may cause a severe or life-threatening skin reaction or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. You should call your healthcare professional immediately if you develop a rash. However, stop taking PREZISTA® and ritonavir combination treatment and call your healthcare professional immediately if you develop any skin changes with these symptoms: fever, tiredness, muscle or joint pain, blisters or skin lesions, mouth sores or ulcers, red or inflamed eyes, like “pink eye.” Rash occurred more often in patients taking PREZISTA® and raltegravir together than with either drug separately, but was generally mild Who should not take PREZISTA ? ®

• Do not take PREZISTA® if you are taking the following medicines: alfuzosin (Uroxatral®), dihydroergotamine (D.H.E.45,® Embolex,® Migranal®), ergonovine, ergotamine (Cafergot,® Ergomar ®), methylergonovine, cisapride (Propulsid®), pimozide (Orap®), oral midazolam, triazolam (Halcion®), the herbal supplement St. John’s wort (Hypericum perforatum), lovastatin (Mevacor,® Altoprev,® Advicor ®), simvastatin (Zocor,® Simcor,® Vytorin®), rifampin (Rifadin,® Rifater,®

Rifamate,® Rimactane®), sildenafil (Revatio®) when used to treat pulmonary arterial hypertension, indinavir (Crixivan®), lopinavir/ ritonavir (Kaletra®), saquinavir (Invirase®), boceprevir (Victrelis™), or telaprevir (Incivek™) • Before taking PREZISTA,® tell your healthcare professional if you are taking sildenafil (Viagra,® Revatio®), vardenafil (Levitra,® Staxyn®), tadalafil (Cialis,® Adcirca®), atorvastatin (Lipitor®), rosuvastatin (Crestor®), pravastatin (Pravachol®), or colchicine (Colcrys,® Col-Probenecid®). Tell your healthcare professional if you are taking estrogen-based contraceptives (birth control). PREZISTA® might reduce the effectiveness of estrogen-based contraceptives. You must take additional precautions for birth control, such as condoms This is not a complete list of medicines. Be sure to tell your healthcare professional about all the medicines you are taking or plan to take, including prescription and nonprescription medicines, vitamins, and herbal supplements. What should I tell my doctor before I take PREZISTA®? • Before taking PREZISTA,® tell your healthcare professional if you have any medical conditions, including liver problems (including hepatitis B or C), allergy to sulfa medicines, diabetes, or hemophilia • Tell your healthcare professional if you are pregnant or planning to become pregnant, or are breastfeeding — The effects of PREZISTA® on pregnant women or their unborn babies are not known. You and your healthcare professional will need to decide if taking PREZISTA® is right for you — Do not breastfeed. It is not known if PREZISTA® can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV should not breastfeed because HIV can be passed to your baby in the breast milk What are the possible side effects of PREZISTA®? • High blood sugar, diabetes or worsening of diabetes, and increased bleeding in people with hemophilia have been reported in patients taking protease inhibitor medicines, including PREZISTA® • Changes in body fat have been seen in some patients taking HIV medicines, including PREZISTA.® The cause and long-term health effects of these conditions are not known at this time • Changes in your immune system can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden • The most common side effects related to taking PREZISTA® include diarrhea, nausea, rash, headache, stomach pain, and vomiting. This is not a complete list of all possible side effects. If you experience these or other side effects, talk to your healthcare professional. Do not stop taking PREZISTA® or any other medicines without first talking to your healthcare professional 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 refer to the ritonavir (Norvir®) Product Information (PI and PPI) for additional information on precautionary measures. Please read accompanying Patient Information for PREZISTA® and discuss any questions you have with your doctor.

28PRZDTC0288R8

PREZISTA® (darunavir) is a prescription medicine. It is one treatment option in the class of HIV (human immunodeficiency virus) medicines known as protease inhibitors.

ily Once-Da

PREZISTA ^ EXPERIENCE

Discover the

Once-Daily PREZISTA® (darunavir) isn’t just an HIV treatment. It’s an HIV treatment experience as unique as you. That’s why you should ask your healthcare professional if the PREZISTA® Experience is right for you. Once-Daily PREZISTA® taken with ritonavir and in combination with other HIV medications can help lower your viral load and keep your HIV under control over the long term. In a clinical study* of almost 4 years (192 weeks), 7 out of 10 adults who had never taken HIV medications before maintained undetectable† viral loads with PREZISTA® plus ritonavir and Truvada.® Ask your healthcare professional about the PREZISTA® Experience. And be sure to visit DiscoverPREZISTA.com for tools and helpful information to find out if the PREZISTA® Experience might be right for you.

Please read the Important Safety Information and Patient Information on adjacent pages.

Snap a quick pic of our logo to show your doctor and get the conversation started. *A randomized open label Phase 3 trial comparing PREZISTA®/ritonavir 800/100 mg once daily (n=343) vs. Kaletra®/ritonavir 800/200 mg/day (n=346). †Undetectable was defined as a viral load of less than 50 copies per mL. Registered trademarks are the property of their respective owners.

