WHAT IS GENVOYA®? medicines that should not be taken with GENVOYA. Do not
start a new medicine without telling your healthcare provider.
GENVOYA is a 1-pill, once-a-day prescription medicine used to
treat HIV-1 in people 12 years and older. It can either be used • The herbal supplement St. John’s wort.
in people who are starting HIV-1 treatment and have never • Any other medicines to treat HIV-1 infection.
taken HIV-1 medicines before, or people who are replacing
their current HIV-1 medicines and whose healthcare provider What are the other possible side effects of GENVOYA?
determines they meet certain requirements. These include Serious side effects of GENVOYA may also include:
having an undetectable viral load (less than 50 copies/mL) for 6
months or more on their current HIV-1 treatment. GENVOYA • Changes in body fat, which can happen in people taking HIV-1
combines 4 medicines into 1 pill taken once a day with food. medicines.
GENVOYA is a complete HIV-1 treatment and should not be • Changes in your immune system. Your immune system may
used with other HIV-1 medicines. get stronger and begin to fight infections. Tell your healthcare
provider if you have any new symptoms after you start taking
GENVOYA does not cure HIV-1 or AIDS. To control HIV-1 GENVOYA.
infection and decrease HIV-related illnesses, you must keep
taking GENVOYA. Ask your healthcare provider if you have • Kidney problems, including kidney failure. Your healthcare
questions about how to reduce the risk of passing HIV-1 to provider should do blood and urine tests to check your kidneys.
others. Always practice safer sex and use condoms to lower the If you develop new or worse kidney problems, they may tell you
chance of sexual contact with body fluids. Never reuse or share to stop taking GENVOYA.
needles or other items that have body fluids on them. • Bone problems, such as bone pain, softening, or thinning,
which may lead to fractures. Your healthcare provider may do
IMPORTANT SAFETY INFORMATION tests to check your bones.
What is the most important information I should know The most common side effect of GENVOYA is nausea. Tell your
about GENVOYA? healthcare provider if you have any side effects that bother you or
don’t go away.
GENVOYA may cause serious side effects:
What should I tell my healthcare provider before taking
• Build-up of an acid in your blood (lactic acidosis), which
is a serious medical emergency. Symptoms of lactic acidosis GENVOYA?
include feeling very weak or tired, unusual muscle pain, • All your health problems. Be sure to tell your healthcare
trouble breathing, stomach pain with nausea or vomiting, provider if you have or have had any kidney, bone, or liver
feeling cold (especially in your arms and legs), feeling dizzy or problems, including hepatitis virus infection.
lightheaded, and/or a fast or irregular heartbeat.
• All the medicines you take, including prescription and over-
• Serious liver problems. The liver may become large and the-counter medicines, vitamins, and herbal supplements.
fatty. Symptoms of liver problems include your skin or the Other medicines may affect how GENVOYA works. Keep a list
white part of your eyes turning yellow (jaundice), dark “tea- of all your medicines and show it to your healthcare provider
colored” urine, light-colored bowel movements (stools), and pharmacist. Ask your healthcare provider if it is safe to take
loss of appetite for several days or longer, nausea, and/or GENVOYA with all of your other medicines.
stomach pain.
• If you take antacids. Take antacids at least 2 hours before or
• You may be more likely to get lactic acidosis or serious after you take GENVOYA.
liver problems if you are female, very overweight, or have
• If you are pregnant or plan to become pregnant. It is not
been taking GENVOYA for a long time. In some cases, lactic
known if GENVOYA can harm your unborn baby. Tell your
acidosis and serious liver problems have led to death. Call
healthcare provider if you become pregnant while taking
your healthcare provider right away if you have any symptoms
of these conditions.
• If you are breastfeeding (nursing) or plan to breastfeed. Do
• Worsening of hepatitis B (HBV) infection. GENVOYA is not
not breastfeed. HIV-1 can be passed to the baby in breast milk.
approved to treat HBV. If you have both HIV-1 and HBV and
stop taking GENVOYA, your HBV may suddenly get worse. You are encouraged to report negative side effects
Do not stop taking GENVOYA without first talking to your of prescription drugs to the FDA. Visit
healthcare provider, as they will need to monitor your health., or call
Who should not take GENVOYA? 1-800-FDA-1088.
Do not take GENVOYA if you take: Please see Important Facts about GENVOYA
• Certain prescription medicines for other conditions. It is including important warnings on the
important to ask your healthcare provider or pharmacist about following page.

Ask your healthcare provider if GENVOYA is right for you,
and visit to learn more.

GENVOYA does not
cure HIV-1 or AIDS.

Take care of what matters most—you. GENVOYA is a 1-pill, once-a-day
complete HIV-1 treatment for people who are either new to treatment
or people whose healthcare provider determines they can replace their
current HIV-1 medicines with GENVOYA.

Migergot®. IMPORTANT FACTS This is only a brief summary of important information about GENVOYA and does not replace talking to your healthcare provider about your condition and your treatment. GILEAD. Teril®). stomach pain with nausea or vomiting. Wigrettes®). • Bone problems. sildenafil when GENVOYA. including: GENVOYA can cause serious side effects. Call your healthcare provider right away if you have any of these symptoms: your skin or the white part of your eyes turns yellow These are not all the possible side effects of GENVOYA. and the GILEAD Logo are trademarks of Gilead Sciences. phenytoin (Dilantin®. including hepatitis infection. light-colored bowel movements healthcare provider right away if you have any new symptoms while (stools). • Have any other medical condition. Wigraine®. Vytorin®. pimozide (Orap®). • Ask your healthcare provider or pharmacist about medicines that • GENVOYA does not cure HIV-1 or AIDS. If you have both HIV-1 and HBV. GENVOYA. once a day HIV-1 medicine. feeling very weak or tired. ergotamine (Cafergot®. bone. ABOUT GENVOYA • Are pregnant or plan to become pregnant. Altoprev®. • This is only a brief summary of important information about rifampin (Rifadin®. dihydroergotamine • Take GENVOYA with food. Rifamate®. cisapride (Propulsid®. methylergonovine (Ergotrate®. including kidney failure. before. which • Those in the “Most Important Information About GENVOYA” section. GET MORE INFORMATION Methergine®). Zocor®). Tegretol®. • Severe liver problems.E. unusual muscle pain. simvastatin (Simcor®.com • Take any other HIV-1 medicines at the same time. Inc. approved to treat HBV. carbamazepine (Carbatrol®. phenobarbital (Luminal®). that they meet certain other requirements. • Changes in your immune system.H. Equetro®. The most common side effect of GENVOYA is nausea. Medihaler Ergotamine®. Do not • GENVOYA is a prescription medicine used to treat HIV-1 in people breastfeed if you have HIV-1 because of the risk of passing HIV-1 12 years of age and older who have never taken HIV-1 medicines to your baby. feeling dizzy or lightheaded. stomach pain. BEFORE TAKING GENVOYA You may be more likely to get lactic acidosis or severe liver problems Tell your healthcare provider if you: if you are female. and show it to your failed HIV-1 treatment. (D. and whose healthcare provider determines healthcare provider and pharmacist. Rifater®. Talk to your healthcare provider or pharmacist to used for lung problems (Revatio®). or its related companies. Tell your (jaundice). GENVOYA is not health before and during treatment with GENVOYA. dark “tea-colored” urine. and have been on • Keep a list that includes all prescription and over-the-counter the same HIV-1 medicines for at least 6 months and have never medicines.. Mevacor®). for program information. • Have or had any kidney. midazolam (when taken by mouth). Propulsid Quicksolv®). Tegretol-XR®. and/or taking GENVOYA. Version date: November 2015 © 2016 Gilead Sciences. (jen-VOY-uh) MOST IMPORTANT INFORMATION ABOUT GENVOYA POSSIBLE SIDE EFFECTS OF GENVOYA Genvoya® may cause serious side effects. irregular heartbeat. Ergostat®. or liver problems. Phenytek®). Call your healthcare provider right away if you have any of these symptoms: • Changes in body fat. and/or a fast or • New or worse kidney problems. which in some cases can lead to death. All other marks are the property of their respective owners. learn more. GENC0020 03/16 . provider about how to prevent passing HIV-1 to others. Inc. John’s wort. Migranal®). including: • Build-up of lactic acid in your blood (lactic acidosis). 45®. All rights reserved. Epitol®. visit GENVOYA. or call 1-800-GILEAD-5 • Take the herbal supplement St. Rimactane®). Ask your healthcare should not be taken with GENVOYA. Your healthcare provider will need to do tests to monitor your • Worsening of Hepatitis B (HBV) infection. • Are breastfeeding (nursing) or plan to breastfeed. lovastatin (Advicor®. • GENVOYA is a complete one pill. very overweight. your HBV may suddenly get worse if you stop taking GENVOYA. feeling cold (especially in your arms and legs). and herbal supplements. Do not stop taking GENVOYA without first talking to your healthcare provider. or triazolam (Halcion®). nausea. Do NOT take GENVOYA if you: HOW TO TAKE GENVOYA • Take a medicine that contains: alfuzosin (Uroxatral®). or have been taking GENVOYA for a long time. GENVOYA can also be used to replace current HIV-1 Tell your healthcare provider about all the medicines you take: medicines for some people who have an undetectable viral load (less than 50 copies/mL of virus in their blood). trouble breathing. loss of appetite for several days or longer. as they will need to check your health regularly for several months. the GENVOYA Logo. • If you need help paying for your medicine. is a serious medical emergency that can lead to death. • Go to GENVOYA.


FAVORITE COVER? Carmen remains committed to that campaign despite being advised against it. In fact. WHY TR E ATM E NT I S TH E B E ST PR E VE NTION but when I closed my eyes at night I dreamt of being a supermodel: CARMEN having the whole world know my CARRERA O N H IV. EDITOR’S LETTER I’ve known since middle school that I was going to be a journalist when I grew up. Carmen may not be poz.hivplusmag. I was BECAUSE YOU’RE MORE THAN YOUR STATUS WHY a short. After all. When you have a supermodel on your Unwilling to give up—either her support for people living with HIV or her career cover. espe- saw on the front of the cially since it deals with the intersections of race. I was BECAUSE YOU’RE MORE THAN YOUR STATUS already writing a column for our local newspaper (we only had 2. We also offer HIVPlusMag and a advice on picking the right medications. side of Carmen Carrera Our annual Just Diagnosed segment reflects optimism as well. — CARMEN CARRERA Carrera. and New York City buses and subways. Sure. Men. That might seem a heavy subject for springtime. A N D B E I N G A TR A N S S U P E R M O D E L wearing haute couture from designers whose clothes weren’t even sold within 300 miles of my tiny Idaho hometown. no one wants a Sports Illustrated swimsuit model associated with HIV. Learning you’re (love the braid!)was a close second favorite. either Lust. she’s an WHICH IS YOUR eager participant in an action that honors the father she lost to AIDS complications. I’m telling you this to explain I DON’T WANT TO BE SOMEONE WHO IS JUST ABOUT GLAMOUR AND FAME. and don’t let anyone throw shade your way. poverty. and Take your meds. softer ing on getting former prisoners connected to care outside. and Iman. with the Sero Project battling HIV criminalization laws and other groups work. one of the most beautiful souls to ever walk a runway.COM books at HIVPlusMag. Alas. debate. After a rousing women who are transgender like her. But. walking the Paris runway MAY/JUNE 2016 www. this one. fat chick with TACKLING HIV AMONG TRANS WOMEN a giant nose.hivplusmag. But 4 | MAY / JUNE 2016 . violence. I FEEL A RESPONSIBILITY. take care of yourself. But she’s not just another model pegged for a public awareness campaign. but she has quite literally become the face of HIV in an ad campaign gracing MAY/JUNE 2016 www. AND NOT DEAL WITH that I sturggled not to totally nerd out about fashion while talking with Carmen THE REAL ISSUES.” someone know the options will be too glamorous to tackle the real issues facing men and women with HIV—especially endless. begninning cover? Vote now with disclosure—coming out to friends and family.000 readers. mixed-race. it means new chal- Which is your favorite lenges. we chose the This issue also features our special three-month investigation into what it’s like tough leather jacket- clad glam shot you to have HIV behind bars. and even explain how many doctors and random winner will win your choice of books— exes (or hookups) you’ll want to call and why. Gia. she’s been told. broach. Meth: A Gay Man’s Guide Happy Spring! to Sex and Recovery or A Woman’s Guide to Living With HIV Infection. I was high on the prestige. it’s a hopeful one too. HIV-positive is no longer the devestating news it once was. against Tell us and win a free book! aligning herself with this cause. but that was half the population of our whole J UST DIAG NOS E D? WE HAVE TH E AN SWE R S town). you’ve got to dreams—Carmen tells me she doesn’t want to be “all smoke and mirrors. lest others assume she’s poz herself. LOS I N G A DA D TO A I DS . offering a sweeter.* BRADFORD ROGNE DIANE ANDERSON-MINSHALL EDITOR IN CHIEF *See what our editors thought about the ing with your sexual partner the changes s/he might want to make. at Facebook. talking to your kids. but we’re here to guide you through some of the hardest parts. who had to settle for MEANS LISTENING TO THEM FIRST living vicariously and plastering my walls with photos of Cindy Crawford.

just log on to HIVPlusMag. designer. integrated marketing JAMIE TREDWELL multiplatform advertising solutions manager PAIGE POPDAN jr.COM |5 . Printed in the USA. We require only your email address to initiate and give us your email address. Los Angeles. Plus (ISSN 1522-3086) is published bimonthly by Here Publishing Inc. integrated marketing JOHN MCCOURT manager. media strategy STEWART NACHT sr. just log on to HIVPlusMag. STEVEN CAPONE. MICHAEL LUONG manager. pharmacy. community-based group. 43430 E. or other agency can request bulk copies for free distribution at your HIVPlusMag HIVPlusMag SOUTHWEST EDITORIAL OFFICES Retrograde Communications. or facility. LUCAS GRINDLEY. To sign up. integrated ad sales/marketing. just email our circulation department at FREE BULK SUBSCRIPTIONS FOR YOUR OFFICE OR GROUP Any organization. JARCHOW ceo PAUL COLICHMAN cfo/coo TONY SHYNGLE executive vice presidents BERNARD ROOK. KING mental health editor GARY MCCLAIN creative director. You may also share your digital copies with friends.. Hemet. director. All rights reserved. California 90024 Phone (310) 806-4288 • Fax (310) 806-4268 • Email to subscribe.. JOHN MONGIARDO. audience development & consumer marketing ROBERT HEBERT director of social media LEVI CHAMBERS associate social media editor DANIEL REYNOLDS circulation director JEFF LETTIERE fulfillment manager ARGUS GALINDO operations director KIRK PACHECO los angeles office manager HEIDI MEDINA production services GVM MEDIA Twitter. F PMB 330. physicians’ office. group publisher JOE VALENTINO art director RAINE BASCOS senior editor JACOB ANDERSON-MINSHALL managing editor TYLER CURRY copy editor ELAINE MENDUS contributing editor KATIE PEOPLES. application development ALEX LIM program manager VINCENT CARTE front end developer MAYRA URRUTIA traffic manager KEVIN BISSADA VP.. Los Angeles. FREE DIGITAL SUBSCRIPTIONS Plus magazine is now available free to individual subscribers—a digital copy of each issue can be delivered to the privacy of your computer or reader six times per year. editorial director LUCAS GRINDLEY senior vice presidents CHRISTIN DENNIS. CA 90024. 10990 Wilshire Blvd. support group. JOE VALENTINO vice presidents GREG BROSSIA. AMANDA JOHNSON ADVERTISING & SUBSCRIPTIONS OFFICES 120 West 45th Street. ERIC BUI. digital media & integrated marketing DAVE JOHNSON director. LLC HERE MEDIA chairman STEPHEN P. Entire contents © 2016 by Here Publishing Inc. digital media SCOTT RAGAN interactive art director CHRISTOPHER HARRITY online photo and graphics producers YANNICK DELVA. JOE LANDRY VP. New York.Lettiere@HereMedia.. FOLLOW US ON FACEBOOK AND TWITTER Facebook. There is a 10-copy minimum. Plus is a registered trademark of Here Media Inc. CA 92544 Phone (951) 927-8727 • Email support@retrogradecommunications. MARK S. Penthouse Suite. editor in chief DIANE ANDERSON-MINSHALL SVP. meeting. Suite 3800. Ste. New York 10036-4041 Phone (212) 242-8100 • Advertising Fax (212) 242-8338 Subscriptions (212) 209-5174 • Subscriptions Fax (212) 242-8338 LOS ANGELES EDITORIAL OFFICES 10990 Wilshire Blvd. Penthouse Ste. Florida Ave. integrated marketing AMANDA JOHNSON senior manager. To sign up. NEED SUBSCRIPTION HELP? If you have any questions or problems with your bulk or individual magazine delivery. integrated marketing PETER OLSON coordinator. CASEY NOBLE senior director.

18 Supermodel Alert!
Transgender model Carmen
Carrera tackles HIV stigma.

32 The 6 Biggest Questions
What we get asked at Plus.
34 How to Disclose Your Status
What and how to tell family
and friends.
39 Here's Why Treatment is
the Best HIV Prevention
It can save your life and prevents
40 How Do I Tell My Kids?
Professionals offer advice.

42 We Don’t Need Another Hero
Working with street educated
trans women changes a girl.

24 Locked Up & Lost
Is society throwing away
the key on prisoners with HIV?

6 | MAY / JUNE 2016

New Odefsey
is now available

Actual Size
(15.4 mm x 7.3 mm)

One small pill contains
rilpivirine, emtricitabine, and
tenofovir alafenamide (TAF).

Ask your
healthcare provider
if ODEFSEY is right
for you.

To learn more visit

Please see Brief Summary of Patient Information with
important warnings on the adjacent pages.

