This is worth applause today -- and is undoubtedly the result of pressure from advocates (including the ACLU but also a myriad of HIV-positive advocacy organizations):
In a written opinion dismissing a charge of bio-terrorism against a 45-year-old HIV-positive man, Macomb County Circuit Court Judge Peter Maceroni ruled that the mere fact a person is HIV-positive is not enough to accuse him or her of unlawfully possessing a harmful biological substance.
The eight page ruling, released Thursday morning, concludes that HIV is not transmitted by saliva without there being blood present. Prosecutors and preliminary hearing testimony did not indicate Daniel Allen was bleeding at the time he allegedly bit the victim, Winfred Fernandis, Jr.
Under the new policy, those who test positive will begin ARV treatment immediately -- which is a radical shift from the decade-long strategy of waiting until the patient's CD4 count drops before a certain level. The policy is defended in two ways: First, that studies increasingly evidence that there can be significant damage done by the virus to HIV-positive people who do not begin treatment immediately. Second, that reducing viral loads in HIV-positive people will reduce rates of transmission:
A growing body of evidence indicates that HIV causes detrimental effects throughout the body long before the CD4 count falls into the "danger zone" for opportunistic infections (OIs).
The large SMART treatment interruption trial found that patients who stopped therapy when their CD4 count rose above 350 cells/mm3 -- and therefore had periods of unchecked viral replication -- not only had a higher rate of OIs and AIDS-related death, but also of non-AIDS conditions including cardiovascular, liver, and kidney disease.
Early treatment has been linked to decreased risk of morbidity and mortality even at CD4 counts above 500 cells/mm3. Many experts are convinced that chronic inflammation due to ongoing HIV replication contributes to non-AIDS conditions and what appears to be accelerated aging in people with HIV.
Another benefit of early ART is that it lowers the risk of HIV transmission, since treated HIV positive people have lower viral loads than untreated individuals, regardless of CD4 cell count. In 2008, Julio Montaner and colleagues from British Columbia presented a mathematical model showing that treating all people with HIV according to ART guidelines (which then had a CD4 count threshold of 350 cells/mm3) could dramatically reduce the rate of new infections.
At least two things worth mentioning:
1. This policy would put people on meds who may not need them until there are better, less toxic drugs available. For instance, someone diagnosed today may not have gone on them under previous guidelines for another two years. In two years, its possible that there will be ARVs available with fewer side effects.
2. Obviously, if implemented, this would eliminate the possibility of long-term non-progressors (a rare group of positive people who can live healthfully for many years before ARV therapeutic intervention is necessary). A friend of mine in SF who was infected in the mid-80s just went on ARVs for the first time. A very rare situation, indeed. But still worth mentioning.
If you live in Michigan, please ask your representative to vote no if and when HB 4583 comes to a vote in the House. From the MM:
Under the proposed changes, a patient will sign a general medical consent which includes permission to test for HIV. If a physician decides to run an HIV test, they will have to get verbal consent before ordering the test and note it in the file. However, a patient is not allowed to verbally decline an HIV test. Patients who do not wish to be tested will be required to put that in writing.
[...]
Mark Peterson, a spokesman for Michigan Positive Action Coalition (MI Poz), a group of HIV-positive people and their supporters in Michigan, said the legislation was not needed.
"I think the problem with this legislation is that it is an answer seeking a problem," he said, noting that hospitals and other medical groups in Southeast Michigan have been complying with the current law, which requires anyone ordering an HIV test to provide a patient with pre-and post-test counseling, as well as sign a specific document on the issue created by the Michigan Department of Community Health.
"It does concern me that we are eliminating that requirement," said Byrum.
The bills sponsor is Representative Roy Schmidt (a democrat from Grand Rapids), to whom I just wrote this note:
Representative Schmidt,
I'm writing in regards to HB 4583, requesting that you withdraw it from consideration. As a sociologist who studies HIV/AIDS for a living, I can say that this law is unnecessary and will do more harm than good. HIV testing is a very sensitive practice that requires a great deal of trust between doctors and their patients. Consent for HIV testing is essential for that trust to be possible. As you are surely well aware, many new infections in Michigan are among African American men who have sex with men - a population that already holds a relatively high level of distrust for medical providers due to experiences of prejudice and mistreatment. Thus, this legislation will damage what is already a fragile relationship between these men and their providers, which would *lower* HIV testing rates due to men avoiding medical attention altogether.
If passed, this bill will have dire, unintended consequences. Please, I ask sincerely that you reconsider this unnecessary and wrongheaded legislation.
Sorry for the long citation, but I think in this case the details are so maddening and violently upsetting that it's worth knowing the details. Michigan is charging an HIV-positive man under terrorism charges ("use of a harmful device") for biting another man during an argument between neighbors:
An HIV-positive Macomb County man is facing charges created under Michigan's 2004 terrorism laws for biting another man in a neighborhood scuffle. That, HIV advocates, state lawmakers and legal experts say is "cowardly" and "nonsense" and increases ignorance and stigma surrounding the virus.
[snip]
The case arose out of an Oct. 18 fight between 44-year-old Daniel Allen and his neighbor Winfred Fernandis Jr. What happened that day is disputed.
