HIV/AIDS: After 50 years, how close are we to a cure? Part II

17th January 2012   ·   0 Comments

By Michael Radcliff
Contributing Writer

“All it took was one day. In December of 2009, I had a friend fly into town. It was a friend who I dated exclusively and who I thought dated me exclusively. I told him to bring a condom since we hadn’t been together in a while and so he did. In the middle of our encounter, he removed the condom because it was bothering him. That’s all it took. Two or three weeks later, I started experiencing flu-like symptoms; fever, chills, etc.

I asked my sister to take me to the hospital because I could not eat and felt really ill. The doctor ran labs and to my surprise it wasn’t the flu, I was diagnosed with herpes and chlamydia. I could not believe I was going through this, I did not want to get tested for HIV because I was afraid of the results and so I didn’t.

Life went on for about another year. I worked and took care of my child and that’s all I did. I don’t date anyone or haven’t dated anyone since my herpes outbreak in 2009. In November of 2010, I felt a bump in the back of my neck, it turned out to be a swollen lymph node. I went to the doctor’s to have it checked out and somehow got the courage to be tested for HIV.

One week later, I received the call. It was my doctor asking me to come in right away; somehow, I knew that the news were not going to be pleasant. I walked into my doctor’s appointment and I was given the results. HIV POSITIVE. I was in a state of shock, could not believe the news and broke out in tears. The first thing I thought about was my children, the oldest being 20 and my youngest five. “Am I going to die?” was the first question I asked. The doctor went through the process of getting a second test to confirm the results and treatment if needed.Second results came in and same news. HIV POSITIVE. I am 39 years old, single mom of a 5 year old and 20 year old. My daughter has been very supportive though this ordeal. I know my 20-year-old will be alright, but constantly worry, feel guilty and heartbroken when I lay next to my five-year- old at night and think about what I’ve done. I think about that night in 2009 when I could have jumped off the bed and told him to get off when he removed his condom. Yes, I still feel very guilty about that night because I trusted him.”

– A Single Mom Living with HIV

Part II of a three-part series

In this continuing series, The Louisiana Weekly in its mission to educate and inform, will be examining the HIV/AIDS pandemic and the origin of this plague of the 21st century; its infectious process; statistics and populations at risk; the social stigma or “modern-day” leprosy, A Day in the Life of an HIV/AIDS survivor; legal rights and ramifications of HIV/AIDS-infected individuals; and current medical treatments, breakthroughs, and an individual who was actually cured of HIV/AIDS. The testimonials of this installment were extracted from the AVERT website and are actual statements given by HIV/AIDS survivors; for oblivious reasons, they remain anonymous. AVERT is an international HIV and AIDS charity, based in the UK, working to avert HIV and AIDS worldwide, through education, treatment and care.

Who Are Those at Risk for Contracting HIV/AIDS?

Although HIV at one time was considered a gay white male’s disease, it isn’t. While In the U.S. the majority of those infected are at present still male, across the globe, over half of the individuals now living with HIV/AIDS are in fact women or girls. HIV/AIDS transcends gender.

While the majority of individuals infected with HIV/AIDS currently live in Africa, there, the rates are steadily declining. The infection rate in most of Europe as well as all of North America however, remains steady or with minimum change in either direction.

“There is a general apathy in this country towards HIV/AIDS,” explained Mike Hickerson, former director of ITT as well as organizer of the annual “Red Umbrella” HIV/AIDS public awareness campaign. “It doesn’t affect most people until it infects them… or their friends… or their family members.”

Since the United States officially recognized AIDS as a potential national threat to American citizens in 1981, over one million documented cases of HIV/AIDS have been reported in the U.S. alone; of these HIV/AIDS survivors, nearly 85 percent live in major metropolitan areas.

• One-quarter of new HIV infections occur among adolescents and young adults (ages 13 to 29)

• The HIV diagnosis rate for African-American women is more than 19 times the rate for White women. Sixty-four percent of all women living with HIV/AIDS are African-American.

• Twenty-four percent of people living with HIV are 50 or older, and 15 percent of new HIV/AIDS cases occur among people in this age group;

• The South and Northeast, along with Puerto Rico and the U.S. Virgin Islands, are disproportion­ately impacted by HIV;

• In the State of Louisiana in 2009 there were nearly 25,000 confirmed HIV/AIDS diagnoses, the actual number could very easily exceed twice this total or more.