Brief Summary of Patient Information What is ODEFSEY?
ODEFSEY is a prescription medicine that is used to treat HIV-1
ODEFSEY (oh-DEF-see) in people 12 years of age and older:
(emtricitabine, rilpivirine and tenofovir alafenamide) tablets
• who have not received HIV-1 medicines in the past and have an
Important: Ask your healthcare provider or pharmacist about amount of HIV-1 in their blood (“viral load”) that is no more than
medicines that should not be taken with ODEFSEY. 100,000 copies/mL, or
There may be new information about ODEFSEY. This information is only • to replace their current HIV-1 medicines in people who have been on
a summary and does not take the place of talking with your healthcare the same HIV-1 medicines for at least 6 months, have a viral load that
provider about your medical condition or treatment. is less than 50 copies/mL, and have never failed past HIV-1 treatment.
What is the most important information It is not known if ODEFSEY is safe and effective in children under 12 years
I should know about ODEFSEY? of age or who weigh less than 77 lb (35 kg).
When used to treat HIV-1 infection, ODEFSEY may help:
ODEFSEY can cause serious side effects, including: • Reduce the amount of HIV-1 in your blood. This is called “viral load”.
• Build-up of lactic acid in your blood (lactic acidosis). Lactic • Increase the number of CD4+ (T) cells in your blood that help fight
acidosis may happen in some people who take ODEFSEY or similar off other infections.
medicines. Lactic acidosis is a serious medical emergency that can
lead to death. Lactic acidosis can be hard to identify early, because Reducing the amount of HIV-1 and increasing the CD4+ (T) cells in your
the symptoms could seem like symptoms of other health problems. blood may help improve your immune system. This may reduce your risk
Call your healthcare provider right away if you get any of the of death or getting infections that can happen when your immune system
following symptoms which could be signs of lactic acidosis: is weak (opportunistic infections).
– feel very weak or tired ODEFSEY does not cure HIV-1 infection or AIDS. You must keep
taking HIV-1 medicines to control HIV-1 infection and decrease
– have unusual (not normal) muscle pain HIV-related illnesses.
– have trouble breathing Ask your healthcare provider about how to prevent passing
– have stomach pain with nausea or vomiting HIV-1 to others. Do not share or re-use needles, injection equipment,
– feel cold, especially in your arms and legs or personal items that can have blood or body fluids on them. Do not
– feel dizzy or lightheaded have sex without protection. Always practice safer sex by using a latex or
polyurethane condom to lower the chance of sexual contact with semen,
– have a fast or irregular heartbeat vaginal secretions, or blood.
• Severe liver problems. Severe liver problems may happen in people
who take ODEFSEY. In some cases, these liver problems can lead to Who should not take ODEFSEY?
death. Your liver may become large and you may develop fat in your liver.
Call your healthcare provider right away if you get any of the
Do not take ODEFSEY if you also take a medicine that contains:
following symptoms of liver problems: • carbamazepine (Carbatrol®, Epitol®, Equetro ®, Tegretol®,
Tegretol-XR®, Teril®)
– your skin or the white part of your eyes turns yellow (jaundice)
• dexamethasone (Ozurdex®, Maxidex®, Decadron®, BaycadronTM)
– dark “tea-colored” urine
• dexlansoprazole (Dexilant®)
– light-colored bowel movements (stools)
• esomeprazole (Nexium®, Vimovo ®)
– loss of appetite
• lansoprazole (Prevacid®)
– nausea
• omeprazole (Prilosec ®, Zegerid®)
– pain, aching, or tenderness on the right side of your stomach area
• oxcarbazepine (Trileptal®)
• You may be more likely to get lactic acidosis or severe liver
problems if you are female, very overweight (obese), or have • pantoprazole sodium (Protonix®)
been taking ODEFSEY or a similar medicine for a long time. • phenobarbital (Luminal®)
• Worsening of Hepatitis B virus (HBV) infection. ODEFSEY is not • phenytoin (Dilantin®, Dilantin-125 ®, Phenytek®)
approved to treat HBV. If you have HBV and take ODEFSEY, your HBV • rabeprazole (Aciphex®)
may get worse (flare-up) if you stop taking ODEFSEY. A “flare-up” is
• rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®)
when your HBV infection suddenly returns in a worse way than before.
• rifapentine (Priftin®)
– Do not run out of ODEFSEY. Refill your prescription or talk to your
healthcare provider before your ODEFSEY is all gone. • the herb St. John’s wort or a product that contains St. John’s wort
– Do not stop taking ODEFSEY without first talking to your What should I tell my healthcare provider
healthcare provider. before taking ODEFSEY?
– If you stop taking ODEFSEY, your healthcare provider will need to
check your health often and do blood tests regularly for several Before taking ODEFSEY, tell your healthcare provider if you:
months to check your HBV infection. Tell your healthcare provider • have liver problems including hepatitis B or C virus infection
about any new or unusual symptoms you may have after you stop • have kidney and bone problems
taking ODEFSEY.
• have had depression or suicidal thoughts
• have any other medical conditions
• are pregnant or plan to become pregnant. It is not known if ODEFSEY
can harm your unborn baby. Tell your healthcare provider if you
become pregnant while taking ODEFSEY.

allergic reaction may need to be treated in a hospital. Rash can be serious. call your healthcare provider or go The most common side effect of emtricitabine and tenofovir to the nearest hospital emergency room right away. including: ODEFSEY. vitamins. alafenamide. These changes may include increased amount of fat in including prescription and over-the-counter medicines. when you get a new medicine. The virus may develop resistance information. Tell your • Do not start a new medicine without telling your healthcare provider. medicines that interact with ODEFSEY. Pregnancy registry: there is a pregnancy registry for women who • Depression or mood changes. The most common side effects of rilpivirine. Your How should I take ODEFSEY? healthcare provider should do blood and urine tests to check your kidneys before you start and while you are taking ODEFSEY. Skin rash is a common For more information. two of the medicines in ODEFSEY. In some cases. • Call your doctor for medical advice about side effects. If you would like more information. and the upper back and neck (“buffalo hump”). and GSI – trouble breathing or swallowing are trademarks of Gilead Sciences. talk with your healthcare • See “What is the most important information I should know provider. • If you take too much ODEFSEY. Your • Take ODEFSEY exactly as your healthcare provider tells you to take healthcare provider may tell you to stop taking ODEFSEY if you it. – dark “tea-colored” urine © 2016 Gilead Sciences. Bone problems may include bone pain. get more from your Tell your healthcare provider if you have any side effect that healthcare provider or pharmacy. Inc. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Talk with – feel sad or hopeless your healthcare provider about how you can take part in this registry. Do not breastfeed if you – have thoughts of hurting yourself (suicide) or have tried to hurt yourself take ODEFSEY. • When your ODEFSEY supply starts to run low. is nausea. with other medicines. ODEFSEY is taken by itself (not with other HIV-1 medicines) to develop new or worse kidney problems. People with a history of hepatitis B or C – You should not breastfeed if you have HIV-1 because of the risk virus infection or who have certain liver enzyme changes may have of passing HIV-1 to your baby. one of the medicines in • Do not miss a dose of ODEFSEY. the amount of virus in your blood may increase if the medicine is • These are not all the possible side effects of ODEFSEY. the ODEFSEY logo. For more stopped for even a short time. • Severe skin rash and allergic reactions. to ODEFSEY and become harder to treat. including kidney failure. It is not known if the other medicines in during treatment with ODEFSEY in people without a history of liver ODEFSEY can pass into your breast milk. arms and face Some medicines may interact with ODEFSEY. trouble sleeping (insomnia). – feel anxious or restless • are breastfeeding or plan to breastfeed. rash and Keep ODEFSEY and all medicines out of reach of children. • Change in liver enzymes. GILEAD. healthcare provider right away if you start having any new symptoms Your healthcare provider can tell you if it is safe to take ODEFSEY after starting your HIV-1 medicine. The purpose of this registry is away if you have any of the following symptoms: to collect information about the health of you and your baby.. ask your healthcare provider or pharmacist. the GILEAD Logo. provider’s care when taking ODEFSEY. medicine. All other – pain on the right side of the stomach (abdominal) area trademarks referenced herein are the property of their respective owners. All rights reserved. are depression. treat HIV-1 infection. provider right away if you get a rash. GILC0216 03/16 . Tell your healthcare provider right take HIV-1 medicines during pregnancy. Call your healthcare www. • Take ODEFSEY 1 time each day with a meal. breast. The exact cause and long-term health effects of medicines and show it to your healthcare provider and pharmacist these conditions are not known. Inc. • Changes in body fat can happen in people who take HIV-1 Tell your healthcare provider about all the medicines you take. Stay under a healthcare to check your bones. Your healthcare provider may need to do tests to check your – Talk with your healthcare provider about the best way to feed liver enzymes before and during treatment with ODEFSEY. Your healthcare provider may need to do tests talking with your healthcare provider.ODEFSEY. • Bone problems can happen in some people who take ODEFSEY. your baby. lips. If you get a Issued: March 2016 rash with any of the following symptoms. This Brief Summary summarizes the most important information about ODEFSEY may cause serious side effects. ODEFSEY. mouth or throat ODEFSEY. softening or thinning (which • Do not change your dose or stop taking ODEFSEY without first may lead to fractures). middle of your body (trunk). Liver problems can also happen in your breast milk. You may What are the possible side effects of ODEFSEY? report side effects to FDA at 1-800-FDA-1088. or its related companies. an increased risk of developing new or worsening liver problems – At least one of the medicines in ODEFSEY can pass to your baby during treatment with ODEFSEY. Loss of fat from the You can ask your healthcare provider or pharmacist for about ODEFSEY?” information about ODEFSEY that is written for health professionals. EMTRIVA. • New or worse kidney problems. This is very important because bothers you or that does not go away. stop taking ODEFSEY and call your healthcare provider right away: – fever – skin blisters – mouth sores – redness or swelling of the eyes (conjunctivitis) – swelling of the face. • Changes in your immune system (Immune Reconstitution • You can ask your healthcare provider or pharmacist for a list of Syndrome) can happen when you start taking HIV-1 medicines. Keep a list of your may also happen. and around the herbal supplements. and headache. call 1-800-445-3235 or go to side effect of ODEFSEY. disease.

Guys The dangers of mixing the two. creators. Reading Poems. 15 Antidepressant Helps Repair Brain A new treatment could fight neurological issues in PLWH. 10 | MAY / JUNE 2016 . Gluten! Is the latest dietary fad right for you? 12 Positive Transplants New rules pave way for organ recipients. prevent HIV in women. Switch Meds Sleep weird hours? Take 52 Do You Need a pills without food? An expert’s guide to which Meningitis Vaccine? meds are right for your Some people are particularly lifestyle. INSERT COVER: Carmen Carrera photographed by Melina Varela BUZZWORTHY 11 Spin Class Proposal A serodiscordant love story is a viral sensation. 13 Coffee RX 7 Ways to get a caffine fix. vulnerable to the deadly disease. BACK COVER: Shutterstock. TREATMENT CHRONICLES THE BEST OF THE REST 50 Salute This 48 I Love Your Microbiome The VA boosts funding to cover New research suggests we more vets living with hep C. 51 First PrEP to Poz Case Rare drug resistant HIV 54 Might Be Time to strain was immune to PrEP. 12 Goodbye. MAY | JUNE 2016 COVER: Carmen Carrera photographed by Alex Evans. 14 Safer Than You Think People in treatment are less infectious than they think. and SHUTTERSTOCK D-Man. and subjects of 3 new projects: 53 Sex & Meth Unsure/Positive. SPECIAL INSERT 53 Put a Ring on It Poz Hollywood This insertable vaginal ring could The HIV-positive actors. 15 Got Food? Get your nutrients with a meal- replacement smoothie. actually fall in love with each other’s stomach bugs. 14 The Cocktail Cure Drink to your health.

everyone appeared to be cycling as usual. In less than 24 hours. ing for a job and Marinelli was instantly smitten. C OM | 11 . “PrEP lifted a huge weight off our shoulders as far as ly broke from the crowd and approached Marinelli. Ganjian assured surprised his boyfriend and fellow JoyRide instructor. The pair had asked their friend al that took the Internet by storm. In ly changed and the cyclists stepped off their bikes and start. when Marinelli began the warm-up. it was Keller’s idea to become a more vocal support- ed to move in formation. Just days later. when Marinelli’s class burst out into a top-secret. spring or fall 2017 wedding in Connecticut. advice. which ultimately led him to begin taking PrEP. emphatically said yes. Keller came into JoyRide look- source of inspiration to come out of the spin class couple. deterred by something like HIV. selves—I want to share that too. HIV. Marinelli that if Keller was the right guy. while laughing and crying.” #TeamJadam is now planning their #TeamJadam became a certified overnight sensation. including the the marriage proposal of Adam Keller and Jared Marinelli. Keller final. artist Jonathan Joseph Ganjian. ing the dots. just two guys in love who won’t let something like sta- Marinelli. views. he also began actively seeking out information and But. Keller making sure we’re doing everything we can to protect our- was equal parts emotional and out-of-breath.” Keller said. HIV-positive mixed HIV-status relationship. With Keller on a bike Keller was not only receptive to dating a person with front and center. fact. Their engagement. he would not be Marinelli. to write about how they became a couple. however. was not the only The story goes like this. Marinelli because Keller and Marinelli are also a public example of a gushed over the new instructor to his friend. with the spotlight by revealing to Plus that they are in chances are you have seen the spin class flash mob propos. but he man. Soon enough. “I think we’re aged to eventually find the words and ask the big question. choreographed wedding proposal. the music sudden. serodiscordant couple. MIXED-STATUS COUPLE BECOMES SOCIAL MEDIA SENSATION Unless you have been living under a social media rock. HIV stigma that he has noticed in the LGBT community. the two decided to do something useful —T Y L E R C U R RY H I V PLU SM AG . Marinelli’s family er of his HIV-positive fiancé and to speak out against the and friends began to fill the room and he started connect. tus stand in the way. point when Marinelli was crushing on Keller but afraid to now known as #TeamJadam.BUZZWORTHY Keller (center) and Marinelli (right) with family and friends. JoyRide spin instructor Keller ervations about revealing his own status. With not a dry eye in the room. racked up over 3 million reveal his HIV-positive status. but also sharing his res- On Valentine's Day.

” says Dr. three essential Ask your doctor about the Array 3 blood test. transplants—or even the study of transplants—between for living HIV-positive persons to donate. will be slow at first to begin positive-to-positive organ transplants. When people with gluten intolerance or celiac disease. according to Dr. associate professor we had to do for so many years. and most medical centers candidates for organ donations.BUZZWORTHY DO I NEED TO GO GLUTEN-FREE? For people who need it. 1. But with the onset of better medications and longer. Those donors could save nearly negative counterparts. organs will only be Though they were not forbidden from receiving donor organs from HIV. and the entire transplant community for letting us use organs The new policy will give HIV-positive patients with end-stage organ from HIV-positive patients to save lives. aren’t yet equipped to perform them. Larson adds. Larson. according to advocates. HIV-positive individuals may now receive organs from new possibilities opened up. rye and barley) from their diet it has a range of benefits from decreasing stomach pain. which legalized treatment. fog. muscle pain. reported in about two weeks. as For many years. like peripheral neuropathy. “Patients can then work with transglutaminase-3 and their physician to develop an appropriate treatment plan that transglutaminase-6). In 2013. brain gluten sensitivity. Array 3 is reactivity more accurately than earlier only recommended “for people who have non-responsive tests. bloating. Dorry Segev. hormone imbalances. since they die on the waiting list even faster than their HIV- according to The New York Times. or multiple com). President Obama HIV-positive donors in the United States. lifespans for people with HIV. as diseases a “new chance at life.” said Segev. It's the the most comprehensive gastrointestinal symptoms present with multiple-symptom analysis available for determining complaints—including joint pain. 12 | M AY / J U N E 2 0 1 6 . Results are enzymes (transglutaminase-2. and the gliadin may or may not include the elimination of gluten from their transglutaminase complex. with HIV. skin rashes.” says Dr. In addition.” Dr. HIV-positive patients weren’t considered good these transplants were illegal for decades. and gas to reducing more serious symptoms like joint pain. instead of throwing them away. For those who don’t.000 people a year. How do I know if I'm gluten sensitive? A new blood test called Array 3. healthier. it’s just money down the drain.— KAT I E P E O P L E S two HIV-positive people had been illegal since 1988. and an advocate for the HIV Organ Policy Segev warned The New York Times reporter Daniel Victor that it Equity Act.” of surgery at Johns Hopkins.  the first and only medical center approved for such an operation. from That’s a lot of science-y words.” diet. The new law seems to Johns Hopkins University School of Medicine recently received be a win-win. the gluten- free movement is far more than the latest fad. Obama. taken from deceased donors for now until it is established that it safe SHUTTERSTOCK negative patients. an advisor on the clinical suffer from depression or neurodegenerative symptoms consulting team for Cyrex (JoinCyrex. opening up a new pipeline of signed the HIV Organ Policy Equity Act. fatigue. “because it accurately identifies sclerosis. So who should take it? Cyrex Labratories identifies gluten Larson tells us that the test isn’t for everyone. remove gluten (a protein found in wheat. gluten reactivity and measures antibody production against 8 wheat And if you have those symptoms? proteins and peptides.  transplants between poz patients. Alzheimer’s disease. and chronic inflammation—or Chad Larson.— DA M The First HIV-Positive Organ Transplant For the first time. and anemia. “We are very thankful to Congress. as HIV-positive patients will have more approval from the United Network for Organ Sharing to perform two potential donors while HIV-negative patients might move transplants between HIV-positive patients: one kidney and one liver. It’s up the organ donor lists. The “Organ transplantation is actually even more important for patients number of HIV-positive donors is estimated between 500 and 600. as they were not expected to live long.

