Another Reason To Start HIV Treatment Sooner?

Apr15 by D Gregory Smith

Science Daily is reporting on a study by UC San Francisco that indicates that the rate of infection among men who have sex with men (MSM) could be significantly reduced by treating HIV immediately upon diagnosis and expanding HIV testing:

If HIV-infected adults in San Francisco began taking antiretroviral treatments as soon as they were diagnosed, the rate of new HIV infections among men who have sex with men would be cut by almost 60 percent over five years….

The finding is published in the April 15, 2011 issue of Clinical Infections Diseases.

The decision of when to begin treatment with antiretroviral drugs is a subject of some debate, with the experts evenly split on whether to begin antiretroviral therapy immediately upon HIV diagnosis or waiting until a patient’s CD4 cell count drops below 500 cells per microliter….”Our clinicians recommended initiating antiretroviral therapy to all of our HIV positive patients based on our assessment that delaying treatment allows the virus to do damage to major organs systems and would lead to poorer outcomes for patients. It is too early to tell if this shift in treatment strategy last year by our clinic and the Department of Public Health has had any impact in preventing HIV infections,” said (study co-author) Havlir.

Starting retroviral treatment early makes sense- it reduces the risk of transmission significantly and probably keeps people healthy and alive longer. And isn’t that the point?

Read the full article here.

University of California – San Francisco (2011, April 13). HIV rate in San Francisco could be cut sharply with expanded treatment, study predicts. ScienceDaily. Retrieved April 15, 2011, from http://www.sciencedaily.com/releases/2011/04/110413093219.htm

Progress, But Still Disappointing

Mar30 by D Gregory Smith

March 29th, from Diane Sands:

Friends…

Today I attempted to “blast” SB 276 out of hostile Judiciary Committee and onto the Floor for a vote. This is Senator Facey’s bill to remove offensive language about “Deviate Sexual Conduct”….the law was ruled unconstitutional in 1997 but the legislature insists on keeping it on the books as part of sentence in the Sex Crimes part of MCA that includes bestiality.

Rep. Ken Peterson still claims that the Court didn’t address this issue entirely and that the crime should stay on the books, including the FELONY status with a penalty of 10 years in prison and a fine up to$50,000 or both.

While we didn’t get the 60 votes required, we did get 51, including a number of Republicans who believe it is a privacy issue.

THIS IS THE FIRST TIME IN THE 20 PLUS YEARS I HAVE WORKED ON THIS TOPIC THAT WE HAVE EVER WON THE MAJORITY OF THE SENATE AND THE HOUSE!!!!

I view this a great progress, especially with the ultra conservative make up of the current legislature.

Sands, the first openly gay member of the Montana Legislature, is a force of nature and a champion of human rights. The words she chose to introduce her motion are powerful and deserve a look/listen:

The words of the opposition also need to be heard- the ignorance and intolerance are epic, an embarrassment to the State of Montana and, indeed the whole country.

The Montana Taliban’s Jihad

Feb23 by D Gregory Smith

Yesterday, the Montana House of Representatives voted to nullify any local anti-discrimination ordinances (Missoula and Bozeman), forcing cities and towns to rely on state law which doesn’t protect LGBT persons from discrimination. 60 Republicans voted for the bill, all 32 House Democrats joined by seven enlightened Republicans voted against. From The Missoulian

It was the second bill that passed Tuesday to nullify a locally adopted policy in Missoula. Earlier, the House banned enactment of local initiatives such as the one Missoula County voters approved in 2006 to make marijuana crimes the lowest priority of law enforcement.
“It is ironic that the first bill of the day and the last bill of the day both intend to override the expressed will of Missoulians to govern ourselves as we see fit,” said Rep. Diane Sands, D-Missoula.

It’s time to call a spade a spade.

There is only one way to describe the faction of the Montana Republican party which is voting to legislate their own arrogant morality, usurping the clear will of persons in municipalities to govern themselves in favor of theological, idealogical and biblical precepts while blatantly ignoring science, reason and due diligence: Religious extremism.

Like The Taliban.

And there is not much they won’t do to erode the rights of other human beings- including ignoring valid democratic processes. I almost believe that they won’t be happy until the statue of the Goddess of Liberty is torn from the top of the Capitol Building and replaced with a cross….

In my opinion, term limits have simply contributed to this process, giving people no chance to cultivate relationships and actually govern. Instead, people are focused on issues and positions, not long-term goals and objectives.

Montana’s Taliban needs to be called to accountability. I refuse to believe that the will of the people is to strip other human beings of protections which were carefully put into place by those who know them best. I refuse to believe that the majority of Montanans approve of the ignorant, dirty dancing these legislators are doing in the name of ~~God~~ their constituents. I refuse to believe that most Montanans want LGBT persons discriminated against, maimed- perhaps dead, because of a lack of protection.

