MT World AIDS Day Award Acceptance Speech

Once upon a time, there was a boy who grew up in a small town- in a time when things were said to be simple- but they were not.

For him.

He was unlike the other kids in ways that weren’t always noticeable to the people around him. He felt things a bit more keenly. He noticed things that other kids didn’t. He wasn’t great at sports, he wasn’t big and strong.

But he was smart.

And sometimes that meant he got picked on even more than other kids.

So he used that.

It made him tough. His parents were good, loving people. His church provided comfort. His books helped him escape.

Maybe it was God, maybe it was chance- it doesn’t really matter what made him different. He just was.

The fact remained that this boy- indistinguishable from a million other little boys- just wanted to be loved, even though he was different.

And when he grew up, he still wanted to be loved – sometimes desperately. Sometimes he trusted people who weren’t trustworthy- simply because the promise of love is often enough to make us overlook danger and potential tragedy.

The promise of love.

That’s what brings us here today.

That’s why I got infected. That’s how I got infected.

The promise of love. Not what you think about when you think of AIDS.

But I want you to think about it.

When I moved back to Montana almost seven years ago, I made a promise: that no gay kid would ever be so starved for love and support- would not be so handicapped by shame- that they couldn’t stay here and have a happy, successful, healthy and safe life if they wanted to. I would do everything in my power to make it happen.

So I came out as gay- and HIV positive- just to show that there is no shame in having a disease. It’s a virus, it’s not a judgment.

A microscopic being that happens to live in my body. And I want to keep it from living in any one else’s.

And so do you, I hope.

This disease  has been around for over three decades. And yet the state of Montana has never allocated state funds for its prevention. Not a penny.

Which begs the question- why?

Is it because of the shame at how the disease is transmitted?

Is it because we might have to talk about sex, needles, addiction and shame and fear?

Isn’t thirty two years long enough to avoid having this hard conversation?

In the Montana that little boy grew up in- that I grew up in- we prided ourselves on helping out where it was needed. We filled sandbags, we stopped when it looked like people were in trouble on the road, we ran to the fire house when the siren rang.

But not for HIV. Not for AIDS. Well, let me correct that.

A few very brave people did stand up. They braved ridicule and stigma to hold candlelight vigils and to hold the hands of people whose parents were too afraid to touch them. I know. I was there. I held some of those hands. And so did Laurie Kops and probably a few others in this room.

I’m not trying to toot my own horn here, but it’s important that we get back to something very basic here in the state of Montana.

Caring for our people.

ALL people.

It’s time to recognize that all people deserve the promise of love in their lives. Deserve the dignity and respect that I believe God gives everyone simply by being born. Deserves the respect of having information and materials at their disposal provided by the state that is charged with enabling public health and well-being.  It’s what I want out of my taxes- I hope it’s what you want from yours.

There are a few legislators here you can tackle on the way out….

My life is good. I have family that love me, a partner who is always there for me and more friends than any man ever deserves.

But it could be better.

Somewhere in the state of Montana there is a kid who doesn’t believe that he’s worthy of love.

And he’s part of our responsibility. Because he does deserve love. And he deserves help to be healthy about it.

Shame is keeping us from health.

Kinda crazy, isn’t it?

It’s time to have those hard conversations.

It’s time to stop shame in its tracks.

It’s time to return the promise of love to all Montanans.

Thank you for listening- and for this awesome award.

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2013 World AIDS Day honorees Stephanie Cole, Chris Gehring, Chantz Thilmony, Greg Smith Lisa Fairman with Gov Bullock and DPHHS Director Opper

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Me and a really cool Governor

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Drug-Resistant Gonorrhea: New Facts

"WARNING - VENEREAL DISEASES" - NARA...

“WARNING – VENEREAL DISEASES” – NARA – 516044 (Photo credit: Wikipedia)

From The National Association of STD Directors (NASTAD) comes a new fact sheet, which begins with this:

For several decades, the Centers for Disease Control and Prevention (CDC) has closely monitored gonorrhea and its potential to become resistant to available antibiotics. Gonorrhea is one of the most commonly reported communicable diseases in the United States. In 2011, there were 321,849 reported cases and another 400,000 estimated unreported cases. If left untreated, the illness can cause infertility in both women and men, dangerous pregnancy complications and can be passed on to newborns, possibly causing blindness or pneumonia. Gonorrhea can also facilitate HIV transmission.