According to a report from Clinton Township Police Department, Fernandis said Allen jumped him without provocation when he went to retrieve a football neighborhood kids accidentally threw onto Allen's yard. Fernandis, according to the police report, said Allen "hugged up" to him and began to bite him. Fernandis suffered a bite wound on the lip so severe, police say, it went all the way through the lip. Fernandis sought medical treatment and the wound was sewn shut.
The story, a man severely biting another man, drew the attention of the Detroit-area media, and Fox 2 News soon had Allen on video admitting he was HIV-positive.
That admission lead Smith, a Democrat, to say he would seek additional charges. On Nov. 2, Smith's office amended its complaint to add a charge of possession or use of a harmful device. That law is a 25-year felony and was part of a 2004 package of terrorism laws created by the legislature in the wake of the Sept. 11, 2001, attacks.
The law makes it a crime to have a harmful device, which is defined as either biological, chemical, electronic or radioactive. Smith's office is arguing that Allen being infected with HIV was "a device designed or intended to release a harmful biological substance," and that his bite was thus an attempt to spread HIV.
Smith's office is relying on a Michigan Court of Appeals ruling in a case of an HIV-positive, and hepatitis B infected prisoner who spit at prison guards during an altercation in the prison. In that case, People v. Antoine Deshaw Odom, the three judge panel found:
We therefore conclude that HIV infected blood is a 'harmful biological substance,' as defined by Michigan statute, because it is a substance produced by a human organism that contains a virus that can spread or cause disease in humans.
The three judge panel was silent on whether the hepatitis infection weighed in as a factor as a harmful biological substance. As a result of this finding, the court upheld a stricter sentencing score for Odom. In 2008, the Michigan Supreme Court refused to hear an appeal on the matter, upholding the Appeals Court decision.
As someone said to me about this case, if this is upheld, it's open season against HIV-positive people in Michigan -- and elsewhere. Read the rest of the VERY upsetting story here.
I was having drinks with a friend of mine -- we'll call him Patrick here -- this weekend when the subject of having sex with HIV-positive men came up. "Oh, I would never have sex with an HIV-positive guy," he casually remarked -- as if such a thing were already obvious. I was shocked not just by Patrick's statement, but also by the categorical bravado in his delivery. To have sex with HIV-positive men, as he went on to explain, was to expose himself to unnecessary risk of infection. I've been replaying this conversation again and again in my head. How could he be so outrageously calculating in his cooIly expressed exclusionary strategy? Today I want to spend a few moments reflecting on these kinds of statements, because I think many people would uncritically read them as legitimate prevention strategies. I will argue here, however, that in reality that these kinds of strategies that are totally bankrupt in terms of actual risk reduction. Moreover, what I think this kind of statement actually tends to do is not actually promote any real reduction in risk, but rather to reinforce and reproduce harmful stigma against HIV-positive people.
Before we get into a discussion of the ethics of "serosorting" -- the practice of choosing to engage in sex with only sero-concordant men -- I think we should bracket my friend's comments as existing only at the very periphery of this term's broad meaning. While taken at face value, it does indeed seem that my friend is practicing serosorting. But correct me if I'm wrong here, but it seems to me that serosorting was more intended to describe men who were seeking to minimize risk of transmission while engaging in sex without condoms. For my friend, this wasn't the goal of his strategy -- condom use was still part of his risk reduction strategy with other HIV-negative men. This is a very important distinction. What I'm going to be talking about here is men who report consistent condom use, but who continue to latch onto serosorting discourses that discourage serodiscordant sexual practices.
Because of these important differences, I want to suggest that Patrick's comments cannot possibly be said to be purely a method of risk reduction. To explain why I think this is so, we need to evaluate whether or not there is actually any risk worth avoiding by excluding HIV-positive men from your pool of eligible partners. Thus, to help illustrate this, let's attempt to assess the risk of transmission between a known HIV-positive partner and an HIV-negative partner when condoms are used. There is no data to suggest that many HIV infections occur in these contexts, absent condom failure -- rates of which are outrageously low (between 0.4% and 2.3%, depending on who you ask). If we take a generous account, let's presume that rate is 2%. In a single incidence, then, the risk of potential exposure is 1:50.
But exposure does not equal transmission. You can be exposed to the virus and not actually seroconvert. Thus, we need to add into this equation the risk of transmission per sexual encounter in the absence of condoms,which vary depending on a number of factors: whether the poz guy is insertive or receptive, his viral load, genital ulcerations, etc. Let's say the poz guy is doing the fucking, for example's sake. The generic risk in this scenario for a receptive HIV-negative man is 1:122 -- that is, statistically speaking, there is a 1 in 122 risk of seroconversion after getting fucked once without a condom by an HIV-positive man (see here for a summary of this data). If we multiply these two risks together, we get something like a 1 in 6000 probability -- give or take. According to risks of death statistics, this puts a person's risk of seroconversion in this abstract, theoretical scenario somewhere between their risk of death by electrocution (1:5000) and their risk of death by drowning (1:8942). Obviously, this is a gross use of statistics -- but I think it helps illustrate the point: the risk of transmission between serodiscordant couples in one sexual encounter when using condoms is EXTREMELY low. Just about negligible. And this example likely grossly overestimates the risk, due to the fact that condom failure is not the same as sex without condoms. Many people will quickly realize the condom has broken, leading to a much smaller window of possibility for exposure. Thus, the 2% exposure rate included in this example is likely much, much smaller in practice.