COFFEE ON THE CHEAP Try the Abraham Mocha Java.99. DancingMoonCoffee. CafeValet. chocolaty. which the touch of a button and it’s tiny enough to easily fit on a chiato). Brewer: $129. and yum. And they focus on coffee you’ll find scrumptiously REASONS beans from the world’s best single source plantations. $13. $12. $6. So we’ve got some fun ways to get your coffee RX. and can be with your favorites (Café my. exclusively at keurig. study proved that drinking three cups $59 for a box of 40. SUPPORT HIV & GO AU NATUREL LGBT CAUSES Dancing Moon’s premium all-natural antioxidant coffee is roasted in small batches. THE NON-EDIBLE BONUS… colors this year—cool blue Serenity Pacific Shaving Company Caffeinated Shaving Cream and and warm Rose Quartz—meant to express the new Aftershave combines an espresso worth of caffeine with organic gender blur and "societal movements toward gender aloe and spearmint to offer a shave (and healthy skin) that'll equality and fluidity. ies proved that drinking two cups of the non-profit of your choice trend with a new brewer in the Pantone Color of the Year. A meta-analysis of kick of a shot of espresso. sugar. transported back and forth easily. in their Caffeinated. Project. —DIANE ANDERSON-MINSHALL THE ONLY BREWER YOU'LL EVER NEED I “went Keurig” three MOCHA MOSES years ago and have never All hail the Chosen Bean: this regretted it. and faves—Mocha. Pantone anointed two AND. but this are donated to Semper Fi Fund and go to help wounded and TO GET YOU Minneapolis-based roaster— critically ill members of the armed forces. makes you more productive. natural. Bonus: every purchase leads to planting of a to get the new Keurig K250 brewing system in Serenity tree. Triangle Morso bar has only 1 gram of of Hope. $1 is donated to are the perfect all-natural.” Coffee activism? Now I can't wait help get you 80 percent and reduced side-effects by more than 80 percent for people living with hepatitis C and HIV. $25. ilM- a day increased treatment success by orso. Try the Full Moon Gourmet Blend or the Ethiopian Yirgacheffe. for every delicious il Morso Coffee Bars pound sold. Mug: $7. The drinking coffee. and Alzheimer’s to 25 calories. One cup revs your color-of-year H I V PLU SM AG . Even unique blends with funny gay better.95 and which offers one of the largest up. and their new double-walled ceramic travel mug in Rose vegan. but the caffeine disease. Even CHEW ON THIS Don’t think you have to drink Turns out you should absolutely be better. A French and Coffee & Cream—offer the highest caffeine quotients. Americano. paraben. It brews a hot. Quartz before they sell out.and sulfate-free. fresh cup in just minutes with the salted caramel mac. besides the taste. Clare House. Each il coffee may help you stave off diabetes. they also Science is on your side.5 grams of fat. For-A-Cause shop. food that are literally tiny oping liver cirrhosis by 44 percent and including these worthy HIV squares of coffee and other other recent studies have shown that groups: Minnesota AIDS sweets without the cup.75 set. is the fact that 5 percent of all profits (and bi) descriptions. high in antioxidants. Christians and atheists alike. and mold-free.9 pounds. and fair trade energy coffee a day lowers your risk of devel. My increases your energy by 16 percent. the light Moses Blend. I love its punny artisan roasted spe- ability to make both sin- cialty coffee that is “Biblically- gle serve and larger pots of coffee or tea with the inspired” is a great fun for simple touch of a screen. Keurig stays on TheChosenBean. eco-friendly ingredients. Certified fair trade. or make your own tea. C OM | 13 . desk or in a dorm room. or Red Ribbon Ride. or for a mere $ Du Monde!). dementia. $16. organic. On a tight budget? Café Valet’s Starter Combo includes the You can use one of 500 dif- Signature Single-Serve Brewer and a 10-count pack of coffee ferent pre-made pods (love the Forbidden Dark Rose.95 and up. 2. PacificShaving. weighs only 1. to get coffee goodness. and 15 Parkinson’ DRINKING COFFEE selections of organic coffee in the country—means business. fill a reusable pod is earthy.99. and there’s never any animal testing of these safe. use solar panels to power the three Primo roasters. fair trade At Rainbow Brew Coffee certified.99 each or $15.

and chili spiked new drinks let you socialize. almond syrup. CROI 2016 . City. and cacao and served a person’s viral load and Want a drink that doesn’t set your with an accompanying cone of maiz cancha. But.K. ginger. Our Germain—still yummy. and a dark chocolate liqueur swer. passion fruit. drink with vodka and served with nigiri sushi). after 3 years of treatment. 100%of those people were wrong. colorful twist on a classic Brazilian favorite with A recent study of people on antiretrovirals showed fresh avocado purée swizzled through crushed ice the disconnect between with cachaça. at the beginning of the 3-year study… 16% thought they had low (or no) risk of transmitting HIV. fiery. or winner of U.’s “Most Imaginative the Tom Yam (a fresh. and have a healthy (even you’re booze-free or in recovery (congrats!). lime leaf. — DA M 90% were wrong—they were actually undetectable. just ask or somewhat infectious a post-workout) cocktail you won’t for a Lychee Cooler without the Grey Goose and St. But if thought they were highly your food.” SushiSamba's tion of coriander. Source: Landovitz/UCLA. with a “shot” of ceviche with a tamarind ponzu). Developed by Richard Woods. an their view of their likeli- health back? If you’re in New York Andean snack like corn nuts). 10% still had detectable viral loads and were infectious.BUZZWORTHY THE COCKTAIL I Think I Can? CURE faves: the vibrant green Avocado Batida (creamy. SushiSamba’s new culinary (Bombay Dry gin swizzled through crushed ice with 52% cocktails menu might be the an. meaning their risk of transmission was actually close to zero. yuzu. the Coco Ceviche hood of transmitting HIV. cooling Asian combina- Bartender Award. feel guilty about tomorrow.

People who suffer from HAND flavors. sesame the aging process and increasing professor at Johns Hopkins University. benefit…of cognitive performance smoothie that provides Studies have shown that HIV. which could dramatically nutrient levels. is available to consumers.” said lead including golden a serious health impact.  Once known to have HIV-associated reduce the time before the treatment you’ve hit 100%. people living with HIV can still healthy. decision-making. Choco. those app that allows you to boosted mental functions related to who took paroxetine saw significant simply drag and drop suggested fruits and cognitive damage and suppressed improvement in decision-making and vegetables (even energy inflammation for patients with HIV. for patients with HIV-associated all the nutrients— associated brain disorders can have neurocognitive disorders. and rice flour. Omega oils—that your disease. Here’s a better with HIV. a nutritionally complete complications like cognitive damage have been able to clearly demonstrate meal replacement and chronic inflammation. Since Paroxetine is boosters) into the on- The drug improved reaction time currently approved for mental health screen simulated blender and decision-making and moderately disorders. Got Food? In order to stay healthy we try to remember to take our meds and use apps and activity trackers to keep us fit. ameliorate these health concerns and learning. and memory. motor and Raw. researchers from experience inflammation. this is the first time we option: 100%FOOD. which is a improve the quality of life for those function. accelerating author Ned Sacktor. In a 2014 study. what happens? We either skip the meal altogether or end up DAMAGE IN HIV-POSITIVE PEOPLE holding a greasy bag of fast food on our way to tick off another to-do You can live a long and healthy life “Over a period of 20 years and after list item. reaction time. body needs to stay autoimmune diseases. the stopping mental decline and reversing better: it comes with an antidepressant drug paroxetine (Paxil) earlier damage. kidney failure. Paroxetine seems capable of protein powders. controlled study. you are neurocognitive disorders (HAND). but many still can experience 10 clinical trials. and Even when virally suppressed.—TC good to go. death rates. It’s vegan and contains no genetically- Fortunately.— DA M H I V PLU SM AG . hemp. seeds. Meanwhile. which in modified ingredients. increased noting the groundbreaking nature of as well as vitamins and inflammation is linked to cancer. a neurology flaxseed. heart the findings. and note the changes in SHUTTERSTOCK suppressed inflammation in patients approval. the lightly malted existing antidepressant may be able to can often experience difficulty with chocolate flavor. dementia. vanilla similar to many aging with HIV. John Hopkins University School of the brain causes damage to nerve and comes in two Medicine recently discovered that an cells. Even In a small. C OM | 15 . but when we’re too busy ANTIDEPRESSANT MAY IMPROVE COGNITIVE to eat. nothing should delay FDA.

I would Looking at a chasm in my sexual history. in Washington D. AIDS is God’s punishment. ending with Aunt Mary. Why not think of life if you’re up and walking? AT 67. panels on the AIDS Quilt is well known to me. But I’d still like to talk to someone about surviving AIDS. granite headstone in Woodlawn I am the one wanting to know why people don’t want to talk. I’M CLOSER TO DEATH FROM OLD When she was young enough to still ride in the child’s seat of the gro- cery cart. Those who listen do so out of kind- ness.” She couldn’t M Y N A M E A N D birthdate are engraved comprehend why. They find this bizarre. willing themselves to hear only words. It was cheaper. There was So at 67. That day I felt fine. and award-winning author of a perceived empty future. but I am much closer to death from old age than AIDS complications. I would have missed telling my story. My life. Square Affair (TimmHolt. And I wonder if came like batteries. said hello to that woman and she won’t talk to me. ing voices of damnation: “Gay is evil. my preoccu- pation with death. D A I LY D O S E BY TIMMOTHY J . I’ve seen them displayed I’ve been at the threshold of death since in the engine room of the Queen Mary in Long Beach and on the mall age 40 when I left a California testing cen. no diarrhea. for 30 years. of my friends who died and visions of those I never knew. I ached to be a panel on that quilt.” looking like a graceful palm tree outside the Most of all though.C. but anyone who might care stopped listening long ago. They’re weary of the same. friends who have died. H O LT Then. archeo- logical dust—unwanted and sifted out. I would testing center. I want to tell someone my thoughts. was a safe haven away from Doctor Holt. like smoke from the morning fire. Trouble is. pictures ter holding a piece of a paper that said HIV. thy. They inquire about the nature of my day. SHUTTERSTOCK ability. I’m now the elder. “Daddy. have missed a lot of life. my concerns. “Honey. a broken vessel. or negative. and I couldn’t understand why she kept asking. I saw my parents’ names en- graved on that headstone. people don’t always want to talk.” I responded. my mortality escaped daily with the stars into the brightness of day. Anxious have been content to be Lot’s wife. lives with his partner in Chicago. and I want to tell them my day always starts with the thought of death. as time wore on. Though I often surrendered my- self to the inevitability of death. the last of my parents’ generation. when you’re not dead you’d like to talk to someone about being a survivor. Mom thought it best I’m not as cute or as innocent as a 3-year-old redhead. my boisterous. Conversations and tears are reserved for those who died. as if I needed it. I AGE THAN FROM AIDS COMPLICATIONS. I have a constant reminder of I don’t want casual conversations about lives lost. Of course. Cemetery. At Dad’s death. old survivor story. Other headstones and other names were added. The number of my immortality. and my friends instantly be. 30-year survivor. glad I did not become that pillar of salt. At that moment. no night sweats. Still hear- salt caught in the moment. The only future I saw was dis. WITHOUT A DATE Occasionally an unfamiliar person at the local coffee shop will engage me in polite conversation. and I never prepared for this rank. 16 | MAY / JUNE 2016 . no neuropa. never to change.. night’s dark their meaning floating up and away unnoticed. if all our names were carved on the headstone. redheaded daughter would often say. a retired physician. and no pill box. and death. Now on a grey. positive. a pillar of about long-term effects of HIV and the drugs used to treat it. Problem is. suffering. forever viewed as positive anyone’s memory can be reduced to a square of fabric. not look at others. where does this leave me? I still have an uncertain future. and I have a patchwork quilt of my own. I became the aftermath of a plague. So why not end it now? That day.


was a little scary at first.” in reach- Fans of VH1’s Couples Therapy know ing her goals and says. In addition to Couples Therapy.BY DI ANE AND E RSO N -M IN S H ALL CALL ME CARMEN SHE’S A MOM. But there was a part hormones and eventually her body said of me that was comforted by the idea that I was doing some- everything for her: when she grew breasts. so she the people that are watching and the people that I’m opening didn’t say anything. coming across as relatable and transgender models in the world (signed approaching others as though the “majority of people” aren’t by Elite).” ing publicly as a gay man—pull off some Carrera. Carrera had a role last year minating in Carrera becoming the first in the film Ricki and the Flash and she was photographed by transgender person to wed on cable TV.” But. The couple appeared on the transphobic.” she to Dr. because it was going precocious toddler trying on maxi pads— to be valuable to my community. thing for my community—and it was good therapy. press-shy husband decided being on the TV. says. Elle. On RuPaul’s Drag Race. it’s not going to work. the legendary David LaChapelle (whose runway show she M 18 | MAY / JUNE 2016 . their The model. going to do it right away. and to the acceptance of us. not for Carrera. stands out on screen and in magazines ra feels being one of the most high-profile as well as she does in person. “the experience was very night. she admits. Jenn Mann and the viewing public. because it wouldn’t sink in. the woman Carre. “I’m happy that I did it. “But go- literally. who has been featured in W. a big Orbitz campaign. “Couple’s Therapy is not the kind of show that’s sen- drag during the day and her real self at sationalized drama. trans-inclusive couple to spill their guts “If I’m trying to educate them. because who wants to put their per- ra had dreamed of being since she was a sonal business out there? I did it anyway. MTV ing through the process on television and letting everyone in viewers watched Carrera—then identify. IS USING HER CELEBRITY TO FIGHT HIV AND ITS STIGMA. Her initial qualms were eased after she watched previous ing Drag Race.” all about that—and the transition. cul. Carrera didn’t know how to tell her intense. NOW CARMEN CARRERA. She just began taking up to—and how I’m going to be perceived. AMERICA’S FIRST TRANSGENDER SUPERMODEL. they just need to be given real information in. AND A GIRL WHO LOST HER FATHER TO AIDS COMPLICATIONS. I wanted to drive home that me and Adrian are just a boy and The transgender model now says she a girl trying to figure it out.” Torres figured it out. but tried not to be overly Laverne Cox about the situation. Overall Carrera feels she “was pretty successful. the first well. Glamour and infidelities. the immense pressure Carre. Except it wasn’t drag. “I knew that I had to make it a casual conversation. show was “a great opportunity” for trans visibility.” was living “between genders” while film. M I L L I O N S O F P E O P L E H AV E “It definitely made us stronger and closer as far as seeing seen actress and model Carmen Carrera each other’s points of view…to have an understanding of become the woman she is today—quite each other [with] fewer expectations. it became groundbreaking.” says Carrera. husband Adrian Torres the truth. says of the fiercest femme drag ever seen on she and her quiet. “I wasn’t That was the real her.” BRENDAN FORBES (Carrera) and pansexual (Torres) individ- uals face. because she’d seen her mom using them. a relatable way.” and she worried about “the judgment of other people. I had By showing the ordinary challenges trans my boundaries. A WIFE. sixth season of the reality show. an HIV and LGBT activist in her own right. feeling like she was in boy episodes.


who starred on Couples Therapy. 20 | MAY / JUNE 2016 . have been together nearly a decade. SHUTTERSTOCK (PG 32) Carrera and Torres.

to actually be in control. [there is] a “don’t ask. I’m to-be was tenacious. I it. NARS. that are learning from you. It’s not ple—it affects the human race. diagnosis and was “freaked out at the time. and that was actually the second cause of I experienced it first hand. Nobody talks about father experienced]. intimate with trans women means you have a high- tionately HIV impacts her community. because we can really end AIDS sooner. carried a lot of that with her after he passed away. BECAUSE I’M through the veins of our nation’s busiest city. AIDS doesn’t just affect gay people or trans peo- tion]. Period. it was a lot macy…a part of you that wants to feel like you are to take in..” the clinic. she’s also painfully aware of how dispropor. but Carrera says. of Health and to target the nightlife scene. in particular. I have two aunts and I have a bunch of cous. and not deal with the real issues. . because his family wasn’t around.” Carrera insists. He was sick for about a year.COM | 21 . lot of flak from the trans community for doing HIV ins…they treat me with a lot of love. death. as though us to be above it. Mark Seliger. these are She says now that marriage equality is the law of the facts. Her mother felt all the stigma attached to an AIDS Or about trans women who seek love at all costs. a former injection drug RESPONSIBILITY ABOUT IT. “I started investigating when I not surprised to hear that these numbers are so high. ‘Oh. a lipstick after Carrera as part of its new Audacious Lipstick Collection. But the model. user. You want to feel that inti- meet them while I was transitioning. “If we I’m going to feel some kind of responsibility about take the treatment serious. maybe all.” stuff. it. recently named I DON’T WANT TO BE SOMEONE WHO IS SMOKE AND MIRRORS. Carrera fears activists have right before my eyes—and there was nothing I could left behind the women who are. a luxury makeup brand. but they were very completely desirable.” accepting.” she argues. She was trying to take care of me. “The way I look at it do because they wouldn’t want to listen. My mom questioning their partner’s status. or that enced me to make some decisions as far as my tran- she would “think that my dad was a bad person. In an effort to counter the myth that all trans selves. so.” Her face now graces the AND FAME. It took me to educate myself. I still have a relationship with them to What she doesn’t understand is why she gets “a this day. of my friends who influ- Fearing what Carrera might say to others. My mom dealt with a lot of the judgment [my don’t tell” around HIV status. Later. “If we take control of it. if we take our [medica. sex workers.’ or ‘People are going to think that being color. and fame. because it even if it means not requesting to use a condom or was so new. “He did suffer from ep- ilepsy. facts are facts. AND NOT DEAL WITH sides of buses and greets subway riders as they travel THE REAL ISSUES. “I got to You just want that love. they were all mother never shared his HIV status. if we talk about it so it’s not so taboo. and Steven Meisel to name a few.” vival sex when other economic avenues are closed.’” would like get [HIV] and not take care of them. and it was so sad to see these things happen women are sex workers. “And in order for want to care about themselves anymore. and I learned it first was 2 when he passed away. and the first thing you “So many of my friends from the club scene want to talk about is HIV stuff ? It’s not a good look. as a trans woman of have HIV.” she recalls. she also met her father’s family. Trans wom. and just about glamour tion back to HIV and AIDS. That’s when I found out. They didn’t know how to treat it. the LGBT community should turn its atten.” her sition goes…my support group. was 16. Because. er risk of getting HIV. It is what it is. It was really weird.. people are going to think that you HIV activism. A lot of trans women…have reached out to Her father’s memory may have helped fuel her me and said. and take care of him—and keep him age of trans women of color who are forced into sur- off of the streets and out of doing drugs. walked). is to talk [they thought] their life was over. died of complications from AIDS. really. like sex work and the high percent- have a career. I don’t want to be someone the land. He was There are other topics she thinks we need to talk living on his own. “My mom told me that he had died from an ep- ileptic seizure.” says Carrera. because and she sees a unique way to engage trans people HIVPLUSMAG.” “The majority. more about too. you have a lot of heterosexual people and little is being done to change that. That’s part of the reason why I Of course she still recognizes the weighty impact decided to work with New York City Department HIV has on transgender women.’ ‘You have a mainstream plat- en of color have the highest HIV rates in the country form like VH1. HIV has been a personal cause for Carrera ever GOING TO FEEL SOME KIND OF since she learned her father.” COURTESY VH1 something to fear. But closer to her heart is a proj- ect many advised her against: representing New AND JUST ABOUT GLAMOUR York City’s new HIV prevention campaign in a saf- er sex ad called “Play Sure.” about it and to not be afraid of it.” because I definitely can understand that completely. She had to take him to hand to be able to speak back to my community. They didn’t is. who is smoke and mirrors. “That’s what they did.

