Meningitis Outbreak – Should You Protect Yourself Prior to Major Events?

 Meningitis Outbreak – Should You Protect Yourself Prior to Major Events?

By now, most of you have seen the news stories regarding meningitis outbreaks that were initially isolated to New York but have now moved to Los Angeles. If we have learned nothing else from the early days of the AIDS plague, it should be that early response trumps a reactive-scramble to matters of public-health. It is not my intent to sound the alarm over meningitis however, it is something that needs to be watched quite carefully. With several major leather events, CLAW & IML on the horizon, attendees need to be fully informed regarding what it is and how they can protect themselves.

Meningitis is inflammation of the protective membranes covering the brain and spinal cord and the most common symptoms are headache, fever, neck stiffness, confusion, vomiting and an inability to tolerate light or loud noises. Meningitis is contracted through “close contact” not simple casual contact, examples of this would be: kissing, coughing, sneezing, sharing eating utensils, glasses, food or towels. Although meningitis is not transmitted exclusively through sexual intercourse, most of the above stated activities occur during sexual contact. It is for this reason that I urge anyone attending major leather events or parties such as CLAW or IML to consider getting vaccinated. There is considerable evidence which supports the idea that the LA patient was exposed during a White Party over Easter Weekend.

The New York City Health Department has suggested that gay men in New York “who regularly have intimate contact with other men through a website, digital application, or at a bar or party” might consider getting vaccinated. This simply means that this group is at higher risk for exposure to meningitis due to the activities that they are engaged in regularly.

Getting vaccinated as a precaution poses no risk to your health. It will take approximately 2 weeks from the initial date of vaccination for the full-benefits of the vaccination to be seen. Additionally individuals who are HIV positive may require a secondary booster to be fully protected. The meningitis vaccine will prevent invasive meningococcal disease from taking root but does not treat the disease if a person is already infected.

Should you get vaccinated against a deadly meningitis outbreak?

Update April 13, 2013: Concern is growing in Los Angeles after a gay 33  y.o. West Hollywood man contracted meningitis this week and quickly went in to a coma.  He felt ill on Monday, went to the emergency room on Wednesday, and by Thursday was in a coma.  He is now brain dead.  He reportedly recently attended the White Party in Palm Springs, though it’s not known if he contracted the disease there.

A 21 y.o. University of Wisconsin-Madison senior has also died of meningitis.  The article do not indicate if he was gay.

It is unknown if either of these cases are related to the outbreak in NYC.  For the details of this latest outbreak, how you contract meningitis, and whether you need to get vaccinated, read on.  Also, I got my vaccinated in early April, cost $165 at my doctor (doesn’t look like insurance will cover it), but a friend was able to get it for half that price on his college campus, so your mileage may vary (check local public health clinics etc.).  I had zero reaction to the vaccine – it’s a dead vaccine, not even a full virus, so no risk beyond any other vaccine.

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April 2, 2013 – I had a great talk yesterday with Dr. Thomas Clark, an epidemiologist and meningitis expert at the US Centers for Disease Control and Prevention (CDC). Our topic: the recent deadly meningitis outbreak among gay men in New York City.

As you may recall, we’ve been reporting on increasingly scary warnings out of New York that a particularly deadly variant of meningococcal disease (bacterial meningitis) was showing up in gay men in New York. The New York authorities are now recommending vaccinations for gay men in New York City who are either HIV-positive, or HIV-negative and non-monogamous. The vaccination warning also includes men in the two categories above who visited New York City at any time since September of 2012.

As I noted in my earlier post on this topic, the warnings from both New York City and New York State on this matter have been somewhat confusing, so I sought out an expert at the CDC, Dr. Clark, to explain what’s actually going on, and who really needs to get a shot.

Let me walk you through what I learned.

Who should get a meningitis shot?

Vaccine via Shutterstock

Anyone covered by the recommendations from NYC and NY state, if you can make sense of them.  But also, really, anyone who’s concerned enough about the outbreak.  I asked Dr. Clark if there was any downside to the vaccine, and he said no.  The vaccine carries no more risk than any other vaccine you might take.  And to further put one’s mind at ease, the meningitis vaccine does not contain a live bacteria, or even a dead one – it only contains part of the shell of the bacteria, so it’s impossible for it to give you meningitis.  Thus, Dr. Clarks’s recommendation, that if you’re worried at all, get the shot.