Prove me right. Please.

Shining A Light Into The Scary Scary Dark…

Feb17 by D Gregory Smith

Whether or not you believe the Montana Legislature has lost it (I don’t want to make clinical assessments about persons I haven’t evaluated personally); whether or not you believe some of the tripe that is being considered for legislation (I know- paranoia is hard to ignore); whether or not you are a believer in term-limits (where are the ~~statesmen~~ statespersons who are concerned for the long-term health and well-being of Montana, and not just for the spasmodic pushing through of personal, unscientific and socially ignorant positions? Sorry, bad sentence structure- read again) and whether or not you are a reasonable human being who would rather they just all go away and not come back for another two years (I’m trying to be open to the process, but I’m losing patience fast); this Legislature is doing things that require the voice of reason to increase in volume.

To wit: Nutjob Bills In The Montana Legislature.

And etc.: Natural Disaster: Republican legislators wage war on Montana’s environmental laws.

And just in case you missed it, the poster child of the 2011 Montana Legislature.

There is a chance to make your voice heard. Get involved. Speak.

And if you want some company, go here.

An Evening With Dustin Lance Black

Feb10 by D Gregory Smith

I have to admit, I went in completely biased.

Like many of you, I watched the Academy Award acceptance speech with tears in my eyes.

“…if Harvey had not been taken from us 30 years ago, I think he would want me to say to all of the gay and lesbian kids out there tonight who have been told that they are less than by their churches, or by the government, or by their families, that you are beautiful, wonderful creatures of value, and that no matter what anyone tells you, God does love you and that very soon I promise you, you will have equal rights federally across this great nation of ours.”

Like I said, completely ~~smitten~~ biased.

But when he began talking about not settling for “close, but not there”, and not giving up on the vision of panoramic human rights, and overcoming the paralysis of fear- “put your pencil on the paper and start moving it- something has to happen”, I knew my predisposition toward this gentle, fiery soul was completely justified. He talked not so much about activism as the promotion of reality- the reality that LGBT people are everywhere, they just want to love and be loved, and they’re not going away. And he’s right. We aren’t.

Unless we give up.

I sat in a full Ballroom at Montana State university with students, teachers, parents, cowboys and a few kids. This was a crowd that could have been distributed down Main Street, Bozeman, and it wouldn’t have seemed different from the normal pedestrian traffic. People listened to this young man- whose story of a rural Mormon upbringing probably hit close to home to many in the audience, with rapt attention punctuated by laughter and enthusiastic applause. Here was a non-apologetic gay man standing in front of a group in a (generally) conservative state whose constitution explicitly prohibits him from full equality, and his story was received respectfully, even enthusiastically. His story and vision no different from my own.

I then had a realization.

It wasn’t new, it had been knocking on the back door of my brain for a while, but I was now able to hear it. It was this:

I had turned all these people into the bullies from my childhood and young adulthood. I had created an enemy/threat out of people who were probably neither. I was projecting. (The irony of my professional blind spot is not lost on me here) I had imposed my childhood fears on (almost) every Montanan- and I’m not a child. I had allowed this weird, unarticulated fear to hold me back.

I don’t want to do that anymore. So I’m going to pay attention to the injustice sensor whenever it goes off- not just when it’s safe. That was my gift from Dustin Lance Black.

Well, one of them.

He answered my question about religion’s scarring of some LGBT’s with “every religion has something important to say. Mine taught me love and respect of family. …but religion is not its leaders. I wouldn’t listen to the leaders all the time. And anger and hurt about religion didn’t keep me from being spiritual.” He talked with people afterward, meeting every one who waited to see him. Of course, I stood in line.

I got a hug, a brief chat about my crazy life story and was able to thank him for his availability and candor. He thanked me right back. Gracious. From the word grace, meaning “elegance or beauty of form, manner, motion, or action”.

Elegant activism. I think I can do that.

Thanks, Lance.

World AIDS Day: A Need To Remember

Nov29 by D Gregory Smith

Because I think it’s still relevant, I’m reprinting (with a few updates) my column for World AIDS Day from last year. I may just continue to do so as long as it still makes sense….

Remember when World AIDS Day used to be important?

I do.

I remember December 1st as a day when people gathered in terror and grief with candles and tears listening to words that couldn’t begin to touch the pain and anger and sadness.

