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Rights Here, Right Now a report from the XVIII International AIDS Conference Vienna, Austria by the Black AIDS Institute Our People Our Problem Our Solution
Rights Here, Right Now is a publication of the Black AIDS Institute, 1833 West Eighth Street, Los Angeles, California 90057-4257, 213-353-3610, 213-989-0181 fax, info@BlackAIDS.org, www.BlackAIDS.org. © 2010 Black AIDS Institute. All rights reserved. The slogan “Our People, Our Problem, Our Solution” is a trademark of the Black AIDS Institute. Views and opinions expressed in this publication are not necessarily those of the Black AIDS Institute. Publication of the name or photograph of a person does not indicate the sexual orientation or HIV status of the person or necessarily constitute an endorsement of the Institute or its policies. Some photographs in this publication use professional models. Rights Here, Right Now is designed for educational purposes only and is not engaged in rendering medical advice or professiona l services. The information provided through this publication should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. This report was made possible by the generous support of EMD Serono, Inc., Tibotec Pharmaceuticals, Inc., Merck and Company, Arcus Foundation, Elton John AIDS Foundation, Ford Foundation, Centers for Disease Control and Prevention/Act Against AIDS, National Institute of Allergy and Infectious Diseases HIV Vaccine Research Education Initiative Program Ver. 1.2
Contents 6 The Year of the Black By Phill Wilson 8 Finding Our Voices, Claiming Our Power By Hilary Beard 10 AIDS is a Black—and Poor—Disease By George E. Curry | from BlackPressUSA.com 12 Q&A with Kevin Fenton By Lynya Floyd 13 What Will HIV Look Like in 2015? By Lynya Floyd | from Essence.com 14 Topical Medication Makes HIV History By Linda Villarosa 16 Q&A with Salim and Quarraisha Abdool Karim By Tomika Anderson 18 Prejudice Remains Obstacle in Epidemic By Rod McCullom 19 Poor Likeliest to Get HIV By Ramon Johnson | from About.com 20 Progress Made in Vaccine Development By Ramon Johnson 22 Protesters Open Up World AIDS Conference with Rage By Angela Bronner Helm 24 Black Women and HIV: Don’t Blame the Down Low By Lynya Floyd | from Essence.com 25 Q&A with Dr. Lisa Bowleg By Ayana Byrd 26 It’s Confirmed: Race Still Matters By Phill Wilson 28 Researchers Moving Toward HIV/AIDS Treatments and Cures By Glenn Ellis 30 Obama Officials, Activists Discuss National HIV/AIDS Strategy By Rod McCullom 32 Sheila Johnson Escaping Shadow of BET By George E. Curry | from Seattlemedium.com 33 Q&A with Sheila Johnson By Linda Villarosa 35 Young People Connect, Struggle to Be Heard By Kali Villarosa 36 Top Officials Discuss New AIDS Strategy with Black Journalists By Linda Villarosa 38 Get Prepared for PrEP: Treatment as Prevention Moves Ahead By Angela Bronner Helm 40 Race Still Matters in Fight against HIV/AIDS By Rod McCullom | from TheGrio.com 42 Women and Girls Obtain Their Place at the Table By Ayana Byrd 44 Freshman AIDS Conference Trip Yields Important Lessons By Gary J. Bell 45 Homophobia, Demonization By Ramon Johnson | from About.com 46 Governments Struggle to Cope with ADAP Funding Crisis By Tomika Anderson 48 CDC Says Poverty Is Factor in HIV Among Blacks By George E. Curry 50 Rally Rocks Streets of Vienna By Lynya Floyd 52 New Gel Is Potential Game Changer for Women By Linda Villarosa | from Women’s Media Center 55 Researchers Get Standing Ovation at AIDS Conference By Lynya Floyd | from Essence.com 56 President Obama’s Mixed Record on HIV/AIDS By George E. Curry | from BlackPressUSA.com 58 Global Village Is Vibrant But Still Not Perfect By Angela Bronner Helm 58 Race Still Matters: Statement by Black AIDS Institute 60 Husband, Wife May Alter Course of the HIV Epidemic By Tomika Anderson 62 Alarming Increase Among Younger Black MSM By Rod McCullom 63 HCV Travels Through Blood By Ramon Johnson | from About.com 64 AIDS-Ravaged Africa Now Offers Best Hope for Future By George E. Curry | from Thedefendersonline.com 66 Institute Takes Media Delegation to AIDS Conference By Glenn Ellis | from the Philadelphia Tribune 68 AIDS Conference Ends with Optimism By George E. Curry | from the Philadelphia Inquirer 70 Too Early to Declare Victory, but It’s About Hope By Phill Wilson 73 African/Black Diaspora Roadmap By the African and Black Diaspora Global Network on HIV and AIDS 82 About the Black AIDS Institute Black AIDS Institute Rights Here, Right Now 2010 3
Rights Here, Right Now Editor Rod McCullom Special Thanks Reporting for TheGrio.com Hilary Beard and Rod20.com Raniyah Abdus-Samad African and Black Editor-in-chief, Black AIDS Kali Villarosa Maggie Abrego Diaspora Global Network Weekly; former editor-in- Youth journalist, reporting for Regina Aragon on HIV and AIDS chief, National Medical the Women’s Media Center Robert Bailey, II Governing Council Association’s Healthy Living Linda Villarosa Charlie Baran Women’s Health in Women’s magazine and Real Health, a Former health editor, New Chris Bland Hands Smart+Strong publication York Times and managing Jeffrey S. Crowley, M.P.H. African Caribbean Council on editor Essence magazine, Christine Deshay HIV and AIDS in Ontario Participating reporting for the Washigton Carl W. Dieffenbach, Ph.D. Interagency Coalition on Journalists Post website TheRoot.com Kevin Fenton, M.D., Ph.D. AIDS and Development Helene D. Gayle, M.D., Black AIDS Institute Tomika Anderson M.P.H., African Services Committee Freelance health writer and Treatment Ambassador Eric Goosby, AIDES television producer reporting Advocates M.D. Light of Africa NRW e.V. for Heart & Soul Gary Bell Scott Hamilton Caribbean Vulnerable Angela Bronner Helm BEBASHI, Philadelphia, Pa. Kirsten Johnson Communities Senior/managing editor, AOL Sheila Johnson African HIV Policy Network Jeffrey Campbell Black Voices Susan Koch St. Hope Foundation, Ayana Byrd Howard Koh, M.P.H., M.D. Houston, Tex. Articles and sexual health and Jonathan Mermin, M.D., Mark Colomb M.P.H. relationships editor, Glamour My Brother’s Keeper, Jackson magazine Jesse Milan Jr., Esq. Miss. Gregorio Millett George E. Curry Natasha Moise Syndicated columnist and former editor-in-chief Emerge Photographers Deborah Parham-Hopson, Ph.D., M.S.P.H., R.N. magazine and the National Alice Tisdale Pierre Peyrot Newspaper Publisher’s Ann Ragland Sid Porter Association News Service Notisha Massaquoi Brenna Pye Glenn Ellis LeNee Richards Syndicated columnist, Online Andria Reta National Newspaper Production Giardy Ritz Publisher’s Association, Manager Gopi Shah columnist EURWeb.com Mitchell Warren Lynya Floyd Mondella Jones Joyce M. Zenon-Peters Senior editor, health and relationships at Time Inc.’s, Print Designer Essence magazine and Essence.com Alan Bell Ramon Johnson Gay lifestyle guide on About. com, a New York Times company Black AIDS Institute Rights Here, Right Now 2010 5
