Showing posts with label HIV Stigma. Show all posts
Showing posts with label HIV Stigma. Show all posts

December 1, 2016

In Russia Healthy Living and Family Values is giving them an Increase of Straight HIV Transmission

 Do You Know What Dec.1st is?(Even if You don’t use condoms, now there is no reason to get HIV in many countries, ask me!


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- For a few weeks in 2012, Yury had a family: His wife, Katya, had given birth to a girl.

But when Yury took his ailing baby daughter to the hospital two months after she was born, he learned that she was HIV positive, and his world began to collapse. After he was tested and came up positive, he said, Katya told him that she had given him the virus -- and had known she had it while pregnant but kept it secret from him out of fear.

A month later, their daughter was dead. Katya, who refused to take antiretroviral therapy to prop up her ailing immune system, died last year.

"We didn't separate or run away from each other. We went to the end," said Yury, a 40-year-old auto mechanic from a gritty Moscow suburb who preferred not to be identified by his surname. "I've come to terms with it all. How can I blame the person who gave me a daughter?"

Russia's HIV epidemic passed a grim milestone in January as the country registered its millionth HIV-positive citizen -- double the number in 2010. About 200,000 of that million have died since HIV was first registered in Russia in 1987.

With less than one percent of the population of Russia's 142 million infected, the situation is less dire than epidemics that have ravaged Sub-Saharan Africa. And yet while the rate of new HIV infections across the world is ebbing, in Russia it is on the rise.

Russia accounts for the lion's share of infections in a Eurasian region, which UNAIDS -- the United Nations' program on HIV/AIDS -- says is the "only region in the world" where the HIV epidemic has "continued to rise rapidly." More than 93,000 new cases were registered in 2015 -- compared, for example, to 44,000 new diagnoses in 2014 in the United States, whose population is more than twice as large.

Yury does not know how Katya contracted HIV, but his own story fits into a trend that some leading experts say President Vladimir Putin's government must face up to fast: The number of Russians infected through straight sex is rising.

Vadim Pokrovsky, the longtime head of the Federal AIDS Center and an expert who has been tracking the disease's progress in Russia for almost three decades says the epidemic is advancing beyond traditional high-risk groups and spilling into general circulation.

Pokrovsky said that infections through heterosexual contact accounted for 45 percent of overall infections in 2015, compared with 10 percent 10 years ago.

He believes Russia stands at a critical juncture: The government should forsake what he casts as conservative policies that deviate from established global practice in the fight against HIV.

"I think it is now spreading into the heterosexual population," Pokrovsky told RFE/RL. "We can no longer keep on saying 'nyet-nyet' [Russian for "No-No"]. We have to urgently take measures."

'HIV Belt'

For years, the chief mode of transmission in Russia has been intravenous drug use, which boomed after the Soviet collapse as the social fabric frayed and factories shut down or slashed workers' jobs, particularly in industrial towns in the Urals and Siberia. Rampant drug abuse tore through cities on the heroin trail from Afghanistan westward in the 1990s and 2000s, forming something of an "HIV belt" across central Russia where the virus remains most prevalent today.

Pokrovsky believes the situation is moving from a "concentrated epidemic" among at-risk subgroups such as injecting drug users to a "generalized epidemic" -- defined by the World Health Organization as a situation with "HIV prevalence consistently exceeding 1 percent among pregnant women."

Pokrovsky said that in over 15 of Russia's 82 regions, more than one out of every 100 women who becomes pregnant has HIV.

"The trouble at the moment is that the number of people contracting HIV through heterosexual sex is rising," Pokrovsky said. "We cannot say that these transmissions are connected to the traditional vulnerable groups."

Other experts say there has been no major shift in the way HIV is spreading in Russia.

In e-mailed comments to RFE/RL, UNAIDS said that "the majority of the new HIV cases in Russia remain concentrated among key populations -- particularly injecting drug users and their sexual partners."