true selves. Some people whole family unit. We have an 11-year-old and Carrera believes HIV-positive trans people have worked too hard to become a 7-year-old who are going through their changes and SETH WENIG/ASSOCIATED PRESS their true selves to just throw it away by not getting treatment.” she gush- es. To be able to come home and func- will last longer than others. I had one experience: I went to an HIV/AIDS rally in Brooklyn and an older gentleman just happened to be standing right next to me…and you can tell that he had to muster up whatever energy he had just to get out of bed and go and be there. Carmen Carrera models a dress featuring characters by the artist Keith Haring during an event on World AIDS Day at the Apollo Theater in New York. full-time. especially if she hopes to reach her goal of appearing in Sports Illustrated or becoming a Victoria’s Secret model. somebody sent me a picture of it. really dealing with the truth.” Does she wonder how her father—the man she nev- er knew and who never had a chance to live a healthy life with HIV—would feel about what she’s done? “Oh. if you’re going to live your life unhealthy. The state of New York will dedicate $200 million more to its $2. and not really creating stability for yourself as a trans person. “[We’re] about the make these decisions. I got the feeling that if my dad had been alive.5 billion effort to end the AIDS epidemic by 2020. It’s already reporting significant milestones: for the first time since the epidemic began. ‘I would’ve been there with him’ and around that: recognizing healthcare as part of transitioning and embracing their for a second I kind of felt that he was there with me. “My mom tells me every day that my dad is smiling down from heaven. great to have a hand in that. around 50. just because it’s me. and it’s tion as a stepmom and as a wife. no new cases of mother-to-child transmission were reported in the past year. When I see that. and they triple up on their estrogen. just to fit in. Her fans certainly want that.” 22 | MAY / JUNE 2016 . Stephanie. But it’s delusional. and it’s something that’s sad to say. and I love it. It defi- something that maybe people do need to hear. taking care of her own body is among Carrera’s top priorities. Their don’t know they’re trans—just to feel better. “Every single day. “I get a tweet or two: ‘Oh. It needs to be. or whatever they need to do to look the way different style of parenting that is different from Adri- they need to look so that they can go out and have interactions with people that an’s and different from Stephanie’s. I would have probably been going with him to these rallies. shar- She sees unhealthy people as being “examples for the younger generation to not ing custody with his ex. in going Today Carrera has her own family: Adrian Tor- through this transition? To just not take care of yourself after that is foolish. I’ve seen it with my friends. want to tweet it out. You get the feeling she’s on the cusp of even bigger acclaim. People want to take photos. you’re on the bus!’ or ‘Sit on the bus with Carmen!’ There was a huge billboard somewhere in Chelsea. Carrera makes that goal seem plausible. and want to like it. so I have the kids a lot of the time. but it’s honest. is amazing. my dad would be so proud of me. because their mom goes to school and works erything else goes out the window. I’m a very active [par- girls who are solely focused on looking 100 percent biological and [not trans]. I have a ple up on their testosterone blockers. I’m so happy that they used me for it. and stuff like that. or they tri. I think it’s great. and I feel so how “you can get lost in your transition sometimes. and if he would’ve stuck around.” Carrera says. which gets the message out even more. But Carrera also sees coming into awareness of who they are. ent]. “We have to keep ourselves healthy. It’s not support also helps me immensely. he’s fulfilling life after the transition and how are we going to do that if we’re not really proud of me. I feel proud of myself.” shorter. Her HIV campaign is certainly putting her on the map. we taking care of ourselves? …if you keep avoiding it.” nitely gives me strength. What’s the point.000 signed a petition urging Victoria’s Secret to hire her. I just kind of felt like. share it. you’re just cutting your life would’ve been going through it together. We need to be able to live a full. That made me feel like he’s definitely watching me.” As a model.” res and her two stepdaughters she helps raise. Ev. and to not choose to avoid dealing with things.

Lo is a triple threat at 47 years last year on Couples Therapy. and take all of my creative juices. “there is something about the stage and live shows that. just because I model. career—but unwilling to rest on her laurels. she says. He loves me because he knows me as a person that wants to make things better. bringing the supermodel SCOTT ROTH/INVISION/ASSOCIATED PRESS real. and I still have a long way to go. It’s all a work in progress. Geena Rocero. and I value that expe. ten there without her husband’s support. Because I feel like everything is be everywhere. I’m very hopeful right now. Stephanie. to realization.” she says. and Mila Jam at the premier of the MTV/ Logo documentary Laverne Cox Presents: The T Word in 2014. training right now. she couldn’t have got. Some day down the line she wants to do a showgirlesque Cirque du Solei type of but it was the first since Carrera came out to the acrobatic show. love me just because I’m an actress. Isis King. That’s how I felt. a cap an. BUT I someone by my side that has been there for the journey. “But it’s way too soon. pursuing those dreams means a lot of hours at the gym so she can “I felt like I was a born again virgin walking down “blow it out the water with modeling” in an industry with high standards. Carrera along with genderqueer and trans luminaries (from left) Jacob Tobia.” Not satisfied with being a celebrity because of her visibility as a trans wom- The wedding episode aired last December. I think that is so priceless to have. there was something about this expe. but everything else was kind of in disarray. in the dress of her dreams. and amazing. “It’s kind of like running a marathon. and then blowing people away. well. He doesn’t COX ABOUT THE SITUATION. and a plethora of friends. Even though we had done trying my best to match them.” HIVPLUSMAG. So they’re like.COM | 23 . this wasn’t her and Torres’s first wedding. so in beast mode. I think that having I HAD MY BOUNDARIES. for me. and all of my experience that I’ve picked up going through…my transition and “He gives me the validation that a lot of trans show them something that’s really new. She’s living the dream—balancing love. He’s my rock. “I would love to be a triple threat. the love was I’m just focused on training and leaning out my body. For now. and fans watched her walk down the aisle pretty young. [Audiences] have seen me as a drag per- rience that was way more special to me. feel humble because he’s known me for so long. and former. I’m it right before. I have about 17 years to go! But I’ll get there. Before when we got married. and has been able to stick around to want to see me succeed gives me that validation and gives me that sense TRIED NOT TO BE OVERLY LAVERNE of love. yeah. I’m still family. Now. After nearly a decade old. she looks it just feels so much more real.” she admits. If J. amazing—she is a supermodel!’” rience so much. ‘Wow. With him I can just be myself. On that day. valuable. because world as a woman.” together. just because I do this. women look for in a relationship.” marrying a boy. The girls.” BECAUSE IT WOULDN’T SINK IN. “I am the aisle. there. That’s long term. “And I I’m working on it. she was just a girl. is still my first love. But she says. family. Carrera dreams of becoming “so qualified that people are excited to have me to a phenomenal year in which Carrera seemed to work with them. with Dita Von Teese influences. they’ve seen me as a showgirl…now it’s the model that needs to emerge. and real. So.” she says. and innovative. and now I just need to put in my effort. Laverne Cox.

like far too many black men. “They handed me two weeks’ worth of medica- tion. Jones and you’ll have a hard time thinking of him as average.” he decided.LOCKED UP IS SOCIETY THROWING AWAY THE KEY ON PRISONERS WITH HIV? B Y JAC OB A N DE R S ON . I was like. providing him with directions to HIV service providers and giving him a bottle of antiretroviral medication to bridge the gap. for decades—prob- ably seemed like a perfect candidate for the reentry program. Worse. “I’m not going there. When Jones was released from an Ohio State penitentiary in 2008 he recalls that a social work- er attempted to link him with care. like thousands of other HIV-positive former inmates. ‘Well I’ve got two weeks’ worth. but what the hell am I to do after that?’” M 24 | MAY / JUNE 2016 . But. But. and in care. he discarded the pills he’d been given. world traveler—who’d been HIV-positive. Jones never showed up at the ad- dresses he’d been given.” he remembers. “And most people probably PHOTO CREDIT did just like me—I left them at the bus station. The college-educated.M I N SHA L L S pend a little time talking with Bryan C. the 55-year-old from Ohio has spent time locked up.


After study’s author. Though HIV rates among black women are down pensions as early as preschool. poverty. both a result benefitted from outside HIV prevention efforts and of and contributor to enormous racial and economic wider access to antiretroviral medications. gay [and] Outliving that prediction—“for whatever reason.” ly vulnerable to being HIV-positive and imprisoned. estimated number of inmates with HIV also declined.” Jones may have depression HIV infection among inmates in state and federal pris- to blame. and even mortality. prevalence is higher among women than men. the deck begins early and casts a long shadow. for possession of crack cocaine was “100 times stricter cial investigation on depression. institutions have also become commonplace in the United States. he admits. pov.” argues Georges to 26 percent—that’s nearly one in four—of all Amer- Benjamin. is an activist. education. impacts on the health of those living with HIV. 70 Pulling disproportionately from disadvantaged com- people in the span of a few years. the latter of which was favored ucator. Jones moved to Atlan.5 proximately 2. creased risk of being incarcerated.” munities with higher risks for HIV. peer ed. but most 40 percent of the total prison and jail population it reflects a startling reality: 90 percent of in 2011. the more damage it can inflict and the great. icans living with HIV are incarcerated at some point lic Health Association. of AIDS-related deaths in prisons overall plummeted erty. the rate of diagnosed depression led me to prison. the executive director of the American Pub. with ap- cilities on any given day. childhood exposure to although by a much smaller amount. The decades-long war on drugs—which Benjamin ger the interruption. “Everyone else study—had a history of incarceration.000 men enrolled in the able luck of watching others fade away.” he reflects now. About 60 percent of the still trying to figure it out”—Jones has had the un-envi. and performer with the unique ability to bring by whites. ality impacted by mass incarceration. “Inadequate prenatal care. His behavior may seem shocking. I’m bisexual men in this study. Jones was ties have long reported much higher rates of HIV than back in Ohio and still struggling when.” just died. director of the Insti- growing up and coming out gay. correctional facili- Nearly 20 years after his HIV diagnosis. have filled prisons to capacity. tells Plus. That was surprising was that there was such a high prevalence in 1984. just 16 percent. plains. 2014 Louisiana Public Health Institute report. men—I think it was over 15. They also dispro- er reservoirs it can establish. In SHUTTERSTOCK (PG 24) More than 2 million people in the United States are fact. pecially among kids of color—can result in school sus. who was also featured in Plus magazine’s spe.8 percent of percent of the U. “Minor behavior patterns—es. and studies show 20 dren to poor performance in school. “I think what was NEARLY ONE IN FOUR AMERICANS LIVING WITH HIV WILL BE INCARCERATED AT SOME POINT THIS YEAR ta where he was later diagnosed with AIDS. The mass incarceration of African-Americans has But in the last two decades. The probability that a young tions in their treatment upon their release from prison. cans more harshly. each year. More than 60 percent of portionately criminalize people of color. population. state. but far too often what leads those with HIV to ons was more than five times greater than the rate prison seems to be the color of their skin. among the general public. lead and other toxins in the home. African-American women remain particular- school-to-prison pipeline. and Jones was told he had six months to live. where HIV incarcerated in federal. the more time the virus remains calls “a war on people”—and mandatory sentencing unfettered. In 2010.S. healthcare. prisons are the only setting in the U. Benjamin ex- former inmates report experiencing treatment inter. according to a He grew up in poverty in “the heart of the ghet. In the same period. laws. of incarceration history among the black. 26 | MAY / JUNE 2016 . This practice starts the overall. African-Americans are incarcerated at five HIV-positive prisoners experience interrup. For guys like Jones. Russel Brewer. tute’s HIV/STI program.S.” where he was a victim of child sexual abuse. and other Still. The number disparities in employment. blacks accounted for al.” people to tears—from laughing so hard—even when Black gay and bisexual men are also disproportion- talking about seriously depressing shit. this stacked 77 percent between 2001-2010. people living with HIV appear to be at an in- early childhood trauma all predispose underserved chil. by enforcing laws that penalize African-Ameri- ruptions lasting two months or more. male state prison inmates known to be HIV-positive. times the rate of whites. The lon. black man will go to prison is tripled if he doesn’t fin- Treatment interruptions can have long-term.6 percent of female and 1. Despite representing only 13. he says the punishment Jones. For example. “my external communities. “Most of my friends…60. negative ish high school. and local correctional fa. The to. than for powder cocaine.

inmates contin- ue to have sex and inject drugs. including those at the Centers for Disease Control and Prevention (CDC).COM | 27 . Very few prisons test both incoming and exiting B RYA N C . with approximately 18. most experts. Furthermore. African-Americans make up two-thirds of all newly reported HIV cases among women and 34 per- cent of female inmates. while state and federal prisons are where time is served after sentencing. Despite widespread concern that mass incarcera- tion of African-American men has fueled the HIV epi- demic in the black community. “The research is really saying that folks are already living with HIV before they enter prison.Further. In fact. generally not long enough for a lab to process the test and notify the indi- vidual before they are released—let alone for providers to link the HIV-positive to care. whose home state of Louisiana “has the high- est incarceration rate in the U. voluntary jail testing. “Despite a four-fold increase in jail test- ing. Los Angeles has the largest jail system in the country. Some jail systems are enormous and dwarf many prisons.” Brew- er confirms. Prison tats had long been thought to spread HIV between inmates but sev- eral studies ruled tattooing out as an HIV vector.S. most rely on various vol- untary options. or jail. One CDC examination of seroconverters in Georgia state M HIVPLUSMAG. JO N E S prisoners for HIV. nine out of 10 jail in- mates are released in under 72 hours.” Unfortunately. folks know their status so that they can get the care that they need while they’re there. largely because of the low acceptance of HIV testing. most people incarcerated in the United States actually serve their time in jail cells rather than prisons. insist that the majority of those locked up with HIV were positive prior to their incarceration. A 2010 study of New York City jails found that 28 percent of inmates with HIV hadn’t been diagnosed at the time of their admission. research- ers concluded.” says his agency is try- ing to expand HIV testing in the state’s correctional fa- cilities. Jails are short-term facilities typically run by the county. “And they just don’t necessarily know their status. The transient nature of the jail population makes HIV testing even more difficult. Some facilities offer testing during an inmate’s intake while others only test inmates upon re- lease. It’s also a misconception that gay and bisexual men spread HIV in prison through sexual contact. While some facilities mandate HIV test- ing for all incoming inmates..” One of the biggest barriers to that knowledge is the fact that there are no universal protocols on testing in- mates for HIV.000 inmates at any given time. “so that upon entry. most undiagnosed infections still are not identified through routine. several studies have shown that men who had anal sex with other men were far less likely to report this activity while they were locked up than prior to and after their incarceration. Brewer. For example.” There is also no denying that HIV can spread be- hind bars. Despite legal prohibitions.

The “Although the medical contract reads like a medical Georgia prison study found that of those who serocon. “We are working to better identify system. Il- face more hurdles than those outside and the services linois. a straight black man. condoms. Unfortunately. Policy & Advocacy for the Center for Health Justice. plan comparable. Georgia study did confirm that—as in the general pop. and developing better transitions to care programs. Thomas is a part of his what they did. Other inmates may not understand risks associat.” no American facility has yet to authorize a needle ex. several have been sued for allegedly Vermont—to do so.” the Cook County. and then fol. Although in the community with the hope that people will con- other countries have successfully integrated harm re. those with medical and behavioral healthcare needs.” Los Ange. sheriff ’s office said in a statement to Chicago’s provided aren’t consistent throughout the correctional Windy City Times. mate was exposed. “I have CO N T I N U E D A F T E R I N S E RT 28 | MAY / JUNE 2016 . tinue to access that care rather than cycling through the duction options for inmates who use injection drugs. where he says he sees a wouldn’t necessarily stop someone else from having provider three to four times a year—just not the same sex (or sharing a needle) with them. peer-to-peer cluding HIV. “It has been my experience that the person I’ve seen ulation—those who find out they are HIV-positive is unfamiliar with my case. California became only the second state—after are equal. the healthcare correctional institutions provide may be lowed them back to determine how each in. in- tional materials. Considering that those serving time often hail antiretroviral prescriptions filled isn’t a breeze. but in their medical care to other providers and not all of them 2014. les jail epidemiologist Garrett Cox told Al Jazeera af. a private plan in the verted in prison. es. While researching her report.” As prison populations swell. HIV Treatment in U. Kerry Thomas isn’t surprised.” and 34 percent were serving life sentences. up. inclusivity of that care.S. “That condoms work is not a mystery. prisons created genetic fingerprints for the from disadvantaged communities with limited resourc- prison’s various HIV strains.) ucation is offered. In. correctional facilities in. the first such care an inmate has ever received. community. “in application it is difficult cerated. sex with other prisoners prior to testing positive. sion the provider thought I was there for hep C follow wards and thereby decrease their likelihood of transmit. had an undetectable viral load. those facing long prison sentences. quired but there are no guarantees about the quality and The World Health Organization and CDC both rec. instructor-led trainings. “people just did As a person living with HIV. recalls that for transmit HIV. that provider. Medical care of prisoners may be constitutionally re- change program. 38 percent reported that an HIV specialist rubber bands. Although he is able to see his doctor from the out- creasingly find themselves serving as primary health care side community once a year. In fact. jail for care. Mary Sylla. to get the services we need at times.S. More dis- wrap. denying HIV care. Jails and Prisons.” Even knowing someone had HIV prison’s Chronic Care Clinic. the one-time Ohio prisoner. but hardly all. was “never” available. (Interestingly. and did not Jones. later admitted to having ing healthcare cuts have dramatically impacted the jail. Or they just may not care. even in. it is not at this facility. sentence in an Idaho prison for not disclosing his sta- ers may have felt they had nothing to lose or that the risk tus to a woman he had sex with—even though he used PRISONS ARE THE ONLY PLACE IN THE U. dis- mates who are aware of their HIV status and/or want covered that only 43 percent of surveyed correctional to practice safer sex rarely have access to condoms. HIV included. latex gloves. 86 percent had committed a violent offense. Thomas says getting his providers. institutions offer educa. 44 percent had been previously incar. Although the contract says that counseling and ed- ting HIV to others. or plastic grocery bags secured with turbingly.” he admits. if not better than.” says Thomas. Some. “On one occa- while in prison do alter their risk taking behavior after. ed with sex or drug use. founder and director of ter the law passed in California. is serving a 30-year of these men may not have understood their risks. oth. WHERE HIV PREVALENCE IS HIGHER AMONG WOMEN THAN MEN of HIV was worth the high or sexual contact. Many prison systems outsource ommend the distribution of condoms in prisons. Those who initially insisted their “Unfortunately the economic downturn and result- only risk-factor was tattooing. care providers reported that an HIV specialist was “of- stead they employ creative solutions like using plastic ten” available to see patients at their facility. While some Thomas. and prevention case management. making it the provider of first resort for any number of Efforts at preventing the spread of HIV inside prisons health problems.

