MT World AIDS Day Award Acceptance Speech

Dec3 by D Gregory Smith

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.

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

Me and a really cool Governor

Capitol rotunda ceremony honors AIDS Day award recipients (billingsgazette.com)
5 honored at Montana Capitol for AIDS work (missoulian.com)
5 honored at Montana Capitol for AIDS work (ravallirepublic.com)
5 Montanans to be honored on World AIDS Day (missoulian.com)

Free Montana HIV Counseling, Testing & Referral Training

May2 by D Gregory Smith

FREE — 3 Days of Training!!!

(1/2 day) HIV/STD/HCV Update, (1/2 day) OraQuick Rapid Test & (2 days) HIV CTRS Training

(Counseling Testing and Referral Services)

June 24-26th, 2013

8am-5pm each day

Big Horn Resort, Billings, MT

Please register by May 14th!!!

Register at: https://catalyst.uw.edu/webq/survey/skcbear/199564

Click here for more info: CTRS Training June 2013-1

~CNE Credit Available~

Why HIV Testing and Treatment Are Still Issues

Sep28 by D Gregory Smith

A key concept for anyone considering the success of anti-HIV treatment in improving the health of individuals and in preventing onward transmission in their communities is the ‘treatment cascade’ or ‘care continuum’. This shows how, at every stage, patients are not retained in the healthcare system or are unable to access the medical care they need.

(Source)

Specifics: Obamacare and HIV (dgsmith.org)
Oral Health and HIV (topdentists.com)
San Francisco Thwarts HIV With Wide Testing, Universal Treatment (npr.org)

Red Ribbons And Mosquitos

Aug23 by D Gregory Smith

Yesterday, a friend sent me the following:

“Today I saw this headline:

West Nile Outbreak Largest Ever, 41 dead

and it made me think of this:

Rare Cancer Seen In 41 Homosexuals

…and wondering about what makes a disease a crisis versus a judgment. The number of victims was the same.”

Indeed.

And to further the irony, the famous speech given by Mary Fisher to the Republican National Convention in 1992- 11 years after the rise of “gay cancer” was highlighted in a feature by the New York Times today:

TWENTY years ago this month, Mary Fisher took the stage of the Republican National Convention at the Houston Astrodome and delivered a 13-minute prime-time speech that was seen by many as a sharp rebuke of her party’s negligence in the face of the growing AIDS epidemic.

Mary Fisher in 1992 made what is considered one of the best American speeches of the 20th century.

Ms. Fisher, a mother of two young children who had worked in Gerald Ford’s White House, addressed the delegates as someone who was H.I.V. positive herself. “Tonight, I represent an AIDS community whose members have been reluctantly drafted from every segment of American society,” she said. “I am one with a black infant struggling with tubes in a Philadelphia hospital.” She added, “I am one with the lonely gay man sheltering a flickering candle from the cold wind of his family’s rejection.”

It was a speech that was both surprising and poignant. Few, including Ms. Fisher herself, expected that she would survive a disease that had already killed more than 150,000 Americans by the summer of 1992.

But Mary Fisher is still alive — and still taking issue with her political party.

As she should. The discrimination and loathing that prevented government intervention is still with us. It’s made itself known in issues of women’s health, gender inequity, transgender rights and the House defense of DOMA.

However, West Nile will probably not become the epidemic that AIDS did. Because mosquitos don’t discriminate.

They bite everyone.

AIDS Activist Mary Fisher Is Defined by Words, Not Disease (nytimes.com)
West Nile spreads in Colo., outbreak becomes largest in U.S. history (kdvr.com)

Join NAPWA (and me) For Free

Jul31 by D Gregory Smith

Infected/Affected by HIV/AIDS?

Join the National Association of People With AIDS (NAPWA). NAPWA is doing amazing work advocating for people HIV infected- and affected. It’s important that they have people from rural areas in their membership, so if you are HIV+ and live in Montana (or other rural areas) I would encourage you to join. From their mission statement:

Founded as a 501(c)(3) charitable organization in 1983, NAPWA advocates for the lives and dignity of all people living with HIV/AIDS, especially the more than a million Americans who live with it today. We want the epidemic to end, and we want life to be better for people with HIV until it does.

They are offering- for the first time ever- a free one year membership. To join me as a NAPWA member, click here: http://www.napwa.org/freemembership

ADAP Watch 7.19.12 (dgsmith.org)
‘Take The Test, Take Control’ On National HIV Testing Day (huffingtonpost.com)
More antivirals would stem HIV spread (bigpondnews.com)

HIV In Prison

Jul30 by D Gregory Smith

FYI:

More than 2 million people are incarcerated in jails and prisons in the United States.
People who are incarcerated are at increased risk for acquiring and transmitting HIV.
The correctional setting is often the first place incarcerated men and women are diagnosed with HIV and provided treatment.

People who are incarcerated are at increased risk for acquiring and transmitting HIV and other infections. Correctional health, public health, and community-based organizations need to improve HIV prevention and care for incarcerated populations through 1) routine HIV screening and voluntary HIV testing within prisons and jails and 2) other effective prevention strategies, including those that address inmates’ transition back into the community. Correctional institutions can be important partners in preventing and treating HIV to protect and improve inmate and community health.