Obviously, if we extend this risk over time, then we run into increased risk of transmission for a variety of reasons -- namely condom fatigue reported within serodiscordant couples. But if you use condoms, your risk of becoming infected from hooking up with a HIV-positive guy is probabilistically very low. Thus, excluding them from your dating pool cannot and should not be considered a risk reduction strategy -- unless you are having unprotected sex.
Now that we've established that there is no real prevention rationale for categorically excluding HIV-positive men from your pool of eligible partners, we need to seriously consider the ways in which doing so actually works to reinforce stigma against HIV-positive men. If you ask any HIV-positive man what kinds of difficulties come with seroconversion, many will immediately respond that stigma and the resulting fear of disclosure are today some of their most pressing concerns. New medications have alleviated what used to be a very immediate sense of death, and their adverse side-effects have been dramatically reduced with even more recent advances in treatment protocols. Rather than "purely" medical, the problems that men describe today with living with HIV are very much in the realm of the social.
Take for example a scenario another friend (we'll call him Matt here) described to me recently at a gay bar in Detroit. Matt was dancing with a cute young man, who curiously told him that "You should stay away from me. I'm dangerous." Matt asked him why, and he ambiguously answered that he was contaminated. Matt then asked him directly if he was HIV-positive, at which point the guy stiffened and gave a sheepish affirmative reply before running away. In this scenario, the young man had so internalized this harmful discourse of transmission that paints HIV-positive people as dirty and dangerous, that he himself did the running away. Matt has slept with HIV-positive men before -- this is not a problem for him. But he didn't even have to not reject him -- the HIV-positive man did the rejecting for him!
While this seems like a very contextual and bracketed example, I think it serves to illustrate the kind of emotional damage that stigmatizing discourses may be having on HIV-positive people's lives. I contend that Public Health -- in its ambiguous and contradictory uses of the term "serosorting" (a topic for another essay) -- is part of the problem here. By refusing to explain what this term means, and by remaining quiet in the way it gets practiced, Public Health is serving to reinforce stigma against HIV-positive people by allowing many men to use it as a rationale for their exclusionary practices. This essay is just a gloss on these issues -- it admittedly raises more questions than it answers -- but I desperately think we need to think critically about the way we (I mean both we as gay men, and we as people invested in promoting Public Health) allow stigma to continue operating in our communities through the lens of "health" and "risk reduction." Backed by medical logic, stigma seems rational, logical, and unproblematic. But we need to expose the ways in which these allegedly science-based logics are actually totally bunk in terms of their validity -- and are actually just forms of stigma veiled by scientific authority.
Author's Note: After publishing, I corrected the 1:122 risk of transmission per incidence for HIV-negative people engaging in unprotected receptive anal intercourse with HIV-positive men from the originally cited 1:132. I also added a link to Poz Magazine's summation of this theoretical risk data. Many people have emailed their frustrations with my gross misuse of statistics. I don't dispute this. Indeed, the kind of very sketchy analysis I engage in is problematic if you are interested in the actual, "real" statistical risk. I'm not really so interested in the precise number, and I don't think it matters much in making this argument. To my knowledge, even if we look at the outcomes here -- seroconversions reported when using condoms with HIV-positive partners -- we just don't see large numbers of transmissions. But I certainly welcome and encourage further research that is invested in precisely quantifying these risks -- and the variety of factors that are bound to contextualize them.
Despite any evidence to suggest they are more susceptible to the disease, the SF Department of Public Health is advising that HIV-positive people take care to get the H1N1 vaccine when it becomes available:
San Francisco health officials stress there is no evidence to suggest that people living with HIV are any more susceptible to the swine flu than they would be for the seasonal flu. "They should think of it as the same as the seasonal flu. Whatever their reaction would be for the seasonal flu should be their reaction for H1N1," said Dr. Susan Fernyak, the health department's director of communicable disease control and prevention. "If they don't care about the seasonal flu, they shouldn't be up in arms about swine flu." Health officials have long advised HIV-positive people to get vaccinated for the seasonal flu each year, and that is still the case this year. Each year 6,000 Californians die due to influenza. "It is still a serious disease in California and people should get immunized for seasonal flu," said Amy Pine, director of the health department's communicable disease prevention unit. "Everyone should get [vaccinated], including people with weakened immune systems."
I teach 75 undergraduate students who will be prioritized in getting the vaccine. But I'm too old to be in the priority category. Hoping for the best!
A new report from the UK suggests what many of us have been arguing for years now: HIV stigma drives some HIV-positive men to engage in riskier sex practices.
Here's the meat of the findings, with quotes from the news article:
1. Rejection and Stigma Shape Risk Management: "The researchers argue that men’s concerns about rejection and stigma shape the way they manage risk. Disclosure leaves men vulnerable to significant harm, including violent reactions and anxiety about ex-partners using police investigations as retribution, as well as rejection leading to emotional upset and problems finding sexual partners. In a community that often remains hostile to people with HIV, men’s instinct for self-preservation often leads them to choose behaviours where disclosure is felt to be unnecessary."
2. Poz Men Rely on Saunas, 'Poz Spaces,' to Obviate Need for Disclosure:: "For example, many men used saunas, not just because sex was readily available, but also because the men assumed that almost all other sauna users were HIV-positive. Like online chat rooms or HIV support group meetings, saunas were thought to be ‘HIV-positive spaces’ where men had implicitly announced their HIV status simply by being there. This allowed men to have unprotected sex there without an explicit discussion of HIV status, but leaving them with their sense of personal integrity intact."