Janssen Therapeutics, Division of Janssen Products, LP © Janssen Therapeutics, Division of Janssen Products, LP 2013 02/13 K28PRZ121037

IMPORTANT PATIENT INFORMATION PREZISTA (pre-ZIS-ta) (darunavir) Oral Suspension PREZISTA (pre-ZIS-ta) (darunavir) Tablets Read this Patient Information before you start taking PREZISTA and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment. Also read the Patient Information leaflet for NORVIR® (ritonavir). What is the most important information I should know about PREZISTA? • PREZISTA can interact with other medicines and cause serious side effects. It is important to know the medicines that should not be taken with PREZISTA. See the section “Who should not take PREZISTA?” • PREZISTA may cause liver problems. Some people taking PREZISTA in combination with NORVIR® (ritonavir) have developed liver problems which may be life-threatening. Your healthcare provider should do blood tests before and during your combination treatment with PREZISTA. If you have chronic hepatitis B or C infection, your healthcare provider should check your blood tests more often because you have an increased chance of developing liver problems. • Tell your healthcare provider if you have any of the below signs and symptoms of liver problems. • Dark (tea colored) urine • yellowing of your skin or whites of your eyes • pale colored stools (bowel movements) • nausea • vomiting • pain or tenderness on your right side below your ribs • loss of appetite PREZISTA may cause severe or life-threatening skin reactions or rash. Sometimes these skin reactions and skin rashes can become severe and require treatment in a hospital. You should call your healthcare provider immediately if you develop a rash. However, stop taking PREZISTA and ritonavir combination treatment and call your healthcare provider immediately if you develop any skin changes with symptoms below: • fever • tiredness • muscle or joint pain • blisters or skin lesions • mouth sores or ulcers • red or inflamed eyes, like “pink eye” (conjunctivitis) Rash occurred more often in people taking PREZISTA and raltegravir together than with either drug separately, but was generally mild. See “What are the possible side effects of PREZISTA?” for more information about side effects. What is PREZISTA? PREZISTA is a prescription anti-HIV medicine used with ritonavir and other anti-HIV medicines to treat adults with human immunodeficiency virus (HIV-1) infection. PREZISTA is a type of anti-HIV medicine called a protease inhibitor. HIV is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). When used with other HIV medicines, PREZISTA may help to reduce the amount of HIV in your blood (called “viral load”). PREZISTA may also help to increase the number of white blood cells called CD4 (T) cell which help fight off other infections. Reducing the amount of HIV and increasing the CD4 (T) cell count may improve your immune system. This may reduce your risk of death or infections that can happen when your immune system is weak (opportunistic infections). PREZISTA does not cure HIV infection or AIDS and you may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. You should remain under the care of a doctor when using PREZISTA. Avoid doing things that can spread HIV-1 infection. • Do not share needles or other injection equipment. • Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.

• D o not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. Ask your healthcare provider if you have any questions on how to prevent passing HIV to other people. Who should not take PREZISTA? Do not take PREZISTA with any of the following medicines: • alfuzosin (Uroxatral®) • dihydroergotamine (D.H.E. 45®, Embolex®, Migranal®), ergonovine, ergotamine (Cafergot®, Ergomar®) methylergonovine • cisapride • pimozide (Orap®) • oral midazolam, triazolam (Halcion®) • the herbal supplement St. John’s Wort (Hypericum perforatum) • the cholesterol lowering medicines lovastatin (Mevacor®, Altoprev®, Advicor®) or simvastatin (Zocor®, Simcor®, Vytorin®) • rifampin (Rifadin®, Rifater®, Rifamate®, Rimactane®) • sildenafil (Revatio®) only when used for the treatment of pulmonary arterial hypertension. Serious problems can happen if you take any of these medicines with PREZISTA. What should I tell my doctor before I take PREZISTA? PREZISTA may not be right for you. Before taking PREZISTA, tell your healthcare provider if you: • have liver problems, including hepatitis B or hepatitis C • are allergic to sulfa medicines • have high blood sugar (diabetes) • have hemophilia • are pregnant or planning to become pregnant. It is not known if PREZISTA will harm your unborn baby. Pregnancy Registry: You and your healthcare provider will need to decide if taking PREZISTA is right for you. If you take PREZISTA while you are pregnant, talk to your healthcare provider about how you can be included in the Antiretroviral Pregnancy Registry. The purpose of the registry is follow the health of you and your baby. • are breastfeeding or plan to breastfeed. Do not breastfeed. We do not know if PREZISTA can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk. Tell your healthcare provider about all the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Using PREZISTA and certain other medicines may affect each other causing serious side effects. PREZISTA may affect the way other medicines work and other medicines may affect how PREZISTA works. Especially tell your healthcare provider if you take: • other medicine to treat HIV • estrogen-based contraceptives (birth control). PREZISTA might reduce the effectiveness of estrogen-based contraceptives. You must take additional precautions for birth control such as a condom. • medicine for your heart such as bepridil, lidocaine (Xylocaine Viscous®), quinidine (Nuedexta®), amiodarone (Pacerone®, Cardarone®), digoxin (Lanoxin®), flecainide (Tambocor®), propafenone (Rythmol®) • warfarin (Coumadin®, Jantoven®) • medicine for seizures such as carbamazepine (Carbatrol®, Equetro®, Tegretol®, Epitol®), phenobarbital, phenytoin (Dilantin®, Phenytek®) • medicine for depression such as trazadone and desipramine (Norpramin®) • clarithromycin (Prevpac®, Biaxin®) • medicine for fungal infections such as ketoconazole (Nizoral®), itraconazole (Sporanox®, Onmel®), voriconazole (VFend®) • colchicine (Colcrys®, Col-Probenecid®) • rifabutin (Mycobutin®) • medicine used to treat blood pressure, a heart attack, heart failure, or to lower pressure in the eye such as metoprolol (Lopressor®, Toprol-XL®), timolol (Cosopt®, Betimol®, Timoptic®, Isatolol®, Combigan®) • midazolam administered by injection • medicine for heart disease such as felodipine (Plendil®), nifedipine (Procardia®, Adalat CC®, Afeditab CR®), nicardipine (Cardene®) • steroids such as dexamethasone, fluticasone (Advair Diskus®, Veramyst®, Flovent®, Flonase®) • bosentan (Tracleer®) • medicine to treat chronic hepatitis C such as boceprevir (VictrelisTM), telaprevir (IncivekTM)

