web analytics
HIV is not a crime
rss feed

Act against Aids

The Body

poz.com

poziam.org, poz iam

crystalmeth.org



hivcruise.com

April 23rd, 2014

NEGATIVE: HIV Negative Gay Men Speaking for Themselves

“Talk to me like you talk to your friends when no one is around.”

That was my only request when I sat down with each of four HIV negative gay men to create a short film about their lives and attitudes (video below).

AJ GrabThey held back nothing, sharing details of their sex lives, their fears of becoming infected, and, perhaps most surprising, what they really think of HIV positive guys. I couldn’t believe their candor, and have worked to distill two days of explicit conversations into ten minutes of brutal honesty (the language is sometimes NSFW).

They don’t speak for every gay man, only for themselves, and the differences of opinion between them is really striking. It really is a snapshot of what it means to be a negative and sexually active gay man these days. No matter which of these men you might relate to the most, there’s no doubt they are all just trying to carve out a satisfying sexual existence during a pretty confusing time.

Evan Grab devilish grin cropI couldn’t help thinking of The Golden Girls when I was editing, because all the archetypes are here: the reserved one, the sensible one, the endearing one, the man-eater. Just saying this makes me guilty of the very thing the video is meant to address: how easily we label ourselves and others, and how we try to assign the same perspective to entire groups of people.

I deliberately produced this without any particular context. No one is presented as right or wrong. It is meant to provide a forum for these men to speak their truth without interruption — and perhaps help us see them as men stumbling through life as we all are, trying to make the best decisions they can with the information they have. I refuse to judge them for that.

If there is anything to be learned from this video, it is that there is no monolithic “HIV negative perspective.” Gay men are far too diverse for that. That’s a lesson our community seems to have to learn over and over again.

Mark

Tags: , , , , ,
Posted in Family and Friends, Gay Life, My Fabulous Disease, News, Prevention and Policy | 7 Comments » | Posted by Mark S. King

April 2nd, 2014

When People with HIV Became Suicide Bombers

Maybe we should blame the criminal prosecutions of people with HIV on the mythical legend of Gaetan Dugas, also known by his slanderous nickname, Patient Zero. Dugas was a gay flight attendant from Canada who, according to Randy Shilts’ 1987 book And the Band Played On, was among the first people with HIV in the United States.

Gaetan Dugas picAs the story goes, energetic Dugas (right) spent lots of time in the very early 1980′s getting laid in practically every city with an airport, even after learning he had the mysterious new “gay cancer.” He wanted to go out with a bang, the book claimed, and he didn’t particularly care who he might infect in the process. The book repeated rumors that after sex with bath house tricks Dugas would point out his skin lesions and then announce, “now you have it.”

Except the story isn’t true. Two years ago, Shilts’ former editor admitted the book needed a “literary device” and had encouraged Shilts to create the epidemic’s first “AIDS monster.” The scandalous sex life of Gaetan Dugas fit the bill nicely. Dugas died in 1984, never having the opportunity to answer his accusers regarding his alleged behaviors.

Instead of placing responsibility with everyone having sex, the book painted people with HIV as suicide bombers. The damage, to the truth and to the public image of people with AIDS, still reverberates today.

Laws exist in more than 30 States that criminalize people with HIV for not disclosing their status to sexual partners. Even where there are no HIV-specific laws, charges range from assault to attempted murder to bioterrorism. It should be noted that the vast majority of prosecutions do not involve the transmission of HIV. Often, the person charged used a condom, had an undetectable viral load, or engaged in sexual behavior that could not have infected their partner.

Anyone with HIV and a pissed off ex-lover should feel worried, since these cases often become a matter of whom you believe. Prosecutors and unfriendly juries are often shocked that people with HIV are having sex at all. They couldn’t care less about condoms or undetectable viral loads. They just want people who don’t disclose their status to face serious charges.

A lot of people see this as righteous and are taking the bait. Many of us know someone infected by a sex partner who lied about their status, and we want that jerk to pay for it. This sense of vengeance plays into the hands of a conservative legal system that is more than happy to send some diseased fags to jail. For a really long time. Regardless of the actual harm inflicted.

This issue is a real mine field of emotion, justice, science, and payback. Fortunately, an upcoming event will bring together advocates, legal experts and people living with HIV to discuss criminalization and map out a strategy to address it.

HIVisNotACrimeART“HIV is Not a Crime” is the first national conference on HIV criminalization.  It will be held on June 2-5, 2014, in Grinnell, Iowa.  Yes, Iowa. Some of the most effective activism around this issue is happening there, where State legislators are actually re-thinking their own laws and health policies as a result of smart advocacy and education. I urge you to alert your local HIV advocates about this important event.

Regardless of your views on criminalization, we can all agree that anyone who intentionally seeks to harm another person should be held accountable for it. That’s why we have laws against hurting other people.

But why are there laws on the books specific to HIV non-disclosure? HIV has its very own laws ordering people to disclose if they have it. The same cannot be said for other infectious viruses such as Human Papillomavirus (HPV) or Hepatitis C, which actually kill more people each year. The reason, in the mind of many advocates, is because those viral conditions are not as closely associated with gay sexuality. Or race. Or the disenfranchised. I hope you’re getting the picture.

Criminalization is not limited to whether or not someone discloses, even if those scenarios capture our imagination the most. Laws have other ways to punish those with HIV. 

Charges for an unrelated crime can be elevated if the defendant is HIV positive. Prostitution, or spitting at a cop, or punching somebody in the face in a bar, can carry more severe sentences based on the fact the accused is HIV positive.

In other words, defendants are guilty of living with HIV. That should give you real pause.

Surveys conducted by The SERO Project indicate that knowing about the risk of being charged with non-disclosure is an impediment to HIV testing. After witnessing how people with HIV are being treated by the judicial system, getting tested might feel like exposing yourself to potential prosecution.

These prosecutions do not rely upon the context of HIV disclosure, either. “The moral obligation to disclose increases with the degree of risk present,” said Sean Strub, founder of The SERO Project and one of the organizers of the Iowa conference, “but the context of the sexual encounter is also a factor.  In the context of a committed relationships, the disclosure obligation is much greater than in a sex club, for example.”

The key point here is morality. Disclosing your status is a moral issue, not a criminal one. Even in the worst years of AIDS, when the virus reliably killed you, we called our doctors to start treatment when we got infected. We didn’t call the cops. Blaming someone for our own risk behaviors seemed ludicrous. It still does.

You wouldn’t know it from news reports, which often feature race-driven cases of predatory men lurking around the countryside infecting the populous. Suicide bombers continue to titillate the media.

Look closely at the stories and you will find that “not disclosing” is usually equated with “intentionally infecting.” It’s as if sex of any kind on the part of someone with HIV is malicious. One side effect of HIV infection, it would seem, is a pathological bloodlust.