How is this variant of meningitis transmitted?

I was quite surprised about how the bacteria is transmitted.  As the NY warnings are targeted at gay men, and specifically at men who seek sex partners online, at a party, or at a bar, I just assumed that this was sexually transmitted.  It’s not.

The bacteria is transmitted through secretions of the mouth, nose and throat – large-sized droplets. What that means is the droplets are far too large to float in the air.  So it’s the kind of thing you’re more likely to get from French kissing, or having someone cough in your face or accidentally spit in your face while talking, or even sneezing – but regular aerosolized drops in sneezes won’t get you sicks, it’s the larger droplets that do it.  That’s why the warnings talked about “close contact.”  What they found was that people living together, even if they’re not in a romantic relationship, we’re at a “very high risk” of contracting the disease from each other.

Can meningitis be transmitted by sex? No, but…

Not only are the mouth, nose and throat instrumental for transmitting the bacteria, they’re also instrumental for receiving the bacteria.  So oral sex isn’t going to transmit it, so long as your mouth doesn’t come into contact with anyone else’s saliva – same goes for any other sex act, the key issue is your mouth (or nose) coming into contact with someone else’s saliva.  I was surprised about that, since I figured this would be transmitted similarly to an STD.  Not so, said Dr. Clark.  Even though the bacteria is a cousin of the bacteria that causes gonorrhea, while gonorrhea adapted to the genital tract as a venue of transmission, this bacteria adopted to the nose and throat.  It is also not, however, as easily spread as an STD.

You’re not at risk if you work with someone who gets sick

Because the bacteria requires prolonged face-to-face contact, simply working in an office alongside someone who came down with meningitis would not put you at risk, Dr. Clark told me.

Are people with HIV more likely to contract meningitis?

This one is tricky.  What they’ve found is that being HIV-positive does not per se put you at risk of catching this variant of meningitis, as being HIV-positive can for other infections.  So it’s not really a question of having a depressed immune system and thus being more likely to get the disease.  But, they’ve found some kind of correlation between being HIV-positive and becoming infected during this outbreak: Many of those infected are HIV-positive, but not all.

It could be something as simple as HIV-positive people in New York generally having sex with other HIV-positive people in that same community.  Thus, if someone becomes infected in that community, he is more likely to pass it to other members of that community.  So the bacteria stays within the HIV-positive community because it’s a discrete community, not because HIV makes you more prone to catch it.   That isn’t necessarily the reason HIV-positive people in NYC are coming down with this disease, but it is an example of how HIV doesn’t put you at risk of catching the disease, yet your HIV status could still be relevant to whether you’re at a heightened risk.

Will the meningitis vaccine help after you’re exposed? No.

If your doctor thinks you’ve been exposed, or you’re already showing symptoms, they will prescribe antibiotics.  The vaccine is only good before you’re exposed.

How quickly does the vaccine work, how long does it last?

The meningitis vaccine takes two weeks to fully kick in, and should protect you for three to five years.  People with HIV may not respond as well to the vaccine, so it’s recommended that they receive two doses – a booster shot, in essence – two to three months apart.  And regardless of your status, if you remain at risk, they recommend a booster after five years.

Can you be exposed and not get sick?  Yes.

Some people are exposed to meningitis and don’t get sick at all.  Others are exposed and develop an immune response to the bacteria without becoming visibly ill, and without even knowing it.  You will not, however, be a “carrier” of the disease if that happens to you.  You would only be contagious during the same time period that anyone else with the disease would be contagious. (Though I didn’t clarify with Dr. Clark how long that would be in the case of someone who didn’t show any symptoms – nonetheless, it didn’t see like a long time, as he said you wouldn’t be a carrier, and you wouldn’t be contagious once you’re body developed the immunity.)

For how long are people contagious?