• An estimated 21 percent of people with HIV in the U.S. do not know their status.

• According to the Centers for Disease Control and Prevention, gay men comprise approximately two percent of the U.S. population, but 53 percent of new infections.

Aside from a brief decline in the first few years of the new millennium; in spite of universal access to the latest drugs, treatment modalities, care, and support – the number of new HIV/AIDS infections in the United States remains steady. Suggesting that it’s not simply a question of money or access to care, but awareness, education, disclosure and self-protection.

HIV/AIDS and Its Devastating Impact on the Black Community

While HIV/AIDS affects all Americans indiscriminately, some populations are disproportionately affected. The early profile of those affected were gay males, IV drug abusers, hemophiliacs, and later Haitians. Inasmuch as HIV/AIDS continues to plague gay males and injecting drug Users, it has now become a serious problem for the African-American community and more recently, the Hispanic/Latino population.

According to the CDC, “African Americans account for 40 percent of all recorded AIDS-related deaths” in America; and in 2009 made up half of all new HIV diagnoses and just under half of new AIDS diagnoses. African Ameri­cans account for the largest population [based on race] of people living with an AIDS in the United States today. While over half of all men diagnosed with AIDS in 2009 were African-American men; the majority of African-American women who became infected, became infected through heterosexual contact with primarily African-American men. African-American men and African-American women are both most likely to be exposed to HIV/AIDS through sex with a man.

There is no one cause for HIV/AIDS affecting the African-American community. A myriad of causes exist and must be addressed. Poverty, education, unemployment, and limited access to health care are just a few of the social ills which propel individuals to engage in risky behaviors. While myths continue to paint certain classes of people as more morally corrupt than others, it is now generally accepted that it is more a question of an individual’s sexual network moreso than her or his behavior, that ultimately determine a risk for contracting HIV/AIDS. In other words, African-American women overwhelming choose African-American men as their sexual partners and thus the axiom “Keeping it in the Family ”unfortunately also applies to HIV/AIDS infections.

The two primary modes of infection in the African American community are: (1.) Sexual transmission

“Having unprotected sex with a man is the leading cause of HIV infection for both African-American Women and Men”

In the summer of 2010, a study conducted by the White House Office of National AIDS Policy revealed that fully one half of the gay and bisexual African-American males in Baltimore, Los Angeles, Miami, New York, and San Fran­cisco were HIV-positive. [CDC. HIV Prevalence, Unrecog­nized Infection, and HIV Testing Among Men Who Have Sex with Men – Five U.S. Cities, June 2004-April 2005.] In the fall of that same year, another study conducted by the CDC of 21 cities [which included New Orleans] concluded that nearly one-third of African-American males having sex with other males were infected with HIV/AIDS. Among this group, young gay and bisexual African-American males, between the ages of 13 to 29 were most at risk for being exposed. They were also least likely to be aware of their HIV status and as a result continued the cycle of passing it on to others.

Higher overall levels of STD or sexually transmitted disease infections among African Americans correspondingly increase the risks of HIV infection. The rate of infection for African Americans testing positive for chlamydia is eight times that for white Americans, and it swells to 18 times, for African Americans testing positive for gonorrhea.

• Gonorrhea: While reported rates are at historically low levels, cases increased slightly from last year and more than 300,000 cases were reported in 2010. There are also signs from the CDC surveillance system that Gonorrhea may soon become resistant to the only available treatment option.

• Chlamydia: Case reports have been increasing steadily over the past 20 years, and in 2010, 1.3 million chlamydia cases were reported, yet the majority of infections still go undiagnosed.

• Syphilis: The overall syphilis rate decreased for the first time in a decade, and is down 1.6 percent since 2009. However, the rate among young Black men has increased dramatically over the past five years (134 percent). Other CDC data show a significant increase in syphilis among young Black men who have sex with men (MSM), suggesting that new infections among MSM are driving the increase in young Black men. This finding is particularly concerning since there has also been a sharp increase in HIV infections among this population.