Never forget that these juicy legal stories represent the lives of real people. Sentences amounting to decades are being wielded. The convicted are having to register as sex offenders. In the often confusing landscape of sexual risk and negotiation, the person with HIV is facing grave consequences for decisions often made in the heat of the moment, or simply because they chose to protect their privacy when no risk to their partner existed.

HIV criminalization does nothing to reduce the impact of a new HIV infection.  It doubles it.

Mark

ALSO…

bars hands 2There’s a lot of great reporting and blogging about this issue right now, and here’s some of the best: Jake Sobo, the always intriguingly transparent blogger behind Promiscuous Gay Nerd, shares the frightening encounter a poz friend had when he visited his local health department and ended up accused of maliciously spreading HIV. HealthlineNews has posted an update on cases in Iowa that involve the very advocates doing such inspiring work there. The Gay and Lesbian Alliance Against Defamation (GLAAD) has made the gutsy choice to post an essay on the media’s role in perpetuating ignorance about criminalization (even though many of their usual media outlets refused to run it).  The most comprehensive piece on criminalization, though, could be “Sex, Lies, and HIV,” a ProPublica piece recently re-posted by HIVPlus Magazine that examines several of the most high-profile cases.

Tags: , , , , , , ,
Posted in Books and Writings, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 4 Comments » | Posted by Mark S. King

March 24th, 2014

Lessons Learned from Kissing a Straight Boy

Last night I kissed a straight guy full on the lips. Then he tenderly put his arms around me and kissed me back. Tonight I’m going to do it again.

It sounds like conquest. Or breaking a taboo. At the very least it fulfills the fantasies of many a gay man.

And it makes me wonder why.

GayKissCartoonThe object of my affections is a man named Travis, and he plays my lover in a play we’re performing about a gay couple doomed by drug abuse.

Travis is most certainly straight, judging by the dorm room condition of his dressing area, his raunchy jokes and the effortless masculinity he possesses and that I can only approximate.

At an early rehearsal, long before any kissing would ensue, the director motioned me aside to share some surprising words.

“Let’s take our time working up to the kisses,” said the director. He lowered his voice a little. “Travis has never kissed a man. He’s straight.” It sounded like a condition.

And in a way, it was. It immediately colored how I acted around him, on stage and off. The play covers our courtship and as we rehearsed I felt another type of courtship happening. Was he watching me, thinking “that’s the guy I have to kiss?” Was I masculine enough? Did he think I was cute? Did he even care if I was attractive or not? Was he disgusted at the thought of touching me?

Obviously he was comfortable enough to take the role. But to be honest, he was nervous and it showed. I finally got the nerve to say something about it during a break.

“So Travis,” I began. “You’re straight and you’ve never kissed a guy I hear.”

“Yeah, yeah,” he said. “Sorry about that.” He was actually apologizing for being straight, and I felt like doing the same thing for being gay. “I guess it’s an issue for me but I’ll get more comfortable. I did a nude scene with a gay guy before, but I wasn’t playing gay and we didn’t kiss or anything.”

This man was on stage naked and found it easier than kissing a guy? I would French kiss the entire cast and crew of “Ugly Betty” before you would find me dangling uncovered on stage.

Bringing it up helped immensely. We not only joked about his “condition,” but we also discussed mine: HIV. It allowed me to engage in some basic HIV prevention education with someone who might not otherwise get candid answers to his concerns. Yes, he knew you couldn’t get it from kissing, but hearing it definitively made him more at ease.

We made a deal that we would start kissing when we no longer needed to hold scripts, and when that time came, I didn’t hesitate. And bless him, neither did he.

It was a brief, perfectly ordinary kiss. And it was done.

Once the occasion had passed I think we both realized it was much ado about nothing. But it got me thinking about why the fact he is straight made the idea of kissing him somehow more exciting. Why? It may be as simple as wanting what you can not have. And that’s a common desire.

It’s the other implications that bother me. Do I see a straight man as innately more appealing than myself? As “better,” as a more authentic specimen of Man? That would suggest I think of myself as less than ideal because of my sexuality.

Whatever the reasons, it’s not the only preconceived ideas I had about my straight co-star. I questioned if he could pull off the gay thing. Or would something, like his macho pride or his clueless heterosexuality, prevent his performance from being “authentic?”

But something happens every performance that surprises me and shames my prejudices. This lumbering straight dude who bristles when I call him “sweetheart” offstage becomes a giving, affectionate lover onstage. His eyes smile at me. He pulls me closer in our bedroom scene. He shows a sensitive, willing and playful vulnerability.

It has been an enlightening experience. I now realize how little faith I had in his talent, much less his humanity. I’m not alone. Half the cast is gay, and almost all of us play multiple roles in various sexual combinations. Between our sincere desire to understand our characters and getting to know each other, the backstage chatter runs somewhere between Dr. Phil and Jerry Springer.

We’ve all learned a lot. I learned that if something got in the way of portraying a gay couple on stage, it wasn’t the straight man’s phobias.

It was mine.

Mark

This piece originally appeared on my blog in October of 2011, but now I am ready to unmask my straight co-star! He is none other than the talented Travis Young, who has gone on to an exciting career as a television actor (he’s a regular on the new Resurrection). You can check out his Facebook page here. As for me, well, I’m still gay. — Mark

PLUS…

HIVisNotACrimeARTIt remains the defining HIV issue of our time: HIV criminalization, or people with HIV being arrested and prosecuted for not disclosing their status to sex partners, for instance. This is a very real thing, folks. Rather than an actual public health service, prosecutions seemed to be based on a belief that people with HIV shouldn’t be having sex at all, and they usually ignore the actual risks involved (judges and juries don’t seem to care if condoms were used, or even if anyone was infected or not). Some of the most exciting advocacy around this issue is being led by advocates in Iowa (yes, Iowa), so it’s fitting that the first national “HIV is Not a Crime” conference on criminalization will take place there. I urge you to look into this issue, and the best place to start would be the web site for The Sero Project.

Grindr picMy occasional health-related items for the pop culture site Queerty (possibly the most trafficked site for younger gay men) have been fun and challenging. Mostly, I’m intimidated writing in a “young, snappy” style that might appeal to their audience, especially since I’d rather just go lie down. So far my pieces have included explaining the new “undetectable” study; the role of meth and the health of people with HIV; and how at least one health department is joining the cruisers on Grindr. I’m really grateful for the opportunity to reach this audience and will keep on trying not to let my age show.

Tags: , , , , , , ,
Posted in Anita Mann and Acting Gigs, Books and Writings, Gay Life, My Fabulous Disease, News | 1 Comment » | Posted by Mark S. King

March 11th, 2014

Will HIV Ever Be Safe Enough for You?

There is a classic episode of Oprah from 1987 that can still raise my blood pressure. That year, the tiny town of Williamson, West Virginia, became part of a national discussion about AIDS when Mike Sisco, who had returned to his home town to die of the disease, dared to step into a public pool.