” says tance from friends and the people I like to call my family in L. very unique. the ingenious film. I hope it’s the start of something new When it premiered at the the 21st Palm Beach and innovative. I am. Back in 2009 when I was diagnosed. Should I tell anyone? The expectations by casting Daniel Berilla. As an actor. MICHAEL MARIUS PESSAH (DANIEL). I received a resounding accep- HIV-positive actor. Yeah. but it’s also going BY DIANE ANDERSON-MINSHALL to create a whole new genre of film. “He’s has a lot to offer as an actor and looked back or regretted the decision to tell the truth because I knew there human being. I’ve been able to experience a whole new side of rative. I’ve PRODUCER always looked young. the director. broke all the rules by Has making this movie changed you in any way? integrating visual poetry with traditional nar. especially when I first moved here. it honestly has. But I was diagnosed less than films and had a memorable a year after my move and I told myself. film.A. that makes it easier to have confi- dence in what I’m doing. I learned I look pretty damn fetch resourceful child who uses poetry to survive in black-and-white. Guys Reading Poems. Hunter is very intuitive. “I believe in Daniel. but this daughters to Google me and find out that their favorite “character” was project was different. Young & family would think. POETRY What’s Hunter like as filmmaker? As a filmmaker. I’ve never Hughes. when his disturbed avant garde painter mom locks him in a puppet box and builds an art You’re one of the few actors who is out about being HIV-positive. to my astonishment. BOYS & very different. Hunter's been gracious enough to being in multiple gay-themed movies…and still living my life to the fullest.. International Film Festival. in black-and-white (shot on the new Red this business… and without this experience I might not have [known] Epic monochrome camera). So I looked deep down Hunter Lee Hughes also defied Hollywood inside myself and thought for days on end. was frightened.” are many people my age…that need to know that you can still chase your Here the guys chat about poetry. The good thing that came out of my situation was my involve- What drew me to Guys ment in gay charities. I. director/producer/writer to what I moved out here to do: act and be gay. SEAN PAUL FRANGET (HUNTER) installation around his imprisonment. positive. The film follows a what I was capable of. Reading Poems first was my friendship with being in a national commercial that still airs today about being positive. all while being HIV-positive. to stop pursuing those shows"… spot on It’s Always Sunny because I honestly believed Middle America wouldn’t want their sons or in Philadelphia. and proud to be. I felt lost. like JASON FRACARO (GUYS IN TIES). scared of what my friends and Last Kingdom’s Alexander Dreymon. becoming a speaker for the LGBT Center in L. DANIEL BERILLA. And as an actor. and HIV. I knew I had a choice to make when it came Hungry’s Rex Lee). As associate producer. While there are celebs among the cast (The anyone else in the world. an answer was “yes” and. An HIV-positive actor helps make an incomparible neo-noir feature film. And it just sounded like I’d be able to explore a new side of myself in a movie that is super creative. but not to the point to where it’s ruined my career. it was ant as being on Disney. Has that impacted your career in any way? ACTOR & ASSOCIATE Yes. and I always wanted to do Disney and Nickelodeon You’ve appeared in a few shows. dreams and live a healthy life. He listens to people’s opinions and takes them seriously. include me in his projects and he showed me I realized that trying to make a difference in the world was just as import- the script for this film and you’re right. to be honest. .A. Will audiences “get” this film or is it too avant garde? This film does speak to a niche audience.

Do you think we’ll see a day when being HIV-positive is more about my grandmother. or simply not represented in the The project began as just a mainstream media since the epi- few pages of dialogue Kiley demic began. America! friends of mine before we shot. they’re now selling most relevant people working in entertainment today. support. and position. So much of our work is about whether or not HUNTER LEE HUGHES. ized narrative about a character itive diagnosis—hit Boston’s like myself. “things crystallized. even made notes in the mar- We can already see a change happening. brother. the series— Kiley says. was. shows that helped him to deal with a new diagnosis. from his own experiences as Louie. Positive. and the idea of CO N T I N U E D O N PAG E 4 6 . I came to learn a lot CO N T I N U E D O N PAG E 4 6 For the new hit web series following characters through Unsure/Positive.. It was just a matter of time before I found a way to try means it will always have [some] opposition. with my close friend Jacqui. DIRECTOR. with HIV. The poems became like psychological puzzle pieces that begun to accept. He was accepted by most. Maybe not everybody. During that conversation. There’s an online list of cutest men of 2015 and you’re sand- wiched between Josh Hutcherson and Tyson Beckford. and he a flavor called Strawberry Honey Balsamic with Black Pepper. Soon. So I don’t see why Guys Reading Poems can’t find its audience. but…I’m actually honored and very surprised that Rex do have a lot in common because all three of them were I’m on a list with people of that stature. realize what was missing. because I believe deep down that he was trying to make a dif. but enough people are buying Strawberry ference as well. helped me figure out a fuller picture of who my grandmother ceived. which follows Kieran from I was going to write a serial- the moment of his HIV-pos. “We were talking like that can tell stories that… about the value of serialized run the gamut in terms of emo- Meth Use. and the Power of Post-Its. but even more of a fighter than a charmer I’m sandwiched between them? That’s not my preferable and I like that about him. Shows The Series Creator Talks About Silence. starred certain titles. his family. over drinks. I love working with actors I already know. Society has already gins. to use poetry as cinematic puzzle pieces in a film. After pre. How What led you to cast Daniel? does that feel? He’s a charmer. specif- BY TYLER CURRY ically on TV. creator and multiple episodes—letting them star Christian Kiley (left) drew act and react against a con- inspiration from his personal stantly changing backdrop. For Unsure/ program at Emerson College.” International Film Festival and He admits that HIV-positive Wicked Queer.” he says. but not everyone. storytelling in media. I decided to take her poetry collection.” something he wrote for his graduate film wants to change. and Breaking Bad to name an HIV-positive man learning a few). Kiley took inspiration His fellow classmates didn’t from other serialized shows that know that Kiley was pulling resonated with him (Nurse Jackie. and I had to walk One beautiful part of being an actor is that even challenging through her house and decide what we moments in your life can be used for creative fuel… if you’re might like to keep.” seroconversion. and try to change how HIV is per. Does that anything to the project? my mother. Honey Balsamic with Black Pepper to keep it on the menu. he recalls. since she had underlined key treated as commonly as say asthma? phrases.A. "I think this trend is actually a “I remember very specifically vector for creators who are mak- Unsure/Positive a conversation. the actors trust me enough to take risks and touch an uncom- PRODUCER & WRITER fortable or tender part of themselves.” ing shows that are more true to their central characters. his life on the line So yeah. So thank you. Kiley began working on “Protagonists whose imper- the script outside of class and fections were their defining his assignment quickly turned aspects. too. the city’s LGBT people have been “pigeonholed film fest. miering online. What led you to create Guys Reading Poems? He’s one of the very few actors who is out about living After my grandmother passed away. What about A-list performers coming out as poz? Are audiences ready for this type of storytelling? It just happened—look at Charlie Sheen! Charlie is one of the At my local ice cream place here in L. I think we can handle a poetry neo-noir feature film. into a passion project. took the risk to put his career.The fact that HIV is a sexually transmitted disease. He and Patricia [Velasquez].

life. . HEALTH. STARTING HIV TREATMENT STARTINGHIVHIVTREATMENT STARTING TREATMENT HELPS PROTECT HELPSPROTECT HELPS YOUR PROTECTYOUR possibletotolive possible livea ahealthy healthy life. stop thethe virusininyour virus yourbody body and and the the damage damage HIVHIV causes. Treatment also helps make it Treatmentalso Treatment also helps make it possible to live a helps healthymake life. but but treatment damage can HIVcan treatment stop causes. There is no cure for HIV. but treatment can stop the There virus There isno nocure inisyour cure body for and for HIV. YOURHEALTH. the HIV. causes.

STAYING ON TREATMENT HELPS LOWER STAYING ON TREATMENT HELPS LOWER THE AMOUNT OF VIRUS IN YOUR BLOOD. your health. put you on the pathit to helps your a long healthcare and provider healthy life. When and healthyprovider canyou helpwork HelpStopTheVirus. ofisyour This calledhealth. it cannot you areby be measured taking care a test. it cannot be measured by a H I V P LU S M AG . When find the you work treatment together. It also lowersand being undetectable the itchance meansof passing you HIV care are taking on toofothers. CO M . it helps that is right your healthcare for you. HelpStopTheVirus. THE AMOUNT OF VIRUS IN YOUR BLOOD. TALKING ABOUT HIV TREATMENT TALKING ABOUT HIV TREATMENT An open conversation with your healthcare provider can help Anput you open on the pathwith conversation to a your long healthcare life. This is Thecalled amountbeing canundetectable and it means get so low. The amount can get so low. It also lowers the chance of passing HIV on to others. provider find the treatment that is right for you.

on your phone. © 2015 Gilead Sciences. Watch videos. privately. share Get the answers you need. Here are two resources that can help.HIVanswers. www.HelpStopTheVirus. Inc. and see how we can all help stop the virus.STARTING HIV TREATMENT IS A HEALTHY STEP. All rights reserved. UNBC1771 03/15 .

In doing so she uncovers the stories of risk. and the National Medal MARK ELIAS/ASSOCIATED PRESS years later. More than 25 MacArthur “Genius Grant. Perhaps that’s a reminder that those with the most to learn The film's co-director/producer. It is a high caliber production.” Although LeBlanc’s team has only reached the halfway mark in their goal to raise more than $500. “The only obstacle to making this film is financial. What pher. where LeBlanc is teach- ing “D-Man in the Waters” to nine of her most skilled students from LMU.” and that influence is reflected in the ages of living with HIV—to create his bittersweet those supporting the making of D-Man (D-ManDocumentary.” a beloved member revisits the backstory with a millennial touch. still an active choreographer. the dance brought the audience inside the heartbreaking strug- formance and tribute to dancer Demian gle of love and ultimate loss that the AIDS epidemic represents. The documentary starts in a dance studio in 2015. Only weeks into rehearsals for their More than two decades later. As the dancers are put through their paces. including Kennedy Center Honors. started as a lighthearted ballet about the movement of water Jones (pictured above) gifted the world transformed into a penetrating look at love and survival during a with his explosive tour-de-force. but it is still here. . performed with the lived through it. director. Over the next six months. People want to see this film get made. loss. Jones and seven of his former dancers recall reeling from the 1988 DANCE MASTERPIECE loss of co-director. in the Waters. LeBlanc says. “D-Man plague. a height of the epidemic. Jones/Arnie Zane Dance Company and teaches dance at Loyola Marymount University. and resurrection that were embedded in the choreography over two AIDS-INSPIRED decades ago. D-Man. sac- THE MAKING OF AN rifice.” an emotional dance per. was also diagnosed with AIDS. It is being made thoughtfully and well. We see their difficulties. “Everyone who has seen the footage has rallied around it. the documentary D-Man gives of Arts. "D-Man in the Waters" in honor of Acquavela. Demian “D-Man” Acquavella. “It was the glorious alchemy that resulted when a dance company committed to to putting one foot in front of the other while an epidemic raged in and around them. celebration of life. Arnie Zane. People need this film to get made. and dancer has AIDS-related complications during the earned numerous accolades. of the company. The virus hasn’t been eradicated—the face of AIDS has changed. Acquavella and others who died from Jones. Renamed. artistic director. a new film new dance called “Waters. and the location of the epidemic has…shifted. to AIDS com- plications.” LeBlanc wanted to explore the tragic back- story that led Jones to create the dance. She's looking to fans to help bring the heartfelt documentary to life. In the film.” LeBlanc says. and later how their under- standing deepens. we understand their inquiries into the history of the dance. The National Young Arts Foundation honored him for audiences a chance to revisit the heart. love. filming has already begun. com). having a “significant influence on the development of young breaking time that led Jones—now 64 and American artists." Tony Awards. seminal dance even as Acquavella’s health deteriorated.000 for the production. Jones created his In 1989. about the impact of the epidemic are those too young to have Rosalynde LeBlanc. the award-winning choreogra. is not “about” AIDS. and dancer Bill T.BY TYLER CURRY Bill T.

where any sign of weakness—or isolation—can open an inmate up to violence and victimization.COM | 29 . or finally having access to health care in prison. having other people know your HIV status isn’t some- thing to be taken lightly.” First. encouraged prison administrators and health care providers attending the 2014 Or- egon Corrections Conference to seriously consider side effects when choosing which HIV meds to give inmates. he says. it’s not surprising that studies show 75 percent of HIV-positive inmates receive their first antiretroviral treatment while incarcerated. inmates cue up in the “pill line” to get their medication and “everyone else can see what you’re getting. I’m up there with five other people and we’re all in this room to talk to this particular doctor.” Jones says. “You would talk to a doctor on a TV. is “a big deal in prison” be- cause inmates don’t have free access to a bathroom. and one of the biggest side effects of ART. With so many inmates either learning for the first time they have HIV. “You could be harassed in a lot of ways. inmates with HIV saw a specialist via telemedicine.” In prison culture. For example. Living with HIV while locked up adds a layer of complication to what can already be a stressful and life-altering chronic illness. “They would call you out during count time. drowsiness could impact both alertness and a prisoner’s ability to respond to a threat. it’s not something that exists.” Lara Strick of the Washington-based Northwest AIDS Education and Training Cen- ter.” In the Ohio facility where Jones served his time.” Jones admits.” one that could serious- ly impact his health. M HIVPLUSMAG.” he recalls. “in prison. rather than in person. “In terms of confidentiality. diarrhea. “You might be harmed. You could be ostracized. So it doesn’t take a lot for other people to realize we all must be positive. so everyone knows. You can’t take a handful of pills without other people looking. K E R RY T H O M A S CO N T I N U E D F R O M PAG E 2 8 to stay on top of the pharmacy to make sure there isn’t a delay. Strick noted that jaundice could broadcast one’s ill health to other pris- SERO PROJECT oners.

notes Brewer in one of his studies. (ADAP) funding for a 30-day supply of meds. particularly because health outcomes for poz ONLY 5% OF HIV-POSITIVE INMATES FILLED A PRESCRIPTION FOR TREATMENT WITHIN 10 DAYS AFTER THEIR RELEASE may have even offended. His cancer added to the many reasons Jones says hav. secure ator of the one-man show about his experience. Talk about releasing people assistance applying for AIDS Drug Assistance Program with undiagnosed or untreated HIV back into a com. but has also had a ripple ed care within a month after their release. and voting make it virtually difference in the world. I was charged with an offense. reestablish connections with friends and family. edu- ing “a good relationship with the nurses [makes] all the cational aid. percent were successfully linked to any type of HIV-relat- sion inside the L.” anteeing recidivism. employment. The people who see inmates only as “offenders” rare. most discontinued their treatment following release ly see the value in providing HIV prevention (especial. that interruption ment of Public Health’s HIV Epidemiology Program. A 2010 review of Texas’s attempts to connect recent- “More than 95 percent of prison inmates will be released ly released HIV-positive inmates to care found that 90 at some point during their lifetime. mission of drug-resistant HIV strains. But prison administrators and public health scription for the drugs within 10 days after their release advocates are starting to see common ground. cancer. Having served time can bar a person from receiv- pressed? It’s not something you want to experience.A. in more than 70 percent of the cases. One munity and suddenly even the most pro-law enforce.” inmates experienced and funding—to preempt a public health nightmare. a number of innovative and successful programs for Afri. For Jones. given the known negative proved exactly that. 30 | MAY / JUNE 2016 . percent of the time there were treatment interruptions. national studies show only 5 percent of inmates HIV treatment (especially when it comes with a hefty receiving antiretroviral medications in prison filled a pre- price tag). These find- sounds like a taxpayer bargain. dramatic decreases in their CD4 lymphocyte counts and Add to that the potential that those prisoners may be simultaneous increases in their viral loads.” “We are called. access facili. striking finding was that “between the time of release ment public officials may discover the political will— from prison and reincarceration.’” Thomas says. and deal with untreated sub- I Die Slowly.” inmates who were reincarcer- The concern over prison inmates going out into the ated after being provided discharge planning services larger community is what really fuels HIV prevention like a 10-day supply of antiretroviral medications and and treatment efforts inside. in. Now lasted at least a month. While implies that a certain behavior is ongoing. his time in prison—and his All released inmates—not just those with HIV—ex- health—were further complicated when he perience social and economic barriers to their efforts to was diagnosed with terminal cancer. jail system. The Georgia HIV study ings aren’t that surprising. Bottom line: the health of inmates with HIV deteri- munities and suddenly controlling HIV in prisons orated after they were released from prison.” A good provider can help you impossible for ex-offenders to have a real chance at life. public housing. bans on welfare. “Having stage four stance use issues and mental health disorders. Thus. with one leg chained to a bed while being de. who previously worked in Los Angeles County Depart. and only 18 percent filled one within 30 days. taking drug-resistant strains back to their home com. and feel like a human being instead of an “offender. not who they are. but to me the term ‘offender’ people generally plummet post-incarceration.” get the right meds.” antiretroviral medication during their prison sentence. ‘offenders. men here of success.” ing public assistance and forever alter one’s legal rights. ly condoms or needle exchanges) and sometimes even In fact. Harawa has launched months or more. These interruptions have compromise efforts to treat the chronic condition. effect on public health in outside communities. deal with side effects. University of Texas researchers followed HIV-pos- can-Americans living with or at risk of HIV. As few as 20 Condom distribution has not only reduced transmis. also been associated with the development and trans- side and outside prison walls. from prison. The cre. “Upon release. itive “repeat offenders. that many of the HIV strains in the health outcomes associated with interrupted or discon- prison system were drug-resistant and could further tinued antiretroviral therapy. “And housing and employment. “I’m not a big Having HIV chips away at even those slim chances fan of that term.” adds Nina Harawa. Over 60 percent of the former in- a professor at Charles Drew University and the University mates experienced treatment interruptions lasting two of California Los Angeles (UCLA). “almost guar- ties. I believe that a the majority of HIV-positive inmates respond well to behavior or crime is what a person did.” jokes about it now.