The second-most common mode of infection in the African-Ameri­can community today is: (2.) Drug Use

At the onset of the AIDS pandemic IDU (or Injecting Drug Use) was identified as a primary means of infection; however, virtually any street drug [including marijuana, crack cocaine, crystal meth, etc.] poses an increased risk of HIV/AIDS infection. In the African-American community drug use is the second-most common mode of transmission for individuals acquiring HIV/AIDS infection. In 2008, drug use, more specifically IDU, accounted for nearly one in five AIDS diagnoses among African Americans. The survival rate of individuals infected via IDU is dismal — they often die relatively quickly after they convert from a positive HIV status to an active AIDS period .

Aside from Injecting Drug Use, virtually any form of illicit drug use places a person at an increased risk for HIV/AIDS. Many addicted users, especially females, often resort to prostitution as a means of supplying their habit. Multiple partners, along with often unprotected sex, often ends up being a formula for infection. Additionally, since drugs generally reduce an individual’s inhibitions, this in turn increases the likelihood of individuals engaging in risky sexual behavior.

African-American Women — A Particular Concern…

In 1983 the CDC documented the first two cases of AIDS in women. Both women — one Hispanic, one African-American — were exposed to the virus through heterosexual sex with the same source – an intravenous drug user. By 2007, or 24 years later, according to the CDC, HIV had become the third- leading cause of death for African American women aged 35 to 44. In 2009, African-American women accounted for 30 percent of the estimated new HIV infections; and most, [or 85%] of the African-American women with HIV acquired HIV through heterosexual sex with African-American males. The estimated rate of new HIV infections for African-American women was more than 15 times as high as that of the rate for white women.

A study conducted in July 2006 by Adimora, Adaora A., et al., showed a link between an African-American woman’s social background and sexual networks in the community. The results as described by AVERT shows that, “rates of imprisonment and death and drug use among [African-American] men influenced patterns of sexual networks conducive to the spread of HIV and other STDs. [for example] African-American women, especially those who were poor or had lower educational attainment [and thus lower self-esteem], were believed to feel dependent on men and more likely to tolerate their partner having concurrent [and multiple] sexual partners. Similarly, African-American women with incarcerated partners were more likely to have other sexual partners. The gender imbalance that results in communities with high rates of incarceration of African-American males also results in an “increased likelihood that the remaining [un-incarcerated males] will have multiple, concurrent relationships with female sex partners,” and therefore an increased risk that a single male will transmit HIV to multiple female partners.”

The Risk Factor Associated with Incarcerated Black Males

While according to the 2010 U.S. Census African Americans comprise less than 13 percent of the population, and with African-Ameri­can males making up a little over six percent of the U.S. population, according to the U.S. Bureau of Justice statistics, Afri­can-American males accounted for 40 percent of the total prison and jail population in 2009. In June of 2009 there were an estimated 841,000 African-Ameri­can males incarcerated in state or federal prisons, or city jails around the nation. At present one in three African-American males are projected to serve time [in prison or jail] at some point in their lifetime.

A study published in 2006 by researchers at Berkeley University demonstrated a trend in the increase in the rate of HIV/AIDS transmissions among heterosexual African-American females, to the rate of incarceration among African-American males. Many other previous studies had already shown that incarcerated men were at a higher risk of being exposed to HIV/AIDS via male-to-male sex while incarcerated, and as a result those who contracted the virus, later went on to infect their partners upon release from jail.

The Stigma of HIV — A Mo­dern-Day Form of Leprosy

“Because people don’t know how it’s contracted and what it is…”, explained Mike Hickerson MSW, founder and former director of In This Together, an HIV/AIDS resource center. “They believe all the negative stereotypes about HIV which prevent people with the disease from revealing their HIV status simply because they don’t want to be ostracized and insulted by something that is just not true. There are still people who will throw away their plates and eating utensils if someone with HIV uses them. There are still people who think that you can get HIV by sitting in the same room with an HIV survivor. There are still people who will scald their hands washing them, if they touch someone with HIV. They believe all of the negative stereotypes and continue to perpetuate myths due primarily to ignorance of the disease. The mission statement of In This Together is to inform HIV/ AIDS survivors that they were not alone and that we are all “In This Together.”