Scary nightmareThe community freakout was immediate. Sisco was quickly labeled a psychopath (rumors emerged accusing him of spitting into food at the grocery store), and the town pool was closed the next day to begin a Silkwood-style pressurized cleaning.

Soon thereafter, Oprah Winfrey arrived with cameras for a town hall forum about the incident.  Fear was the order of the day. “If there’s just one chance in a million that somebody could catch that virus from a swimming pool,” the town’s mayor told Winfrey’s worldwide audience, “I think I did the right thing.”

Sure. Why not react in the most extreme way possible, if there is a chance in a million?

Williamson citizens were not swayed by health officials who calmly explained the established routes of HIV transmission and the impossibility of infection from a pool. “The doctors can say you can’t get it this way,” a woman countered, “but what if they come back someday and say, ‘We were wrong?’”

Indeed. What if? If there’s a chance in a million…?

That broadcast might have remained a sad footnote in HIV/AIDS history, an instructive example of people ignoring scientific fact to protect a satisfying fear, if history didn’t enjoy repeating itself so much. Today, though, the willful ignorance isn’t coming from uneducated residents of a southern town you can barely find on a map.

It’s coming from gay men. And they are just as threatened, frightened, and dismissive of science as the townsfolk of Williamson were thirty years ago.

Recently, research known as The PARTNER Study was presented at the prestigious Conference on Retroviruses and Opportunistic Infections (CROI). PARTNER proved something HIV advocates have long suspected: people with HIV with an undetectable viral load are not transmitting the virus to their partners. The study included nearly 800 couples, all involved in an HIV positive/negative relationship, gay and straight, with the positive partner maintaining an undetectable viral load. Over the course of two years, more than 30,000 sex acts were reported and documented (couples were chosen based on their tendency to have sex without condoms).

Not a single HIV transmission occurred during the study from someone with an undetectable viral load. If PARTNER had been researching a new medication, they would have stopped the trial and dispensed the drug immediately.

The PARTNER results bolster the prevention strategy known as “Treatment as Prevention” (TasP), meaning, a positive person on successful treatment prevents new infections. To date, there is not a single confirmed report of someone with an undetectable viral load infecting someone else, in studies or in real life.

Just don’t tell that to a sizable contingent of skeptical gay men, many of whom took to their keyboards to dismiss the PARTNER findings. Phrases like “false sense of security,” “positive guys lie,” “junk science,” and “if there’s even a small risk” appeared on Facebook postings and in web site comment sections. The people of Williamson must be slowly nodding their heads.

Resistance to the PARTNER study corresponds with stubborn doubts about PrEP (pre-exposure prophylaxis, or HIV negative people taking the drug Truvada to prevent infection). Although virtually every nervous argument against PrEP has been overruled by the facts, naysayers continue to either reject the evidence outright or make moral judgments about the sex lives of HIV negative gay men on PrEP.

Yes, there are unknowns. There always are when scientific studies meet the real world. And every strategy will not work for every person. But the vehement rejection of such profound breakthroughs suggests there is something more, something deeper, going on in the minds of gay men. What is it?

Our collective memories of AIDS horror are hard to shake, and that’s a good place to start. On a gut level, any study suggesting that HIV could be neutralized is met with a weary doubt. Good news is no match for the enduring grief that has shadowed us for 30 years.

The PARTNER study also threatens the view that positive men are nothing more than risks that must be managed. The study kills the HIV positive boogeyman. It means positive gay men who know their status might actually care enough about their health to seek out care, get on treatment, and become undetectable. And, once the positive partner is no longer a particular danger, both partners would bear responsibility for their actions. What an enormous psychic change that would require in our community.

It’s tough to do that when fear creeps in and “what if?” fantasy scenarios take hold. What if my partner missed a dose yesterday and, even though HIV meds stay in the bloodstream for extended periods, his viral load has inexplicably shot up? What if he isn’t being truthful about his viral load? What if he doesn’t know?

The greater threat, folks, isn’t positive guys who think they are undetectable but are not. It’s men who think they are HIV negative but are not. But we’d rather stay focused on the positive person being at fault, because, well, people with HIV lie a lot. We miss doses constantly because we have a death wish or we’re too busy finding our next victim.

I have some “what if?” questions of my own. What if these unrealistic fears were meant to stigmatize and isolate HIV positive people? What if I am undetectable and feel no responsibility to discuss my status with a sex partner because I don’t care to engage in a science lesson? What if everyone availed themselves to prevention options that worked best for them? What if my HIV status were none of your damn business?

These risks could be alleviated, of course, if everyone simply protected their own bodies when having sex with people they don’t know or trust. But that would place an equal burden on negative men, and what a bother that is.  Better to leave that discomfort to those with HIV, vectors of disease that we are. Just consider us criminals, lying to you about our viral loads and spitting in the food in Williamson, just waiting to infect you when we get the chance.

 

As long as we’re giving undue attention to fantasy scenarios we’re not focused on the real threats. The rates of STD’s are up. Young gay black men in the United States don’t have proper access to healthcare and have infection rates worse than any developed country. Our community is plagued by  alcoholism, addiction, and mental illness. Do we want to debate established science or should we devote that energy to other challenges to gay men’s health?

If you still have the arrogance to believe you could win the HIV Powerball Lottery and be the one person who gets infected in ways science has disproven, you’re perfectly entitled to that point of view.

Here are some helpful instructions, however. Carefully step away from your computer and don’t touch the cords because 50 people die of product related electrocutions each year. Walk slowly to your bedroom, being mindful of debris in your path because slip-and-falls kill 55 people every single day. Once there, refuse food or water because, well, you never know. Now slip into your bed of willful ignorance and try to make yourself comfortable.

The good people of Williamson are keeping a spot warm just for you.

Mark

p.s. In the time it took you to read this article, the number of people who were infected by someone with HIV who had no viral load was zero.

Tags: , , , , ,
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 37 Comments » | Posted by Mark S. King

February 28th, 2014

Our Problem with Being ‘CURED’ of HIV

In the late 1980′s, I let this odd, fussy man into my office at LA Shanti, my first AIDS agency job. He seemed earnest and harmless and he just wanted a few minutes of my time. “I have the cure for AIDS,” he politely announced. Sadly, he wasn’t the first person to say that to me, but we practiced more suspension of disbelief during that wretched decade so making such a statement wasn’t immediate cause for removal from my office.

CURED CoverHe set a wooden box on my desk, the size of a breadbox and with unfinished wood, like something you had just started building in shop class. He opened it to reveal a jumble of wires and what appeared to be a very large battery of some kind. It looked like a bomb.

“Electromagnetics,” he said, with his index finger up, like a teacher. I was so entranced by the device that I didn’t notice him attaching one of the wires to my finger with a clip. I felt it softly bite my skin and looked down, horrified.