IMPORTANT PATIENT INFORMATION • m edicine for cholesterol such as pravastatin (Pravachol®), atorvastatin (Lipitor®), rosuvastatin (Crestor®) • medicine to prevent organ transplant failure such as cyclosporine (Gengraf®, Sandimmune®, Neoral®), tacrolimus (Prograf®), sirolimus (Rapamune®) • salmeterol (Advair®, Serevent®) • medicine for narcotic withdrawal such as methadone (Methadose®, Dolophine Hydrochloride), buprenorphine (Butrans®, Buprenex®, Subutex®), buprenorphine/naloxone (Suboxone®) • medicine to treat schizophrenia such as risperidone (Risperdal®), thioridazine • medicine to treat erectile dysfunction or pulmonary hypertension such as sildenafil (Viagra®, Revatio®), vardenafil (Levitra®, Staxyn®), tadalafil (Cialis®, Adcirca®) • medicine to treat anxiety, depression or panic disorder such as sertraline (Zoloft®), paroxetine (Paxil®, Pexeva®) • medicine to treat malaria such as artemether/lumefantrine (Coartem®) This is not a complete list of medicines that you should tell your healthcare provider that you are taking. Ask your healthcare provider or pharmacist if you are not sure if your medicine is one that is listed above. Know the medicines you take. Keep a list of them to show your doctor or pharmacist when you get a new medicine. Do not start any new medicines while you are taking PREZISTA without first talking with your healthcare provider. How should I take PREZISTA? • Take PREZISTA every day exactly as prescribed by your healthcare provider. • You must take ritonavir (NORVIR®) at the same time as PREZISTA. • Do not change your dose of PREZISTA or stop treatment without talking to your healthcare provider first. • Take PREZISTA and ritonavir (NORVIR®) with food. • Swallow PREZISTA tablets whole with a drink. If you have difficulty swallowing PREZISTA tablets, PREZISTA oral suspension is also available. Your health care provider will help decide whether PREZISTA tablets or oral suspension is right for you. • PREZISTA oral suspension should be given with the supplied oral dosing syringe. Shake the suspension well before each use. See the Instructions for Use that come with PREZISTA oral suspension for information about the right way to prepare and take a dose. • If your prescribed dose of PREZISTA oral suspension is more than 6 mL, you will need to divide the dose. Follow the instructions given to you by your healthcare provider or pharmacist about how to divide the dose. Ask your healthcare provider or pharmacist if you are not sure. • If you take too much PREZISTA, call your healthcare provider or go to the nearest hospital emergency room right away. What should I do if I miss a dose? People who take PREZISTA one time a day: • If you miss a dose of PREZISTA by less than 12 hours, take your missed dose of PREZISTA right away. Then take your next dose of PREZISTA at your regularly scheduled time. • If you miss a dose of PREZISTA by more than 12 hours, wait and then take the next dose of PREZISTA at your regularly scheduled time. People who take PREZISTA two times a day • If you miss a dose of PREZISTA by less than 6 hours, take your missed dose of PREZISTA right away. Then take your next dose of PREZISTA at your regularly scheduled time. • If you miss a dose of PREZISTA by more than 6 hours, wait and then take the next dose of PREZISTA at your regularly scheduled time. If a dose of PREZISTA is skipped, do not double the next dose. Do not take more or less than your prescribed dose of PREZISTA at any one time. What are the possible side effects of PREZISTA? PREZISTA can cause side effects including: • See “What is the most important information I should know about PREZISTA?” • Diabetes and high blood sugar (hyperglycemia). Some people who take protease inhibitors including PREZISTA can get high blood sugar, develop diabetes, or your diabetes can get worse. Tell your healthcare provider if you notice an increase in thirst or urinate often while taking PREZISTA. • Changes in body fat. These changes can happen in people who take antiretroviral therapy. The changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the back, chest, and stomach area. Loss of fat from the legs, arms, and face may also happen. The exact cause and longterm health effects of these conditions are not known.

• Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Call your healthcare provider right away if you start having new symptoms after starting your HIV medicine. • Increased bleeding for hemophiliacs. Some people with hemophilia have increased bleeding with protease inhibitors including PREZISTA. The most common side effects of PREZISTA include: • diarrhea • headache • nausea • abdominal pain • rash • vomiting Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of PREZISTA. For more information, ask your health care provider. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. How should I store PREZISTA? • Store PREZISTA oral suspension and tablets at room temperature [77°F (25°C)]. • Do not refrigerate or freeze PREZISTA oral suspension. • Keep PREZISTA away from high heat. • PREZISTA oral suspension should be stored in the original container. Keep PREZISTA and all medicines out of the reach of children. General information about PREZISTA Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use PREZISTA for a condition for which it was not prescribed. Do not give PREZISTA to other people even if they have the same condition you have. It may harm them. This leaflet summarizes the most important information about PREZISTA. If you would like more information, talk to your healthcare provider. You can ask your healthcare provider or pharmacist for information about PREZISTA that is written for health professionals. For more information, call 1-800-526-7736. What are the ingredients in PREZISTA? Active ingredient: darunavir Inactive ingredients: PREZISTA Oral Suspension: hydroxypropyl cellulose, microcrystalline cellulose, sodium carboxymethylcellulose, methylparaben sodium, citric acid monohydrate, sucralose, masking flavor, strawberry cream flavor, hydrochloric acid (for pH adjustment), purified water. PREZISTA 75 mg and 150 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose. The film coating contains: OPADRY® White (polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). PREZISTA 400 mg and 600 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose. The film coating contains: OPADRY® Orange (FD&C Yellow No. 6, polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). PREZISTA 800 mg Tablets: colloidal silicon dioxide, crospovidone, magnesium stearate, microcrystalline cellulose, hypromellose. The film coating contains: OPADRY® Dark Red (iron oxide red, polyethylene glycol 3350, polyvinyl alcohol-partially hydrolyzed, talc, titanium dioxide). This Patient Information has been approved by the U.S Food and Drug Administration. Manufactured by: PREZISTA Oral Suspension PREZISTA Tablets Janssen Pharmaceutica, N.V. Janssen Ortho LLC, Beerse, Belgium Gurabo, PR 00778 Manufactured for: Janssen Therapeutics, Division of Janssen Products, LP, Titusville NJ 08560 Revised: April 2013 NORVIR® is a registered trademark of its respective owner. PREZISTA® is a registered trademark of Janssen Pharmaceuticals © Janssen Pharmaceuticals, Inc. 2006 991772P

Hello Justin, Just checked out your video regarding the biohazard tattoo and it inspired me to write. I was diagnosed with HIV two years ago. When this happened I did the responsible thing and notified those I had sexual relations with to ensure all were tested. I never was able to pinpoint who passed it to me but, to be honest, it doesn’t matter. I accepted the issue and moved on accordingly. I often think about getting a biohazard tattoo myself because I do have multiple sex partners from time to time. I do practice safe sex. I am in a fourteen-year open relationship with my wonderful partner. He knows my status and accepts it. However, from time to time, he insists on having unprotected sex. I am freaking out over this....I can’t bear the thought of passing this infection on to someone, let alone someone I love so much. For the time being I have convinced him to practice safe sex. Do you have any advice that can help when this issue comes up again? I apologize in advance if the question is one you are uncomfortable answering, but I find myself alone when dealing with issues like this. Need a little kind advice. Thanks. —J Let me say, fourteen years in a relationship is a very long time in “gay” years; you’re like on your fiftieth anni-

versary…no, just kidding. CONGRATS! Okay, let me first explain to my readers why I had a biohazard symbol tattooed on my abdomen. The reason why I had this done is because of what it meant to the gay community in the past and not what it means to many of us in the gay community now. I made a conscious decision to get the tattoo because it symbolized that I had HIV. A red ribbon is about HIV awareness and, yes, I could’ve gotten that, but I’m not that kind of person. In September 2013, I went through a spiritual awakening so I had my biohazard covered with a Triquetra. A Triquetra represents the connection of mind, body and soul, and in Celtic-based Pagan groups it is symbolic of the three realms of earth, sea, and sky. I also have the modern elemental symbols of Earth (Capricorn), my Sun Sign; Fire (Aries), my Rising Sign; and Fire (Aries), my Moon Sign. So then I got a biohazard on my back because I still wanted it on my body but so that every time I look in the mirror I will see spiritual inspiration. Some in the gay community use the biohazard symbol to mean that they bareback. I admit I have barebacked before but now I only bareback with my husband; I’m no angel and I’ve made mistakes in the past. In terms of using prevention tools, let me say that people are going to do what they want to do. Once you have voiced your opinion, that is about all you can or need to do. But you need