I remember when it was a time for all kinds of people to gather together, people that probably wouldn’t be in the same room for any other reason. At World AIDS Day services in the early Nineties, I remember seeing queer activists, quietly closeted gay men and women, Episcopal and Catholic priests, Native American leaders, Protestant ministers, atheists, nuns and agnostics. I saw elected officials, Republicans and Democrats, wheelchair-bound elderly, parents, children, nurses, doctors, cowboys, lawyers, accountants, little old ladies and, once, a rodeo clown. All coming together, all looking for comfort and hope and compassion among others who could maybe understand.

We don’t really do that now. And maybe it’s okay that we don’t.
Maybe it’s good that the terror I remember so vividly on the faces of friends and complete strangers is no longer there. Maybe it’s good that people aren’t dying so fast and so painfully, isolated and afraid. Maybe it’s good that we’re not so traumatized by fear and grief and anger.

Maybe.

Is terror a good thing? Is a painful death beneficial? Is emotional trauma something to be longed for?

No. But I have to say, those scenes of suffering and bravery certainly helped capture the zeitgeist of the Eighties and Nineties. It helped keep AIDS in our collective consciousness. Drama and fear and compassion fueled activism and grassroots movements and the formation of community-based organizations. AIDS was overwhelmingly real. It was dramatic. It went to the Oscars, the Emmys, the Grammys and the Tonys. And it won. More than once.

So I’m not sure if it’s a good thing that HIV isn’t such a drama queen anymore. Not to say that I want people to suffer needlessly. I don’t. I just happen to think we’re not paying attention because it’s no longer hip, sexy, avant-garde and noble to do so. I think that our short attention spans need to be constantly reminded. And, there’s really not a lot of spectacular theatrics to grab our attention today. Well, not compared to the past.

But, trust me, it’s still there. There are some rather dramatic facts to consider:

People are still being infected. In the U.S. there are over fifty thousand new diagnoses a year. The CDC estimates that one in five persons with HIV doesn’t know it. That means they may not be protecting their sexual partners out of ignorance. That means more HIV.
Gay men, and/or Men who have Sex with Men (MSM) account for more than half of all new infections each year, and MSM is the only risk group in the country whose infections are increasing. MSM account for nearly half of all persons living with HIV in the United States today. Nearly half. And those are just the ones we know about. That means that for all the talk we hear about “AIDS is not a gay disease,” it is. That means sexually active MSM are having sex with HIV+ partners statistically more often than any other members of the general population- and being infected. HIV significantly and dramatically lives in the bodies of gay men.
HIV strains the budget of every state in the Union. So much so, that states have cut or are considering cuts in funding to drug assistance programs and other HIV support and prevention services. These services keep people alive at a cost of hundreds of millions of dollars a year. More money is needed with every new infection. That money comes out of your taxes.
People are still dying. Yes, the drugs help, and people with HIV are living longer lives, but the drugs don’t always work, and HIV mutates. Our immune systems are under a great deal of strain and one serious opportunistic infection can kill. I lost a friend just this year.
It’s not over. Families are still being traumatized and our community is being hurt by this epidemic. Here in Montana, with its relatively miniscule gay population, new members joined my HIV+ support group this year, most are gay men in their twenties- kids, really. All facing a lifetime radically different than they had hoped for.

And those are just some of the many points to consider.

Is it good that people are no longer dying and suffering in such huge numbers? Yes.
Is it good that we no longer gather in great numbers, sharing strong emotions, standing hopefully resolute in the face of pain and suffering and memory? I don’t think so.

Personally, I need to remember these facts and these people, because they’re part of my history, my community, my country and my world. I need to be reminded that my compassion, my voice and my heart are all still relevant. I need to be reminded that I’m not alone, I need to remind others of the same thing. And I think doing it once a year is the least I can do.

That’s why I’ll be going to a World AIDS Day service this year. That’s why I’ll be wearing a red ribbon, holding a candle in the dark, listening to words of grief, bravery and encouragement. To remember, to remind, to regroup.

Because I still think it’s important.

Gene Research Finds Important Clue In Long-Term HIV Survivors

Nov5 by D Gregory Smith

H I V

There are human beings who live with HIV- some for decades, without ever having had a symptom.

Not one. The Boston Globe:

For decades, they lived a mystery: Why were they able to survive with the AIDS virus, free of symptoms and the need for potent drugs, while so many others with the same germ turned deathly ill?

Their innate ability to keep HIV infections in check intrigued researchers, who suspected these people, known as “controllers,’’ might carry clues to designing effective vaccines after nearly 30 years of frustration.

Now, an international team of researchers, led by specialists in Boston, has cracked these HIV survivors’ genetic code, sifting through almost 1.4 million pieces of DNA to discover five amino acids that separate the small cadre of controllers from the vast majority who must take medication or face death.

This is the kind of research that could actually go somewhere. The full article here.