His scholarly tone didn’t change at all. “When I attach this to your other hand,” he said, reaching for it, “the magnetic field will purge your body and your blood.” I saw him taking my other hand. “This is science,” he added proudly. He was smiling.

I sprang from his grasp and shook the clip from my finger. I suddenly remembered I had a staff meeting. An extremely important staff meeting. I thanked him and excused myself to get to my very important, life saving staff meeting.

It’s tricky in the HIV community, using the “C” word. Long term survivors like me have had our hopes raised so many times, only for the rug to be pulled out from under us, again and again.  The list of miracles-in-waiting goes as far back as the dawn of the AIDS crisis itself. Herbal remedies. Rare fish guts. Tribal potions from exotic locales.

And so picking up a new book with that word right in the title, well, you can imagine the skepticism.

CURED: How the Berlin Patients Defeated HIV and Forever Changed Medical Science is exactly as advertised and a little more. Nathalia Holt‘s (below) engaging new book is quite a pleasant surprise, taking a user-friendly approach to its complicated subject. Not only does it provide the timeline of the advancements to date in HIV cure research, it gives us juicy, humanizing details about all of the players involved.

CURED Nathalia picMuch of Holt’s book has the characterizations and forward motion of a good novel. We meet “Christian” (not his real name), the first Berlin patient who has achieved a functional cure to date. We find out exactly what happened in that Berlin clinic when he received his HIV tests results, what he was feeling, how it affected his relationships. We learn that it was Christian, not doctors or scientists, who elected to end treatment after several months (beginning very soon after his infection), leading to the discovery that his virus was under control and has not flared up since.

The same goes for Timothy Brown, who achieved even more notoriety as the later “Berlin Patient” because of the drama of his curative process (he had two bone marrow transplants and nearly died more than once) and because he has been willing to be public about it.

Timothy is the real heart of CURED. His endearing humility draws you to him as the book follows everything from his medical journey to his love life to his surprisingly modest existence today.

(In both Christian and Timothy, minute amounts of HIV virus have been located in their bodies since their treatment, but these reservoirs have not caused health problems. This is known as a “functional cure.”)

All the principle players evidently cooperated with Holt, an HIV researcher herself, and the level of access shows. We not only learn who each of the major researchers are, but what brought them here, what their families are like, and what personal sacrifices they faced along the way. Particularly juicy are the stories of egos and competition among the scientists — and how people who made no contribution at all to various studies scrambled to get their names attached because of the cutthroat world known as academic publications.

Science has never been my thing. I’m not confident writing about it, and intimidated by reading about it. But, except in its last chapters when Holt hurriedly catches us up on the latest research, CURED is easy to follow and has engaging insight into the very real people behind the headlines.

And hey, how cool is it that no one was electrocuted as part of this research?

Mark

 

Tags: , ,
Posted in Books and Writings, Living with HIV/AIDS, My Fabulous Disease, News | 5 Comments » | Posted by Mark S. King

February 25th, 2014

What Donna Summer Still Means to Gay Men

The music my friends liked when I was a teenager intimidated me. It was the head-banging rock of the early seventies, and it felt alien and unappetizing. Most of all, it just felt… straight, in a way I knew I could never be. Alone in my room, I listened to my beloved Broadway musicals, and resigned myself to the fact that popular music would never really speak to me.

And then in 1977, when I was sixteen years old, I began sneaking into the only gay bar in Shreveport, Louisiana. Inside I found joy and liberty, fashioned with bell bottomed pants and handsome smiles and the dance floor – oh my God the dance floor – centering the nightclub was a glorious explosion of colored light and swinging hips and arms reaching up, up to the sky as if we could clutch it in our hands. The music was an entrancing bombardment of sound, and one song, one mesmerizing invitation to touch the heavens, was played again and again.

It was Donna Summer. And she was singing “I Feel Love.”

The track was really the triumph of producer Giorgio Moroder, who created the driving, synthesized beat that would define Donna Summer’s music for years to come. But I knew I had to own this amazing song, and soon I stood proudly at the record store cashier to buy my very first popular album, Donna Summer’s I Remember Yesterday.

I had found my music, my voice, and my lifelong muse.

The following year I had come out as a senior in high school, and Donna Summer was still in her “whisper period.” It was never my favorite sound from her – it felt like playing chopsticks on a grand piano – and I knew from her other album tracks that she could let it rip. As I was graduating she did just that, with the release of her iconic “Last Dance.” Her full-throttle pipes were on stunning display. Dance parties would never be the same.

By the time I left home for college in New Orleans, the music of Donna Summer had exploded into popular culture. I felt so proud of her, as if I had discovered her myself. My nights in the French Quarter were spent in the Parade disco on Bourbon Street, dancing to “Hot Stuff” and “Bad Girls.”

The feeling of joyous exuberance that surrounded that disco is hard to describe. It was a sea of shirtless men, staking claim to our sexuality and the promise of infinite possibilities ahead. The incessant thump! thump! thump! of the beat was our clarion call, and it shouted Here! Here! Your tribe is here! We were so beautiful, in ways we were much too young to know.

And then soon, of course, the lights began to dim.

By 1982, I was struggling in Los Angeles as an aspiring actor, and Donna Summer was having a musical identity crisis. Record executives wanted a new sound for her to accompany the changing times, and her longtime producer Giorgio Moroder had been replaced by a succession of others. The red-hot Quincy Jones produced her Donna Summer album that year and their studio clashes became legendary. The album floundered and produced no significant hits.

At the Los Angeles gay pride festival the next year, I was thrilled to hear Donna’s voice again, sounding gorgeous and almighty, singing “She Works Hard for the Money.” I took to the dance floor but was somehow unable to muster the joy I had known only a few years before. Life had intervened. And it had brutal plans for the men under the dance floor tent.

Donna Summer produced dance floor singles, if not hits, in the years that followed, but we weren’t paying attention. The night club crowds dissipated, as a silent killer plucked men away one by one. AIDS had begun its murderous march through the gay community.

The villain wasn’t simply the disease in those darkest of days. It was ignorance, and the judgment that rose up from social conservatives who saw Godly retribution in the horrific deaths of our friends. And so, when Donna Summer became a born-again Christian during this period and announced she would no longer perform her early, erotically charged hit “Love to Love You, Baby,” her gay audience viewed her with immediate suspicion.

An ugly rumor began. Someone claimed to have heard her make a homophobic remark during a concert appearance. Depending on who was repeating the story, she had either said AIDS was God’s judgment, or that God made Adam and Eve, not Adam and Steve. The unsubstantiated rumor swirled and grew, in an environment in which gay men were particularly sensitive to ignorance and hatred. By the time Donna Summer took it all seriously enough to set the record straight, it was too late. What was left of her popularity fell victim to the social maelstrom of AIDS.

