HIV/AIDS infection rates have not slowed and are even speeding up in certain populations in the United States. The causes for the continuing scourge of HIV/AIDS in America are too many to list, ranging from widespread meth use to a mysterious lack of visibility in Hollywood of poz celebrities. I have always felt that prevention education is the key to halting the spread of the epidemic, but we see a disturbing trend of spending cuts and silence when it comes to prevention.
Part of the problem, of course, is that the picture of what prevention is supposed to look like isn't clear. The HIV/AIDS game is changing. People aren't dying of AIDS as often, with the leading cause of death among people living with HIV quickly becoming heart failure. This presents a unique challenge to prevention educators: HIV just isn't that scary any more, and it softens the message and impact of campaigns warning people from risky behaviors. Dan Savage, as I mentioned before, has very publicly stated that modern prevention is hamstrung by the pesky need to be factually accurate regarding the consequences of HIV in modern times to patients.
Regardless of his concerns, it's possible to tailor prevention campaigns to include the very real consequences of HIV that still exist. There are health concerns, financial concerns, and a slew of other problems that can discourage someone from unsafe practices.
So let's talk about them, shall we?
I have HIV. I tested positive on January 3rd, 2009, and it's been a pain in my ass since.
To start with, informing your friends and family about your serostatus can be insanely difficult. I ended up being the one consoling half the people I talked to, as they dissolved into tears, hysterics, etc., sure that I was going to die any minute.
Disclosure is still a necessary (and difficult) evil. At Netroots Nation, I stood up and disclosed my status in the LGBT pre-conference, primarily because I wanted to talk about HIV/AIDS issues, but also because I figured I would have hot activism sex and didn't want any awkward moments when I told my partners about the virus I carry. See? Mind like a steel trap, this one.
Of course, the big consequences are health related. While it's not likely that I will die of immune issues, there is a very big chance that I could die of cardiovascular disease. HIV, for some reason, hardens arteries and I must watch what I eat in response.
My greatest concern, of course, is my medicine. While there are great medications out there that keep my CD4 (think T-cells) high, they can have a drastic impact on my health. I'm on my second regimen, Isentress and Truvada, because my first one involved Norvir, which made me SICK. AS. HELL. I essentially spent two months alternately sitting on the toilet and vomiting every meal I ate. If I were to tailor a campaign about the modern consequences of HIV, it would probably involve this image:
My first regimen devastated my GI system so badly that even though I'm on a completely different regimen, I still cannot digest dairy. Really. A bowl of cereal in the morning can ruin my day (and everyone else's, yuk).
Lastly, medicine is fucking expensive. I take almost $300 worth of medication a day as part of my HAART regimen. Seeing as how I'm a broke-ass blogger, the government has to pick up the tab, and with drastic budget cuts to HIV/AIDS budgets being hung over our heads, it is not certain that I will always be able to afford the medication that keeps me alive. Even now, finding the funding to pay for my meds is a huge pain, with reams of paperwork being filled out and endless consultations with a myriad of social workers and bureaucrats.
In short? No. We're not dying off in droves. But if you don't want to possibly shit your pants while on a date or spend hours arranging insurance and comforting friends and family about your serostatus, don't get fucking HIV. It still really fucking bites.