The Year of the Black By Phill Wilson In the weeks since the Black AIDS Institute’s delegation Phill Wilson of journalists, activists and people living with HIV/AIDS left the International AIDS Conference (IAC) in Vienna Austria, I’ve been sorting, filtering and putting into perspective our experiences and memories of the week. By the end of the conference we were exhausted, but we were also extremely inspired. I don’t think I was alone in wishing every Black person in America could have par- ticipated in this year’s IAC gathering. Many of the major findings and stories of this year’s conference were about Black people. It was, if you will “the Year of the Black.” A few days before the Blacks living in either urban and poverty in urban inner The purpose of this report is conference opened, President centers or poor Blacks in the cities have to ask the ques- to share with you as many of Obama released the first U.S. rural south. tion, “Who is poor in inner the highlights of the Vienna National HIV/AIDS Strategy. The first major story of city America?, and Who gets conference as the pages of The strategy explicitly calls the conference was about AIDS in inner city Ameri- this report will allow. for focusing on the most race, poverty and AIDS. To ca?” It’s not an accident that at-risk populations includ- make sure that this story was both groups of people are A good ing Black Americans, men characterized and contexu- overwhelmingly Black. beginning who have sex with men and alized in an accurate way, a The third and most people living in the south delegation of Black journal- moving experience of this Even before the confer- and north east. From our ists met with a representa- conference is the story about ence began, we learned about point of view all three of tive of the CDC to provide microbicides. This story is new breakthroughs that these vulnerable populations a Black perspective on this important for women, and might help in the develop- are disproportionately Black. study. In the United States, it’s particularly important ment of an HIV/AIDS vac- The epidemic among gay and at least, you cannot disen- for Black women across the cine. Researchers identified bisexual men is dispropor- gage poverty from race. Not Disapora and in Africa. three antibodies that when tionately Black, with young only are they of a whole The majority of the women combined provide protection Black gay men at particu- cloth, they are causal, in impacted by HIV are Black against 99 percent of strands larly high risk. Likewise, fact, while Black people do women. The fact that this of the virus, and the primary the epidemics in the south not come close to making a extremely elegant clinical antibody was found in a and northeast are primar- majority of poor people in trial and presentation were Black man. ily driven by high rates of America. Studies about race performed completely by 6 Rights Here, Right Now 2010 Black AIDS Institute
South Africans exposes the ference. In our small way, the journalists, activists, youth, lie and the stereotype that report attempts to chronicle and people living with HIV/ Africa can’t deliver quality the role of the CDC (in- AIDS that lost sleep and t- science. That was a wonder- cluding conversations and cells to bring you this report, ful experience. presentations by Dr. Kevin I hope you find it interesting, The fourth leading story Fenton and Dr. John Mer- inspiring, but most impor- of the conference was PrEP, man), NIAID, HRSA, and tant, I hope it helps you be Pre-Exposure Prophylaxis. U.S.-based community- better at doing your work. PrEP involves using a bio- based organizations as well We look forward to receiv- logical barrier in people who as looking at what the phar- ing feedback from you and are HIV-negative to prevent maceutical industry is doing. working with you on future HIV transmission. PrEP is There are stories about Black projects. Until then, please most likely to be a strategy leadership from the Honor- take care of yourself and employed in populations able Barbara Lee, Dr. Helene your blessings. where there are dispropor- Gayle (the Chair of the tionately high rates of HIV President’s Advisory Council Yours in the struggle, infection like Black America, on HIV/AIDS), Jeff Crowley the Caribbean and sub- (director of the White House Saharan Africa. office of National AIDS The next time this body Policy), and philanthropist, Phill Wilson gathers will be in Washing- Sheila Johnson. President and CEO ton, D.C. There’s no way that Black AIDS Institute conference cannot focus special thanks primarily on Black people. So the road to AIDS2012 in We want to thank our Washington D.C. has already partners in this effort, from begun. the community-based orga- nizations we worked with importance to like BEBASHI, My Brother’s black america Keeper, and the St. Hope Foundation, to corporate These are just a few of partners, Merck, EMD Se- the stories from the XVIII rono and Tibotec. International AIDS Confer- We are at a crossroads ence included in this report. now: a lot of the tools neces- We’ve attempted to include sary to end the AIDS epi- stories that would be of par- demic are in place. It’s up to ticular importance to Black us to pick up those tools and America from the activities to use them efficiently, effec- presented by the African, tively and compassionately Black Diaspora Global to bring about the end of the Network to the U.S. govern- AIDS epidemic in our com- ment’s delegation to the con- munities. On behalf of the Black AIDS Institute Rights Here, Right Now 2010 7
Finding Our Voices, Claiming Our Power By Hilary Beard When I was asked to lead from relationships, families a friend who attended the her children—a lineage that the Black AIDS Institute’s and communities in devas- session where the researchers would, in time, include me. Black media delegation to tating numbers—wreaking had announced their results. I knew that, if necessary, I the 2010 International AIDS havoc upon millions and “I don’t know,” he replied, would leverage this heritage. Conference in Vienna in costing America dearly, a “I wanted to ask but was The question would be asked July, I assumed that I would price that it doesn’t acknowl- chicken shit.” in the press conference that work in the background as edge it pays. afternoon. an editor often does. I would I wanted to know how Feeling But how does a Black assemble the team, research, this microbicide would play, “No Ways Tired” woman pose such an indis- plan, assign, edit, and coach not just in Peoria (or Preto- creet query in the presence writers as they penned their ria, for that matter), but in We both knew that lives of men whom she does not pieces, and if lucky, I would Black Philadelphia—Penn- lay in the balance. If wom- know and a media that con- attend a few sessions and sylvania and Mississippi. en—and hopefully, men— sistently exploits her likeness perhaps even write a little. Would women use it under are one day to use such a gel, and refuses to see beyond Our journalist team would real-world conditions, in their partner cannot detect it Black women’s body parts? be out front, researching and which they may fear not only nor can it interfere with the Might asking dishonor me, reporting on issues impor- losing love, but jeopardiz- sexual experience. Someone my race or my ancestors tant to Black people world- ing their economic stability, needed to inquire what the whose bravery had forged wide, particularly Black placing their children in gel tasted like, whether feel- my pathway into that room? Americans. harm’s way, experiencing ing timid or not. The South Could my honest question But on Day Two the verbal, emotional