I never believed the story, and defiantly continued buying her albums, though they appeared with less regularity. Donna Summer would have only one more true hit, “This Time I Know It’s for Real,” which I chose to perform for my maiden appearance in drag at an AIDS benefit. The fact that during this time Donna Summer was raising money for AIDS research gained little traction among emotionally bruised and unforgiving gay men.

Today, disco may be dead, but Donna Summer’s music laid the groundwork for everyone from Madonna to Lady GaGa, even if my body has found it harder to approximate the dance floor moves of my youth. But in my mind, as I blast “Dim All the Lights” in the privacy of my living room, I am young and powerful and life is making promises that are wonderful and possible.

Donna Summer is among the spirits now, joining the legions of ghosts haunting brightly colored discos from another era. She is still cooing to them, to these throngs of boisterous men, inviting them to the dance, where there is everything to celebrate and nothing to forgive.

The men are moving to the beat and laughing and holding one another. They are all beautiful, and they know it.

And they feel love.

Mark

(This originally appeared on this blog in May of 2012, shortly after her death. I continue to play Donna’s music, or at least hear it playing in my memories, every single day.)

Tags: , , ,
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease | 7 Comments » | Posted by Mark S. King

February 17th, 2014

The Fog of a Thousand Years

“Remember when Billy Perry gave you a black eye?” David asked me. He stood on a ladder with a screwdriver in his hand.  I was holding up Mom’s new light fixture while David attached it to the ceiling. We took on the project during a visit I made back home a few weeks ago.

MarkDavidKids“Of course I remember, David.” My response had the weary, patronizing tone I reserve for my older brother.

I’ve been speaking to him that way since  we were kids, I suppose. The strategy is to act like I’m completely bored with him so, if he tries to make fun of me, it will look like I don’t care. I always thought I needed the mechanism, since I came of age as a pimply-faced pansy who was an easy target. That, as opposed to David, who was only one year older and a blond, blue-eyed star athlete. No one ever believed we were brothers.

“So what do you remember, then?” he asked.

I rolled my eyes. “I was eight or nine,” I began. “Billy and I were goofing around in the back yard, and I pissed him off somehow and he punched me right in the eye.” My arms were getting tired from holding up the fixture and I shifted my feet.

“That’s all?” he asked, still focused on his work. “Stop moving.”

“Pretty much. I went inside and I was upset –”

“You were crying, man,” he corrected. He laughed under his breath.

“I was very upset. Mom was getting me ice and stuff. So after a while, Billy rang the bell and Mom made me come to the door so he could give some fake apology. Billy’s mom obviously made him do it. I’m sure he loved seeing how bad my black eye looked.”

“And that’s all you remember? Seriously?”

I wasn’t enjoying reminiscing about Billy Perry. “Yes, David. That’s all that happened.”

“No, it’s not,” he said, and he stopped his work to look down at me. “You walked in the house. You were crying. I asked who hit you and you said Billy. So I left and found him down the block and I kicked his ass.”

David watched my jaw drop. “Billy’s mother didn’t tell him to apologize, Mark,” he added. “I did.”

“Oh c’mon, no way,” I replied, a little weakly, feeling something like frustration. How could I not have known this? And besides, this was my black eye story. I’m the one who got punched.

“Hold the light up higher,” David said, and he tugged on the fixture. “Do you even know how many times you would have been beaten up if it wasn’t for me?”

MarkDavidFishRecasting David as my protector seemed ludicrous. He was frustrated all the time when we were growing up, unsure how to handle a brother who wasn’t the companion he might have expected. I loved Broadway musical albums. He loved the noisy drum set that dominated our shared bedroom.

And yet, the most antipathy he could muster was to ridicule me as I made my way through the confusion of gay adolescence. I resented his effortless masculinity and the fact I had to watch this annoyingly handsome straight dude grow up right beside me, reminding me on a daily basis of all I would never be.

My shoulders ached from holding up the fixture but now I barely noticed, too busy trying to get a handle on a lifelong resentment that suddenly wasn’t holding up under close scrutiny.

Brothers fight. But I only got one black eye in my whole life. And it wasn’t from David.

“What do you mean I would have gotten beaten up?” I asked him, finally. “I was so gay those guys were scared to get near me. I freaked them out too much.” I honestly believed that my late 1970′s fashion choices of jumpsuits, platforms and elaborate jewelry kept the straight boys of Bossier City, Louisiana too off balance to bash my face in.

“Mark, I had guys on my football team who wanted to crush you,” David said. “All the time. But they knew I would never let them. That’s how you made it out of high school alive.”

He finished with the installation and stepped down. I finally let go of the fixture and shook the numbness from my arms.

David was changing the narrative of my adolescence and I didn’t like it.  I wanted to count him among the high school jocks and hayseeds who taunted me. Those  bullies are gone, lost to time or floating around in alumni Facebook groups that I never join. David remains, so he became the default stand-in for the injustices of my youth.

I was sweeping bits of wire and drywall from the room when David spoke up again. “Did you ever think about what it was like for me, Mark? When we were in high school?”

I narrowed my eyes at him, amazed the popular varsity quarterback would dare take any childhood sympathy for himself. “Oh, please, David. Really?” He stood there. “Fine. What was it like for you?” I dripped sarcasm. “How did my struggle coming to terms with my gay identity in a hostile environment affect you, pray tell?”

He considered his words, mentally editing them down to a single remark. “It was just hard, Mark,” he said. “That’s all.”

And somehow, in that moment, my selfishness abated. I allowed the possibility that it could be tough growing up with a gay pride parade float as a brother.

MarkDavidTodayOnce you change the lens, other things come into view. Like the openness of David’s emotions, and his guilelessness when facing our family tragedies. He was the one who said he could never handle it if Dad died, even as our father’s fate was sealed, even as the rest of us had the same thoughts but couldn’t express them.

David tells me he loves me, even if I stare back wordlessly. He asks blunt questions.

“Are you going to die?” David had asked in a crackly long distance phone call nearly thirty years ago, when I told the family I was HIV positive. “Are you sure you’re not going to die?” he repeated. It was what everyone in the family wanted to know, of course, only no one dared to pose the question. It never occurred to David not to. If I had been able to peer over the wall I had constructed between us, I might have loved him for asking.

We are the storytellers of our own lives. We select the bits and pieces to remember, and the truth fades. It becomes lost in the fog of a thousand years.

Mom returned home to the sight of her two youngest sons standing beside their afternoon installation. While I displayed the fixture like I was a model from The Price is Right, David explained the details of his electrical prowess.

“But I vacuumed,” I jumped in. I clicked off my contributions as if they were a checklist for Mom’s affections. “I took all the parts out of the box. I cleaned up the mess. I held the light fixture!”

“You didn’t need to hold the fixture,” David said, and his smile gained wattage. “I just liked seeing you squirm.”

I threw up my arms. “What do you mean? It could have fallen on my head!”