But almost all agree on the need for urgent action in Russia, where several factors -- including the persistent stigma attached to homosexuality, a strained health-care system, a lack of education about risks, government pressure on NGOs, and logistical problems that critics say have been created or aggravated by the state -- are making the HIV/AIDS problem worse.

Rising Concern?

There are some signs of new attention from the government, and the media that serve it, to an issue that was long considered peripheral.

Recently, newspapers such as Komsomolskaya Pravda, a popular pro-Kremlin tabloid, have carried stories with headlines like: "HIV can happen to anyone: go out and get tested!"

Prime Minister Dmitry Medvedev declared the situation a matter of "national security" in March, and on October 20 signed off on a five-year strategy to combat the crisis through 2020. 

But despite the indications of increased concern, activists, doctors, and NGO workers fear that the new government plan remains hamstrung by the same conservative, go-it-alone approach that has stymied efforts to rein in the epidemic so far.

Among other things, the strategy prioritizes raising awareness, with the help of NGOs, among "key groups of the population." But in a common point of criticism, Pokrovsky said the strategy fails to clarify how the government plans to work with key HIV risk groups such as injecting drug users, sex workers, and gay or bisexual men.

"No one has answered the question of how we are going to warn people about the circulation of HIV among drug users -- although about 20 percent of intravenous injecting drug users already are infected," said Pokrovsky. "Nothing is said about how to prevent the infection of the remaining 80 percent."

"The same goes for sex workers," he told RFE/RL. "There is not a word about prevention among them. Everyone knows there are many of them. But there are no special programs planned for this group. The same goes for men who have sex with men."

The state "just does not pay enough attention to prevention -- prevention is very weak in Russia," Pokrovsky said, adding that this is reflected in government funding to fight HIV. "If 18 billion rubles ($278 million) are spent on treatment, only 400 million rubles ($6 million) go to prevention."

Zero Tolerance

There are no well-known state outreach organizations or programs working with high-risk groups. This is the exclusive preserve of largely foreign-funded NGOs such as the Andrey Rylkov Foundation For Health and Social Justice -- the only group in Moscow that distributes clean needles, contraceptives, and medication to drug users, the main group incubating and spreading the virus.

The Rylkov foundation receives no financing from the Kremlin and relies on grants from abroad. In July, the group was labeled a "foreign agent" under legislation signed by Putin early in his third term in 2012 that pressures and marginalizes many NGOs with foreign funding.

Foundation activists also encounter street harassment. In October 2013, police threatened to arrest activists who had traveled to a pharmacy in a rundown district in southeast Moscow where they handed out clean needles, bandages, condoms, and ointments. The police ordered them to disperse, prompting them to move to a new location where they continued their work. 

Although 1 million Russians have been registered with HIV in the last 30 years, Pokrovsky estimates there could be another 500,000 living with the virus who have not been identified -- many of them injecting drug users.

"Over half of our cases are contracted through drug use," said Elena Orlova-Morozova, a doctor at the Moscow Region AIDS Center. "It is very hard to identify HIV in this group and make progress with this group. Drug use is criminalized here and there is no talk of decriminalizing it."

“Drug users therefore are scared, of course, and cannot go to state buildings [such as hospitals] to be monitored,” she added. 

Activists also criticize Russia's refusal to legalize heroin substitution therapy which has been used widely across the world -- including in authoritarian countries such as Iran -- to wean drug users off heroin by giving them orally imbibed methadone.

Anya Sarang, head of the Andrei Rylkov Foundation, dismissed Medvedev's strategy as more of the same policy that has brought the epidemic this far. She suggested that one big obstacle to improvement is the growing prominence during Putin's third term of conservative ideas, anti-Western sentiment, and views espoused by the Russian Orthodox Church leadership.

"I guess the Health Ministry is still trying to figure out the 'Russian' and more godly way to deal with the problem since they are not in favor of internationally accepted, evidence-based prevention programs such as needle and syringe distribution and opioid substitution therapy," Sarang said.