The CDC now reports that gonorrhea has become resistant to all but one of the antibiotics recommended to treat it, and resistance to the remaining antibiotic is increasing. If no new antibiotics become available, gonorrhea has the potential to become a serious epidemic. However, by increasing public health infrastructure investment and encouraging pharmaceutical companies to create new antibiotics, we can prevent a public health emergency.

Read the full fact sheet here: ncsd.astho_antibiotic_sheet

For Men Only- Your Sexual Health

From the National Association of State and Territorial AIDS Directors (NASTAD) and the National Coalition of STD Directors (NCSD) comes a new pamphlet aimed at helping men who have sex with men (MSM) take charge of their sexual heath:

“Whether you are gay, bisexual or any man who has sex with other men (MSM), there are certain health services that are important for you to talk about with your doctor to protect your sexual health. This brief pamphlet is designed to help you get the best sexual health care during your visit to the doctor.”

An amazing array of helpful information about special health concerns and working with your healthcare provider.

View “For Men Only- Your Sexual Health” here.

With Resistance to Treatment Rising, CDC Updates Gonorrhea Treatment Guidelines

From The National Coalition Of STD Directors:

Today, the Centers for Disease Control and Prevention (CDC) released updated guidelines for the treatment of the sexually transmitted disease gonorrhea, which is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission.[i]  CDC estimates there are more than 700,000 gonorrhea infections each year in the United States.  The updated guidelines were published in CDC’s Morbidity and Mortality Weekly Report. 

The change marks an end to CDC exclusively recommending oral antibiotic treatment as the first line of defense for gonorrhea, and now instead recommends that infections be treated with the injectable antibiotic ceftriaxone in combination with one of two other oral antibiotics, either doxycycline or azithromycin.  This change in treatment has significant implications for clinical service delivery and infected patients alike, as the simple act of taking pills is replaced by an administered injection by a certified health professional.

“We applaud the CDC’s preemptive strike of changing recommended treatment and with the intention of extending the life of the last effective drug,” said William Smith, Executive Director of the National Coalition of STD Directors (NCSD). “However, the rising resistance of gonorrhea to our last line of defense against it must be a clarion call to policymakers and private industry alike to invest in the research and development pipeline for new antibiotics and more sophisticated diagnostics…and quickly.  We desperately need additional options to meet the challenges of this infection,” continued Smith.

Last summer, the CDC sounded the alarm on gonorrhea’s rising resistance to antimicrobials. This report outlined that we are on the verge of a highly untreatable gonorrhea epidemic as   gonorrhea has developed resistance to every class of antibiotics put up against it and there is no new drug in the pipeline.  Documented increases in resistance throughout the U.S. are what has prompted the CDC to make the current recommended treatment change.

Full presser here.

Impact of Affordable Care Act On HIV/STD Prevention

Wondering about the Supreme Court’s decision on HIV/STD prevention and care? Some help from The National Coalition Of STD Directors:

Sexually transmitted disease

As you consider the impact of today’s Supreme Court ruling on the Affordable Care Act on different populations, I would like to share with you the impact of today’s ruling on our fight to prevent and treat sexually transmitted diseases.

Sexually transmitted diseases (STDs) remain a major epidemic in the United States.  Each year, there are approximately 19 million new cases of STDs, approximately half of which go undiagnosed and untreated[i], giving the  United States the highest STD rate in the industrialized world.[ii]

STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences, including infertility, higher risk of acquiring HIV, and certain cancers.[iii]

  • Young people will continue to have expanded coverage under their parent’s insurance.  Young people bear a disproportionate burden of STDs—those aged 15-25 make up half of the STDs contracted annually, but make up only one-fourth of the sexually active population.
  • Private insurance will continue to have to cover prevention services with no cost out-of pocket costs to patients.  Many of those who visit STD clinics are low-income and would not be able to receive prevention sexual health services without coverage by insurance.  While there is still work to be done for certain at-risk populations, such as men who have sex with men, expanded STD testing and  STI counseling will be covered by insurance under this expansion of preventative care in the law and it is a great start.
  •  The continued need for safety-net service providers is underscored.  With the narrowing of the Medicaid expansion provisions, the very real possibility exists that many low-income individuals will not have access to affordable health care coverage.  Patients at STD clinics are young, minority, and poor—populations that are bear a much higher burden of STD disease—and may be left without coverage in a state that may choose not to expand their Medicaid coverage.