“Not a chance,” David said. “I was actually holding it up at the ceiling.” He punched me in the arm. “I had you the whole time, little brother.”

And with casual amusement and affection, David grinned again.

Mark

———————————————————–

PLUS…

poz raftingTwo upcoming events for people with HIV are selling out fast, and I’m a big fan of both of them.  The 10th Anniversary HIV Cruise Retreat (“The Poz Cruise”) will set sail this November 1-8, and special incentives are being offered until the end of February. This is an amazing week of fun and fellowship for people with HIV of all stripes and our allies.  Meanwhile, if you are an HIV positive gay man and in recovery, the 2nd annual Positively Fabulous retreat is being held this April 10-13 and they are nearing their capacity as well. Check the web links for more information!

Tags: , , ,
Posted in Family and Friends, Gay Life, Living with HIV/AIDS, My Fabulous Disease | 7 Comments » | Posted by Mark S. King

January 27th, 2014

The Sound and Fury of the PrEP Debate (and the Facts to Win It)

“We don’t know the side effects of this drug. It’s too expensive. Insurance won’t cover it. It hasn’t been studied enough. It will encourage slutty behavior. And why the hell don’t people just use condoms?”  

– Objections raised to the oral contraceptive progesterone (“The Pill”), approved by the FDA      54 years ago.

When the drug Truvada achieved FDA approval in July of 2012 as a medication to prevent HIV infection among people who are negative (a strategy known as pre-exposure prophylaxis, or PrEP), it’s as if the ghosts of naysayers from the 1960′s rose from their resting places, delighted and re-energized, and began drilling their mid-century objections into the hearts and minds of contemporary society.

Condom in a jeens' pocket and crossed fengersMaybe proponents of PrEP like myself believed the response to the drug would be more enthusiastic. Surely anyone who lived through the horror of early AIDS would thank God that a new prevention strategy exists that doesn’t rely upon condoms alone. The fury of the response has been a little startling to me.

Fortunately, Facebook groups and online sites that explain the facts about PrEP are springing up everywhere to address misinformation and to clarify legitimate areas of concern. Here are the most persistent objections to PrEP, and the facts as we know them.

People wouldn’t need PrEP if they would use condoms. They just want to bareback. Studies show that people on PrEP do not have an increase in high risk sexual behavior, but cynics have visions of wanton orgies ahead worthy of vintage gay porn. Alas, what others do in their sex lives is out of our control, whether that drives people up the wall or not.

The facts are these: more than half of gay men do not use condoms or do not use them consistently. This fact has remained true throughout the 30 years condom use has been measured among gay men, including during the darkest years of the AIDS crisis. We can address 50,000 new infections a year or we can have a useless moral debate.

The lack of condom use is what makes PrEP so exciting as a prevention method. The very first large study of Prep was the iPrEX Study, an international study of 2,500 people that was comprised mostly of gay men and some transgender women. The study showed that people who use Truvada as PrEP correctly (taking a pill every day) can have their risk reduced by 90% or more, depending on adherence. Some models show an efficacy rate of up to 99% based on near-perfect adherence.

PrEP is also not dependent on last minute decisions in the heat of passion. Taking a pill in the morning is calmly detached from having sex that night.

PrEP is not necessarily an either/or proposition, because lots of people taking PrEP are also using condoms. But let’s be real. Most people seeking out PrEP already don’t use condoms or they don’t want to use them anymore. Since they are trading one prevention device for something that has a better success rate and is easier to use, what’s it to you?

We don’t know the side effects of TruvadaWe have years of data of Truvada side effects on people with HIV (it’s been FDA approved to treat HIV since 2004). Truvada was selected for clinical trials as a PrEP drug because of its favorable safety profile.

It is true that there are some reports of bone density and kidney problems among people with HIV using Truvada as part of their treatment regimen. These side effects have sometimes been serious. We can’t assume the experience of HIV negative people will be the same, and that’s why Truvada patients, positive and negative, should be routinely tested for bone density and kidney function.

More and more HIV negative writers and bloggers (and even a gay porn star) are sharing their experiences on PrEP but, thus far, side effects haven’t been part of their story. Watching them share their progress publicly over time should be quite interesting.

PillUnderstanding side effects is part of the assumed risk we take with medications, as any television commercial for a pharmaceutical drug will attest. If you don’t want to cough up blood, for instance, or have bloody stools or nausea or a ringing in your ears, don’t take aspirin. Those side effects are uncommon, and so are the side effects for Truvada.

People taking PrEP also have the option of discontinuing Truvada depending on life events and necessity. Maybe you stop dating the HIV positive guy, or take a break from casual sex, or return to condoms for a while. Starting and stopping the drug in this way does not lead to resistance as long as a medical professional verifies you are HIV negative before restarting.

If you are wary of Truvada side effects, don’t use it. And allow others to make that same determination for themselves.

PrEP is too expensive and insurance won’t cover it. This argument is losing steam rapidly. The Affordable Care Act in the United States is underway and by all accounts every insurance company as well as Medicaid is covering Truvada — although it may require pre-authorization from a doctor for use as PrEP (the CDC has produced a handy document available online to help explain PrEP  to your physician).

For those without insurance or money for a co-pay, Gilead (the maker of Truvada) has a patient assistance program that can provide the drug outright or supply co-pay cards worth up to $200 per month. Even if none of this were true, the potential benefits of a drug should not be assessed solely by its price tag.

The people who need it most can’t access it anyway so what’s the point? It’s a good thing we don’t have this attitude towards condoms. Access isn’t the same as efficacy.

But it is certainly true that young gay black men, whom the epidemic is affecting in shocking numbers, have less access to healthcare. This is a systemic problem and it is unfair, frankly, to expect PrEP to solve it. It is also true that PrEP can be an occasion for HIV negative people to seek care, and once on PrEP they are typically required to have medical follow-ups throughout the year, which offers obvious benefits.

The biggest hurdle is often physicians themselves. HIV negative people may have a doctor unfamiliar with HIV care, much less PrEP, and those doctors are often intimidated by what they see as the complexities of HIV treatment. Until more professional education is done, potential PrEP users must learn to advocate for themselves and share CDC recommendations with their doctor.

People won’t adhere to PrEP and that will create resistant strains. It is true that in some early PrEP trials adherence was a problem. Real life behaviors, though, differ from clinical trials in some important ways.

Trial participants have no idea if they are taking the actual drug or not, and in trials the efficacy of the drug hasn’t even been proven. So, the commitment of trial participants to stay adherent to the drug is less rigorous than users today, who know that the drug works, know they’re getting the real thing, and are invested in remaining HIV negative. People taking PrEP today have more skin in the game, as it were.

For those who do miss the occasional dose, Truvada is somewhat forgiving. The protective ability of the drug doesn’t drop if you miss a single dose because Truvada remains in the blood for up to 72 hours (compare that to missing a condom occasionally, which CDC statistics show to be as risky as never using them at all). That being said, it is optimal and recommended that Truvada be taken consistently each day, and users should take seven daily doses for Truvada to achieve optimal protection.

