Before taking the stage at a local middle school to talk about HIV/AIDS prevention, Michael Harney overheard one pre-teen boy offer a preview to another.
“He’s going to pray to the vagina,” one boy said.
Apparently, word gets around, says Harney.
“I fall on my knees and offer thanks for vaginas because none of us would be here without them,” Harney says, smiling. “I offer information in ways people will remember because it’s so important that they do remember.”
As an employee of the Western North Carolina AIDS Project, Harney has been educating children, teens and adults on safe sex practices for 20 years. He says that what he does best is street outreach, which means talking frankly about safe sex practices and advocating for education and harm reduction. Some adults might be uncomfortable with his methods in reaching youth, but he’s undeterred.
“Kids today don’t have any memory of what AIDS was,” says Harney, who has degrees in business administration and Spanish. “They think it’s a chronic, manageable disease, which it is now, but will it stay that way? Isn’t it better to prevent it rather than treat it?”
“The evidence of return on prevention versus treatment is all around us,” says Jeff Bachar, executive director of WNCAP. “It’s much, much more efficient and inexpensive to prevent HIV/AIDS than it is to treat it.”
Although it’s difficult to quantify, the education offered through WNCAP has helped to lower the incidence of HIV and other sexually transmitted diseases, says Harney.
“Our rates [of new cases] are lower here than in many other places,” he says.
Across North Carolina, the rate of HIV/AIDS per 100,000 population in 2014, the latest year for which figures are available, was 13.6; in Buncombe County, it was 8.4, according to the N.C. Division of Public Health (publichealth.nc.gov).
Harney has been approached by people who attended his talks a decade or longer ago, say they took his advice to heart and credit him with their current state of health. That anecdotal evidence is heartening, but the lower rates of HIV/AIDS are even more so, says Harney.
“When I drop that pebble of information into the pond, the ripple effect is such that it comes back to you in unexpected ways,” he says.
When Harney began as an educator, HIV/AIDS was still a death sentence to many who contracted the virus. Treatments were making inroads into the death toll, but prevention was — and still is — the best way.
“We have to reach people where they are,” says Amanda Stem, outreach coordinator for WNCAP. Harney was the one who motivated her to join the fight against HIV/AIDS when he spoke to one of her college classes, she says. “We have to speak in the parlance, in the language people use,” says Stem.
Every physician should ask every patient whether they want to be tested as part of a routine annual physical, Stem says. It is one of the reasons she is active in the effort to expand access to health care for everyone. “We need to understand one of the reasons everyone should have access to care is that access helps people stay healthy by catching health problems early, and it helps doctors educate people in ways to stay healthy,” she says.
Stem is concerned with the lack of knowledge most people have about HIV. “Too many people don’t realize that the most common form of HIV transmission is heterosexual sex,” she says. “Right now, more than 90 percent of new cases are from heterosexual, not gay sex. And when we ask people how HIV can be transmitted, too many people — especially young people — don’t know it can’t be transmitted by kissing.”
Harney also believes every doctor’s office, every health clinic, should have references to testing and to safe sex practices where patients can see them. “Put up posters, have a basket of condoms, wear a red bracelet or ribbon,” he says. “Bring up the topic and talk about it, even if people aren’t completely comfortable.”
One of the highest rates of transmission of STDs is among older adults, and that’s because they don’t realize how vulnerable they are, Stem says.
And it’s not just HIV/AIDS, Bachar says. Cases of syphilis and gonorrhea are on the rise, and cases of antibiotic-resistant gonorrhea are appearing.
“Right now, 2 percent of gonorrhea cases are antibiotic-resistant in the United States,” Harney says. “The only way to fix that is to prevent new cases, resistant or otherwise.”
In Buncombe County, the rate of gonorrhea went from 82.9 per 100,000 people to 97.8 between 2012 and 2014, and rates of syphilis went from 2.5 per 100,000 to 5.6, according to the state Division of Public Health.
One of the most effective prevention methods is making sure anyone who uses needles for whatever purpose uses clean needles, Harney says.
“You should never have to use a needle that has been used by someone else, whether you’re using it for insulin or heroin,” Harney says. “I don’t expect to get my flu shot with a dirty needle, and I don’t expect anyone else to have to use a dirty needle for any reason.”
WNCAP has made access available to more than 400,0000 clean needles in the last year and would have offered more if there had been more money to buy them, says Bachar.
“We’re about meeting people where they are and not condemning them for their behaviors but by giving them the tools they need,” Stem says.
People come in with behaviors that are stigmatized, and they don’t always believe there are no strings attached to the clean needles and condoms, Bachar says.
“They may feel a lot of shame about what they’re doing, but we are not here to judge them; we are here to help them,” Bachar says.
It is that welcoming attitude that encourages people to come back, and it plants the first seeds of self-esteem in many people, Harney says. It is by nurturing that self-esteem that people can be persuaded to change behaviors.
WHAT: WNCAP’s 8th Annual NAMES Project AIDS Quilt Memorial Exhibit Installation. WNCAP sponsors a week-long exhibit of 20 blocks from National AIDS Quilt. The original NAMES Project (aidsquilt) began in June 1987 when a small group gathered in San Francisco to document the lives they feared history would neglect. Their goal was to create a memorial for those who had died of AIDS and to thereby help people understand the devastating impact of the disease. This meeting of devoted friends and lovers served as the foundation of the NAMES Project AIDS Memorial Quilt. Today the Quilt is a powerful visual reminder of the AIDS pandemic and consists of more than 48,000 individual 3-by-6-foot memorial panels. WNCAP honors all of those impacted by HIV/AIDS by bringing 20 blocks of the Quilt panels to Asheville for a week of commemoration and awareness. This exhibit is free and open to the public.
WHERE: Renaissance Hotel Ballroom, 31 Woodfin St.
WHEN: 6 p.m., Nov. 21-27
WHAT: WNCAP’s Annual World AIDS Day Commemoration, which features HIV-positive speaker Cecil Baldwin from the podcast “Welcome to Night Vale” (welcometonightvale.com); viewing of the HIV/AIDS-related documentary “The Last One” (thelastonefilm); and words by local and regional leaders in HIV service and advocacy.
WHERE: Renaissance Hotel Ballroom, 31 Woodfin St.
WHEN: 6-9 p.m., Dec. 1