“So. Finding that the ing on going to the doctor yet. “Therefore doing much of the same things that Jones hopes to see I have had the same doctors since 1988 and before my in Ohio. and ADAP enrollment. pre-release interactions need to start earlier. a first-of-its-kind program and similar programs in Los Angeles. he says. agrees that ing. Jones says the Department of Corrections in Ohio “Those who are getting social services. “were those who found out [they person that’s been incarcerated…so positive inmates were HIV-positive] when they got to prison.” Harawa concludes.” she stammers. HIV-positive inmates are “supposed to get 30 If Link LA. launches its program 180 days before the client’s release ing to explain why people are getting lost after they get date in order to complete the requisite paperwork and out of prison. jail! Why did he not know what to do with it?” She also “The jail system represents an important aspect of the worries about the person who stumbled upon the med.” he explains. Marguerite Casey Foundation. and generally people were getting the National Institutes of Health.” completing a Texas ADAP application. HIVPLUSMAG. DeAnn Gruber. You’ve got to worry about applications for post-release HIV medical care.” Thomas says he’s heard that “there are issues in ects of National Significance) to encourage more back- Idaho in this area.” Brewer says. He now runs a pre-release support group for HIV-positive in. Jones says.” But his personal experience—he’s and-forth communications and hopefully increase the been in and out several times while living in the same likelihood that HIV-positive prisoners will link to care Idaho city where he was incarcerated—has been con. or other services that you might need.” Harawa says.” she says. case other stuff. Formerly incarcerated people with HIV who had un. case sends somebody from the health department to visit management. “And that has a positive effect. port network who could help them along the way.” Gruber’s department launched When it comes to “transitioning HIV care after re. unless they found you get out.” portunity for dialogue. they were just—pretty lost.COM | 31 . grounds with those coming out of jail to meet them at tiretroviral drugs in a public venue. be. In the state of California. You’ve got to take care of traditional system offered “a limited focus and little op- your other business. that stuns Harawa. It’s amazing to me that days. “What are they doing?” ningham explained when the program began. the jail. “But you to determine which services I needed. fell apart quickly af- When Jones was released he was given those two ter people [left jail]. an action So William Cunningham. “So I’ve been trying to propose to our Depart. STD/HIV Program Director at Lou- “It really is difficult to find employment. ‘I’ve been they’d only first gotten care in prison. isiana’s Department of Health and Hospitals. and that helped. proud that the program has gotten a positive response.” poz prisoners “maybe 30 days before your release date. that more likely to fill their prescriptions within the first ten they were bold enough to attend. that revolving door. those released inmates return to.” weeks of medication he left at the bus station. the gate upon release. your immediate needs. or maybe can [listen] to another positive person saying. Harawa is shocked clinical study that employs people who share back- by Jones’s admission that he discarded expensive an.” seemed to stay pretty lost. it could end up serving as a model body to reestablish their care. help them access HIV services. seem to do better.” Cun- ication after that. as were those who received assistance [it] went so well. or a friend sup- A lot of people don’t even want to go into a hospital. “The people who really seemed to struggle in our ment of Corrections a peer program. but they were generally for other correctional facilities—and the communities able to do so. she admits. succeeds in slowing that. within 90 days of their release. sistency in care.” Post-release programs are making an impact. vider before they went to prison. Harawa still believes in vism rates for HIV-positive men are extremely high— providing people getting out of prison with a starter it’s like a revolving door between the community and supply of antiretroviral meds.’ a really good social service provider. In fact. As someone who helped establish launched LINK LA. a video conferencing program (funded by Special Proj- lease. a randomized controlled trial funded by days of release meds. epidemic that hasn’t been addressed sufficiently. and other services. forget care. the same clinic that serves the prison system. Louisiana repeating what he’s heard from former inmates and try. it often. they still aren’t reaching everyone.” “But they need to start that process a lot earlier. It might take that long for some. his HIV provider is with Los Angeles has started a “peer navigator” program. find hous.” Harawa acknowledges. they cause that’s where infectious diseases breed. This article was produced as part of a 2015 Equal mates closing in on their exit dates. like beautiful plans. When they got in and this is what I did. support. And.” Jones But. You can’t be focus. especially if they already had a care pro. though. a professor at UCLA. Voice Fellowship awarded Jacob Anderson-Minshall “It’s important to me to make sure that people who by a partnership of New American Media and the are coming out of prison are linked to care. “There is transitional case management that release in 2003 a case manager came out to the prison goes on in our jails. explains. management. To have a positive study.” That’s where a peer can intervene. “Recidi- Despite Jones’s experience. detectable viral loads at the time of their release were “I was surprised that people would attend these. “But. If necessary give me a call when out.” know. “He was on medication in the and reintegrate into the community. I can go with you to a doctor’s appointment.


” mission via oral sex was about four one-hundredths of one percent (0. Unless DO I NEED TO STOP HAVING SEX? you had other health conditions prior to diag. be cautious. including gonorrhea. did before because it’s vital that you monitor your There are ways to protect yourself and your partner. weight loss or clinics aren't supposed to pressure you for this infor. via oral sex. any firm evidence even to show that it actually occurs. RN. head- or penalize you in any way for not divulging. and the HIV-positive person’s spouse within the last Maithe Enriquez.” said Dr. or have medical side effects you didn’t the at-home test. tes. He determined the rate of HIV trans- for HIV infection in the last six months.0004). Laurence Peiperl. aches. exercise regimen. looked at oral trans- result is only accurate if you haven’t had any risks mission among men who had sex with men. health closely. be more prone to infections. or have the health department notify. With proper treatment. in the last an HIV-positive man. The federal Ryan White HIV/AIDS Pro. Although the risk of HIV transmission is exceedingly low. by the early 2000s—decades after the start of the AIDS epidemic. when you believe you were exposed and how will. the biggest change in your daily routine will be clinic for the second test. Years ago.COM | 33 . and Treatment as Prevention care provider will keep you up to date. you 10 years. sexually transmitted diseases. again in three months. serosorting. “It takes time for seroconversion to the changes in your life. if their test is negative. So it’s a biological possibility but it’s exceedingly rare and here’s why: As first one. But hands down. RN. The likelihood transmission. virus to penetrate them. You will be asked sition by receptive oral sex without ejaculation is so unlikely. loss of appetite. and recreational drugs. False negative test results taking medication. with more PARTNERS DO I HAVE TO TELL? than 36 million people infected by the virus world wide—fewer than 40 cases of This is kind of a murky Swallowing semen or pre-cum is not a risk because stom- According to the New York Department of Health. having someone perform cunnilingus on reported is determined on a case-by-case basis you is also extremely low risk. a professor at University of California San Francisco’s Center School of months after that first screening test. However. It can be hard to distinguish whether these symptoms are just passing or sign of a more serious WHAT WILL CHANGE NOW THAT I'M POZ? issue. and the drugs often have (mostly minor) side effects. public health departments and should pay special attention to particular symptoms: diarrhea. Regular visits with your HIV health PrEP (for an HIV-negative partner). a second test a factor in your transmission (there’s a link between crystal meth use and HIV to make sure you’re HIV-positive. that we don’t have to notify.IS IT POSSIBLE I GOT A FALSE POSITIVE? your doctor about changes that need to be made to your diet. to your partner if you ejaculate into their mouth. Orgasms help you sleep. we encourage you not to. and reduce stress and depression. “HIV acqui- activists and public policy experts. or difficulty remembering things. a study by Eric Vit- the CDC recommends that you be retested three tinghoff. to transmit HIV three months of your last possible exposure to HIV. being HIV-positive is a Farnan and Enriquez suggest keeping written records of weight and other fac- manageable. you cannot pass HIV to your from two weeks to six months after infection. In HOW MANY FORMER SEX fact. tact info. prescription medicines. or asthma. for example). your recent sex partners (say. but keeping track of your body’s patterns will greatly benefit your health. you have an HIV test with a negative result within With blow jobs. with debate between possible oral transmission had been reported in medical literature. you can still get other ing (or able) you are to dig up those names and con. it’s a good idea to go to a doctor or have before. so if you come up positive and your daily dosage. Speak with (see page 39) . any. it is technically possible. ARE THERE SYMPTOMS I SHOULD WATCH OUT FOR NOW? gram requires states to make a good-faith effort to There are certain signs and symptoms to look out for and a few health fac- notify current spouses and anyone who has been tors that should be constantly monitored. they need year). one you have had sex with or shared needles with former director of UCSF Center for HIV Information. chronic condition like lupus. occur. including condom use. Your partner(s) will need to be tested now to have open wounds in the mucous membranes in their mouth in order for the and. No! In fact. how far back in time known partners should be And if you are a woman with HIV. if this was your subject. If drugs were should be offered a confirmatory test. You might need to exercise cau- tion with some of your regular activities. HIV medication requires strict adherence to the prescribed can happen too. new cough. especially if you’re not menstruating and your depending on such factors as the approximate dates partner doesn't have open sores in her or his mouth (even then the risk is low). white patches or sores in or mation and they cannot withhold your test results around your mouth. You may tire of two false positives is extremely rare. HIVPLUSMAG. shortness of breath. dizziness. So if partner if you perform oral sex on them. blurred vision. long-lasting fever. boost your immu- nosis. trouble or pain when swallowing. diabe- tors that can change over time. Period. ach acid and other enzymes kill HIV. Open com- partner comes up negative. A negative Medicine’s Department of Epidemiology and Biostatistics. authors of What Nurses Know About HIV/AIDS. but extremely rare. your doctor may recommend rehab. even if you ejaculate into someone else’s mouth. If you took more easily. According to Rose Farnan. you’ll likely see a physician more than you noglobulin levels (which fight infections). When your initial test comes back positive you and use of alcohol. According munication with your doctor will ensure that you are fully equipped to handle to AIDS. at a roundtable on the since your last negative HIV test or. This is when your body begins to produce CAN I TRANSMIT HIV THROUGH ORAL SEX? the antibodies an HIV test is looking for—anywhere Because you can’t transmit HIV through saliva.

can easily assuage any stress or apprehension you may have. here are a few ways to can graduate to deeper discussions. If nobody trauma caused by these theoretical night- comes to mind. one of the immediate. To mind at ease. all before you to get advice from a person who has personal experience. it helps that flood your headspace. The to someone in your life who you know is HIV-positive. you need to get over your to will have quite a few questions. talk with someone you know who has at least dated mares is often enough to keep you sec- someone with HIV. Seek out online support groups and look for a new ond-guessing who to tell and who to keep friend who can give you good advice. BY TY L E R C U R RY W HEN YOU FIR ST LE AR N T H AT you are HIV-positive. and walk before your run. JUST DIAGNOSED HOW TO DISCLOSE YOUR HIV STATUS TO YOUR FAMILY AND FRIENDS Your First Step Is Making Sure You’re Not Alone In This. But make sure you get your make the process easier. facts straight by only using reputable sources: search topics on 34 | MAY / JUNE 2016 . The best way to stay healthy and manage your virus well is to create a support sys. dreaded thoughts that can come to mind is this: How will I ever tell my family and friends that I’m positive? What will they think of me? What usually follows is a barrage of TALK TO OTHER HIV-POSITIVE PEOPLE  It’s always better what-if scenarios of rejection and shame to crawl before you walk. Once you allay their concerns about your health. chances are the people you disclose your status order to do that. Reach out utter those three little letters out loud. Prepare yourself with some of hang-ups and come out about your status the facts and figures about the state of HIV treatment to put their to those who are important in your life. you help you get there. If you can. Gaining a real life perspective quiet around for far longer than it should. ARM YOURSELF WITH THE FACTS   Just like when you tem of people who you love and trust. In first found out.

won’t know the most up-to-date information about HIV. it will get easier and easier. you will be dis- how to approach the rest of the world. Give them time to learn and and believe that you’re worthy of love and process the information. HIVPlusMag. and AIDSMap to start. In a month or two. Be brave the manageable chronic condition it is. Remember. the same way you talk about your job and BE PATIENT It’s more than likely that your family and friends your love life. Support them through this and they will support—because you That’s because TAKE IT ONE PERSON AT A TIME Don’t worry about how they are worried about you. They may who you care about is never easy. and they BE BRAVE Discussing HIV with someone may have stigmatizing beliefs about HIV-positive people. Start with the person reaction. who love you will probably be very con- cerned and upset at first. you can decide patient. HIVPLUSMAG. someone who supports you no matter what. It’s a natural everyone in your life will handle the news. nothing worthwhile ever is. rather than again. the Center for Disease Control and Prevention’s likely return the favor. Be After you've told the people in your inner circle. just like the one you probably had you're closest with.COM | 35 . Then SHUTTERSTOCK initially mistake your new HIV status as a terminal one. people HIV site. Every time you say "HIV" cussing your lab results and your T-cells in out loud. when you first learned of your status.


nosed. Couples can choose Not only is TasP on of the most effective and use whatever additional protective methods they deem necessary. only 30 about TasP can greatly reduce the stigma of living with HIV and promote healthy dis- percent of people living with HIV are uti. But make no mis- ISTOCK and under-utilized form of HIV prevention. Here's why:  about worst-case scenarios and slut-shaming rhetoric. have a healthy sex life. IT REALLY WORKS. cussion between sexual partners. the majority of people with HIV aren't in treatment or taking advantage To date. Currently. there has not been one confirmed of TasP. at-risk audience who have a greater TasP as their HIV prevention method has virtually no risk of transmitting HIV. of transmitting the disease by 96 percent.COM | 39 . due to numerous reasons. lizing TasP by being on and adhering to IT WORKS. a person living with HIV must stay on treatment to remain healthy. It doesn’t work only in conjunction viral load. 5 Reasons Why TasP Is the Best HIV Prevention WHY THE MOST UNDERRATED AND LEAST TALKED ABOUT FORM OF SAFER SEX MIGHT JUST BE THE BEST. between HIV-positive and negative people and encourages conversation about shared are living with HIV and 50. the use of treatment JUST as prevention (dubbed TasP) is one of the DIAGNOSED most underrated yet most effective ways to prevent the spread of HIV. That's because HIV stigma still very much exists. the conversation tions occur annually. undetectable levels. TasP doesn't prevent other STIs . It’s difficult to talk about PrEP without getting bogged down into anecdotal discussions vention methods out there. or even condoms—the use of TasP to prevent HIV has the added roviral medication.S. TasP has been that their treatment is empowering. viral meds. but—unlike PrEP. No disclaimers needed.  WHAT IS TASP? TasP is when someone who is HIV- positive achieves an undetectable viral load through the use of consistent antiret. take. their treatment to maintain a suppressed TasP doesn’t work only in conjunction with PrEP. When it comes to PrEP and TasP. An HIV-positive person who is using geted. TasP is reason to use this prevention method. On its own. and more importantly.2 million people in the U. they reduce their risk IT EMPOWERS HIV-POSITIVE PEOPLE. Like PrEP. IT REDUCES HIV STIGMA AND PROMOTES HEALTHY CONVERSATION. It just works.  the best way for anyone with HIV to protect themselves from transmitting HIV and still IT SAVES LIVES. There's also no denying the disempowerment people feel when they are first diag- load who has transmitted HIV. other. But when it comes to advocating for PrEP.000 new infec. When a person with benefit of saving an HIV-positive person’s life. including not knowing their status or having access to case of someone with a suppressed viral care. not just a symbol of stigma. one is not better or worse than the IT CAN HAVE A BIG IMPACT. PEP. The use of TasP. interests in preventing HIV. proven to work. Period. TasP users represent a more tar- with condoms. TasP works. the inclusion of TasP removes the barrier An estimated 1. BY TY L E R C U R RY ALTHOUGH THE USE of Truvada as pre-exposure prophylaxis (PrEP) contin- ues to make headlines. HIVPLUSMAG. Promoting the effectiveness and benefits of TasP can show those living with HIV Study after study. When evaluated with the added benefits associated with antiretro. Whereas an HIV-negative person doesn't have HIV has a viral load that is suppressed to to take PrEP. it’s simply the best HIV pre. Unfortunately.

40 | MAY / JUNE 2016 . figuring out SHUTTERSTOCK how to tell your children is even harder. JUST DIAGNOSED Finding out you’re positive is tough. A noted child therapist talks to several experts about doing it right.

DO I HAVE TO TELL THEM? You can assure them that—unlike years ago—there are now med- Probably. “This is hard for me to tell you. unless it’s a highly unusual circum. This can spark question. advises Peterson. parent’s medicine cabinet. if your time.” Peterson suggests acknowledging life specialist at Seattle Children’s Hospital. is an expert in the treatment of angry and high-intensity children. MA. What can you leave out of this initial conversation? You don’t need Older children may figure out the parent to share how you got HIV. “What do you want to Don’t rush home from learning about a do with this information?” Douglas says. “This is the one to talk to—who would you pick? A best friend. “The smallest children. “This is very distressing. says Douglas. and more details for teens or son. says Ken Howard. but it’s team first and hear about your treatment another thing entirely to have had absolutely no say about it.Talk about possible conse- HIV diagnosis and tell your child imme- quences. and welcomes your feedback at athena@athenabrewer. LMFT. we’ll young adults. by saying. ‘What else haven’t your child. She ciency Virus. Your first conversation will be the beginning of a continuous conver- sation with your family. This conversa- feelings of betrayal.” says AIDS complications. Give them power by including them in that decision-mak- diately. Put a plan in Hobbs-Lawrence offers another option: “You can tell your teen. the child already senses something we’re going to have some really hard days. a ther- name of my medication.COM | 41 . We’ll “Make a list of your goals.” says Douglas.’” your fears—what your children could expe- rience that you don’t want.” adds can try something gentle but clear. HIVPLUSMAG. teachers. Tell your child you want to hear their ques- tions.” intuitively know when a parent is lying. ‘I’m going to stand up to the stigma. and a certified child that means this is very serious. I haven’t been feeling well. It’s one thing to deal with ignorance. a psychotherapist WHAT SHOULDN’T I SAY? in private practice. With a young- Dougy Center.” he says. warns Bernard Douglas. says Peter- children. “I have some other health conditions Christa Peterson.You need some- some concrete details. Sit down with your medical ing process. Some people call it HIV.” but also make it clear is it’s not anyone’s fault.” AM I READY TO SHARE? For older kids. But be prepared if they do. place. “‘Maybe we want a You want to use age-appropriate language. A child who feels betrayed er child. healthy lives. No one is going to be left alone in this. and they found out what I have. “We’re a team. You want to be able to temper your expectations AFTER YOU COME OUT TO YOUR KIDS for how your children should react. you can ask your teenager. explain. Or.’” Douglas says.” which can be a huge burden. but do it at another time. and Often. like: Hobbs-Lawrence. Ask how they want to share information. It’s something called Human Immunodefi. and other activities with their peers. and a list of handle it.’” says Hobbs-Lawrence.Yes. open about their diagnosis could impact their child’s invitations to dence in you. Douglas says parents need to ask themselves how being that you didn’t tell them. Hobbs-Lawrence says you face this together. Athena Brewer. telling your child is best. options. will say. Be with your children. says Douglas. he says. You want to be able to tell them ‘My preference is that the whole school won’t know.” has a private practice in Seattle. tion is also not a time to bring up safer sex. by going through the private practice. sporting events. ‘My mommy’s sick’ but generally gram and Grief Services Coordinator at The won’t use the word ‘HIV. can lose confi. that has to be considered. “Allow the child to have the choice [whether or not] to ask that founder of Gay Therapy LA. ‘Do we want HOW DO I DO THIS? to share one-on-one?'” says Hobbs-Lawrence. you want to educate “The child wonders. And even very young children that “not every day is going to be hard.” says WHAT ABOUT PRIVACY? Rebecca Hobbs-Lawrence. says Steve Lapuk. sleepovers. “Say. Pathways Pro. The doctors ran some tests. PsyD. “but if their child will be excluded. if your prognosis is serious. “Parents may think. like. rule that anyone can call a family meeting? Maybe a Q&A box?’” which means using simple terms for young Families that focus on problem solving do best. a psychotherapist in has HIV on their own.’” That ensures your to think about your goals for sharing this child is not “keeper of the secret. diagnosis has a more serious prognosis because of comorbidities or stance. they told me? Am I not part of this family? Do they not feel I can handle it?’ They can start to question their own abilities.” You’ll also want apist? We’ll make sure they have accurate info. sure to add that “’if it does get around. Children feel protected when they hear. “Ninety-eight percent of the icines that help people with HIV live long.