3. Some Men Suggest Condoms Instead of Disclosing Status:"In some settings, some men tried to avoid disclosure but maintain their sense of moral integrity by suggesting to sexual partners that it would be a good idea to use a condom. Nonetheless one man described how these suggestions prompted one sexual partner to ask directly whether he had HIV. When he said yes, the man became angry and left."
4. Some Tick 'Safer Sex Needs Discussion' Box on Online Profile Instead of Disclosing: Another form of implicit disclosure that men tried was ticking ‘safer sex needs discussion’ on a Gaydar internet profile. Few men explicitly advertised their HIV status on their profile, but might mention it during private instant messaging. The respondents described ambiguities and misunderstandings in disclosure on the internet, but generally found that the internet enabled them to screen potential partners with less fear of disappointment or reprisal."
5. Behavioral Risk Reduction Strategies Limited: "Nonetheless, the researchers found that men used risk reduction strategies to quite a limited extent. No respondents mentioned reducing the duration of anal intercourse or the impact that viral load or a sexually transmitted infection could have on the risk of transmission. Just a few men discussed the greater risk of infection for the receptive partner or the possible benefit of withdrawing before ejaculation."
6. Some Serosort, But Highly Controversial Topic: "Some men did practice some form of serosorting (seeking partners of the same HIV status) and respondents said that it allowed them to have uninhibited sex where HIV status did not remain the most salient concern throughout. Nonetheless the researchers stress that very few men exclusively practiced serosorting in a way that could guarantee that both partners had the same HIV status. Disclosure was often implicit (by being in a sauna, for example) or was not reciprocal... However, the majority of men actually rejected the idea of serosorting. It was associated in their minds with high-risk, esoteric practices, and in the words of one respondent, men who are “going spreading it round because they are shagging willy-nilly”. Many men were at pains to distance themselves from this behaviour. They were appalled by the idea that unprotected sex could ever be a regular or planned activity, and so rejected serosorting, strategic positioning, withdrawal before ejaculation and other risk-reduction strategies."
7. Many Aspire to Use Condom Everytime -- But Lack Self-Confidence, Skills to Implement Goal: "Nonetheless these same men had all had some unprotected sex. It tended to be described as an exceptional event, explained by circumstances such as substance use or a partner’s insistence. The researchers make it clear that a number of men lacked the self-confidence or negotiation skills to manage such situations. Many men aspired to use a condom every time, but were not able to fall back on risk-reduction strategies when, for whatever reason, condoms weren’t used."
Some HIV-negative men in long term relationships with HIV-positive men have an antibody response in saliva which may inhibit HIV infection, report Swedish researchers in an article published online ahead of print in AIDS. This is the first time that such a response has been described in saliva, and may help explain why infection through oral sex is somewhat infrequently reported even in serodiscordant couples.
While it is well established that while HIV infection during fellatio and other types of oral sex can and does happen, the number of infections that can be attributed to oral sex is relatively small in comparison with the number of times that unprotected oral sex is practiced. One reason is that saliva contains enzymes which partially inhibit HIV infection.
Neato! The new safer sex message: Suck, swallow, repeat!
I was reading a totally banal post from a doctor over at Gay.com responding to a reader who claimed he had unprotected anal intercourse with his HIV-positive partner, and was asking whether he will test positive. The comments are so predictable and trite, but I think this comment in particular sums up many gay men's problematic / neoliberal / rational choice attitude about gay sex and sexuality:
Knowingly having unprotected sex with an HIV+ partner, particularly when you are the bottom and let him cum inside you is just foolish. If you don't care about your health then you probably have some serious self esteem issues. You should seek professional mental health counciling. The part that steams me is that with all we know people will still make a "selfish" choice. Accidents will happen and it is great there are organizations to help with funding, staffing and meds but to knowingly participate is ridiculous. If you become positive then please do not drain the public resources for Poz guys. You made the choice, you should pay for all your testing and support your own treatments if it comes to that. Don't waste funding and millions of volunteers time.
The moral of the story: people who test positive should have known better, and it is therefore their own fault. Therefore, they don't deserve publicly funded medication or treatment.
Disgusting isn't even the word. Terrifying is more like it -- that so many men out there agree with this person. Sigh.
Disgusting. We're seeing a spat of this criminalization of HIV-positive people happening all over the world -- including the United States. Now this from Indonesia:
Lawmakers in Indonesia's remote province of Papua have thrown their support behind a controversial bill requiring some HIV/AIDS patients to be implanted with microchips -- part of extreme efforts to monitor the disease.
Health workers and rights activists sharply criticized the plan Monday.
But legislator John Manangsang said by implanting small computer chips beneath the skin of "sexually aggressive" patients, authorities would be in a better position to identify, track and ultimately punish those who deliberately infect others with up to six months in jail or a $5,000 fine.
The technical and practical details still need to be hammered out, but the proposed legislation has received full backing from the provincial parliament and, if it gets a majority vote as expected, will be enacted next month, he and others said.
Indonesia is the world's fourth most populous country and has one of Asia's fastest growing HIV rates, with up to 290,000 infections out of 235 million people, fueled mainly by intravenous drug users and prostitution.
But Papua, the country's easternmost and poorest province with a population of about 2 million, has been hardest hit. Its case rate of almost 61 per 100,000 is 15 times the national average, according to internationally funded research, which blames lack of knowledge about sexually transmitted diseases.