or physical African principal investiga- be distorted into a shameful, groundbreaking CAPRISA abuse, and or experiencing tors were not faint-hearted but all-too-common, image: microbicide research (see less of such a basic human and had not backed down Black woman hyper-sexual- pages 14, 16, 20, 52 and pleasure in their (often an- despite failing on seven ized? And what would Jesus 55) captured my attention. guishing) lives? previous attempts. The Black do? Women the world over I, too, have experienced South African female clini- struggle to protect them- such trepidation—in my case cal trial volunteers hadn’t Serving selves from HIV/AIDS, in worrying that my persistence chickened out, but rather the World part because of unequal about using condoms might had risked the well-being of gender dynamics and demo- strain a romance, but noth- their most intimate selves in During the press confer- graphics; greater authority ing more severe than that. I an effort to end AIDS’ dev- ence the taste question hung often rests in men’s hands, am well educated, provide astation. My parents hadn’t in the air—no journalist increasing women’s infection well for myself, don’t have wavered after deciding that asked the obvious. I sum- risk. Many African Ameri- children to worry about and our family would integrate moned the courage to pose can women experience this have never been abused. our neighborhood despite it myself, but a Black woman reality, as they seek to love, Such privilege demands neighbors’ threats to burn can’t just walk up to a mic bear children and build that I advocate for others. down our home. My great- and say, “How does the mi- families in communities Both the Bible and African great-grandmother, enslaved crobicide taste?” Or can she? decimated by our govern- proverbs guide me: To whom in Georgia, had fearlessly I asked my friend and men- ment’s “war on drugs” and much is given, much is chopped off her own big toe, tor Linda Villarosa, whose its consequent criminaliza- required. undercutting her market pedigree includes Essence tion of Black males, whose “What does the micro- value after hearing that she magazine and the New York incarceration wrenches men bicide taste like?” I asked would be sold away from Times, for advice. She sug- 8 Rights Here, Right Now 2010 Black AIDS Institute
gested asking the researchers notepads and pens, a sea of African television cam- than we’ve been before; to describe the gel’s proper- (mostly) white faces lined up eraman told me that my we must locate our most ties. Perfect! several rows deep. question was brilliant—a powerful voice. Black people, My turn. “Last question; Then I witnessed right-brain question in a left- in particular, must start quick question; quick an- something remarkable: brained room. Perhaps. Yet expressing the previously swer,” the moderator said. Black women, followed by I had merely asked what any unspeakable, communicat- As I deep-breathed the several white men, shoved woman who might use the ing about subjects we’ve voice in my head recited their way through the gel would want to know. The never discussed before and the Marianne Williamson reporters to sample the gel fact that I needed to pose the advocating for ourselves, our line that I’d memorized for themselves. Stunned question at all underscored loved ones and our commu- years earlier (and often and now humbled by what the importance of my pres- nities. We each must find the erroneously attributed to their determination implied, ence in that room and of our courage to ask: Nelson Mandela’s inaugu- I placed a small blob into delegation’s vital role at the m Is this a monogamous ral address): Your playing several hands then displayed conference. relationship? small doesn’t serve the world. my microbicide-filled palm Of course, I was not the m Do you know your There’s nothing enlightened to the cameras. only Black journalist who HIV status? about shrinking… brandished a braver voice m When can I see your “Can you characterize Brilliant that week. Each member of HIV-test results? the nature of the gel for me, or Basic? our delegation became pro- m Why don’t we use a please? What does it look gressively powerful. Wheth- condom? like? What does it smell But my ancestors er refuting mainstream m Father, mother, uncle, like? What’s the touch-feel? warned me not to sample media claims that poverty, auntie, sister, brother, have How does it taste? Take me the gel. “Your job is done,” rather than race, drives the you spoken explicitly to your through the five senses,” I they whispered. I left the U.S. epidemic, demanding son, daughter, friend, loved said. on-camera taste-testing to the same advance access to one about the steps they Then principal co-inves- somebody else. With the experts that mainstream must take to avoid becom- tigator, epidemiologist Dr. media’s attention elsewhere, outlets obtain, or represent- ing infected—and are you Quarraisha Abdool Karim, I examined the microbicide ing underserved people engaging in those behaviors startled me by inviting me to discreetly: it is clear, odor- by voicing their interests, as well? the dais to see for myself. A less, the consistency of KY we asserted ourselves as m Leader, what actions panelist passed the applica- jelly and has a slightly saline, analysts and advocates for are you taking to help end tor to me and I squirted a body-like flavor. A woman Black people throughout the this epidemic? dollop of gel into my hand. could use it without her Diaspora. If my Vienna experience When I looked up I found partner knowing. (It has not The international AIDS taught me anything, it taught myself encircled by TV yet been tested for men.) community took note. me this: As our community cameras, digital cameras, Afterward a white South People inquired who we finds its collective voice, the were and why we had come, world will treat us with the Hilary Beard considered our perspec- respect we deserve. We will tives, honored our concerns, end this curse upon Black granted late-night interviews communities. In the process and even admitted being our offspring will witness unable to address all of our our courage, empowering queries because they’d never them to conquer the plights considered questions like they will face during their them before. Opened eyes lifetimes. At that point and honest dialogues proved people like me will step from that we’d earned universal the spotlight and return to respect. the background. But not until then. Untying Still adjusting to the Our Tongues limelight, Whether overseas or in the United States, publi- cally or in our bedrooms, the AIDS epidemic requires us Hilary Beard to step beyond our comfort Editor-in-Chief zones. We must be braver Black AIDS Weekly Black AIDS Institute Rights Here, Right Now 2010 9