42 | MAY / JUNE 2016 .

and advocacy services for disadvantaged communities. She had developed a class to teach other trans women about health issues and wanted me to become her co-facilitator. housing. M SHUTTERSTOCK Editor’s Note: Erika’s name has been changed to protect her privacy. approached me with another opportunity. BOOM! Health. As my grant-funded position was set to end. survival. was the first place to give me a desperately needed reprieve from unemployment alley and the chance to wet my feet in social work as a peer mentor. legal. HIVPLUSMAG. Eriká. a transgender colleague. and feminism than my entire college degree. by elaine r. We Don’t Need Another Hero Working with street educated trans women around HIV and health issues taught me more about life. mendus I M OV E D T O N E W YO R K C I T Y after college graduation to get out of rural America for good. a Bronx- based provider that integrates HIV.COM | 43 .

and other wrong I was. I could mate partner and sexual violence. I happily to make sure I understood them all before accepted the offer and on the subway ride the training began. As a liberated young trans mates were happier than I was because millennial with a college degree and tons this new position meant the rent would be of earnestness. even worked with. 44 | MAY / JUNE 2016 . I just knew I would be able on time. checks. backgrounds. I was thinking about future pay- taking me on to assist in this endeavor. outspo. I Later that night. ken attitude. Not only was it a reprieve from topics that might have been familiar to my pending joblessness. My first day would show me just how silicon pumping. especially garnered the respect of someone I’d never those making permanent hiring decisions. a springboard to a full-time position. I read up on hepatitis c. Hell. I was thrilled that she was Sure. I needed to impress home. I couldn’t get over the fact that I had Eriká and others at BOOM!. trans women were often victimized by maybe I could even save a life. I didn’t know Eriká well. but I also had people to save. I started imagining all planned to introduce a segment on inti- the good I could do in this new role. I wanted to hit a home run and use this as but I respected her for her brash. Eriká provided. I knew really teach these women something. students would be coming from sex work I fell asleep with a smile. I wanted honored to be wanted. Only my room. I was others but were quite new to me. to save women who hadn’t had the educa- SHUTTERSTOCK I spent time studying a course outline tion and enlightenment I had. especially since some of our Wonder Woman bursting to the surface. needle sharing. My inner such violence.

a mint simply weren’t camera-friendly enough to green blouse. I came in early. weren’t about to be taught (or saved) by Now these women were throwing it around like it was just a light-skinned Puerto Rican girl who another word. The women I was here to plications. but thought she was better than them. I was quickly learning that My mom would have backhanded me for saying the c-word at these women were totally real. Some of these women were engaged in sex work. world. Words flew back and forth. They didn’t need saving. and legions of trans resources cal activism I’ve witnessed since. rates of HIV. Black and Latina trans- with a little more chutzpah. at least not until one sentence hit me like a freight train. a red tracksuit top. before inspire me more than any protest or radi- Jazz Jennings. much just have to get out of their way. They had survival skills. HIVPLUSMAG. Maybe then we can more real to me than the trans women I encountered complaining stop turning dead trans women of color on social media sites. cautionary tale—and yet they had a lot to Her long and perfectly manicured nails clicked when she touched teach me. of death from violence. To put it another way. nearly myth- girls chatted. The other girls were also dressed more casu. save those who are already saving themselves. and to help save. They seemed far them lead for a while. It too often closed to them. evoke once a year on Transgender Day of These women may have lacked degrees—some hadn’t even Remembrance. the become a little like unicorns. It turned out that cunt—like fish—was a hell of a com. They didn’t need lectures on a trans woman didn’t pass. and they home. These girls had let nothing stop their tran.” I had come to teach these women. but seemed isolated from. I learned just how asinine my savior approach had been. and outside of the transgender commu.COM | 45 . trans women of color to the front and let There was something tangible about them. But their use of the c-word why “cunt” was an offensive term. This was a safe space. You can’t women are and start listening to them. before Janet Mock was Redefining Realness. or people we should only me. and it was women receive a lot of love and “rest in delightful. the media spotlight was as some kind of She wore leggings. need are opportunities from a society pliment to these women. They power” comments when they are dead. or to be shady. and brown trans women are real people. These “educate” exuded that infamous New Yorker attitude. social justice ally than I. They shade was everywhere. gender women have some of the highest I held my tongue and listened to how the girls talked that day. these girls memes. it’s time we started paying these women nity that I was familiar with. but I was quickly getting an What I learned they did—and do— education. even if it seemed strange and unfamiliar to me. black trench coat even appear in a public service announce- protected me on the way up from the subway. Bring less trans. could it? called the c-word “a trigger. many already know what they need—we sition in an era where it was still dangerous to even be gay. Girls had no problem with call. When I stepped into ment and the only way they would be in the office-space-turned-lounge. black and brown trans women have As we waited for everyone to arrive and sorted out lunch. graduated from high school—but they had the street smarts to The wisdom and courage of those make it through the tumultuous times before Laverne Cox was women at BOOM! has continued to a TV star. pretty much anything. and yet they had survived. “She looks cunt!” Rather. wouldn’t be caught in a classroom dis- ing each other a “man” or saying that somebody else cussing abstract gender studies. Yet it didn’t seem like they were using it to offend or cut each other down. Let’s stop existed on the Internet. and I didn’t really pay ical beasts that everyone wants to study— attention. and black Doc Martins. In the college educated. They didn’t sound like shade. Black Internet and come of age in college gender studies classes. of death from AIDS com- It was a gateway to a whole new world. nor did “looked like a man” in jest. A long. And they need was sort of like the more politically correct term “passing. they exuded ant” the lives of black and Latina trans power. It implied that a girl was born female. I was decked out in black dress pants. but instead of talking about how “precious” or “import- the exploited and trafficked women I had imagined. Carmen Carrera. Teaching these women actually turned into an education for Not sacred idols. suggesting they need to. wouldn’t have known what it meant if I’d Cunt couldn’t be a compliment. They were already Let them speak and you’ll discover that being their true selves.” only their voices heard. or even the middle class activists who showed into “rest in peace and in power” protest up at protests and Pride parades. the one that had blossomed on the attention while they are still alive. and bright red sneakers. Eriká greeted me with a smile.

” Kiley says.’ and that seemed perfect. and Kiley says the realism paid off. by Amy DePaola.” that I had to put it in our film. Allie. “We aimed to shoot the scene that front is to actually engage in itive long-term survivors. His worry of young people who are newly to disgust. Kieran’s story is derived from his to friends and loved ones and ask ing the show. with the world of the show now “A second season will also allow involved understood… [it] was cru. Kiley admits. What poem really sticks with you? ens his work. desserts. between Patricia. established. sadly. them simply have never really felt might experience before decid. in part.” that we really want to explore— not spective of long-term survivors. I had to compartmentalize He says that Kieran’s story. so Kieran’s have reacted to. was in some way a turning about a character who was deal- the scene where my character. about interracial marriage was sim. who is CONTINUED FROM INSERT remind him over and over that we relatable. I’d talk to change the subject. ing to relapse was something tan. His denying your truth and.” lot to work with. which just creates him “for offering a perspective that sode in which Kieran uses meth. and if you walk into level. taboo subject. he says “everyone is very excited to shouldn’t expect controversy to go cifics of what that world is like. trigger for me.” I think acting out that whole scene. Maybe. 46 | MAY / JUNE 2016 . and myself. I was really so moved by Steven Reigns poem. played and so do other topics. and Paula.” Despite the high praise (or per- in the production. There was a time when talking affected by the epidemic. has “drawn comes up. Daniel. around life with HIV and all that to give props to my crew and cast ters lives in more detail. It do it and part of the reason for that away next season. played by Ken the people who love them. Sometimes when three months of silence is actually hopeful and upbeat moments of a subject like crystal meth use nothing compared to the nearly five the show. but the media hasn’t a similar gamut. who was my fiancé at one. some of so that the adrenaline rush that one fruitful discourse around the sub.” along with life—which goes on for us guys in a sexually suggestive mon. allowed one spoiler. which was a very Kiley admits it’s a completely the name Kieran means ‘little dark legitimate concern. by Maureen Kieller. “When I was first diag- “My father-in-law—who I admire really like from my own past expe.” community is that it’s treated as a and dozens of viewers have thanked There’s also a fairly intense epi. ject. there needs to Post-its. and I would be an HIV-positive character. We “Most importantly. “One of the most like to talk about. audience. There’s a perhaps too well. nosed. the weird roommate.” own personal history and because for the help I needed. are characters an undetectable viral load. Unfortunately. So I have to delving into some of the charac. palpable. because everyone is.” was one of the longest processes the discussion forward. stigma around those who use it. Kiley felt it was necessary to poz folks these days—I might have tage. Casting that scene ilarly taboo. I’m all about moving someone who is HIV-positive. too. is important for a few reasons. many artists do pay it. did not like that scene. different thing to receive an pos- one. they hadn’t ever considered. viewers actors to fully commit to the spe. There’s a psychological cost to pay for as open.” POETRY/POZ HOLLYWOOD that the studios and actors themselves sometimes strive to create. because felt more empowered to reach out he’s still on the fence about watch. [if] there had been a series greatly—saw…a few seconds from rience. the per- ficult scene. He other medical issues? decides to sort the names of his friends into categories in the same way I hope so. “Some of them are HIV-pos- says. giving voice to the scores tions and reactions: from affection that this wasn’t reality. like having fessional set while we shot this dif. I think the my diagnosis.” where Kieran comes from. to mention Ottavio. and back again. we’re looking forward us to contribute to the discourse cial in getting things right. and talented as Daniel. members what this situation was caught up. which my apartment. accessible to a mainstream were just acting out a situation. haps because of it). now. But in the end.UNSURE/POZ HOLLYWOOD had to discuss it a lot. Here in Hollywood. people instinctively try years of isolation I experienced after out a bit of controversy. It takes place just after the period when so many suc- Will we see a day when HIV is treated like cumbed to AIDS and the author recounts all his friends who died. Rex. notes. has really just begun with season itself physically—as lots of Post-it My husband. that fact manifests the relapse scene very carefully. played goes with it— PreP comes to mind. lots and lots of color coded the time. especially with that recipe boxes are organized…hors d’oeuvres. There’s male actors.” he “I consider that high praise!” he The only way to make progress on says. In Irish. Kieran. That’s was that the scene might act as a infected and living with HIV now. They really are a miracle. I think include the scene. paid off though. but I’m only problem of meth use in the gay Unsure/Positive is filling that gap. for maintaining a completely pro. That’s CONTINUED FROM INSERT why I’m so proud of casting four openly gay actors in the film. We needed our With season two on the horizon. point for me and my struggle with ing with post-diagnosis depression. entrees. vulnerable. itive diagnosis today than it was Reactions from viewers have run explaining to my very talented cast 20 years ago. And it deep. there’s an illusion of perfection a reason I chose “Recipe Box” as the final poem of the film. relapses with three other past meth use.” about that more. “Recipe Box. He was so dismayed. living with HIV provides a whole range of new experiences to bring to the table. That’s not the only scene viewers “it’s something that people don’t I had no model for that. they feel as though they know gible. “On a personal Breese.

All rights reserved. UNBC1857 03/15 . Starting treatment means you’re protecting your health. Find out why it’s so important at HelpStopTheVirus. TREATMENT HELPS MAKE IT POSSIBLE.YOU CAN LIVE A HEALTHY LIFE WITH HIV. © 2015 Gilead Sciences.

research is revealing that it does and many of For example. the microbiota on the back of the tongue is more similar the reasons why. the ing our offspring as much as possible.D. and that of all of metabolic pathways. our love life. I LOVE YOU…ACTUALLY I LOVE YOUR MICROBIOME YOU MAY NEED REAL CHEMICAL ATTRACTION TO FIND A MATE. which we depend on for our survival. have shown that we are unconsciously attracted to other partners whose Our relationships with these obligatory immunological background is complementary to our own.BY WILLIAM B. Typically. It seems This is often our only way of reconciling the that there is a shared linkage in microbial composition in the mouths force of attraction between these two opposites. The microbiome represents all the thing extends beyond that. but that identity It’s becoming increasingly apparent that does not clearly correlate to any kissing behavior or frequency. Astoundingly. and they cantly influences how we select mates. Nor does our microbiome has a tremendous influence it appear to be due to specifically shared environmental factors. The combining of the immunological capacities of healthy mates that are 48 | MAY / JUNE 2016 . Their influence is a crucial element How might any organism cope? Our evolutionary path. The However. “They remained hidden from our appraisal until recently. we exist on a planet also inhabited by aggres- microbial companions is essential to our well sive bacteria and other microorganisms. being. W H AT D E T E R M I N E S C H E M I S T R Y How could germs influence our sexual choices? Those factors had between two people? Who has not said. between kissing partners than unrelated individuals. of sexual partners that operates regardless of kissing frequency. life in our mouths is startling and the transfer between kissing partners matched to our judgment. The current estimate is that There is evidence to suggest that this the case—and that it is based on we harbor 100 trillion cells that we would not our immunological status. often that it seems trite. JR. the microbes that are shared between each. We ask ourselves. M. is extensive. our relationship with our choice of mates. Some- upon us. it actually makes sense from an evolutionary perspective. what if the concept of chemical implication is that there is a background connection with the microbial attraction has a direct biological basis? New realm that might influence our initial choices of sexual partners. As part of this process. MILLER. we direct Now we do and current research has found that the amount of microbial that remark towards a couple that looks mis. This biological imperative signifi- mediation of our immune systems. microbial partners are intimate. we tend to seek to mate with those that differ from our- out us. So it think of as our own. there is more afoot. They are critical other complex organisms includes mechanisms directed towards protect- participants in glucose regulation. microbial realm. we each even partially regulate our emotional responses have a group of genes crucial to immunological defenses. Although this may seem odd on first that they can affect our social choices and even consideration. We simply did not have good chemistry together?” We hear it so have the technological means to assess them. However. microorganisms that are in us and on us. It should not be totally surprising then selves on an immunological basis. the particular surprise is that although frequent “What do they see in each other?” Our usual intimate kissing between partners does correspond to the composition of answer is that their “chemistry” is just right. We cannot sur. In order to best protect our children against an intrusive and agitating vive without them and they cannot exist with. these are so numerous that they COULD IT MEAN THAT WE ARE ATTRACTED TO ONE ANOTHER ON THE outnumber our own innate cells by a factor of BASIS OF FORCES THAT ARE UNAPPARENT TO OUR TYPICAL SENSES? ten to one or more. should not be shocking that our immunological status might affect our Importantly. Afterall. Experiments to stress.

Cats serve as an intermediate host There are research studies that reinforce this finding. and even physical appearance. Miller has been a physician in academic microbial partnership that is crucial to our immunological and private practice for over 30 years. the next generation gets a boost. but there is an important one that has been previously obscure. When contrasting individuals both mix genes and The Microcosm Within: Evolution and Extinction in the share microbes. the influence of the microbial serves as a scientific advisor to OmniBiome Therapeutics. different confers better protection to the next generation. we seem to search As strange as it may seem. Hologenome (themicrocosmwithin. lovingly at your favorite other. your microbiome might and microbes. in a crucial evolutionary HIV. However. tip your hat mentally to your our species is best protected by the mixing of opposing genes hidden microbial partners. In the aggregate as a species. Microbes play a part in creat. called Toxoplasmosis. in carefully controlled experiments.COM | 49 . The answer lies within both our own personal genes and our What should we make of all this? The next time you gaze particular microbial complement. have made you do it. William B. Successful mating proceeds for many reasons. HIVPLUSMAG. it can attracted to certain body odors. Although it rarely Experiments have demonstrated that sexual partners are causes illness in those with healthy immune lead to an infection of the brain among people living with ing those human aromas. Research has a pioneering company in discovering and developing solu- demonstrated that infection with certain parasites can tions to problems in human fertility and health through overtly guide sexual choice. for sexual partners that are not our match immunologically. Surprisingly. the parasite has also been shown to affect twist. but it also frequently infects humans. site types. On an evolutionary basis. SHUTTERSTOCK sphere extends well beyond these factors. human behavior. He currently Even more astoundingly. human females perceive infected males as more dominant What might underlie this instinct? and more masculine than uninfected males. that odor attraction is not for similarity but for oppo. That additional reason is our critical association with a vast Dr. physiology. Such an example is a parasite management of the human microbiome. He is the author of balance. In truth.

the VA increases funding to cover more veterans living with hepatitis C. This year. veterans are living with HCV. According to recent studies. Treatment for hepatitis C has dramatically improved in recent years.” VA Under Secretary for Health Dr. thanks to an increase in funding and a decrease in drug prices. with costs for the three-month regimen running close to $80. Now. which it hopes to increase to $1.5 billion in 2017. Veterans of the Vietnam War are considered to be at particular risk due to blood transfusions and blood contact during warfare. Veterans Affairs Hospitals had limited treatment to those who were severely ill. a rate five times higher than the average population. previously we established treatment priority for the sickest patients. That led to more than 180. “To manage limited resources. “We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C. it has dedicated nearly a billion. —TYLER CURRY 50 | MAY / JUNE 2016 . one out of 10 U. with the development of new curative therapies like Gilead’s Sovaldi. the VA is encouraging veterans living with the disease to take advantage of the life-saving treatment. all veterans will be able to receive HCV treatment through the VA regardless of the stage of their liver disease. David Shulkin said in a statement.000.TREATMENT VETERANS CAN NOW GET THE HEP C TREATMENT THEY NEED After outsourcing treatment last year.000 veterans being outsourced for their HCV therapy last year.” Veterans Affairs spent $696 million—or 17 percent of their total annual pharmacy budget—on HCV medication in 2015. But.S. With the increase in the budget for HVC SHUTTERSTOCK PHOTO CREDIT treatment.