Q-Notes has just published this rather unsatisfactory editorial regarding the case I reported on last week in which a NC DJ was arrested for having unprotected sex (which was a term of his probation for a prior conviction of "spreading communicable diseases").
I'm headed out the door, so I'll have to add more of my thoughts later. But initially it just seems that they've repeated every cliched argument about poz guys / HIV / "responsibility" they could dig up. Perhaps the most ridiculous claim: "Lastly, remember that Q-Notes is a newspaper, not an advocacy organization." Riiiiiiiiiiight. That's the kind of thing you say when you want to justify your already glaringly apparent bias.
More later! Must go! Headed to Detroit to explore the city. But do leave some thoughts here for digestion!
Editorial: Raleigh HIV case warrants news coverage
by Q-Notes Staff | November 1st, 2008
Since the publication of our Oct. 23 web story “Gay DJ put on house arrest for second HIV violation,” Q-Notes has received some pointed criticism. We welcome this exchange of ideas and want our readers to know the reasons we decided to publish the story online, why a version appears in this issue and how we came to the conclusion that it was newsworthy. (See story: House arrest for Gay DJ’s second HIV violation)
The editorial staff first became aware of Joshua Waldon Weaver in late August, as we were preparing our Sept. 6 issue. Ironically, we were chastised by a member of the community for not covering the story quickly enough.
Weaver had just been convicted of violating state health regulations governing the spread of communicable diseases including HIV, as well as others such as tuberculosis. As previously reported, Weaver admitted in court and to Q-Notes via phone that he had unprotected sex with three men and failed to disclose his HIV-positive status.
For pleading guilty in the case, Weaver received a 40-day suspended jail sentence and probation. Terms of his probation ordered him to comply with communicable disease control measures set by the state, such as using a condom and utilizing other safe sex practices.
It is important to note that the court and the state have never said an HIV-positive person cannot or should not engage in sex. That the State of North Carolina and its courts publicly recognize the validity and need for intimacy among gay males is a fact to be applauded. We commend state government for this vital recognition of LGBT and HIV-positive people’s right to sexual privacy and freedom.
In our Sept. 6 story, we contacted HIV/AIDS advocates and asked them about the efficacy and application of the laws applied to Weaver’s case. We believe we handled this complicated issue sensitively and reached acceptable conclusions to the key questions: Are these laws necessary? (Yes.) When and how are they enforced? (Rarely and in extreme circumstances.) What is the obligation of a person with HIV? (Disclose his or her status to their sexual partners.)
Matt Comer’s Editor’s Note in the Sept. 20 issue (“New HIV numbers should spark action”) took members of the LGBT community to task for caring too little about their sexual health and failing to practice safe sex. The piece delved into a plethora of cultural and societal conditions that contribute to the ongoing HIV/AIDS crisis among gay and bisexual men and men who have sex with men (MSM) but do not identify as gay.
In the end, Comer encouraged LGBT people to address these complex issues openly, while at the same time taking more personal responsibility for their own safe sex practices and sexual health.
Weaver jumped back on our radar late last month when he admitted in open court that he had already broken his probation orders. It is not our intent to demonize this man, but he continues to behave in reckless and negligent ways that not only endanger his own health, but also the health of others.
In cases such as these, when a person is a threat to himself and others, we expect our government to step in. Weaver has shown that he is not willing to take precautions in the interest of public health. While his sexual partners also bear responsibility for their behavior, it is Weaver’s duty alone to follow the law, inform his partners of his status and wear a condom during sex.
Among the criticism directed toward us, there’s been discussion about the stigma surrounding HIV and AIDS. Some have stated that our coverage only adds to this stigma. In reality, isn’t it Weaver’s own behavior that adds to the stigma? When many people, gay or straight, think of people with HIV, they think of the stereotype of the unrepentant man who repeatedly engages in dangerous behavior wantonly infecting others. Rightly or wrongly, Weaver is fueling this image.
Lastly, remember that Q-Notes is a newspaper, not an advocacy organization. People tend to forget this because our reporting comes from a decidedly pro-LGBT ideological stance. Nonetheless, it is paramount that we guard against becoming an uncritical cheerleader for the community.
When there are issues or people that deserve criticism, it is our responsibility to report it. And when Q-Notes deserves criticism, it is our obligation to air your concerns. There’s a reason why letters to the editor and uncensored web comments are accepted — utilize these outlets and blister us whenever you feel aggrieved. We can handle it.
More than anything, we hope our coverage of this unfortunate situation leads to an honest and open discussion about HIV, AIDS and sexual behavior among men in the LGBT community.
For instance, why do so many gay and bisexual men seemingly refuse to take personal responsibility for their own health? Why have we practically fetishized an extremely risky sexual practice (anonymous, bareback sex)? Why don’t we push our elected leaders to do more? Why would we rather watch the Oscars and go clubbing than lobby for more HIV/AIDS funding and comprehensive sex education?
For our community’s health and welfare, we’re willing to have these difficult conversations. Are you?
I don't even know what to say about this story. I know this person from my years spent in Chapel Hill, going to the gay bar in nearby Raleigh, Legends. I'm upset by a few things:
1) That he was arrested in the first place. Criminalizing sex and HIV-positive people's lives is not only unethical but a dangerous practice that will undoubtedly stoke the flames of hate and stigma against Poz people.