to protect yourself. If this man loves you he will not want to put your health in danger. I suggest getting tested for STIs more often. Honestly if he is doing it without you knowing there is a big trust and communication issue you might want to bring up. We who are HIV-positive are more susceptible to other STIs as well. If he is barebacking with others you really need to start taking precautions and talk to him about what he might be doing with others. If he says he wants to bareback with you, there should be something inside of you that asks, “WHY?” Also be informed that Truvada, as PrEP, is a drug that is used to protect people from getting infected with HIV, but know that it is not indicated for protection against other STIs as well. There are several types of viral hepatitis, such as A, B, C, D, E, G; the most common types are A, B, and C. The hepatitis viruses primarily attack the liver. Most of the individuals who are infected with hepatitis recover with a continuing immunity to the disease, but some people infected with the hepatitis virus die in the critical phase. Hepatitis B and C may develop to chronic hepatitis, in which the liver remains inflamed for more than sixmonths. This can lead to cirrhosis, liver cancer, and sometimes death. Also think about syphilis, drug resistant HIV, herpes, and chlamydia—which isn’t called the “Silent Killer” for nothing. THINK ABOUT IT! ◊

A&U • FEBRUARY 2014

Justin B. Terry-Smith 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. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at jsmithco98@hotmail.com.

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Test of Time A conversation with New York City-based artist Carmine Santaniello about surviving the AIDS crisis, and creating art that helps today’s youth to Play Smart and be in the know about AIDS and practicing safer sex by Alina Oswald

here’s often a process of self-discovery associated with looking at a work of art. The experience can be a fascinating one, especially when we find ourselves surrounded by Carmine Santaniello’s artwork. Stunningly beautiful, dark, edgy, and fearless, it reaches us on a personal, human level, daring us to take that second look within, to rediscover a darker, edgier, more fearless side of our own selves. Carmine Santaniello has created art his entire life. And ever since he can remember, art has been his life. “I started drawing before I could write my name,” he says when I reach him by phone. “I was always artistic,” he adds, “fortunate enough to really make a living as an artist.” Born and raised in New York City, he has pursued an art education, and then career, starting from an early age, attending the High School of Art and Design, and later on the School of Visual Arts and Parsons School of Design. Santaniello’s art appeals to a lot of demographics, traversing genders, ages, ethnicities, and sexual orientations, because the subjects it portrays have human qualities everybody can relate to—they are strong, but also vulnerable; beautiful, and proud; or, as the artist comments on his portraits, they are an edgier representation of people he knows. His portraits invoke innermost human feelings and emotions in an artistic, subtle, yet powerful way. They’ve evolved with time, while preserving their urban and contemporary elements. After all, the artist likes to challenge himself, to keep his work fresh and contemporary.

Some have names like The Aboriginal Man or The Snake Man. The model posing in Saint Sebastian, for example, may bring out different feelings in different individuals. Its intensity may intrigue viewers. But when I inquire further, I find out that the model is...a face created by the artist. “That’s not a model. I put him together,” Santaniello explains. I find out that Saint Sebastian is part of the artist’s most recent series of portraits, called “Creative Faces.” One of the things the artist likes about this A&U • FEBRUARY 2014

Opposite page: Untitled (c43), 2013, mixed media, 14 by 11 inches Above: Saint Sebastian, 2013, lithography and Chine collĂŠ, 21 by 12 inches FEBRUARY 2014 â&#x20AC;˘ A&U

series is that he doesn’t have to worry about finding models. “I’m creating them myself,” he says, “which is intriguing for me, as an artist. And people say, ‘Oh, I like that model you use.’ But then again, he doesn’t exist.” The face of Saint Sebastian is made up of about five different pieces of other people’s faces. The eyes, nose, the chin and mouth...the artist pieced them all together creating a new person, a new persona. “I’m almost like a Frankenstein,” he says, and I can sense the smile in his voice. “And the way I do it, I enhance it so [that] maybe it’s a little smoother.” He used the same technique to create his most recent black-and-white collages, and also what he refers to as 8 1/2, 12, and 86. When I inquire about the meaning of the numbers, the artist explains that he used to title his works with the word “Untitled” followed by a letter and a number, so that he could keep track of them easier. “I was also a graphic designer,” he adds, commenting on the presence of numbers and letters in his work. “I like to play with typography, and I would incorporate that into [my work] as a tattoo or as another mark. It’s [the artwork’s] title, but [the subject is] wearing it.” Although he confesses he doesn’t have any tattoos on himself, as an artist, Santaniello finds tattoos very appealing, a mark of the times in which we live. “I think that they really lend themselves as a creative step for me,” he adds. There are also other, perhaps more timeless, symbols that populate his work. Like those in Untitled c43, a mixed-media piece showing a Top: Play Smart, 2013, mixed media, 18 by 12 inches Bottom: Collage 2, 2014, collage, 10 by 8 inches