Taking Truvada alone when a PrEP user doesn’t know they are already positive can lead to resistance and significantly reduce treatment options. Resistance has not been found with individuals who were verified HIV negative at the time they started Truvada, but it has happened in people who became HIV positive due to low adherence.

PrEP is just putting money into the pockets of pharmaceuticals when we have cheaper solutions.  I can’t imagine anyone telling HIV positive people not to take their medications because their drugs are making profits for Big Pharma. The argument that HIV negative people aren’t worth a fraction of that investment astounds me. I suppose we should wait until negative people get infected before it’s okay for them make a profit for the drug companies.

And those are the facts as we know them about PrEP. I have no delusions that the debate will calm any time soon, of course. Human nature is far too predictable for that.

Just recently, politician Mike Huckabee addressed a gathering of fellow Republicans. Part of his remarks, delivered half a century after The Pill was approved for contraception, was his belief that “smart” women don’t need the government “providing them a prescription each month for birth control because they cannot control their libido.”

Right. Because birth control, as critics have been saying since 1960, would be unnecessary if women only showed some restraint and didn’t behave like barebacking sluts.

Everything old is new again.

Mark

My thanks to HIV advocate Jim Pickett of AIDS Foundation Chicago for his expertise on this issue. Jim is active in the development of rectal microbicides (lubes and douches that kill HIV on contact). Damon L. Jacobs, who writes about his personal experience taking PrEP, also served as a resource.

Tags: , , , , , ,
Posted in Gay Life, My Fabulous Disease, News, Prevention and Policy | 19 Comments » | Posted by Mark S. King

January 19th, 2014

Designing and Disclosing on Project Runway

If you’re considering how to best disclose your HIV positive status to everyone you know, here’s one suggestion: learn to sew. Television’s long-running reality hit Project Runway could be holding a spot just for you.

Jack MackenrothOver the course of a dozen seasons, the fashion competition series has tackled everything from drug addiction to racism to gender reassignment among contestants, and it has hosted more HIV disclosures than any other reality show. The latest addition to the trend is designer Viktor Luna, the contestant who sported the fluttering handheld fan on this year’s Project Runway: All Stars.

Exactly how these disclosures have come about over the years is a study in contrasts, as different as the three HIV positive contestants themselves – and the whims of show producers.

In 1998, season four of Project Runway introduced the world to designer Jack Mackenroth (pictured right), the competitive swimmer, model, and all-around sex symbol who had already been living openly with HIV for 17 years. His casual disclosure during an early direct camera interview during his season showed a man comfortable with himself and his status.

“The producers knew I was positive because we fill out a stack of background information,” Mackenroth told HIV Plus. “They had my entire medical history, like every other contestant on the show.”

Already an HIV advocate at the time, Mackenroth knew the producers would eventually use his HIV as a dramatic device, but “that was fine with me,” he said, “because I saw it as an important tool as well, for HIV visibility and as a chance to fight stigma.”

That opportunity was lost when fate intervened. Before he could disclose to his fellow contestants on camera, Mackenroth developed a serious infection unrelated to HIV that forced him to withdraw from the show five episodes into the season.

“Tim Gunn sat me down and reassured me,” said Mackenroth. “He told me that everything happens for a reason, and in that moment I was like, Yeah, right. I was exhausted and emotional. But the truth is, that show gave me my platform. It worked out great.”

It would be years later until an HIV positive contestant would actually disclose their status to the cast on camera, but when it finally happened it brought all the drama and emotion the famously controlling Project Runway producers could ever imagine.

MondoIn 2010, season eight of the series included Mondo Guerra (pictured left), an insanely talented young designer who was as guarded as he was endearing. Although one should be mindful that footage is carefully edited to create characters and increase drama, Guerra certainly seemed like an artist with a painful secret or two.

During a challenge to create an original textile, Guerra designed a graphic print with a conspicuous “plus” sign throughout it. In direct camera segments, he revealed that the design reflected his HIV-positive status but otherwise kept his inspiration to himself, having not disclosed to even his own family at that point.

When pressed on the runway later to explain his design, Guerra demurred again. The judges stared in wonder. The music swelled. Filled with nervous emotion, Mondo haltingly revealed his HIV status as the inspiration for his textile. Viewers saw not only his tears but something more: a humble sort of triumph.

“I feel free,” Guerra said plainly.

Guerra’s disclosure was given generous air time during the episode and was the dramatic centerpiece of the entire season. The moment has been replayed endlessly on YouTube and was shown to a packed ballroom at the 2013 United States Conference on AIDS. It was undeniably inspiring, seemingly spontaneous, and brilliant television.

“Knowing Mondo, I think that happened organically,” said Mackenroth. “Of course, everyone is working nonstop, producing a full season in 35 days. When these vulnerable situations come up, we hardly have time to think it through.”

“When the judges genuinely wanted to know the story behind my print and design, that felt like the right moment,” Guerra told HIV Plus. “So I told them what it really represented and that moment was a turning point in my life.”

If Mondo provided the pinnacle of televised disclosures, the current season of Project Runway: All Stars has given us the most curious presentation of The Big Reveal.

ViktorIn one episode, designer Viktor Luna (pictured right) and the cast were scampering about, hard at work, and suddenly Luna begins speaking of his great anxiety in voice-over. Something is weighing heavily on him. He takes two designer pals aside and quickly shares his HIV-positive status. His friends say supportive things, they hug, and then they all dash back to their sewing machines as if they’d just had a quick smoke break. Luna’s status is never mentioned again.

Luna’s disclosure, as edited, felt like an afterthought, as if the producers noticed a lull in the excitement and cued Luna to bring on the drama. Producers might have hoped for something touching, but the hurried editing actually minimized the complicated nature of HIV disclosure. Everything about it felt false.

You know we are living in a more fortunate time when the merits of one televised HIV disclosure over another are being argued.

“Regardless of how it’s produced, it’s all a win,” says Mackenroth. “Whenever this or any show combats stigma, the HIV community benefits from it.”

Guerra sees a personal benefit too.

“Personally, it wasn’t until I was open about my status that I started to take better care of myself,” Mondo told us. “For that reason, I applaud Jack’s openness about his status.”

Today, Mackenroth continues his advocacy as one of the creators of the HIV=Equal campaign. Guerra has entered the fashion design stratosphere and is a key player in the Project iDesign Campaign, which encourages doctor/patient partnership. Luna wrote about his HIV disclosure on Huffington Post, sharing the details of his HIV journey that were not included in his Project Runway: All Stars episode.

Nothing is assured, in fame or fashion. Project Runway contestants are often struggling designers who leave whatever jobs they have to compete on the show. For any of them to put their personal lives on the line, to take the sometimes frightening step of revealing their HIV status to the world, takes a special kind of courage.