'My Son Died Today'

LaSky, an HIV NGO that works with homosexual and bisexual men in Moscow, has not been labeled a foreign agent despite receiving money from abroad. But it has had to adapt to other restrictive legislation passed during Putin's third term.

On a November afternoon, Aleksandr, 29, a shop director who moonlights at LaSky, pasted "18+" stickers onto fliers and pamphlets about HIV and homosexuals so as to avoid being accused of violating a 2013 law that criminalizes the spread of gay "propaganda" to minors.

Rights groups and Western governments say the law marked a major setback for gay rights in Russia, encouraging prejudice and adding to the stigma attached to the lesbian, gay, bisexual, and transgender (LGBT) community in Russia, where homosexual relations were a crime in the Soviet era.

Ilya, a 20-year-old gay man who has attended counseling sessions at LaSky, has felt the stigma firsthand since he contracted HIV in December 2015 and was disowned by his family, which is prominent in his Siberian hometown. 

When he called his mother with the news of the test result, she said "my son died today" and hung up the phone.

Ilya, who did not want his last name published, said he became depressed and fell behind on his studies at a Moscow university. When exam time came in May he asked for an extension, citing his HIV status and a doctor's note, but was swiftly expelled, he said.

"In Russia, HIV-infected people are not seen as people who need help and are sick, but as people deliberately spreading the plague," said Ilya.

Activists at LaSky say the lack of information about HIV is a major problem. Aleksandr, a gay man from a Volga River town who preferred not to be identified by his surname, said he had no idea when he contracted HIV in 2013 that sexually active gay and bisexual men are at a high risk of infection.

"This information is nowhere, no one talks about it, no one knows anything about it," he said.

Activists say sex education in schools is grossly insufficient. At his high school, Aleksandr said, there was just one lecture that talked about condoms -- and it focused on using them to prevent unwanted pregnancy.

"There was nothing specifically about HIV," he said. "No one in the regions gets that. As a rule, they say superficially that there are sexually transmitted infections and you need to use a condom."

LaSky offers support in getting around a major logistical hurdle for many HIV sufferers in Moscow: The state guarantees free medical treatment for citizens, but only in the locale whether they officially reside -- and many Russians who live in the capital formally remain residents of their hometowns.

After Aleksandr tested positive for HIV, he had to travel back home -- 400 kilometers east of the capital -- for time-consuming treatment. He tried to hold onto his job by asking in advance for time off, but eventually was forced to resign. He has now managed to get registered for treatment by registering at the Moscow Region AIDS Center with LaSky's help.

Champagne, Not Condoms

Activists criticize some of the awareness campaigns that do exist, such as state-sponsored signs at Moscow train stations that make no mention of the use of condoms as a preventive measure.

One public-service poster sponsored by the Moscow government says simply, "Ignorance puts you in the risk group," without further explanation. Another suggests that adhering to traditional family values is key, warning: "Infidelity puts you in the risk group."
  
Pavel Lobkov -- a TV presenter who broke a taboo last year when he disclosed his HIV-positive status on the air on World AIDS Day, December 1 -- said condoms should be far more accessible.

"They should be handing them out free of charge in clubs where there is a heightened sexual atmosphere, or at rave parties, and so on," Lobkov told RFE/RL in an interview.

"When in a normal shop a pack of 12 condoms costs as much as a bottle of Soviet champagne, a couple of 18-year-olds will buy the champagne and not those boring condoms."

Lobkov said that "there were outreach programs for many years" -- but that times have changed.

"In the 1990s, I remember in all gay clubs or rave clubs there were free condoms at the bar," he said. They've disappeared now. They should be in your face" he said.

But social conservatives who have gained influence during Putin's public push for adherence to what he and the Russian Orthodox Church cast as traditional values tend to oppose such measures.

Lyudmila Stebenkova, a long-time Moscow legislator who heads the city Duma's public health committee, called on November 15 for a ban on the distribution of free condoms.

Stebenkova, who has won awards from the church, said condoms only offer 80 percent protection from infection and that their free distribution inculcates "irresponsible sexual behavior."