disparities AIDS is a Black—and Poor— Disease CDC Report Demonstrates Link between Poverty and HIV risk, and a Widespread HIV Epidemic in America’s Inner Cities By George E. Curry | from BlackPressUSA.com Phill Wilson, president and HIV/AIDS, Viral Hepatitis, overall have disproportion- Jonathan Mermin, direc- CEO of the Black AIDS In- STD and TB Prevention, said ately high HIV- infection tor of the CDC’s Division stitute, has good reasons for in a statement. “In this coun- rates, there was no sig- on HIV/AIDS Prevention, describing AIDS as a Black try, HIV clearly strikes at the nificant racial or ethnic gap stated, “There is nothing disease. Although Blacks economically disadvantaged among heterosexuals living biological that has caused are 12.8 percent of the U.S. in a devastating way.” in poor urban neighbor- African Americans to have population, they represent 45 hoods. such a disproportionate rate percent of all people infected first time study “Within the low income of HIV infection. It’s the so- each year with HIV, the urban areas included in the cial, it’s the economic, it’s the virus that causes AIDS. The CDC findings were study, individuals living epidemilogical environment Black women represent 66 released here at the biennial below the poverty line were in which people live.” percent of all new HIV cases international AIDS Confer- at greater risk for HIV than He added, “There are each year among women. ence. The study, conducted those living above it (2.4 per- multiple factors associated A study conducted in five in 2006 and 2007, included cent prevalences vs. 1.2 per- with HIV infection in the major cities found that 46 more than 9,000 hetero- cent), though prevalence for United States. percent of gay and bisexual sexual adults aged 18 to 58, both groups was far higher One of the main factors Black men have contracted about 77 percent of whom than the national average is race. In addition, even HIV, compared to 21 percent were Black. Specific census (0.45 percent),” the CDC among African Americans, of similar white men, and tracts in 25 communities said in a statement. “There poverty is also a risk factor, although Black teenagers with a poverty rate of at least were no significant differ- as it is with others.” are only 15 percent of the 20 percent were selected to ences in HIV prevalence by According to the Na- U.S. teen population, they be studied. The CDC report race or ethnicity in these low tional Poverty Center at the account for 68 percent of combined data from census income urban areas: preva- University of Michigan, 24.7 all new AIDS cases among tracts in 23 of the 25 cities, lence was 2.1 percent among percent of Blacks lived below teens. including Atlanta, Wash- Blacks, 2.1 percent among the poverty line in 2008, In what it calls the first ington, D.C., Newark, St. Hispanics, and 1.7 percent compared to 23.2 percent federal study of its kind, the Louis, New Orleans, Dallas, among whites. of Hispanics, 8.6 percent of Centers for Disease Control Detroit, Philadelphia, Los “By contrast, the U.S. non-Hispanic whites and and Prevention has now Angeles and Seattle. It did epidemic overall is char- 11.8 percent of Asians. Pov- added poverty as another not provide data on the indi- acterized by severe racial/ erty was defined in 2007 as factor—at least for hetero- vidual cities. ethnic disparities: the HIV an individual with an annual sexuals living in poor, urban Although the CDC has prevalence rates for Blacks is income of approximately communities in the United conducted major studies on almost 8 times that of whites, $10,000 or less. States—likely to increase the HIV prevalence rates among and the HIV prevalence rate “What’s surprising about risk of becoming infected gay and bisexual men as among Hispanics is nearly 3 these results is that if you with HIV. well as drug users, this is the times that of whites.” are living in these areas and “The study reveals a first time it has conducted your household income is powerful link between a separate study on hetero- risk factors less than $10,000 a year, poverty and HIV risk, and sexuals living in poor urban you’re seven times more a widespread HIV epidemic communities. In an interview with a likely to have HIV than if in America’s inner cities,” Researchers were group of African American you’re in these areas and Dr. Kevin Fenton, director of surprised to discover that reporters assembled by the your household income is CDC’s National Center for although African Americans Black AIDS Institute, Dr. greater than $50,000 a year,” 10 Rights Here, Right Now 2010 Black AIDS Institute
Kevin Fenton Black AIDS Institute Rights Here, Right Now 2010 11
said Mermin, whose depart- ment supervised the study. Phill Wilson of the Black Q&A with AIDS Institute looked at Kevin Fenton the numbers from another The Centers for Disease Control and and Hispanic, which is equal to if you’re perspective. Prevention released a study of over 9,000 poor and white. He said, “The study tells heterosexual adults living in high-poverty us that when other racial and areas of 23 cities nationwide. One of the Seventy-seven percent of the ethnic groups face the same findings: HIV prevalence rates in urban people in the study were Black and social determinants of health poverty areas did not differ significantly by only four percent were Caucasian. as Blacks—the social and race or ethnicity. Were you at all concerned about economic conditions within We asked Kevin Fenton, M.D., Ph.D., comparing such a small group of which they live and that im- director of CDC’s National Center for Caucasians to such a large group of pact their well-being—their HIV/AIDS, Viral Hepatitis, STD, and TB Blacks? HIV rates rise to similar Prevention, to give us some insight into No, because it reflects the reality of levels as those of Blacks, what the study means. inner city life in the United States. And even for whites whose rate statistically we have enough in each cell to of infection is normally sub- Bottom line: Is the study saying do the comparison. stantially lower than rates for that the high rates of HIV in African both Blacks and Latinos.” Americans are due to poverty, not Are there assumptions about why The link between poverty race? poverty is driving HIV? and HIV is an intriguing one No. A better bottom line would be We’re working the causal pathways. If that raises critical questions that poverty is a factor which is driving you’re poor, you may have to participate in about access to health care, the high rates of HIV that we’re seeing in transactional sex [selling sex] to survive. the socio-economic standing African Americans and other minorities We know that in poor parts of the country of sexual partners and the in our inner cities. We know there are we not only see high rates of HIV but also impact one’s environment individual factors: for example, high rates high rates of STDs and those are co-factors has on contracting the virus. of unsafe sex, injection drug use, having for HIV. Poor areas also have high rates of CDC officials acknowl- multiple concurrent partners, high STD injection drug use and other types of risk edge that additional research rates. We know there are health system behaviors. Poverty is also related to qual- needs to be conducted now factors, for example, poor access to quality ity, location and access to health services. that a direct link has been services. And then social determinants of In poor parts of many cities, community clearly established between health drive vulnerability to the epidemic, health centers, quality of private doctors poverty and HIV. including poverty, cultural factors, are all going to be factored into increasing “Why is poverty associat- racism, discrimination, poor education. vulnerability to HIV. ed with HIV infection among This