2) That Q-Notes (Charlotte's gay newspaper) published his photo. You should know better! I'm so fucking disappointed about this decision. It's no different that newspapers in the 1950s posting photos of gay men arrested for having sex.
3) That his engaging unprotected sex is license for them to order him to a "psychological evaluation." The message is clear: you have to be crazy to have unprotected sex or not disclose your HIV status. But in a climate filled with stigma and hate against Poz people, it's no wonder that he didn't choose to do so.
That's only the tip of the iceberg, I'm sure. Why do you think he didn't disclose to his partners in North Carolina? Oh that's right, because HIV is so stigmatized there that Poz folks there feel like lepers in the community. We know so little from this story. Were his partners negative? Did he top them?
I'm so upset about this. It makes me want to cry and scream and vomit all at the same time. I don't just want to write a letter about this. I want to intervene in some way. To call the system out for its injustice and pathologizing actions. I'm disgusted. And sad. Deeply sad.
Here's the "story" from Q-Notes. I've bolded the parts that piss me off the most:
A gay disc jockey in Raleigh originally convicted of violating HIV infection regulations in August has been placed on house arrest after admitting he broke probation orders in early October.
On Sept. 6, Q-Notes reported that Joshua Waldon Weaver, 23, who works in clubs in Raleigh and Wilmington, pleaded guilty to charges that he failed to disclose his HIV-positive status and engaged in unprotected sex with three people. Weaver was given a suspended jail sentence and placed on probation. The terms of his probation ordered Weaver to use protection when engaging in sexual activity.
About two weeks ago Weaver was arrested after Wake County Public Health officials contacted his probation officer with information that he had possibly violated court orders by having sex without a condom. Assistant District attorney Boz Zellinger told The News & Observer that health officials became aware of the DJ’s violation after he contracted another sexually transmitted disease that could have been prevented by the use of a condom.
Weaver could have faced 40 days in jail for his most recent violation, but District Court Judge Jacqueline Brewer instead sentenced him to six months of electronically-monitored house arrest. He will not be allowed to leave his father’s house except for probation-approved employment. Brewer also ordered Weaver to undergo a psychological evaluation..
If Weaver breaks his probation again, he will face up to 25 days in jail and prosecutors will ask for a two-year quarantine in a state prison hospital.
“His behavior hasn’t changed,” Zellinger told the Raleigh newspaper after the hearing. “We’re trying to address the callousness his actions have demonstrated.”
Zellinger added, “It’s not a witch hunt. It’s a desire to change his behavior to benefit the community.”
Weaver’s attorney, Evonne Hopkins, who declined to speak with Q-Notes for our original Sept. 6 story, said she’s “confident we will not be back here.”
“Josh is very sorry we’re back in court,” she said.
North Carolina Administrative Code 10-41 and North Carolina General Statute 130A-144(f) address control measures regarding the spread of HIV and require those with communicable diseases — including other sexually transmitted diseases, hepatitis and tuberculosis — to comply with measures intended to curb their proliferation.
Weaver is only the second Wake County resident in 15 years to be sentenced for failing to follow laws governing the transmission of communicable diseases, according to The News & Observer. In 2007, only 16 people statwide [sic] were convicted of violating the communicable disease law. Rather than HIV, many of the instances were related to diseases such as tuberculosis or hepatitis.
UGH! This people don't fucking get it!
UPDATE: From the comments section of the Q-Notes newsstory. Looks like Q-Notes will be providing some feedback on their coverage in an upcoming editorial on Nov 1st. I've been rankling them in the comments and on of course here on my blog. I hope this will be a positive (so to speak) move:
Trevor, et al.,
Q-Notes will be publishing a staff editorial addressing this issue in the Nov. 1 print edition. The editorial will also appear online the same day.
In case there is some confusion, please note that this story, as noted in the text, is a follow-up to a Sept. 6 article:
We encourage concerned readers to guard against making conclusions that are not supported by the facts as reported in this story, in the Sept. 6 report or any other report by other news agencies. Further, we encourage readers to also guard against making personal and/or ad hominem attacks against the subject of the article or those participating in community discussion on this website.
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The IAC is underway in Mexico City, and today the CDC finally made public their long-delayed new estimate for HIV incidence for 2006, using a new technique to estimate the numbers. It's been a controversial road to the IAC (see here) for the CDC. Here's the NY Times:
The United States has significantly underreported the number of new H.I.V. infections occurring nationally each year, with a study released here on Saturday showing that the annual infection rate is 40 percent higher than previously estimated.
The study, conducted by the Centers for Disease Control and Prevention, found that 56,300 people became newly infected with H.I.V in 2006, compared with the 40,000 figure the agency has cited as the recent annual incidence of the disease.
The findings confirm that H.I.V., the virus that causes AIDS, has its greatest effect among gay and bisexual men of all races (53 percent of all new infections) and among African-American men and women.
The new figures are likely to strongly influence a number of decisions about efforts to control the epidemic, said the disease centers’ director, Dr. Julie L. Gerberding, and other AIDS experts. Timely data about trends in H.I.V. transmission, they said, is essential for planning and evaluating prevention efforts and the money spent on them.
“C.D.C.’s new incidence estimates reveal that the H.I.V. epidemic is and has been worse than previously known,” Dr. Kevin A. Fenton, who directs H.I.V. prevention efforts at the agency, said on Saturday.