Opposite page: 86, 2013, lithography and Chine collé, 15 by 11 inches

young man with thorns on his arms. He seems vulnerable, but also fearless, as if part of a kinetic environment the artist creates using mixed media techniques, which include drawing, printing, and collages. The symbols, like the thorns, have religious connotations, in part because of the artist’s upbringing. “I have a Catholic background,” Santaniello explains. “I went to parochial grammar school in the sixties, with the nuns. It was a crazy time. Going to parochial school, to church, seeing these iconic images like Christ on the cross, [one] cannot not be affected by all of this,” he says. “My grandmother was always talking to me about art and Italy,” he continues. “At seven or eight I was introduced to Michelangelo. And being a gay young boy at the time, these images were so strong and so powerful, [they followed me].” But these symbols, these “marks” that come through in many of Santaniello’s pieces don’t necessarily translate into symbols of the mark that AIDS has put on people throughout the decades. “Regardless of what the disease is,” he explains, “I think life in general puts marks on you. Being alive, either surviving an epidemic or going to the store, marks you. I think maybe that’s what you’re seeing in my work. Maybe it’s a generalization, not necessarily any virus.” What marks Santaniello’s art is a profoundly human element that runs throughout his work, like a common thread, or theme. In a time of crisis, like the AIDS crisis during the eighties, this human element stood out in his work, helped it transcend the decades, and stand the test of time, of AIDS and any other kind of crisis. The artist has survived the AIDS crisis, but that doesn’t mean that the pandemic has not A&U • FEBRUARY 2014

A&U Gallery influenced his work. “You can’t help but be influenced,” he comments. “I mean, I’ve lived through [the AIDS crisis], I’ve lost a lot of friends [to it]. So, as an artist, you’re always feeling these things. It always has an influence [on your artwork] not a strong one [anymore] but it enhances what you do.” To this day, AIDS continues to mark Santaniello’s work in some way. Nowadays he uses his art to create and spread AIDS awareness. Each year, he participates in the annual Postcards from the Edge show, hosted by New York City’s Visual AIDS, because he believes it’s a great cause. He’s also involved with Visual AIDS in other campaigns, such as the most recent annual Play Smart campaign. “They approached me for doing something that talks very strongly about safe sex,” Santaniello further explains. “And if my work could reach out to people, and help them perform that task better, I jumped on the opportunity.” Every year since 2010, Visual AIDS organizes the Play Smart campaign in an effort to promote and distribute safer sex messages, and information about HIV testing and AIDS education to individuals living in the U.S. and Canada. Each year, Visual AIDS asks an artist to create images for playing cards that are to be distributed to the intended audience—men who have sex with men, and also anybody, especially young individuals, who needs to get information and become educated about HIV/ AIDS. Each package includes two cards and a condom, placed in a little plastic bag. On the front of each card there’s an image created by the chosen artist, and on the back, an educational message about safer FEBRUARY 2014 • A&U

sex, or information about where to find help, HIV testing sites, and the like. The artwork Santaniello created for the Play Smart IV campaign is a mixed media piece showing two men wearing tattoos, caressing each other. It’s contemporary. It is edgy. Striking. And it speaks to the audience, delivering the intended message. “The two men are caressing each other,” the artist says, “[the message would be] that you may want to take it slow in the beginning, to play it safe.” As an artist, Santaniello believes that art can be used as a powerful and effective tool through which to reach out to the masses, to inform and educate people about HIV and AIDS. Play Smart proves just that. He believes wholeheartedly in the campaign. “I think it’s fabulous,” he com-

ments. “[Its] images reach out to younger people to tell them to take precautions in their lives.” Talking about AIDS and the younger generation, Santaniello mentions that he found it exciting to be involved in the most recent Play Smart campaign, “because [after the AIDS crisis] people think ‘there’s a pill I can get and I can do everything’ and it’s not like that,” he says. “AIDS is something you can avoid with the right tools and the right education,” he continues, reflecting on the epidemic of today. “AIDS is something you can avoid by being aware and by being smart. AIDS is something that can be prevented, and people should take any means to prevent it. “When you are young you’re so fearless, aren’t you?” he asks, continuing to weigh in on the subject of today’s youth and HIV. “Like it-can’t-happen-tome sort of attitude. But it can happen to you,” he says, slightly accentuating the word “can.” “So I think people should really, really look back at what this disease has done, and what it continues to do to a lot of people. [...] People should educate themselves.” And then, addressing youth directly, he adds, “Maintain your health, especially when you are young, so that you can live, and get on with your life.” Find out more about Carmine Santaniello’s artwork by visiting him on-line at: http:// carminesantaniellofineart.blogspot.com and www.facebook.com/CarmineSantanielloFineArt. Alina Oswald is a writer, photographer, and the author of Journeys Through Darkness: A Biography of AIDS. Contact her at www.alinaoswald.com.