study confirms that poverty is a African Americans and even strong determinant of HIV rate and risk, I know the results can’t be more so, perhaps, among particularly in the inner cities of the U.S. generalized to non-urban poverty white Americans and Latino areas, but is that something you Americans?” Mermin asked, Is the implication that wealth may might look into later? Other socio- rhetorically. “That’s some- protect you from HIV? economic strata? thing we need to look at.” Not necessarily. In fact, in the very early Absolutely. This is one of the things we’re days of the epidemic, wealth was a risk committed to looking into at the CDC. We George E. Curry is a former factor for HIV because with wealth you have a very good handle on those individual Washington correspondent and New York bureau chief were able to travel, you were able to move level determinants I mentioned earlier. for the Chicago Tribune between cities that had high incidence of We have a less good handle on the social and was editor-in-chief of HIV, or you may have had resources to determinants of health. So, for example: Emerge magazine. participate in risky activities, for example, How is poor education attainment driving purchasing sex. In some societies, wealth the epidemic in the U.S.? How are high rates may be associated with having multiple of incarceration driving the epidemic in Af- concurrent partners. You have more money, rican Americans. This [poverty] study is one so you’re more socially desirable. of a series of studies we’re doing at CDC. But clearly what this study is saying —Lynya Floyd specifically in the U.S. context is we can show that poverty is an equalizer in these Lynya Floyd is the senior editor cover- inner city areas. If you’re poor and Black, ing Health and Relationships at Essence magazine. your rate of HIV is equal to if you’re poor 12 Rights Here, Right Now 2010 Black AIDS Institute
policy What Will HIV Look Like in 2015? Plans Call for Reduction in New Infections, Decrease in PWAs Who Don’t Know It, Increase in Speedy Care for Newly Diagnosed By Lynya Floyd | from Essence.com What a difference five years educates and supports HIV+ can make. Or can it? Last women and their caregivers. Barbara Lee week, President Barack In the past, the govern- Obama unveiled the U.S.’s ment has received significant first National HIV/AIDS criticism for not putting Strategy, which plans to sig- forth a plan to combat a dis- nificantly lessen the impact ease epidemic that infects 1.1 of the epidemic in America million Americans. “But this by 2015. And they’re not is the first win in a series of vague about what success challenges we have before us. would look like when it There’s a real opportunity for comes to a disease that’s the us to expand and see things number one killer of Black happen in a way they haven’t women 25 to 34. before,” she added. In just five years time, the strategy plans to: reduce creating the annual number of new accountability HIV infections by 25 percent Leadership Commission on istration. “If we are negative from 56,300 to 42,225. The White House was AIDS (www.nblca.org). “We we can protect ourselves by Another goal: Decrease clear that this isn’t just a must go into areas where we practicing safe sex. We can the number of people living federal government initia- find larger segments of Black be the example for our sons, with HIV who don’t know tive. It’s going to take efforts women such as our sorori- daughters, nieces and neph- it from 21 percent to 10 from local governments and ties, our civic organizations, ews. We can talk to them so percent. communities. And, let’s be the National Coalition of 100 they know the things they A third: Increase the pro- honest, you. What can you Black Women, The Links. can do to stay negative.” portion of newly-diagnosed personally do to make the They have conferences every patients linked to clinical five-year-goal a reality? year. It’s up to us to get the Lynya Floyd is the senior editor covering Health and care within three months “Demand that your con- information out there. En- Relationships at Essence of their diagnosis from 65 gressmenbers hold up this courage people to get tested magazine. percent to 85 percent. And strategy,” suggests congresss- and be involved on many that’s not even half of all the woman Barbara Lee (D-CA) levels.” goals that have been set. who has attended the last “We Black women are At the 2010 International six international HIV/AIDS often the central figure in AIDS Conference in Vienna, Conference, including this our families. We can set several key leaders in the one in Vienna. “Hold them the example by getting HIV/AIDS community gath- accountable at the ballot tested and knowing our HIV ered to discuss the national box.” status,” suggests Deborah strategy. “This is a bit of a “We need to take ad- Parham-Hopson, Ph.D., poker game and the feds vantage of opportunities to R.N., associate administra- have anted up,” noted Dawn educate and inform Black tor for HIV/AIDS in the U.S. Averitt Bridge, founder of women,” suggests C. Vir- Department of Health and The Well Project, a not-for- ginia Fields, President and Human Services’ Health Re- profit corporation which CEO of the National Black sources and Services Admin- Black AIDS Institute Rights Here, Right Now 2010 13
women Topical Medication Makes HIV History Breakthrough Microbicide Research Paves Way for Female-Controlled HIV Protection By Linda Villarosa In a groundbreaking study, few effective interventions S. Abdool Karim, director Dr. Quarraisha Abdool a gel made using an anti- targeting women of color. of the Centre for the AIDS Karim explains that the retroviral drug was found Ideally it will stem the tide of Programme of Research in research grew out of frus- to be effective in reducing a increased infections.” South Africa (CAPRISA), tration at not being able to woman’s risk of becoming located in Durban. He and offer protection to women infected with HIV. This is A major coup his wife spoke to a small del- who would come into clinics the first time in history that egation of Black journalists where she worked in South this kind of topical medica- The study of 889 unin- who had traveled to Vienna. Africa. “When they asked tion, known as a microbi- fected Black women aged The two researchers of color us what can we do to protect cide, has worked, despite 18 to 40 in rural and urban provided this exclusive ac- ourselves, we had nothing to many earlier trials. The KwaZulu-Natal, South cess to assure that African offer them,” she said. “Absti- research broke yesterday Africa, found that the gel Americans got the full story nence? They were married or at the International AIDS containing the HIV drug te- the night before the couple in a stable relationships—no. Conference in Vienna and nofovir (currently prescribed presented their results to Behavior change? They were is widely believed to be the in pill form under the trade the full conference. When faithful, but not sure about biggest news that will come name Viread) cut infections the scientists unveiled their their partners’ faithfulness. out of the 6-day event. by 39 percent. Among the findings, thousands listened. Condoms? Men don’t want Though the results will women who used it con- Even the overflow room was to wear