A separate historical trend analysis published as part of the study suggests that the number of new infections was probably never as low as the earlier estimate of 40,000 and that it has been roughly stable overall since the late 1990s.
Over the past few months, there has been an explosion of activity around the possibility of repealing the travel ban that blocks HIV-positive folks from traveling or immigrating to the United States. Britain-born Andrew Sullivan -- whose been openly Poz for many years now -- was one of the more vocal critics of the ban, which blocked him from getting a green card. He posted this celebratory message on his blog:
I'm not usually speechless but I'm ecstatic to report that the Senate just passed PEPFAR without the Sessions amendment, and Senator Biden, who managed the bill, just said they will probably avoid a conference with the House and send the bill forthwith to the president's desk. Barring some unforeseen event, the HIV Travel Ban - a relic of the days when HIV was a source of fear and stigma and terror - is finally over.
Obviously, the bigger achievement in PEPFAR is the funding for continued help for those with HIV and AIDS in the developing world - people whose plight is unimaginably worse than mine or so many others trapped by this HIV law. Bush's legacy in this is one for which he is rightly proud. But for those of us who have long dreamed of becoming Americans, and have been prevented by 1993 law from even being able to enter or leave the US without waivers or fear or humiliation, this is a massive burden lifted.
I'm not exaggerating when I say that it's one of the happiest days of my whole life. For two and a half decades, I have longed to be a citizen of the country I love and have made my home. I now can. There is no greater feeling.
So the Senate passed it. Let's get it signed into law! Pronto!
Hop on over to The Gayest Podcast in Michigan to check out the latest -- the second in a two-part interview with my friend Troy Wood. This installment is very emotional -- we talk about testing HIV positive, quitting crystal, and getting back on his feet. It's beautiful. You'll love it.
This is incredibly sad news. While most psychotherapists make my blood curdle -- particularly when it comes to sex politics -- Shernoff was one of the good guys. He worked hard and asked difficult questions since the very beginning of the AIDS epidemic. Sadly, he was diagnosed in March 2006 with pancreatic cancer, and lost his battle with the disease last Tuesday.
If you're unfamiliar with his work, see this interview he did with The Advocate in 2006 about his last book, Without Condoms. I love this quote from that interview, which sums up his approach to "risky sex" and gay men:
It’s important for me to meet patients where they are at. Good therapy provides curative emotional experiences. I don’t need to act like a nonapproving parent. With patients who have developed drug problems, I needed to advocate a harm-reduction approach if the patient in question wasn’t ready to stop using. I decided to apply that same approach to men who engage in unsafe sexual behavior so that I wouldn’t run the risk of alienating them or driving them away from my office. If I shake my finger at them and try to tell them what to do, the patient feels judged and infantilized. A harm-reduction approach doesn’t eliminate harm all together, but it can help the individual make certain choices that reduce the risk to himself and to the broader community should he choose not to use condoms during sex.
Losing another good guy from his generation is.... :(
This was a very short, three minute whimsical film out of London featuring a performance art piece with two female-bodied performers -- chests bound by a kind of black duct tape -- dancing to a song by bending back and forth. It read to me as a celebration of the ability to move our bodies freely and whimsically, without care. It was good natured fun.
"THE BOND"
Director: Michael T. Connell
Trevor's Rating: 3.5 / 5 Stars
What a charming little film! Basically, this short six minute piece features a father's reminiscing about his daughter's transition from male to female. I think his frank and honest commentary may have made some trans folks in the audience uncomfortable -- he talked a bit about mourning the loss of his son -- but I appreciated his candid disclosure. Before she transitioned, she served in the army, married, and had two kids! Oy vey! It was lovely to have the father and daughter both at the screening (and at the trans-filled afterparty). Very cute!
"DONNY AND GINGER"
Director: Jon Bush
Trevor's Rating: 3.5 / 5 Stars
Trailer for HBO SHOUT Short Film Contest:
My friends hated this movie. I wasn't quite as offended as they were by its somewhat cliche story, but I'm getting ahead of myself. This film won HBO's LGBT "SHOUT" short film competition, giving director Jon Bush $15,000 to produce the flick (see trailer above). So in comparison to many of the other low-fi films included in this collection, it was fairly polished and professional looking. My friends took issue with the 10 minute movie's plot, which opens with a transgender sex worker asking a cop for a ride. There's clearly more to this relationship than meets the eye, as the burly male cop winds up taking the woman to breakfast. It turns out that the cop is the woman's father, and bitter estranged family dialogue ensues. My friends were upset that the only film directed by a non-trans person in this collection of shorts about trans people was the most stereotypical of the batch. It's a fair criticism. But taken out of the context of this screening, I think the film is fairly solid, if perhaps a bit stale.
"FELICIA"
Director: Tim O'Hara
Trevor's Rating: 4.5 / 5 Stars
What a charmer! This film was a delight. In eight minutes, it opened up a window into the life of Felicia Elizondo, a transgender woman facing the reality of aging alone. The film opens with her talking about her pets, a 17 year-old dog, a 18 month year old dog, and a 9 year-old cockatoo. Every morning when she wakes up, she makes sure to give the older dog and the cockatoo a good shake "to make sure they're still alive." Funny stuff. Felicia's been HIV-positive for many years, and has lost many of her friends to the disease. But she still has a group of friends that she makes sure to keep in touch with regularly, calling them every day or every other day. She's a gem, and I loved hearing her story. I'm glad this film was made.