HIV-specifics from Lambda Legal:

“This is a victory for all Americans, but in particular, the Court’s decision today will save the lives of many people living with HIV – as long as states do the right thing. The Affordable Care Act will finally allow people living with HIV to access medical advancements made years ago but that have so far remained out of reach of many. With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic.

“But this is not a complete victory, because today’s decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it. Our continuing challenge will be to make sure that states opt to expand Medicaid so that more low-income people, and particularly those with HIV, can get the health care they urgently need.”

Related articles

Paying For Negative HIV Tests

Michael J. Coren writes a fascinating article about HIV: if health isn’t a good enough reason to protect yourself from HIV and STD’s, maybe money is.

Excerpt:

Scientists at MIT’s Poverty Lab recently published findings in BMJ Open that tested that theory in Tanzania. They used payments known as conditional cash transfers (CCTs)–known to encourage socially desirable behavior elsewhere in areas like such as school enrollment and medical check-ups–to deter risky sex among young people (18 to 30-year-olds) in Tanzania.

As much as 5% of Tanzania’s population is infected with HIV/AIDS. Although rates have declined there during the last five years, the country’s sub-Saharan neighbors are not so lucky. Just 10 sub-Saharan countries account for more than one-third of people infected with HIV worldwide; an equal proportion of new cases also occur there. It’s clear controlling existing infections is not enough; cheap and effective prevention is needed.

The MIT researchers asked about 2,000 participants to receive tests for four common STIs–chlamydia, gonorrhea, trichomonas, and M. genitalium–every four months during the course of a year. If results were negative, participants were paid $10, $20, or nothing depending on the experimental group. If positive, participants were treated, but did not receive cash. The STIs served as a proxy for HIV infection risk from sex, since payments were not contingent on HIV status, given the stigma attached to the infection in many communities.

Read the results here.

America’s Most-infested STD States

From Men’s health comes this story about gonorrhea, chlamydia and syphilis- HIV is mysteriously absent- and some cool graphics:

In celebration of STD Awareness Month, we gathered data from the 2010 Center for Disease Control’s annual report to give you the breakdown on which states have the highest STD rates, and incorporated some need-to-know info about each of the leading culprits that are spreading across the U.S.

Today’s free PDF: The Great Men’s Health Sex Survey

Gonorrhea

What to Look Out For: Gonorrhea often shows up within 10 days of infection, but typically there are no symptoms early on. Given time, though, it’ll raise it’s ugly head—discharge from the penis (and vagina for women), frequent urination, and discomfort during urination. As a bonus, it can also lead to epididymitis in men, which can cause infertility.

How it spreads: Gonorrhea is caused by bacteria and is transmitted through semen and vaginal secretions during intercourse. According to the CDC, it’s the second-most reported infectious disease with nearly 356,000 infections in 2007, but it’s estimated that about twice as many new cases actually occur but are undiagnosed and unreported.

Treatable? Yes, with antibiotics. [But something to keep in mind: Researchers recently discovered a new strain of gonorrhea, H014, that can’t be killed with current antibiotics. So playing it on the safe side makes even more sense.]

Excellent information, nonetheless. For Chlamydia and Syphilis info, Click Here.

Facebook: The Next Tool In Fighting STD’s?

Makes sense to me.

Salon.com: 

Imagine being able to download a Facebook app that would alert you to your sexually transmitted infection risk based on your friend’s status updates. This may sound far-fetched, and it still is, but as some researchers shift their focus to risk among friend groups, as opposed to just sexual partners, social networks are rapidly becoming a tool to prevent the spread of  (Sexually Transmitted Infection) STIs.

Peter Leone, a professor of medicine at the University of North Carolina’s Center for Infectious Diseases, is one of those experts. Earlier this month, he spoke at an international health conference and underscored the importance of exploring such possibilities. Real-world social networks — in other words, a person’s circle of friends and sexual partners — have already proved to be strong predictors of STI risk, he says. It follows that sites like Facebook, which convene all of those real-world connections in one virtual setting, have huge potential in this arena.