condoms, and at the need to be confirmed and a sistently and correctly, the full, as participants crowded time there was no female product won’t hit the market results were even better: 54 around screens in the hall, condom. for at least a few years, this percent effectiveness. Either applauding as Drs. Abdool “So today, although we news marks a major stride way you look at it, in the Karim spoke. don’t have the microbicide,” for women around the world, science world these numbers she continued, “the results particularly in Africa and in signal a major coup. hope for women signal hope for women that African American com- The researchers also they will have something munities. It will finally offer noted that genital herpes This kind of break- that is 39 percent more effec- a female-controlled way for risk dropped by 51 per- through is urgently needed. tive than nothing.” women to protect themselves cent, which was a surprise. In sub-Saharan Africa, in the sexual arena, where Actually, said epidemiologist where the epidemic is most a long time men, too often, call all the Salim S. Abdool Karim, Ph. dramatic and deadly, 22.4 coming shots. D., who with his wife, Quar- million are living with HIV “This becomes a self raisha, also an epidemiolo- and every year millions In the United States, the empowerment resource gist, led the study team, the more become newly infected. disease continues to ravage for Black women, who are results were a surprise. Seven Women account for almost African Americans. A num- disproportionately impacted of their previous trials over two-thirds of those living ber of communities have among all women with many years, he explained, with HIV in the region, and rates of infection as high or HIV,” says C. Virginia Fields, had failed. young women, often poor higher than in some African president and CEO of the “When we sat down at and powerless, bear the countries. Black men and National Black Leadership the table to finally see the re- brunt of the epidemic. South women represent only 13 Commission on AIDS. “This sults, it hit us—this works— Africa, where the study took percent of the population, would provide a much-need- and we were stunned. In fact, place, has more people living but account for almost 50 ed tool in our arsenal against we didn’t say anything for a with HIV than any country percent of people living with HIV, given that there are so full minute,” said Dr. Salim in the world. HIV and just about half of 14 Rights Here, Right Now 2010 Black AIDS Institute
Quarraisha and Salim Abdool Karim Black AIDS Institute Rights Here, Right Now 2010 15
Q&A with Salim and Quarraisha Abdool Karim The Black AIDS Institute conducted an change in the face of the epidemic [in the exclusive interview with the scientists at the U.S.], where women feature much more International AIDS Conference to discuss than they did about a decade ago. their exciting new findings and to find out Salim: We all recognize and understand what the results mean for Black women the importance of women—in particular, worldwide. young women—bearing the brunt of the HIV epidemic in Africa. Tenofovir gel Why is this new gel so significant? potentially adds a new approach to HIV Salim: Once confirmed and prevention, as the first that can be used and implemented, tenofovir gel has the controlled by women. It can help empower potential to alter the course of the HIV women and help them take control of their epidemic. By our estimates, we could bodies to help protect against their risks of prevent 1.3 million new HIV infections and HIV infection. more than 800,000 deaths over the next 20 years in South Africa alone. Who participated in the study? Salim: All the women are Black. How long did it take for you to We recruited from two clinics in create it? predominantly Zulu-speaking communities Salim: It took eight trials. [When we in rural and urban areas near Durban. finally saw our results,] there was a bit of Quarraisha: The age range we were disbelief because we’d been battered by screening was 18 to 40 years. The mean repeated studies that had just not shown age was 23.2 years old. The majority of the anything. It’s been a hard road. You have women over 25 were already infected by to have a certain level of doggedness to stay HIV. in a field where you take knocks every time you do a study and it doesn’t work. You Is it safe to use? begin to question the wisdom of why you’re Salim: Our findings show no substantial even doing this. safety concerns, although there have been some reports of minor diarrhea. There is How effective is the gel? [virtually] no tenofovir resistance and we Salim: Our study shows a 39 percent found it is safe for Hepatitis-B infected protection against HIV overall and 50 women. The 51 babies born during the percent protection from HIV after one study had no congenital abnormalities. year of tenofovir gel use. In women with a high adherence, it shows 54 percent What’s next in this process, and effectiveness. And it also shows a 51 percent how long do you think it will take reduction in HSV-2, otherwise known as for the gel to come to market? genital herpes. Salim: Additional studies are urgently Quarraisha: One in five sexually active needed to confirm and indeed to extend people globally have HSV-2, and if you have the findings of this study for safety and HSV-2 you have double the risk of getting effectiveness, so this study is the first step. HIV. But I would be disappointed if it were not available to women three years from now. What do your findings mean for —Tomika Anderson Black women throughout Africa and the United States? Tomika Anderson is a freelance writer Quarraisha: We used a slide [in our based in Brooklyn, New York. Her work has appeared in Essence, POZ, Real Health and presentation] that shows the distribution Ebony magazines, among others. of HIV infection in the U.S. in 1985, and then in 2006. It shows how heterosexual transmission has increased from 3 percent to 31 percent [of infections among Black American women]. So we’ve seen a big 16 Rights Here, Right Now 2010 Black AIDS Institute
new infections. Sixty-four ton, where the HIV rate is Deserve. “We must continue “In the scientific commu- percent of all women living highest in America. to recommend condoms for nity, we need to think about with HIV/AIDS are Black “This is a major break- protection against HIV. what it is going to take for and the diagnosis rate is 19 through in addressing an “I think this will be most all of us to work together to times higher than it is for unmet need for women—a useful for married women make this a reality,” he said. white women. A government female-controlled HIV and who feel that they can’t use a “I would be disappointed study released in March STD prevention method. condom, but might be suspi- if we were not able to make found that 50 percent of If this vaginal gel proves cious and want that bit of a microbicide tenofovir gel Black women have genital to be safe, available and af- protection without demand- available in three years.” herpes. fordable, we may finally be ing condom use,” Dr. Hutch- In the meantime, in The vast majority of closer to shifting the power erson added. “However, I Vienna, conference attendees African American women dynamics that have fueled would personally