In a follow-up Facebook post, Stebenkova attacked foreign NGOs whose methods she called "strange and even irresponsible: giving out one-use needles to drug addicts and propagandizing condoms, which they give out even to schoolchildren." 

“In Moscow we decided to go down a different route: the propaganda of healthy living and family values," she wrote


November 1, 2016

Positive but Not Toxic



                                                                           





I came across a very interesting blog with a great posting written by Alexander Chaves. This is a subject that should be close to every gay, bi hearts in our world community. Those that not negative need to keep that in mind in order to keep it that way. It has never been easier to stay negative while having sex but the fact remain that everyone that has become positive has remain so. True in those undetectable that have been taking their meds as prescribed they wont need to have the conversion to positive of someone on their consciences. Still it is no picnic taking those meds everyday and at the same time still suffering from stigma from their community. This is where Alexander comes in:                
                                           

                                              




                                                     “Positive but not toxic waste"

My only commandment for life is one shared by Aleister Crowley — do as thou wilt, gents — with one exception: HIV-positive guys, stop getting those radiation tattoos, the kind they put on hazardous chemicals. We’re not toxic waste.

Here’s a story. I got a black star on the back of my neck three years ago, almost two months after one very bad day at the student health clinic. The days between the clinic and the tattoo parlor are dark and muddled and I do not remember much of them.

On the first day of school, I was fine. It was the start of my fourth year of what had been a tumultuous and largely rewarding undergrad. On the second day, I was not in class. A friend who knew I had gone that morning to get my STD test results left me forty panicked voicemails throughout the day. Later that evening, when I finally answered, I told him I had been shopping, which was true. I had wandered through the city making absurd purchases until it got cold. I asked him if I could come over.

Every night for the following week, I slept on a different friend’s couch, too scared of what I would do if left alone. Two months later, I went with two friends after class to get a tattoo.

Neither of them knew the real reason behind it, nor — I’m ashamed to say — did the tattoo artist. As it healed, I invented bullshit meanings for it to satisfy my friends. “I’m going to become a graffiti tag artist,” I lied. “The black star is my new symbol.” I posted a picture of it on Instagram on October 30, 2013.

For most of the three years since, my status was displayed on my Scruff and Grindr profiles but intentionally kept from Facebook. It was talked about in private messages with strangers but hidden in plain sight at Thanksgiving and Christmas. On these occasions, my mother frowned at my new ink — the next step, she reasoned, in my ongoing crusade to be as different from her and my father as possible.

My parents and the rest of my family saw the tattoo as something childish but harmless. They did not know that, for me at least, it was an indicator of something that led me to the darkest places, mentally and otherwise, I had ever been in my life.

My parents know HIV. As medical professionals, they saw countless AIDS patients at clinics in Zambia where my family lived for several years when I was little. As missionaries, my parents were driven by faith against staggering numbers. In 2014, 70% of all HIV-positive people in the world — about 25.8 million — lived in sub-Saharan Africa. As a general surgeon and gynecologist, respectively, my father and mother had seen the virus at its ugliest: emaciated babies, tiny skeletons wrapped in skin, washed by their mothers in tin buckets with filthy water. Years later, I would flip through the photos from our time there and see the grim similarities between present day Africa and American gay life in the 1980’s.

Places like Africa make the white, Western gay embracement of radiation symbols ugly. The symbols sing of outbreak and contagion — words that have real meaning in a place where people don’t have penicillin.

Last December, the same day my op-ed was published, I called my parents to tell them the secret I had kept from them for three years. On a sunny sidewalk in Los Angeles, I told them something that no parent wants to hear. They were both at work — I called my father first, then my mother. I feel cruel for doing it that way. I privately hoped that each of them left the office lounge or wherever they were and went outside to breathe for a minute. I made the decision to publish the article knowing I would post a link to it on my Facebook page, and if I put it on Facebook, a friend of theirs would eventually see it and call them. This was my way of telling them first.