The good thing and bad thing about this disease is that you generally get sick a day or two after you were exposed, though it’s possible, but unlikely, for it to take up to two weeks.  The bad news is that you can become quite ill quickly, and if you don’t get medical help you can die.  The good news is that the quick onset of the disease makes it harder to spread.  Why?  Because once you’re in bed sick as a dog, you really don’t feel like going online and hooking up, or going to a bar and drinking with your buddies.  So the disease generally only gets a chance to spread in that 24 to 48 hour window after you’re first exposed and still feeling fine, which thus limits the spread of the disease.

Is this a gay disease? No.

I mentioned to Dr. Clark that some of the readers were confused as to why the warning went out to the gay community and not the straight community as well.  How could a disease target only gay people?

He said that it’s not a “gay” disease, and that meningitis usually targets schools, college campuses, and corrections facilities – i.e., a small enclosed community.  Occasionally, the disease can hit a “virtual community,” like the gay community. By “virtual,” he means that gay men are not a geographically-confined community as are kids in the same high school building or college dorm, or men living in the same prison.   So the community is more “virtual,” as the tie isn’t immediate geographic proximity per se (though obviously it’s affecting people within a discrete geography like New York City, but that’s different than actually living together in the same building and thus you all get sick).

Also, 98% of the cases in the US every year are sporadic, they occur by themselves, rather than striking a community.  Only a small fraction turn into “outbreaks” like this one.

One more thing Dr. Clark noted was that this disease tends to strike in specific clusters, in specific communities, and it tends to stay confined to that community, without spreading to other communities.  And that’s another reason why the warnings are only being given to gay men, and only, so far, in NYC.

Just how big is this outbreak?  Not big at all, actually, but big enough to be concerned.

There was one case in 2010, four in 2011, and thirteen in 2012.  Those numbers may look small, but in public health terms, they’re not.  What has experts worried is that they keep hitting the same community, gay men in New York City, and it’s not going away.  Most outbreaks happen quickly, Dr. Clark told me, with usually just a few cases occurring at once in a short period of time, and then they go away.  This has been going on in NYC since 2010 and it’s growing, rather than going away.  Thus the concern.

I just talked to Dr. Clark about some of the comments here, and on Facebook, saying that with these low of numbers, this was blown out of proportion by the authorities in NY.  He says that’s not true at all.  Here’s why….

In public health terms, an “outbreak” is defined as 10 cases per 100,000 people within a short period of time (say, a few weeks).  When you have an “outbreak,” that’s suggestive that the disease has reached a point where it may accelerate and spread to even more people.  In public health circles, it’s their job to stop outbreaks from becoming something bigger.  To the public, these numbers sound small.  But in public health terms, these numbers are statistically significant and worthy of increased concern.

That’s why when they get 2 or 3 cases in a school of 600 kids, or a prison of a few thousand inmates, they vaccinate everyone to prevent the disease’s spread.  That’s enough cases to set off alarm bells.

In NYC, we’re talking more on the order 13 or so cases last year.  But, you might say, hey, that’s 13 cases for 8 million people, so who cares?  But that’s not really correct.  It’s not 8 million New Yorkers.  It’s gay New Yorkers.  And it’s only gay men who are getting sick, not lesbians, so now the number is cut down even fewer. And it’s not all gay men in NYC, it’s gay men in certain boroughs.  And it’s not every gay men in those boroughs, it seems to be gay men in those boroughs who are sexually active and particularly using Web sites, phone apps, bars and partys to meet guys.  That cuts down the number even further.  So you’re now a lot closer to that 100,000 figure than you were when you thought this was about 8 million New Yorkers.

The uncertainty of the size of the community exposed to this disease is part of what worries public health professionals.  It’s not possible to accurately define whether we’re talking 13 cases per 100,000, per 200,000 or per 50,000.  So they err on the side of caution because this is such a particularly deadly variant of the disease, killing 1 in 3 who get it, rather than the normal 1 in 5.   And in public health, you try to cut off disease before they become a huge problem.  Thus you have to look at small numbers, and historically what those numbers tend to mean for the future, and act accordingly.

That’s pretty much it.  I know my concerns were allayed greatly in talking to Dr. Clark.