demand are buzzing with the news, contract both herpes and the HIV epidemic and, more the condom if I thought my scientists and advocates HIV during heterosexual importantly, closer to saving husband was cheating.” alike. sex, most often from men women’s lives.” It’s important to re- “The microbicide trial they are married to or at Participants in the member that most Black results are fantastic. Women least seriously involved study were sexually active women in the U.S. with deserve a win,” says Ebony, a with. This point strikes at and applied the gel both 12 HIV contracted it from men young HIV-positive African the heart of why a woman- hours before and 12 hours who didn’t know they were American woman living in controlled form of protection after sexual relations. It is infected with the virus. One Amsterdam and attending is so important. inserted into the vagina in five Americans aren’t the conference as an activist. “This lets women take using a plastic applicator. aware of their HIV status, “A microbicide gives women control of their own sexual Half of the women used and Blacks are believed to be choice and control; however, health, instead of depending a product that contained less likely to know. A woman the work can’t end there. We on husbands and boyfriends the drug, while the other who has no idea her partner still need the female con- to protect them,” says Van- half received a placebo gel is positive wouldn’t have dom and male condoms to essa Johnson, deputy execu- with no medication added. reason to use the gel. prevent unwanted pregnan- tive director of the National Sixty of the 444 women who Though the study cies and other STIs and a Association of People with used the placebo contracted pointed to the gel’s safety, non-antiviral microbicide AIDS. HIV, compared to 38 of the it’s best to keep expecta- that can meet the needs of “It also potentially gives 445 women who used the tions in check until more is women living with HIV.” women living with HIV/ gel containing tenofovir known, urges Gail E. Wyatt, AIDS a valuable means of became infected. The area Ph.D., a UCLA professor of Linda Villarosa directs the not transmitting their HIV where the study participants psychiatry and biobehav- journalism program at City College in New York. She to others,” continues Ms. come from is considered the ioral sciences and associate has covered the Interna- Johnson, who contracted “epicenter of South Africa’s director of the UCLA AIDS tional AIDS Conference five HIV from a former boy- explosive HIV epidemic,” Institute. “If confirmed, the times. friend and has been living where women engage in microbicide has potential to with HIV for 20 years. “We infrequent but very high-risk save women’s lives, but the have high hopes.” Experts sex with migrant men. research needs to be careful- aren’t sure whether this ly read and understood,” said product protects against keeping Dr. Wyatt, also author with either female to male or anal expectations her husband of the book No transmission of HIV. This in check More Clueless Sex. “The ef- study didn’t look at either. ficacy of the trial is promis- It’s a long time com- Despite the promising re- ing, but the study also needs ing, said Eleanor Hinton sults, experts advise women to be replicated in America Hoytt, president and CEO of to celebrate, but cautiously. before passing judgment.” the Black Women’s Health “This is great news, but it is Dr. Abdool Karim says Imperative. “Since the mid- not 100 percent effective,” he’ll also feel more confident 1990’s when the promise of said Dr. Hilda Hutcher- once the results are repeated. microbicides was first intro- son, a clinical professor Another project called the duced, we have watched HIV of obstetrics and gynecol- VOICE study is currently infection rates skyrocket ogy at Columbia University looking at 5,000 African among women worldwide,” and author of a number of women, comparing a gel said Ms. Hinton Hoytt, books, including Pleasure: compound with HIV medi- whose nonprofit organiza- A Woman’s Guide to Getting cation in pill form. Findings tion is located in Washing- the Sex You Want, Need and are expected in 2013. Black AIDS Institute Rights Here, Right Now 2010 17
Stigma Prejudice Remains Obstacle in Epidemic Global Health Leaders Say Criminalization Exacerbates HIV Epidemic Among Black Gay, Bisexual, Other MSM By Rod McCullom From pre-conference events Gustave Nana, executive di- A Runaway involved in the violence,” to the massive human rights rector of the Johannesburg, Epidemic he said, referring to a march through downtown South Africa-based African now-infamous incident of Vienna, world leaders, public Men for Sexual Health and “The stigma, discrimina- a 2,000-strong mob sur- health experts and HIV Rights (ASMSHer). The West tory laws and criminaliza- rounding several gay men activists honed in with laser- African laws vary in extrem- tion of HIV transmission and stoning them. The police like precision on a com- ity—just “exposing a person encourage the spread of this were called to the scene and mon message at The XVIII to HIV, regardless of if the disease,” adds Nana. “Why the officers also struck the International AIDS Confer- virus is transmitted, is a should someone seeking young men. ence in Vienna : The ongoing crime in Benin, and Tanza- testing or medical advice Carr sighs. “With Jamai- persecution and criminal- nian law carries a possible come forward if you could be can MSM infection rates at ization of gay, bisexual and sentence of life in prison for arrested? There is no incen- 32 or 33 percent, it became other men who have sex with intentional transmission,” tive.” obvious that you couldn’t do men—MSM, in public health reports Medical News Today. The fear of “coming out,” effective HIV work in this shorthand—is undermining While the overall life for pop culture which celebrates context.” efforts to control the global Black MSM may be better homophobia and churches Although a state spon- HIV/AIDS pandemic. in North America, there and churchgoers that sored, religious–based Chief among the obstacles: are drawbacks. The United demonize gay Black men terror campaign has targeted More than 80 nations have States and Canada lead the compound the problem for African MSM from Algeria laws that still criminal- world when it comes to pros- Black MSM in America, the to Zimbabwe, there are some ize same sex behavior. In ecuting people who infect Caribbean and Africa. positive developments to some of these countries, or expose others to HIV, a “This is the context in report from AIDS 2010. conviction can even result surprising new study reveals. which you have a runaway, “We now have 14 coun- in the death penalty, reports Black men have been dispro- dangerous HIV epidemic in tries out of 54 that include UNAIDS. portionately targeted with Jamaica,” adds Dr. Robert men who have sex with these prosecutions. A Black, Carr, the co-chair of the men in their national HIV Pronounced gay, HIV-positive Michigan International Council of strategic plans,” AMSHer’s Across Africa man was recently charged AIDS Service Organizations Nana said. “It doesn’t mean Diaspora as a bioterrorist for allegedly (ICASO). “There is a clear the services will be delivered biting a neighbor’s lip during link between religious con- to