The op-ed moved my HIV status beyond something only talked about for sex to something I could publicly write about for Plus magazine without using an alias. I did not mention my tattoo in the op-ed — in fact I have hardly thought about it since I got it.

That changed after I watched some hot bareback porn recently. A group of guys were “pozzing” a sub, which means they were fucking him hard and bare with the intention of seroconverting him. I don’t know if the sub really was HIV-negative, or if the guys fucking him really were HIV-positive. The fantasy scenario was just that — a fantasy that, deep in that dark inner place where desire lives, was hot to watch. I had not been seeking HIV when I tested positive, but I had been group fucked by multiple guys and taken all their loads. (The news sent me into a dark depression that lasted half a year, but looking back I can ask myself, “What did I think would happen?”)

The video was a studio production, not amateur, so the likelihood that all the guys on camera were HIV-negative was pretty high, especially if the video was shot in California. I noticed that some of the men fucking the lucky cum dump had radiation tattoos on their arms.

The tattoos were so obvious that they might have been fake, pressed on minutes before shooting, but they did add a considerable touch of realism to the video, because many HIV-positive guys do get radiation symbols tattooed on their bodies. In modern gay symbology, it is almost exclusively associated with HIV and bareback sex. Even the website where I found the video was embellished  with radiation symbols, just in case a casual visitor missed the movie titles, all of which were variations of “gay pig bare fucks submissive cum slut no condoms.”

After jacking off, I thought about the black star on my neck, which honestly had been this close — this close — to being a radiation symbol.

I have met other poz guys that marked themselves with something different — a bear paw, a plus sign — after their diagnoses. Some of them knew the modern reality of HIV before they tested positive. Others, like me, didn’t know a thing, and believed it was still a death sentence. Either way, we were all there in some white, sterile clinic, faced with an understanding that our names and our bodies were irreparably marked by something that many people feared and many had died from.

That was a blow unlike any I have experienced in my life. I applaud the efforts made by HIV activists who do good work educating the masses and informing them that HIV has become significantly more manageable, and well-informed people know this to be true. But HIV still changes your life.

If you live in a good metro area or have good health care, the costly medication will reduce the once-deadly virus to little more than a chronic illness. But you will still face a lifetime of blood tests and checkups, pill bottles with printed labels, and a whole new list of words and numbers that suddenly have crucial meaning — “CD4 count,” “T cells,” “viral load,” “undetectable.” You are still faced with an identity shift.

I no longer fear stigma, and my sex life and relationships have dramatically improved in the years since I converted. I announce my status on every hookup profile I have, with this addendum: “If you have a problem with my status, block me.” I don’t waste time with uninformed people, and the guys I fuck have been hotter, kinkier, and more health cognizant as a result. One pill a day is my only reminder that I am different from my HIV-negative comrades, and it goes down every morning with my allergy meds and Vitamin C capsules without a thought.

When I talk to friends who are newly diagnosed, I see on their faces the same look I had, like a bus had suddenly run over my dog. A newly diagnosed friend told me recently that for the first few weeks he took multiple showers a day because he didn’t feel “clean.” Another friend said that he went to the gym like a maniac for a few months after, and over-scrubbed every weight machine for ten minutes with the sanitary spray. In the same way that I went shopping and refused to sleep alone — and started an unhealthy sex crusade in the weeks that followed — these guys are learning life again from the ground up.

When you test positive, you really have two options. You either choose to live or you don’t. The latter doesn’t necessarily mean suicide; many guys simply never recover, and drown themselves in bad addictions, bad sex, and severely toxic relationships, and die slowly over the course of years.

Whether done fast or slow, both are forms of self-destruction, and I came close to both. I got the tattoo the day I decided, after a long solo run the night before, that I wanted to live. It took me a month or two, but I decided that I was not going to take everything in my medicine cabinet with a full bottle of whiskey. I had to choose life when it and the alternative were very even choices.