doctors. the tions by at least 70 percent if adopted across the country. PrEP is still 86 percent effective even among macokinetic data” backed up the patient’s those using it “on demand” (which is technically one dose two to 24 claims that he seroconverted despite having hours before sex. adhered to his treatment. the first documented case of someone becoming poz involves rare multiclass drug resistance. transgender women. Knox. David C. what some activists call a moral crusade against the drug. including emtricitabine and tenofovir. the far more scientists. and then twice more the two days following sex). a new Researchers from several other facilities. AP/ JEFF CHIU heralded the prevention method as a game changer. Michael’s Hospital. a HIV transmission among those who take it daily as prescribed. In fact. and activists have two main ingredients in Truvada. Sure. Truvada as PrEP has had its critics. FIRST MAN TO BECOME HIV-POSITIVE WHILE ON PREP IS RARE EXCEPTION After tens of thousands of PrEP successes. The report was PrEP has proven to be around 99 percent effective at preventing presented at CROI by Dr. who noted that “clinical and phar- Infections (CROI). with the first documented case of injection drug users. including Toronto’s St. using PrEP as prescribed. the head of AIDS Healthcare Foundation. CDC study shows PrEP has the potential to reduce new HIV infec. As physician at Toronto’s Maple Leaf Medical was reported at the Conference on Retroviruses and Opportunistic Clinic. British Columbia Centre for Excellence in M HIVPLUSMAG. The 43-year- taking Truvada as pre-exposure prophylaxis (or PrEP) to prevent old Canadian man appears to have been HIV infection. and partners of HIV-positive individuals—start HIV infection in a PrEP user. naysayers recently got the tiniest bit Prevention issued historic guidelines recommending that thousands of ammunition for their culture war over of Americans—particularly gay and bi men. However. public health experts.COM | 51 . most notably Michael The man’s virus was found to have an Weinstein. PrEP. who has led uncommon resistance to multiple drugs. It’s been nearly two years since the Centers for Disease Control and Still.

provided over 2. New York active ingredient.—DIANE ANDERSON-MINSHALL concludes now. scientists have always cautioned that the possibility existed. infection with evidence of long-term adherence to [Truvada as the organization went beyond their doors to stem the New York PrEP]. law. “But gratefully there is a vaccine that is safe. Viread (tenofovir). which showed Affairs and Policy Vice President at Gay Men’s Health Crisis. most experts. “We urge [everyone]. the New York City Department of Health and Mental Hygiene have seroconverted to HIV-positive. Resistance to Truvada’s other Centers for Disease Control and Prevention. “People living with HIV and AIDS. to get vaccinated and protect themselves. they are also more likely to die if infected.” says Anthony Hayes.600 vaccinations in bars and clubs in the city as well as on Fire Island. emtricitabine. Ziagen (abacavir). and “phylogenetic analysis of the V3 loop of enve. Vitekta (elvitegravir). In other words. reports that over half (55 percent) of bacterial meningitis In addition.” 16 showed consistent dose-taking in the preceding one to two HIV-positive people aren’t just more susceptible to the months. and This case reiterates that there is no 100 percent guarantee SHUTTERSTOCK life-saving. two After the litany of tests the newly-poz man has already doctors on GMHC’s board. but the State only required colleges and universities to provide education strain that managed to bypass the safety of PrEP for the man in about meningitis and offer the vaccine to incoming students. consistent with infection from a single source. Not lines. GMC has lobbied tirelessly for legislation requiring considering PrEP is 99 (not 100) percent effective.” of prevention—not even with PrEP. “Meningitis is a silent killer. outbreak.” Hayes adds. but it boils down to labo. making him.” That is one of the reasons GMHC has prioritized fighting the That’s a lot of scientific jargon. was one of the first a mutation like this wasn’t seen among the participants— HIV-positive gay men to die in the 2012 outbreak. Prezcobix (darunavir/cobicistat). the strain is resistant to many of the medi- cations most commonly used to treat HIV. as recommended by the about one percent of all cases. and of the nearly 10. But. percent) than those who were HIV-negative (20 percent). and Emtriva (emtricitabine). undergone. disease. further analysis seems unwarranted.TREATMENT HIV/AIDS. Frank Spinnelli. and the University of Colorado ran a battery of tests. this case meningitis vaccinations for children. “the first reported case of breakthrough HIV content in simply making the vaccine available at GMHC’s clinic. and integrase inhibitors. Epivir (lamivudine).” Phylogenetic analysis of the man’s HIV strain revealed a very DO YOU NEED A narrow range of sequence diversity. Last year. local politicians. “Meningitis is a highly-contagious. effective. thus overlapping with the time period when he would disease.000 people in the famed iPrEx study of PrEP even family members of those who’ve died of the disease—like among gay and bi men and trans women acquired HIV—and Kevin Cummines. with a fully suppressed viral load. tenofovir-resistant strains of HIV only account for vaccinations for youth in public schools. Dr. yes. GMHC’s pressure helped push a meningitis vaccine While resistance to tenofovir is cited as a main concern bill through the New York State Legislature. lope protein gp120” to characterize the “founder virus. ple from day zero” to determine the quantities of each medi. “are at greater cation in his system. Since then. outreach. that can lead to death—even with treatment. leading researchers to conclude that the MENINGITIS VACCINE? virus acquired the drug resistance prior to being transmitted to If you have HIV.—DAM 52 | MAY / JUNE 2016 . as was phenotypic testing for resistance to integrase deaths also occurred among those who were HIV-positive (32 inhibitors. Demetre Daskalakis and Dr. fast-moving disease that How can researchers be certain the man was really adherent leads to death in 20 percent of cases. an exceedingly rare occurrence. In fact. Tivicay (dolutegravir). includ. With the new law.” GMHC CEO Kelsey Louie said in this study involved a mutation that was resistant to both medi. you do. Fortunately.” according to Knox. vaccination efforts to help end a meningitis outbreak in 2012. the man. standard population sequencing and deep infections that occurred in the city from August 2010 to March sequencing to 2 percent of the viral population was completed 2013 were among people with HIV. among people living with HIV who are resistant to treatment New York has become the 29th state to require meningitis worldwide. including those living with HIV ing those in this study. The HIV organization also may indeed reflect that one percent failure rate. Completing standard and deep sequencing of the virus revealed CCR5-tropic clade B HIV-1 with mutations that were resistant to nucleoside reverse transcrip- tase inhibitors (NRTIs). Public to PrEP? They reviewed his pharmacy records. including Isentress (raltegravir). A greater proportion of on day 7. Dried blood spot testing collected on day risk than the general population of acquiring the infection. Kyle Spidle.” Hayes rare. The organization led public education. is more common. a written statement announcing the passage of the New York cations. non-nucleoside reverse transcriptase (NNRTI). Poz’s Benjamin Ryan reports that “despite all these resistance mutations. Liquid chromatography–mass Meningitis is a serious infection of the brain and spinal cord spectrometry “was performed on the untimed plasma sam. consistent prescription refills. He is taking Tivicay (dolutegravir). and ratory confirmation that the man was following PrEP guide. say that cases like this will likely remain and AIDS. and Edurant (rilpivirine). whose fiancee. Previously. While none teamed-up with dozens of other groups. Moreover. the man in the case study is currently on successful HIV treatment.

and therapeutic for whom the ring lowered the rate their control and doesn’t rely on the support—but it is wholly possible. upon the amount of dapivirine in which makes it a life saving device in Nationally-recognized psychotherapist Dr. That success violence against women. and Meth: A Gay Man’s Guide to Recovery gives us the lowdown on a drug up to 30 percent of young gay and bi men have used. The Infection with a Ring for Extended HIV transmitted through rape is also a first exhilarating high is therefore not obtainable Use”)—conducted in Africa among sex. This results visits or using the ring consistently. the scientists determined that — E L A I N E R I TA  M E N D U S Men. and sends sexual antiretroviral drug dapivirine and ring consistently. can’t have one without the other. crucial things to know. METH INCREASES SEXUAL DYSFUNCTION New England Journal of Medicine the disparity existed because the Sure. taking a terrible toll on users. rate rose to 37 percent when scientists The ring isn’t nearly as effective 3. receptors. stokes the brain’s ravenous hunger for sex. home to 80 percent of BEHAVIOR Meth destroys the brain’s dopamine and ASPIRE (“A Study to Prevent the world’s women living with HIV. Here are three ring can prevent HIV infection for some women. world. when it came to women 25 and older. Learn more at David-Fawcett. high-risk sexual encounters. and generally unprotected sexual 18-45 years old found the ring was conflicts serve as harbingers of sexual behavior—placing them at risk—in an attempt to only 27 percent effective. 3 THINGS TO KNOW ABOUT METH AND SEX The expert-author of Lust. Most gay and bi men know of the drug’s power to intensify sexual Study suggests that use of an insertable vaginal experience. meth users turn to darker. meth reduces form of HIV prevention that is under and requires time. but many women in Sub. sleep-deprived days immersed in the pursuit extended protection against HIV— that means there is something about of—and then the painful recovery from— at least for older women.—DAVID FAWCETT.COM | 53 . which is still at least a year in persistent sexual dysfunction. METH CREATES SEXUAL AND INTIMACY removed data from locations where as PrEP. “If you could get a compulsion into overdrive. HIVPLUSMAG. METH ESCALATES HIGH-RISK SEXUAL Two large studies—the Ring Study Saharan Africa. Users spend inserted within the vagina provided 61 percent efficacy in the older group. but not pregnant. and Infectious Diseases has announced it “The real question is. but it increases reports that a ring filled with the younger women weren’t using the a false sense of confidence. major issue in the region. why is it not working in the images eventually dulls one’s ability to actually mine why the ring wasn’t as effective younger group?” achieve sexual arousal.” Dr. a region wracked by sexual violence. would offer women a meth from sexuality is crucial for recovery. the so-called pleasure centers. Consequently. and Meth. in the real the constant barrage of sexual thoughts and will fund follow-up research to deter. but few realize its devastating impact on sex and intimacy. patience. Disconnecting Results were remarkably different from market.” The ring. They simply women were not returning for study accessing that preventative protocol. The research was conducted in Sub- 2. Fawcett provides a roadmap to recovery in Lust. for younger women. recapture the initial intoxication. it ironically also causes erectile dysfunction. PHD of HIV infection by 61 percent. women United Nations study found frequent rougher. PROBLEMS Meth and sex quickly “fuse” in “it was apparent early on that many Saharan Africa have little chance of the minds and bodies of users. Now the this that works. David the younger women’s blood streams. But while meth National Institute of Allergy and NIAID director said in a statement. PUT A RING ON IT Methamphetamine use in the gay community has reached epidemic proportions. ually active. Based use of condoms by sexual partners. Anthony Fauci. where a 2011 again. 1. Men.

you may be con- Klappholz says that he regularly treats new patients who sidered what doctors call “otherwise healthy. For some make the wrong decision for you. New patients can often ease. Therefore.” This just means elect to switch meds because they didn’t know enough when that you aren’t at any significant risk for cardiovascular dis- they first started taking treatment. you don’t smoke factor into determining which medication will work best. The chances ing with HIV. your schedule. you lifestyle. NOT ALL PILLS ARE CREATED EQUALLY. Not only that.BY TYLER CURRY ARE YOU ON THE RIGHT MEDS? WHEN IT COMES TO YOUR HIV TREATMENT. who treats a variety of people liv. it doesn’t “Most people might just buy into the one-pill once-a-day eliminate a lot of other options later on. but there are plenty of factors that someone should consider when choosing their HIV medication. which makes you the perfect candidate for Triumeq. and even if you do. in best cases. 54 | MAY / JUNE 2016 .” or drink heavily.” says IF YOU’RE “OTHERWISE HEALTHY” Klappholz. However. missing even a dose or two here and there can To help figure out what meds will work best for you. “Your job. and you aren’t overweight. if alternating or swing shifts. but pa. “I would typically prescribe Prezcobix we asked nurse practitioner Eric Klappolz. medication to fit his or her needs.” says Klappholz. N OW T H AT H I V has become a chronic disease that. be quite the problem. Once a person SHUTTERSTOCK with HIV has successfully achieved viral suppression and the IF YOU CAN BE CONSIDERED “OVERWEIGHT” emotional component of treatment has subsided. Texas. and Truvada for this patient. it is in a place where they can better assess if there is a better does come with certain cardiovascular risks. Unfortunately.” could help their doctor make the right choice. can be relatively easy to manage. because there is no other interactions with other medi- tients can be reticent to share some of their behaviors that cations and it just seems to me to be the best thing out there. he or she Although Triumeq is an excellent drug choice for some. An unusual schedule can make you don’t know the right questions to ask. medications. Maybe you travel to different time zones often or. it’s crucial for a person living with HIV to consider a variety of fac. you work mal amount of unnecessary side-effects. you might Klappholz tells us which medications would correspond think that there isn’t much difference when it comes to se. best with several common lifestyle factors. of building a resistance is low. these all If you are not dealing with any coinfections. most forgiving if you are likely to miss dosages. I am putting my new patients on Triumeq when ask their doctor the right questions. just because the Prezcobix is the cialist in Dallas. lecting your antiretroviral medication. be so fixated on their diagnosis that they do not think to “Right now. your doctor could it difficult to comply with a strict dosage schedule. an HIV spe. IF YOU HAVE AN UNUSUAL SCHEDULE tors in order to get the maximum outcome with the mini. and that is it. I can.

once again. “But even specialist in Dallas. Unfortunately. Eric Klappholz. so it is important to select Klappholz recommends that his patients switch the right medication to best treat both diseases to a newer medication that provides all of the Our new expert on-call while minimizing any unnecessary risks. Complera is the safest bet during the duration patients who claim to no longer have side-effects Texas. and Genvoya has are also living with hepatitis C. let your doctor know. Klappholz the same suggestion of Prescobix and Truvada says that Stribild or Genvoya are most likely the is recommended because. who treats people of the person’s HCV treatment. knocked the popular drug down a notch. yet to completely give up smoking. is determined to be HCV-negative. is nurse practitioner medications are making hep C easier to treat.COM | 55 . Instead. If you have TYLER CURRY dose by time specified or altogether. IF YOU’RE A LONG-TIME USER OF ATRIPLA Atripla was once the go-to for people with HIV. An HIV/HCV co. will try and minimize their tobacco use when son who engages in heavy alcohol or recreation. IF YOU ALSO HAVE HEPATITIS C but the arrival of new medications such as More than 20 percent of people living with HIV Stribild. Even if you smoke al drug use runs the risk of missing their daily occasionally. a per. fects. “I will often hear.” then re-evaluate their HIV medication about three to six months afterwards. ‘But it’s working and I don’t have any bad side-ef. for patients who might miss doses. an HIV as well. HIVPLUSMAG. Once he or she from Atripla usually come back in a month or two living with HIV. is the best choice. such as Stribild or Genvoya. Truimeq. Klappholz doesn’t recommend that patients most forgiving when it comes to drug resistance who are overweight take this drug. “If one of my patients also has HCV. Complera. Likewise. he says a Tenofivir-based medication. New benefits with fewer side-effects. it is the best options for you. Now morbidity more than triples a person’s risk for that Atripla is no longer a first-line medication. speaking with their doctor. multiple liver issues. many patients Much like people with unusual schedules. so why change?’” Klappolz says. a patient can saying that they are so happy with the switch. IF YOU SMOKE A person who smokes should avoid Triumeq in IF YOU’RE A HEAVY DRINKER OR order to avoid any additional increase in car- RECREATIONAL DRUG USER diovascular risks.

which some scientists think has been inherited from ancestors who survived the massive bubonic Cancer Research Center in Seattle. and Africans. though having only one parent with the cure for AIDS. However. SHUTTERSTOCK Institutes of Health. researchers at the and their enthusiasm should excite those who live with HIV.” Brown said at the U. About 1 percent of cal companies are conducting research on this process. but matched sortium of academic and private sector research institutions of defeatHIV other components of Brown’s immune system —a Delaney Cell and Genome Engineering Initiative—are hoping to use closely enough that his body would not reject the stem cells from HIV-positive individuals to mimic the genetics of humans cells. into a patient’s body. That possibility Under the sponsorship of the National is enough to excite researchers into seriously pursuing further results. not as a stand alone). the Fred Hutchinson though. Asians.” In fact. but. be a light at the end of the tunnel. of tests. 56 | MAY / JUNE 2016 . When CCR5 is on the surface of the cell. 23AndMe. mutation still leaves a child better prepared Brown is now a vocal advocate for bringing a cure to others living with to defend HIV than having none. first to assess its Caucasians have it. The con- who not only had this mutation. then its effectiveness. Researchers are now focusing on the pos. later efforts by doctors to successfully cure other for the HIV immunity test have closed down. Researchers trying to find out why discovered some people carry a genetic muta- tion that makes them highly resistant to HIV infection. AIDS conference in July. the groundwork laid down by Hütter in curing Brown of his kemia. Clinical trials are now opening up within the consortium sibility of introducing the rare genetic mutation for patients who meet multiple eligibility factors. PERHAPS. Medicine in Philadelphia. inherit the HIV-shielding genes from both par. there was great difficulty finding a donor HIV is now viewed as one blueprint for creating a cure to HIV. patients using Hütter’s treatment method have all failed. Northern Europe are virtually immune to AIDS. when it is not. Gero Hütter. Those lucky enough to be resistant must which Brown has formed in partnership with the World AIDS Institute. There might. or other complications before it so-called “Berlin Patient” cleared of HIV after could be determined if HIV had been removed from their bodies. is real possibility following the path of the Berlin Patient. A CURE BY E L A I N E M E N D U S A N D T R U DY R I N G E V E N T H E M O S T careful individuals can find themselves with a positive HIV diag- nosis. and the doctor who cured genetic testing company. and it is even rarer in Native safety. and other institutions and biomedi- plague in Europe centuries ago. while others couldn’t get the disease if they tried. A 2005 report ipants’ anti-HIV medications to see if their immune systems continue to indicated that 1 percent of people descended from suppress the virus.A GENETIC MUTATION THAT BLOCKS HIV MAY HOLD THE KEY TO FUTURE TREATMENT AND. immune to HIV. the cell’s “door” is effectively closed to HIV. University of Pennsylvania Perelman School of indeed. At least one HIV. is still very much up in the air. That said. keeps a protein called CCR5 from rising to the surface of the immune system’s T cells. Joining in such research will be the Timothy Ray Brown Foundation.N. This mutation. the dying from the stem cell transplant itself. pointed out that Brown was in the “right place panies that once catered specifically to gay men at the right time. receiving stem cell transplants to treat his leu. a recent interview with Brown. it seems that there been modified so as to have the CCR5 variation. How soon they can find it. Very few people have this genetic variation. though many com. has served to underscore how much luck played a role in Brown’s does the HIV immunity test (among their battery own cure. The latter will involve stopping study partic- Americans. infusing T-cells that have It may be a while until we can find a cure to HIV. HIV is able to latch on to it and infect the cell. with patients In the case of Timothy Ray Brown. His doctor. called Delta32. “The Timothy Ray Brown Foundation will be solely dedicated to finding a still him.

Plus. visit HIV. All rights reserved. You want time Walgreens HIV-specialized pharmacies can coordinate your prescription reflls so you can pick them all up on the same day. ©2015 Walgreen 97483-620-1015 .Walgreens. To learn more. we can for important remind you about medication doses and reflls. It’s our way of helping you simplify your things busy life.