Many people with HIV may not be fashion designers, but they can certainly relate to that.

Mark

(This is a slightly edited version of my essay that originally appeared on the site of HIV Plus Magazine. Jack Mackenroth photo by Stan Madden. Viktor Luna photographed at Mercedes Benz Fashion Week by Fernanda Calfat/Getty Images.)

Tags: , , , , ,
Posted in Living with HIV/AIDS, My Fabulous Disease, News | 2 Comments » | Posted by Mark S. King

January 9th, 2014

HIV Treatment Activist Nelson Vergel Faces Down Cancer

In the summer of 2013, thousands of subscribers to Nelson Vergel’s “PozHealth” listserv received a startling email from the HIV positive fitness and nutrition expert.

Nelson Bald“You are probably wondering why I have been so quiet the last few weeks…” the message began. Vergel, a trained chemical engineer who devoted himself to HIV treatment advocacy after testing positive in 1985, had a troubling explanation for his online absence. A diagnosis of cancer.

“It took me months to come out to the poz group,” Vergel said about revealing his diagnosis to his listerv. “It was a struggle for me.”

Vergel had begun the group in 1999 when lipodystrophy was a hot topic among people with HIV/AIDS and they needed a place to compare notes, and it has since become the largest treatment information listerv for people living with HIV. It still thrives at a time when the exchange of HIV treatment information among peers has waned.

The success of the group perfectly reflects the dedication of its host, a gay bodybuilder whose own serious struggle with AIDS over the years belies his appearance of physical strength. Group members clearly admire Vergel and see themselves in his medical challenges and triumphs.

So it was with some trepidation that Vergel revealed a new health crisis to the group, one that forced his HIV to the back burner. “I was very concerned that people might panic, not about me, but themselves. I didn’t want them to think this applied to them,” Vergel said. “I really was more concerned with them projecting my challenge onto themselves.”

He had little choice, however. His condition was serious.

In June, Vergel was experiencing stomach problems that doctors initially believed to be ulcers. Then came a diagnosis of H Pilori, a stomach bacteria. Vergel requested an upper GI endoscopy, during which ulcers were found and biopsied. While treatment with antibiotics killed the bacteria, the news from the biopsies was grave: Vergel had a aggressive brand of cancer known as non-Hodgkins lymphoma.

“I was shocked,” said Vergel. It wasn’t the feeling of impending death he had experienced when he tested HIV positive in 1985, but something more incredulous. “It hit me really hard. I had been preparing for heart attacks, or anal cancers, which I have checked every year. I was controlling those high risk situations. But this…?”

Despite the cruel irony of battling mightily against one disease and then facing another, it didn’t take long for Vergel’s instincts as a treatment advocate to take hold. “After I got the news, I got into my car and cried a little,” he said. “And then, before I called my partner, I got on the phone and did a Google search.”

Nelson ChemoHis research confirmed the treatment plan of chemotherapy that his doctor recommended, but he soon discovered that cancer healthcare isn’t nearly as accustomed to empowered, involved patients as is the world of HIV.

“I realized how behind oncology is from HIV,” Vergel said, “because there are fewer online resources for patients. It felt like early HIV. They don’t discuss side effects until they happen to you. I kept finding out things randomly. It made me realize how good we have it in HIV. In oncology all they care about is killing the cancer. But part of the goal should be protecting the patient from side effects.”

His treatment as a patient was often the antithesis of what he has advocated for HIV patients for decades. That advocacy, and Vergel’s influence in crafting programs to empower HIV patients, is considerable.

Vergel educated himself on HIV pathology and medications after his HIV diagnosis, and became involved in several national health commissions, leading to his founding of the Program for Wellness Restoration in 1994. Because of his interest in physical fitness, he pushed for federal funding for studies of anabolic steroids and promoted results of earlier studies that showed that once you reach 55% of lean body mass, your chances of survival drop precipitously.

He was convinced that resistance training, nutrition and supplements are a key weapon against HIV. His 1998 book, Built to Survive, found a place on the shelf of nearly every gay man who had HIV and a gym membership.

For better or worse, the image of muscled gay men with HIV that emerged in the 1990′s, pumped up from weight training and anabolic steroids, can be directly attributed to the seminal work of Nelson Vergel, who trumpeted the importance of lean body mass in fighting HIV infection and maintaining a healthy immune system.

Unfortunately, his own HIV has been multi-drug resistant, and Vergel is currently on the last available regimen to treat his disease. The clinical expression for patients like him is “treatment failure.” Vergel hates the term.

“Being called a failure sends the wrong message to patients,” he said. “and I have been trying to change that language in the treatment world. It’s demeaning to patients who are adherent.”

As his cancer treatment progressed, other differences between his two health crisis emerged.

“A good friend of mine was diagnosed with cancer the week before me. He said, ‘I have neighbors cooking for me. Doing my laundry. Isn’t it sad that I could never disclose my HIV, but I can disclose this and everyone rushes to help? This is a diagnosis that my community can get behind. Isn’t it sad that HIV isn’t the same way?’”

The good news is that, unlike Vergel’s history with HIV medication, the cancer treatment seems to have worked.

Nelson Wedding“There is no cancer based on my last biopsy,” Vergel said. True to form, Vergel made the decision himself to stop the rounds of chemo early because he was concerned with its effect on his immune system. But he remains vigilant. “You are never cured of cancer. Like HIV, you have to keep an eye on it.”

The last six months have been “the most intense of my life,” he said, but it has also included signs that life, and joy, can go on. Vergel and his longtime partner were married in Washington, DC, on September 21.

“Always enjoy the moment,” Vergel said. And then he adds an observation for those living with HIV. “Apply what you have learned in HIV and take control of your own health, no matter what the diagnosis. Oncologists are not used to seeing patients like us. Long time HIV survivors have many years of experience dealing with the healthcare environment, we have gathered lessons on second opinions, questioning our doctors, we’re relatively young and healthy and have learned a lot of skills.”

Today, Vergel is again busy posting to his POZHealth listserv, offering advice in TheBody.com’s “Ask the Experts” forum, and he just founded a new men’s health program, ExcelMale . Even the hair he lost during chemo is growing back.

“I didn’t know how resilient I was until I went through this,” Vergel says, and then there is a thoughtful pause. “Resilience. I like that word.”

Mark

Some of the most popular My Fabulous Disease videos have shown Nelson trying to whip me into shape. “Fitness Stud Nelson Vergel Raids My Fridge” is hilarious and informative, “Hitting the Gym with Fitness Expert Nelson Vergel” benefits from his tight tank top, and “The Hard Facts on Erectile Dysfunction” offers advice on, well, you know (and opens with us in bed together). Check them out!

Tags: , , , , , ,
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, Prevention and Policy | 6 Comments » | Posted by Mark S. King