Fear, the attached stigma and corresponding discrimination, make it difficult for HIV/AIDS survivors to reveal their status to family, friends and often unsuspecting partners. Fear often causes individuals to refuse to be tested and as a result they go about unknowingly infecting other people. Also, due to the stigma attached to homosexuality, many bi-sexual [or down low] males, refused to reveal their sexual history to their female partners, thus putting them at greater risk for infection.

A Day in the Life of an HIV/AIDS Survivor

James, a 46-year-old HIV-positive, African-American male who counsels HIV/AIDS survivors, sat down with The Louisiana Weekly to discuss his personal experiences as an HIV/AIDS survivor as well as his professional observations as a professional counselor on the many challenges faced by HIV/AIDS survivors.

“I was first diagnosed as being HIV-positive back in the summer of 1990,” he told The Louisiana Weekly. “That was 22 years ago. I didn’t do drugs so I supposed it had to be through sex with other men. I’ve lived a homosexual lifestyle for as far back as I can remember. I worked as a bartender back then and I lived a wild and carefree lifestyle; I was a single man and since I wasn’t married, I had multiple partners because I was discovering my own sexuality. I really don’t know who infected me, and since HIV can remain dormant for years – I don’t even know when I got infected.

“I knew very little about AIDS back then,” he continued, “but while I knew it existed, all of my partners on the surface appeared to be clean; everyone looked good… I mean, no marks, sores, lesions, or any signs of an illness. The first people suffering from AIDS were gay white men, so the face of AIDS was painted as a gay white male, so if you weren’t a gay white male, you had nothing to worry about… or so we thought. Then one day I realized that I was becoming fatigued very easily, simply doing my daily activities. I wasn’t sick and I was only 24 years old so I couldn’t attribute it to getting old, so I voluntarily got tested and back then you would have to return three days later to get the results. They told me that I was I was HIV- positive.

“I lived by myself back then, so I was alone. Everyone I knew who contracted the disease died within two years. I was too embarrassed to tell anyone, I had no one to talk to, so I cried, and cried, and cried. It was really devastating for me at that time. The routine back then was to write your will, do this, do that… in essence – prepare for death. I had to decide how I was to tell my family. So I called my brother and my sister and told them and we got together and we decided that since HIV at that time was not an issue for me in as far as my health both mentally and physically, that we would not tell our parents until it was absolutely necessary; and thank God, it never became necessary to tell them. They passed never knowing that I was afflicted. For most people, informing your family and friends is the most difficult thing that you do and most of the time it’s the very last thing that you do mainly because of all the stigmatizing, the blame, being shunned, and being carefully looked at and scrutinized… the very last thing that you do is tell someone your HIV status.

“HIV changed my life tremendously, tremendously,” James added. “HIV forced me to grow up. I realized that if I wanted to continue to live, that I had to change my lifestyle. Before I was diagnosed, I was a social butterfly in the worst kind of way. HIV caused me to actually go back to school because I realized that at some point I was going to get sick and that it was no way that I was going to be able to take care of myself doing the type of work that I did. So I had to go back to school.

“When I was first diagnosed with HIV I remember I had to take 13 pills multiple times during the course of a day. Which was very, very difficult given the fact that I worked every day…. How are you gonna swallow 13 pills, some every four hours, some every six hours, some three times a day, and not expect the people you work with noticing you going to the restroom so often. It was just crazy, but if you want to live you just had to figure it out. It drove me to the point where I just said forget it and stopped taking the medication. Then bad things started to happen… my hair started falling out, my gums got infected… so I had to go back to the daily regiment and somehow over the course of many years I did it and now, thanks to all of the research, today I’m at a point where I only have to take three pills once a day, in the morning.

To maintain my overall health, strength and stamina, I have to eat healthier so I do. I’m hyper cautious about little things that most people take for granted such as colds, small cuts, minor infections or anything that appears to be abnormal. Aside from that, I have to take blood work on a routine basis to monitor my T-cell count and even though my partner is also HIV-positive, we still have to use condoms because most people don’t realize that there are different strains of HIV and if you don’t protect yourself, you can actually be re-infected with a different, more aggressive strain of the virus.”

This article was originally published in the January 16, 2012 print edition of The Louisiana Weekly newspaper