I’ll be honest, some days I still fear getting back to that place. It would be so easy to go off the deep end. I could be addicted to hard drugs with every STD imaginable in a month and just not care. I live with that boundary, and consciously aim for a life above it. If I had chosen death, I would have never met the good and beautiful men that I have been privileged to love in the years since. All the good people yet to meet me would never get to do so, which is sad. I think I’m a pretty cool person to meet.

In the tattoo parlor, the “radiation symbol” was trashed for something simpler. I wanted the tattoo to mean more than HIV, which does not define me and never will. I wanted it to prompt a story that I would tell later. Now I can.

Mortality is a complex idea with few visual representations beyond grave stones and skulls, both of which portray destruction as something that comes at the end of the line. Few images portray mortality as something you carry, something you survive every day — so I made one. My dark passenger is in for a long and exciting ride.

— Beastly

May 18, 2016

Study: HIV Cancer Patients Less Likely to be Treated


 
Image result for cancer cells






 






ATLANTA -A new study finds HIV-infected patients with cancer in the United States appear to be less likely to receive cancer treatment, regardless of insurance and other existing health conditions. The study, by researchers at the University of Utah, National Cancer Institute and the American Cancer Society, appears early online in Cancer.

Cancer is an increasingly common cause of morbidity and mortality among individuals infected with the human immunodeficiency virus (HIV). In the United States, cancer incidence rates in this population have increased since the introduction of highly active antiretroviral therapy (HAART). Cancer is now the second most common cause of death among HIV-infected individuals, after AIDS-related deaths.

While previous studies have shown that cancer patients who are infected with HIV are less likely to receive cancer treatment compared with HIV-uninfected individuals, whether that was due to insurance status and other conditions was largely unstudied. For the new study, researchers led by Gita Suneja, MD, MSHP, from the Department of Radiation Oncology at the University of Utah used the National Cancer Data Base to study non-elderly adults diagnosed with ten common cancers from 2003 to 2011. They examined associations between HIV status and lack of cancer treatment, taking into account insurance status and comorbidities.

After adjusting for those two known predictors of lack of treatment, the disparity remained for all cancers studied, except anal cancer. HIV-infected patients were more likely to lack cancer treatment for cancers of the head and neck (relative risk [RR] = 1.48); upper gastrointestinal tract (RR = 2.62); colorectum (RR = 1.70); lung (RR = 2.46); breast (RR = 2.14); cervix (RR = 2.81); prostate (RR = 2.16); Hodgkin lymphoma (RR = 1.92); and diffuse large B-cell lymphoma (RR = 1.82).

The authors say factors that predicted a lack of cancer treatment among HIV-infected individuals varied by tumor type (solid tumor vs lymphoma), but black race and a lack of private insurance (e.g.: having Medicaid, Medicare or no insurance) were found to be predictors for both groups. However, even among privately insured cancer patients, HIV-infected cancer patients are less likely to receive cancer directed treatment compared to HIV-uninfected patients.

The study says several factors may contribute to the finding. HIV-infected patients have historically been excluded from cancer clinical trials, thereby limiting the applicability of clinical trial results for this population. Cancer treatment guidelines specific to HIV-infected patients are not available for most cancer types. Clinicians may lack experience treating HIV infected patients with cancer. Furthermore, the psychosocial and economic challenges associated with the dual management of cancer and HIV treatment may make adherence to treatment a challenge.

"...cancer care providers and policy makers need to devote special attention to the HIV-infected patient population to understand and address the factors driving differential cancer treatment," write the authors. "Cancer treatment not only extends survival from cancer, but also can improve quality of life, even for patients with advanced stage disease. The observed disparity is of particular importance given the extended survival of HIV infected patients treated with antiretroviral therapy and the rising number of cancer cases."

###

The study was a collaboration between the University of Utah School of Medicine Department of Radiation Oncology, American Cancer Society Intramural Research, Emory University Epidemiology, and the National Cancer Institute Division of Cancer Epidemiology and Genetics.

Article: Disparities in Cancer Treatment among Patients Infected with the Human Immunodeficiency Virus, CANCER; published early online May 17, 2016 DOI: 10.1002/cncr.30052
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