As this decade comes to a close and the 40th anniversary of the HIV/AIDS epidemic approaches, we cannot be deterred from the work still at hand: to teach next generations our history, the history of a complicated virus whose genetic mutations keep scientists on their toes seeking ways to block further transmission while also making HIV easier to live with. And thanks to newer treatments, people are living longer, healthier lives with HIV— in the United States, half are now 50 years of age and older.
Still, younger members of our communities are vulnerable when not provided enough knowledge to avoid getting this easily preventable viral infection and not to become a continuous cycle of new generations with HIV in decades to come.
Comprehensive sex education is one tool in the prevention toolbox, but that’s not an easy subject to cover when the stigma of human bodies outweighs the rationale of how biology works; almost nobody receives an age-appropriate human anatomy book for a birthday or holiday gift. Maybe this year will be different.
And when is the last time we took ourselves to the health department or to a medical provider and got tested for HIV and other sexually transmitted diseases like chlamydia, gonorrhea or syphilis?
North Carolina’s 85 county health departments also make available free testing for HCV, the virus that causes hepatitis C, a liver disease more and more prevalent in our state, which can be spread through sex or contact with blood when needles or other drug-using equipment is shared. Incidentally, because of intensive screening, HIV and HCV are almost never transmitted anymore by transfusions.
More great news about hep C: It is now usually curable in eight-12 weeks, using medicines with few side effects, unlike older treatments. These hep C cures are now available in Asheville and Western North Carolina; your health care provider, health department personnel or hep C bridge counselors can tell you where.
Getting tested for HIV and HCV is particularly important if you were born between 1945 and 1965, the age range where HCV is most prevalent; if you ever shared a needle/syringe behind someone; got tattoos in prison; received blood products or had an organ transplant or transfusion years ago; or are currently using needles/syringes recreationally where exposure within your social group from blood or sex may be a risk.
HIV is also treatable, with increasingly life-sustaining medications. A scientific update to know about called U=U, which stands for Undetectable = Untransmittable, is all the talk in POZ or Plus magazines. It means a person taking HIV meds that suppress their viral load to fewer than 200 copies per milliliter for six months or more will not transmit HIV through sex, nor would condoms have to be used — though they’re still recommended to avoid exposures to other bacteria and viruses.
Under North Carolina’s updated HIV control measures, a person living with HIV and meeting U=U conditions doesn’t have to disclose their HIV status to a sexual partner anymore. You may be shocked to learn this, so take a look at the literature for yourself and talk about it with your health care provider. Visit www.cdc.gov to read more. …
There are additional options in the HIV prevention toolbox. Ever heard of PrEP — preexposure prophylaxis? It means taking one pill a day during periods of heightened risk of acquiring HIV. No discrimination or stigma. Let’s be real: We make social connections that may include a variety of sexual expressions and substances used. Not gonna talk real? Really? Nowadays? Up to you.
Meanwhile, injectable PrEP administered every month or two for prevention may soon become available. Known as Cabotegravir, it’s still in clinical trials but showing promising results.
There is so much to know, but how do the details ever get to the many people — especially future generations — who need to know them? Are you willing to share this conversation over the holidays as we near the end of this decade? If so, and you need more information, please contact The Rubberman at the WNC AIDS Project. He’ll be glad to furnish information and resources to help you become the educator to the community you serve. He always says he can’t do it alone.
Last, remember those who’ve passed from HIV and AIDS on Dec. 1, World AIDS Day. The national theme this year is Ending the HIV/AIDS Epidemic: Community by Community, urging us to redouble our efforts here at home to achieve the national and worldwide goal to End the Epidemic by 2030. WNCAP and Tranzmission are hosting a local event with the theme HIV and the Trans Experience, featuring special guest speaker, activist and author Tori Cooper. See www.wncap.org for more information [and in this week’s Food section].
Say the names of those we remember. Make a quilt panel if you haven’t already. We mustn’t forget them, but we can look forward to a better day when this is all archived in the library and researchers look back for an understanding of something we lived through for decades. It is not over yet, but getting there. Be well.
— Michael Harney
aka The Rubberman
WNC AIDS Project