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Patient model. Pill shown is not actual size.

What is COMPLERA? COMPLERA is a prescription HIV medicine that is used as a complete regimen to treat HIV-1 in adults who have never taken HIV medicines before and who have an amount of HIV in their blood (this is called “viral load”) that is no more than 100,000 copies/mL. COMPLERA contains 3 medicines – rilpivirine, emtricitabine and tenofovir disoproxil fumarate. It is not known if COMPLERA is safe and effective in children under the age of 18 years. ®

COMPLERA® does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking COMPLERA. Avoid doing things that can spread HIV-1 to others: always practice safer sex and use condoms to lower the chance of sexual contact with body fluids; never reuse or share needles or other items that have body fluids on them, do not share personal items that may contain bodily fluids. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others.

IMPORTANT SAFETY INFORMATION What is the most important information you should know about COMPLERA? COMPLERA® can cause serious side effects: • Build-up 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 (not normal) 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 (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. • You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions. • Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking COMPLERA, your hepatitis may suddenly get worse. Do not stop taking COMPLERA without first talking to your healthcare provider, as they will need to monitor your health. COMPLERA is not approved for the treatment of HBV.

Who should not take COMPLERA? Do not take COMPLERA if you have ever taken other anti-HIV medicines. COMPLERA may change the effect of other medicines and may cause serious side effects. Your healthcare provider may change your other medicines or change their doses. Do not take COMPLERA if you also take these medicines: • anti-seizure medicines: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin, Dilantin-125, Phenytek) • anti-tuberculosis medicines: rifabutin (Mycobutin), rifampin (Rifater, Rifamate, Rimactane, Rifadin) and rifapentine (Priftin) • proton pump inhibitors for stomach or intestinal problems: esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), dexlansoprazole (Dexilant), omeprazole (Prilosec), pantoprazole sodium (Protonix), rabeprazole (Aciphex) • more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate • St. John’s wort (Hypericum perforatum) If you are taking COMPLERA you should not take other HIV medicines or other medicines containing tenofovir (Viread, Truvada, Stribild or Atripla); other medicines containing emtricitabine or lamivudine (Emtriva, Combivir, Epivir, Epivir-HBV, Epzicom, Trizivir, Atripla, Stribild or Truvada); rilpivirine (Edurant) or adefovir (Hepsera). In addition, tell your healthcare provider if you are taking the following medications because they may interfere with how COMPLERA works and may cause side effects: • certain antacid medicines containing aluminum, magnesium hydroxide, or calcium carbonate (examples: Rolaids, TUMS). These medicines must be taken at least 2 hours before or 4 hours after COMPLERA. • medicines to block stomach acid including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine HCL (Zantac). These medicines must be taken at least 12 hours before or 4 hours after COMPLERA. • any of these medicines: clarithromycin (Biaxin); erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) methadone (Dolophine); posaconazole (Noxafil), telithromycin (Ketek) or voriconazole (Vfend). • medicines that are eliminated by the kidneys like acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex) and valganciclovir (Valcyte).

COMPLERA.

A complete HIV treatment in only 1 pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and have no more than 100,000 copies/mL of virus in their blood.

Ask your healthcare provider if it’s the one for you.

These are not all the medicines that may cause problems if you take COMPLERA. Tell your healthcare provider about all prescription and nonprescription medicines, vitamins, or herbal supplements you are taking or plan to take.

The most common side effects reported with COMPLERA are trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, and depression. Some side effects also reported include vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles) and pain.

Before taking COMPLERA, tell your healthcare provider if you: liver problems, including hepatitis B or C virus infection, or have abnormal liver tests • Have kidney problems • Have ever had a mental health problem • Have bone problems • Are pregnant or planning to become pregnant. It is not known if COMPLERA can harm your unborn child • Are breastfeeding: Women with HIV should not breastfeed because they can pass HIV through their milk to the baby. Also, COMPLERA may pass through breast milk and could cause harm to the baby

This is not a complete list of side effects. Tell your healthcare provider or pharmacist if you notice any side effects while taking COMPLERA, and call your healthcare provider for medical advice about side effects.

• Have

COMPLERA can cause additional serious side effects: or worsening kidney problems, including kidney failure. If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider may need to do regular blood tests. • Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: feeling sad or hopeless, feeling 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 had changes in their liver function tests in the past may have an increased risk for liver problems while taking COMPLERA. Some people without prior liver disease may also be at risk. Your healthcare provider may need to check your liver enzymes before and during treatment with COMPLERA. • Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do additional tests to check your bones. • Changes in body fat can happen in people taking HIV medicine. • Changes in your immune system. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new symptoms after starting COMPLERA. • New

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088. Additional Information about taking COMPLERA: • Always take COMPLERA exactly as your healthcare provider tells you to take it. • Take COMPLERA with food. Taking COMPLERA with food is important to help get the right amount of medicine in your body. (A protein drink does not replace food. If your healthcare provider stops COMPLERA, make certain you understand how to take your new medicine and whether you need to take your new medicine with a meal.) Stay under the care of your healthcare provider during treatment with COMPLERA and see your healthcare provider regularly. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.