71 year-old Vicki Marlane is the oldest living, continuously performing drag performer in the world. She performs to this day over at Aunt Charlie's Lounge here in San Francisco, every Friday and Saturday night. I've actually seen Vicki perform before, and she's a real treat. This nine minute short documentary was BRILLIANT. I loved every second of it. Vicki is a trip and a half, hamming it up for the camera at every turn. She used to perform in carnival acts in the 1950s, sometimes filling in as "two of the four legs of the four-legged woman." She has many on stage stories to tell, many involving her "usual cocktail" of a stiff drink and sleeping pills. But hands down my favorite part had to be when she reveals her make-up secret: applying two pieces of clear tape to her forehead to stretch away a few years. Wow. Despite living with HIV for many years, Vicki still has the spirit of a 22 year old on stage. That resilient spirit shines here in this fabulous film. Get your hands on it if you can.
"THE ROLE I WAS BORN TO PLAY"
Director: Lukas Blakk
Trevor's Rating: 2.5 / 5 Stars
This short film wasn't short enough. Using nine minutes of clips from the movies She's the Man, Boy's Don't Cry, and Just One of the Guys, Blakk attempts to piece together a kind of personal gender monologue -- but the film is just a mess. Boy's Don't Cry is nothing light to throw around, and one scene flashes the movie's most violent scene, interspersed with a kind of inner monologue about why the narrator never hooks up with people he's not out to as trans. Using clips from other movies in this way is an interesting idea -- certainly many of us look to cinematic portraits of queer life to help us understand our lives and worlds -- but it's not executed particularly well at any point.
"THORN IN YOUR SIDE"
Director: Dean Hamer
Trevor's Rating: 3 / 5 Stars
I understood this making of this film to be almost about producing a historical record of a small piece of the transgender movement here in San Francisco, the Trans March. And basically, that's what you get here -- a glimpse at the March's activities and spirit. It's innocuous, very cute.
Okay, I'm a bit biased. Ethan Suniewick, the film's creator and primary director, is one of my best pals here in the city (my BFF Jackson is also featured here). Like Johanna's film that I blogged about yesterday, Ethan worked on this film over his second year at SF State for his Masters thesis project. But his film really is fabulously important. What I love about Ethan's film is that it has an applied practical purpose -- it's a short, 18 minute training video for health care providers. How cool is that? There's no jargon here, just real stories about trans people's experiences with providers, and suggestions for how providers can take steps to improve their trans-competency. One of the most troubling stories, for instance, comes from a transgender woman who works in a clinic in the city who went to the ER with a fever and bronchitis. Despite this, she found herself being hoisted into stirrups under a spotlight while a group of doctors looked at her vagina. Enraging! But the film is quite touching. Very smart, straight the point. Bravo, Ethan! We're so proud!
This film was cute, if a bit silly. A transgender puppet living in the 2040's reminisces about life back in the early 2000's, before he moved back to "the land" to take over his family's farm. The agro-politics here are just a bit outrageous, but hey, it's always good to think about what we want our future to look like. So I appreciate this film's commitment to imagining it, however whimsically.
I had the chance to attend the world premier of the new film, Holding Trevor, at this year's Frameline 31st annual LGBT film festival. The description sounded quasi-cliche, but I was happily suprised to find that it was a refreshing and incredibly well done film. The writing and acting were both incredible! It's a film about friendship and love - and loss, really. Three friends are the focus (two gay men + one straight woman), and in particular the relationships that Trevor has.
In the film, I was struck by the writer's decision to have a woman test positive for HIV. It's actually a remarkable scene. One of the gay men suggests they all get tested, and their straight woman friend Andi goes along for support. Suprisingly, she's the one that tests positive - not either of the gay men.
In particular, what was suprising about this decision was the fact that she had only had sex *once* in recent memory. We're led to believe, then, that she contracted the virus through this one encoutner that she was too drunk to remember. During the Q&A with the cast and crew after the film, I asked the writer about that deliberate decision to have her seroconvert after only one encounter. He said something about wanting to go against type, and also that he felt that tragic things happen to random people (I think he may have said "innocent" people here), whereas there are 10 other people out there essentially asking for it. This didn't satisfy me at all, so I said that I felt like every new case of HIV was tragic - not just those infections in people who aren't whores. He backpeddled, but it was clear how he felt.
I was walking home afterwards with my friend Jackson, and I mentioned my discomfort with his answer. Jackson made a good point. In film, there's no good narrative to tell, it seems. Had the woman have had a lot of sex, then it would have reinscribed the age-old slut-gets-sick narrative that we all know and hate. However, by choosing for the character only have one sexual encounter, the writer essentially sent the message that you can get HIV from one encounter. Which, of course, you can - but it's highly improbable (especially if they didn't have anal sex). In fact, for vaginal intercourse, the odds for a negative female partner with an HIV-poz male partner would be about 1 in 111,111!!!!!! That's right, 1 in 100 and 11 THOUSAND.
Highly unlikely. She'd sooner get mauled by a tiger while visiting the zoo. Possible? Sure. But probable? Definitely not.
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Pam's House Blend
She's a fabulous North Carolinian blogging about politics, LGBT and women's rights, the influence of the far Right, and race relations. What more can I say?