those populations, but it is Further exacerbating the a scuffle, Black AIDS Weekly demnation, criminalization, an acknowledgment. That’s a problem, according to a re- reported in June. stigma and HIV infections. first step.” port by Planned Parenthood, “The prosecutions are We see this all the time in “Kenya was the first “58 countries have laws that arbitrary,” said Nana, in the Caribbean.” African nation to include criminalize HIV or use an interview after a press MSM in their national HIV existing laws to prosecute conference organized by Condemnation = strategy,” Nairobi-based people for transmitting the The Global Forum on MSM Death peer educator Job Akuno virus. Another 33 countries & HIV. The day before the told Black AIDS Weekly. are considering similar conference officially opened, Carr adds: “Politicians Akuno is a counselor with legislation.” the Global Forum held a and church leaders endorse the Nairobi-based SHAP, The trend is “even more 24-hour event to address the homophobic violence. Police Scaling Up HIV and AIDS pronounced” across Africa soaring global rates of MSM refuse to protect MSM or Prevention, partially funded and the Diaspora, said Joel seroconversions. are complicit or directly by PEPFAR, the President’s 18 Rights Here, Right Now 2010 Black AIDS Institute
disparities Poor Likeliest to Get HIV Blacks, Gays Likeliest to Be Poor By Ramon Johnson | from About.com Emergency Plan for AIDS Since the HIV epidemic be- tute at UCLA, poverty rates Relief. “That was in 2006. gan in 1983, many have been for LGBT adults are as high But...it seems like we are eager to label the HIV/AIDS or higher than rates for het- rolling back on some of the epidemic by who’s most af- erosexual adults. The think gains that we made.” fected, but the fact remains tank found that 24 percent of “Kenya is starting to look that HIV is a universal lesbians and bisexual women like one of the countries that problem that has devastating are poor compared to 15 per- we should look up to,” Nana effects on all communities. cent of gay men, strikingly adds. “The HIV movement is What’s of particular concern high numbers given the gay more open to include MSM. are the social-economic wealth misconception. And there is a strong MSM factors that make some com- movement in Kenya, too. It munities more vulnerable to Ramon Johnson is a new is one of the few countries HIV infection than others. media journalist and the gay lifestyle guide at About.com. in Africa where a MSM orga- The Centers for Disease He was named GLBT Person nization was able to place an Control released a poverty of the Year by GayAgenda in ad in the newspaper for the study at the XVIII Interna- 2008. About.com was se- International Day Against tional AIDS Conference ti- lected as ‘Best Gay Lifestyle Blog’ by BestGayBlogs.com. Homophobia on May 17.” tled “Communities in Crisis: Akuno says the HIV Is There a Generalized HIV Prevention and Control Act Epidemic in Impoverished criminalizes deliberate HIV Urban Areas of the United transmission. “The sentences States?” that examines the are up to 10 years. No one impact of poverty on HIV has been prosecuted, but infection rates. What they now there is talk to make the found is that in poorer com- law harsher. If you criminal- munities, incidence rates ize HIV transmission or only among whites and Hispanics target MSM, that will further are just as high as among stigmatize the disease and Blacks living in the same drive many people into community. Infection rates not wanting to know their among females and males results.” also matched. Job Akuno shrugs. “What This is the first time in can you do but hope for the the U.S. that HIV is being best?” looked at through the lens of poverty. According to the Rod McCullom, a writer and numbers, poorer people are television news producer, more likely to be infected blogs on Black gay, lesbian, bisexual and transgender with HIV. Previous studies news and pop culture at say Blacks are more likely to rod20.com. be poor. And, according to the 2009 LGBT Poverty Re- port by The Williams Insti- Black AIDS Institute Rights Here, Right Now 2010 19
science Progress Made in Vaccine Development Blacks Needed in Clinical Trials but Is Risk in Vaccine Studies False Positive Test Results? By Ramon Johnson Last week, U.S. government and Infectious Diseases at scientists announced their the National Institutes of discovery of three antibod- Health. “If we’re ever going ies in a man’s cells, includ- to get a cure for HIV,” Dr. ing one that neutralizes Fauci says, “we’re going to 91 percent of HIV strains. have to have a patient whose At the age of 60, this man, immune function has some known in scientific circles as degree of integrity.” Donor Donor 45, became one of the 45’s does. most important participants in HIV research. Donor 45 tricking is Black, gay and has been the body living with HIV for 20 years. and the test What makes him special in the field of HIV is not his But the contributions gender or race or sexual ori- of Donor 45 and other entation or age. He has a rare clinical-trial participants ability to produce antibodies don’t come without risk. that block HIV from invad- A study presented at the ing his cells. XVIII International AIDS As a clinical trial par- Conference by Lindsey R. ticipant, Donor 45’s identity Baden, M.D., of Brigham remains a mystery and the and Women’s Hospital and antibodies that he produces Harvard Medical School are under wraps. Most HIV- in Boston, found that the positive people like Donor test results of nearly half 45 are what scientists call Donor 45 of the trial volunteers she “elite controllers.” These men surveyed yielded false- and women, also known as positive results. This means “long-term survivors” or in this group. is unnecessary. Donor 45 that many trial participants “non-progressors,” naturally Scientists hope to bet- is of particular interest to who subsequently got maintain viral loads, the ter understand why elite vaccine researchers because, screened for HIV tested amount of HIV virus present controllers’ bodies produce unlike his fellow elites, his HIV-positive—only to in their blood, at levels so antibodies that other HIV- viral load remains high discover later that their low that the virus can’t be infected people’s bodies whereas their viral load is HIV-positive results were detected. Somehow their do not. Uncovering this typically low. Yet, even with wrong; they were in fact bodies stop HIV from repli- mystery offers another step a high viral load Donor 45’s HIV-negative. Besides the cating. They remain healthy toward what researchers call immune system is stable, traumatic emotional impact with undetectable loads for a “functional cure,” defined a fact which offers a build- an HIV diagnosis can long periods of time without as a life free from symptoms, ing block to developing an have, this vaccine-induced taking prescription drugs. where the disease does not HIV vaccine, says Anthony seropositivity/reactivity About 1 to 4 percent of HIV- progress and prolonged Fauci, M.D., director of the may cause the person who infected people are said to be antiretroviral treatment National Institute of Allergy receives an HIV-positive 20 Rights Here, Right Now 2010 Black AIDS Institute
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