Learn more at www.COMPLERA.com

Brief Summary of full Prescribing Information

COMPLERA (kom-PLEH-rah) (emtricitabine, rilpivirine, tenofovir disoproxil fumarate) tablets ®

Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information including Patient Information. What is COMPLERA? t

COMPLERA is a prescription HIV (Human Immunodeficiency Virus) medicine that is used to treat HIV-1 in adults – who have never taken HIV medicines before, and – who have an amount of HIV in their blood (this is called ‘viral load’) that is no more than 100,000 copies/mL. Your healthcare provider will measure your viral load.

(HIV is the virus that causes AIDS (Acquired Immunodeficiency Syndrome)). t

COMPLERA contains 3 medicines – rilpivirine, emtricitabine, tenofovir disoproxil fumarate – combined in one tablet. It is a complete regimen to treat HIV-1 infection and should not be used with other HIV medicines.

It is not known if COMPLERA is safe and effective in children under the age of 18 years old.

COMPLERA does not cure HIV infection or AIDS. You must stay on continuous therapy to control HIV infection and decrease HIV-related illnesses.

Ask your healthcare provider if you have any questions about how to prevent passing HIV to other people. Do not share or re-use needles or other injection equipment, and do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal fluids or blood.

Who should not take COMPLERA? Do not take COMPLERA if: t your HIV infection has been previously treated with HIV medicines. t

you are taking any of the following medicines: – anti-seizure medicines: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal); phenobarbital (Luminal); phenytoin (Dilantin, Dilantin-125, Phenytek) – anti-tuberculosis (anti-TB) medicines: rifabutin (Mycobutin); rifampin (Rifater, Rifamate, Rimactane, Rifadin); rifapentine (Priftin) – proton pump inhibitor (PPI) medicine for certain stomach or intestinal problems: esomeprazole (Nexium, Vimovo); lansoprazole (Prevacid); dexlansoprazole (Dexilant); omeprazole (Prilosec, Zegerid); pantoprazole sodium (Protonix); rabeprazole (Aciphex) – more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate – St. John’s wort (Hypericum perforatum)

If you take COMPLERA, you should not take: – Other medicines that contain tenofovir (Atripla, Stribild, Truvada, Viread)

What is the most important information I should know about COMPLERA? COMPLERA can cause serious side effects, including: t Build-up of an acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take COMPLERA or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: – feel very weak or tired – have unusual (not normal) muscle pain – have trouble breathing – have stomach pain with nausea (feeling sick to your stomach) or vomiting – feel cold, especially in your arms and legs

– Other medicines that contain emtricitabine or lamivudine (Combivir, Emtriva, Epivir or Epivir-HBV, Epzicom, Trizivir, Atripla, Truvada, Stribild) – rilpivirine (Edurant) – adefovir (Hepsera) What should I tell my healthcare provider before taking COMPLERA? Before you take COMPLERA, tell your healthcare provider if you: t have or had liver problems, including hepatitis B or C virus infection, kidney problems, mental health problem or bone problems t

– feel dizzy or lightheaded Severe liver problems. Severe liver problems can happen in people who take COMPLERA. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems:

– your skin or the white part of your eyes turns yellow (jaundice) – dark “tea-colored” urine – light-colored bowel movements (stools)

are breast-feeding or plan to breast-feed. You should not breastfeed if you have HIV because of the risk of passing HIV to your baby. Do not breastfeed if you are taking COMPLERA. At least two of the medicines contained in COMPLERA can be passed to your baby in your breast milk. We do not know whether this could harm your baby. Talk to your healthcare provider about the best way to feed your baby.

– loss of appetite for several days or longer

Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.

– nausea

– stomach pain t

are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn child. Pregnancy Registry. There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.

– have a fast or irregular heartbeat t

Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take COMPLERA, your HBV may get worse (flare-up) if you stop taking COMPLERA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. COMPLERA is not approved for the treatment of HBV, so you must discuss your HBV with your healthcare provider. – Do not let your COMPLERA run out. Refill your prescription or talk to your healthcare provider before your COMPLERA is all gone. – Do not stop taking COMPLERA without first talking to your healthcare provider. – If you stop taking COMPLERA, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking COMPLERA.

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

COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works, and may cause serious side effects. If you take certain medicines with COMPLERA, the amount of COMPLERA in your body may be too low and it may not work to help control your HIV infection. The HIV virus in your body may become resistant to COMPLERA or other HIV medicines that are like it.