More here.

Infographic: Ending The Drug War Will Help End AIDS (dgsmith.org)
HIV Rising in Gay Men in Urban US (abcnews.go.com)
We Can’t End AIDS Until We End the Drug War (alternet.org)
AIDS conference calls for removal of HIV-related travel restrictions (ghanabusinessnews.com)

“All Adult HIV Patients Should Be Offered Antiretroviral Therapy”

Jul23 by D Gregory Smith

From Science Daily:

Included in the 2012 International Antiviral Society-USA panel recommendations for human immunodeficiency virus (HIV) patient care is that all adult patients, regardless of CD4 cell count, should be offered antiretroviral therapy (ART), according to an article in the July 25 issue of JAMA, a theme issue on HIV/AIDS. Other new recommendations include changes in therapeutic options and modifications in the timing and choice of ART for patients with an opportunistic illness such as tuberculosis.

Melanie A. Thompson, M.D., of the AIDS Research Consortium of Atlanta, presented the findings of the article at a JAMA media briefing at the International AIDS Conference.

Journal of the American Medical Association (Photo credit: Wikipedia)

“Since the first antiretroviral drug was approved 25 years ago, improvements in the potency, tolerability, simplicity, and availability of ART have resulted in dramatically reduced numbers of opportunistic diseases and deaths where ART is accessible,” according to background information in the article. “New trial data and drug regimens that have become available in the last 2 years warrant an update to guidelines for ART in HIV-infected adults in resource-rich settings.”

The benefit of suppressing the virus, in my opinion, is greater than the possible toxicity of medication and navigating possible side effects. We know that as long as HIV is in the body, unchecked, it’s doing damage. It’s more likely than possible that people who start antiretroviral therapy early will have less problems with secondary conditions (joint pain, arthritis, memory problems) as they progress in their lives. I think this is tremendous news.

Full Story Here.

Potential cause of HIV-associated dementia revealed (sciencedaily.com)
HIV Treatment Breakthrough: Weekly Injection Could Replace Daily Pill Regimen (dgsmith.org)
Ahead of AIDS Conference, New Reasons for Hope (news.health.com)
FDA Approves First Drug To Reduce Risk Of HIV Infection (medicalnewstoday.com)
World´s leading HIV/AIDS Experts to gather in Washington D.C.on HIV Cure (oblogdeeoblogda.me)

AIDS Drug Assistance Program (ADAP) Watch 7/1/12

Jul2 by D Gregory Smith

From NAPWA:

The waiting list numbers continue steady, just over 2,000, down from 9,000 in September of last year.

Coming off another National HIV Testing Day, we have to wonder how some states can encourage their citizens to get tested but not help them get lifesaving medicines if they test positive.

We also wonder what kind of cost analyses the waiting list states are doing. The cost of clearing the waiting lists completely just isn’t that great. Virginia has just under 600 PLWHA on its waiting list. If drugs cost $15,000 for one ADAP beneficiary for one year, drugs for 600 will cost $9 million – and we just don’t believe $9 million can’t be found in an $85 billion fiscal 2013 Virginia state budget. PLWHA on Virginia’s and other states’ waiting lists will cost the public sector a lot more if they don’t get drugs that can keep them from progressing to AIDS.

Here are the latest numbers from our friends at NASTAD:

‘Take The Test, Take Control’ On National HIV Testing Day (huffingtonpost.com)
Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
It’s National HIV Testing Day: Where You Can Get Tested for Free (laist.com)

ADAP Watch

May21 by D Gregory Smith

From NAPWA: Recently released supplemental federal funding is slowly bringing state waiting lists down – 2,552 this week. Regional disparities are troubling, though. Ninety percent of Americans on ADAP waiting lists are in the South. The only non-Southern state with comparable numbers is Nebraska. The South is where HIV is spreading fastest, and providing HIV drugs to those who need them would help prevent new infections.

Here are the latest numbers from our friends at NASTAD:

Montana ADAP Waiting List: Tuesday: 0, Wednesday: 1 (dgsmith.org)
MT ADAP Wait List: Tuesday, 0; Wednesday 1 (bilerico.com)
Some Startling HIV Facts (dgsmith.org)

Some Startling HIV Facts

May8 by D Gregory Smith

…from The CDC’s Annual Report from the Division of HIV/AIDS Prevention (DHAP), Accelerating Progress, Investing for Impact. This report provides an overview of some of the HIV prevention activities conducted and supported by the Centers for Disease Control and Prevention (CDC) during late 2010 to the end of 2011.

Too few Americans with HIV are getting the testing, treatment, and care they need to stay healthy and prevent transmission to others.

Surprisingly, only 28% of all HIV-infected persons are considered to have HIV under control ( viral load less than 200/ml). That’s not enough.

Percentage of HIV-infected Individuals Engaged in Selected Stages of the Continuum of HIV Care, 2010-11

All HIV positive individuals- 100%

Aware of their infection- 80%

Linked to HIV care- 62%

Retained in HIV care- 41%

Receive antiretroviral therapy- 36%

Have their virus under control*- 28%

*Plasma viral load < 200 cells/ml

Source: MMWR 60(47);1618-1623