Leone found that when sexual partners of patients newly diagnosed with HIV came in for testing, 20 percent turned up HIV-positive. It might seem counter-intuitive to extend the targeted test circle to those a newly diagnosed patient is merely friends with, but people in the same social circle often sleep with the same people, and might engage in similar risk-related behavior. Instead of looking at people within a particular at-risk demographic, this approach allows them to target known clusters of infection.

Makes you think of the people on your “Close Friends” list a bit differently, doesn’t it?

Full story here

Missoula County Sees Spike In HIV Infection

HIV infection has increased unexpectedly in Missoula County- 12 new cases in five months- almost half the number of all reported cases in Montana last year.

From The Missoulian:

“We tend to see small numbers of new cases every year, but to have this many new cases – at this count 12 – documented in a five-month period is an unusually high number,” Missoula City-County Health Department Director Ellen Leahy said on Wednesday. “Twelve cases in one county in five months is an outbreak.”

HIV causes acquired immune deficiency syndrome or AIDS, a debilitating and sometimes fatal disease. It is spread by unprotected sexual contact or infected blood transfer, such as sharing infected hypodermic needles. Leahy said all the Missoula cases appeared to stem from sexual activity.

The announcement was made after consulting with many community groups, including Partnership Health Center, the Montana Gay Men’s Task Force and the Open Aid Alliance. Open Aid director Christa Weathers said the decision to publicize the outbreak was a hard one, because health officials depend on people self-reporting their condition to track the disease’s spread.

“It’s hard to issue a public health risk without creating alarm, or without pointing fingers at any group of people,” Weathers said. “It’s a great opportunity to remind people this is a risk and why testing is so important. But we don’t want to discourage anyone who may know they may need to get tested, but they’re afraid to come in and then this hits the media and they’re gone.”

So far, all the confirmed cases are adult males. But Leahy warned that women who don’t consider themselves members of a high-risk group for HIV infection have also been exposed.

“It’s sexually spread, but it’s time to remind ourselves – you really cannot know if you’re infected unless you’ve been tested,” Leahy said. “We recommend health clinics regularly offer HIV testing to sexually active patients. Rather than presume someone is in a risk group, it’s risk behavior, not membership in any group, that they need to think about.”

Several of my sources say the newly-infected persons are young men who simply didn’t practice safe sex, thinking “It’s Montana- I’m not at risk”. These men, mostly in their twenties, I’m told, will now have a lifetime of medication, stigma and health issues to deal with. It saddens me.

Today is a good day to be tested. For a list of Montana free Rapid HIV Testing sites, click here.

If you’re in Bozeman, call AIDS Outreach 406-451-5718 (the number in the link above is incorrect) or go to AIDSOutreachMT.org

Gonorrhea And The Antibiotic Wake-up Call

I’ve been talking about this for a while now, but it’s now being seriously discussed in the mainstream media.

From the Los Angeles Times:

Linezolid

Image via Wikipedia

On the growing roster of antibiotic-resistant diseases, gonorrhea is the one that has most recently captured the attention of public health officials. Writing in the New England Journal of Medicine, researchers at the U.S. Centers for Disease Control and Prevention warned last week that 1.7% of certain types of gonorrhea infections show little response to treatment, even with cephalosporins, the last line of antibiotic defense.

At this point, no matter what happens with cephalosporins, resistant gonorrhea is on its way to winning out over available antibiotics, making it one of many worrisome bacterial strains, such as total-drug-resistant tuberculosis and MRSA,or methicillin-resistant Staphylococcus aureus. Resistant infections are emerging faster than new antibiotics. According to the nonprofit Pew Health Group, from 1935 to 1968, 13 classes of antibiotics were created; since 1968, there have been only two. Antibiotics are hard to develop and the profit margin on them is low because, unlike antidepressants or medications for high blood pressure, they’re not usually taken on a long-term basis.

The demand for such classes of antibiotics is clearly growing- but outside of one of the board members of Merck or Abbott or Pfizer gets untreatable gonorrhea or MRSA- you can bet it won’t happen without a struggle.

Full story here.