I got my vaccination last week.  It was $165 or so at my doctor’s, a friend got his on a college campus for around $85.  At least this disease sounds like it should have a much harder time spreading than some others in our history.

West Coast City Issues Strong Warning Regarding Meningococcal Infection

City Issues Strong Warning Regarding Meningococcal Infection

Posted Date:4/12/2013

The City of West Hollywood issued a strong warning at a news conference held Friday, April 12th regarding meningococcal infection, a bacteria-caused illness that can lead to potentially deadly meningitis.

“We don't want to panic people,” said West Hollywood Councilmember John Duran. “But we learned 30 years ago the consequences of delay in the response to AIDS. We are sounding the alarm that sexually active gay men need to be aware that we have a strain of meningitis that is deadly on our hands,” continued Duran.

According to the Centers for Disease Control and Prevention, bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities.

Infectious diseases such as meningococcal infection tend to spread more quickly where larger groups of people gather together. College students living in dormitories and military personnel are at increased risk for meningococcal meningitis as well as people with weakened immune systems such as those living with HIV/AIDS.

The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing). Fortunately, most of the bacteria that cause meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms which include:

• Nausea 
• Vomiting 
• Increased sensitivity to light (photophobia) 
• Altered mental status (confusion)

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within three to seven days after exposure.

The Centers for Disease Control and Prevention has been alerted about a Los Angeles County case of meningococcal infection. Tests are being conducted to determine the imprint of this strain, which is not a new one. There may be similarities to an especially deadly strain of meningococcal infection found recently in New York that has resulted in twenty-two cases, including seven fatalities since 2010. The outbreak in New York City involved a strain circulating among men who have sex with men and may be transmitted during intimate encounters including sex.
For more information visit the Centers for Disease Control and Prevention website.

• Questions and Answers about Bacterial Meningitis [PDF]
  Provided by the County of Los Angeles Department of Health Services Public Health

Kansas seeks to imprison HIV-infected People

Today while on Facebook, a message popped up regarding a proposal that was being made in Topeka, Kansas that sought to quarantine those infected with HIV/AIDS. While this is completely absurd, we currently have criminal statutes in 34 states that are dong this very thing.

HIV Criminal Statutes State by State Breakdown

Patients who are living with HIV are treated as second-rate citizens who seemingly have no protectin under the law. That is a fact! While everyone can see the injustice of a message calling for quarantine, there seems to be little or no outrage over current criminal statutes which are putting patients in prison. Additionally a person that is prosecuted and sentenced in one state may get a life-sentence while in another state it substantially different.

Kansas Seeks to quarantine those infect with HIV.

There is no data to support that criminalization helps to reduce rates of infection. In fact these criminalization statutes only serve to further stigmatize those who are living with HIV/AIDS and to stop people from getting tested and starting treatment. Below are comments highlighted by Sean Strub who heads up the cause of modernizing HIV criminal statues with The SeroProject.

HIV Criminalization is Bad Public Health Policy
HIV criminalization statutes are terrible public health policy because they discourage persons at risk from getting tested. Those with HIV who are aware of their HIV positive status are more responsible in their sexual behaviors than those who are unaware they have HIV ; testing is a basic tool of HIV prevention as well as an essential gateway to care.

Criminalization statutes also make it more difficult for persons with HIV to disclose their HIV status. Those who know they have HIV already suffer significant discrimination and stigma. Disclosing one's HIV status can be emotionally difficult, risking rejection from family and friends, sometimes with great insult or abuse, and often jeopardizes one's employment, housing, relationships or personal safety. Criminalization of HIV legitimizes the ignorance, homophobia, racism and sexophobia that fuels inflated fears of HIV and those who have HIV.

Criminalization undermines efforts to prevent new HIV infections and provide access to care in multiple ways: Ignorance of one's HIV status is the best defense against a "failure to disclose" prosecution, which creates a powerful disincentive to getting tested and learning one's HIV status.

Young African American men who have sex with men are among those at highest risk of acquiring HIV, yet also among the most difficult to get tested. The prospect of prosecution for failing to disclose--especially since these prosecutions often boil down to a "he said, he said" or "he said, she said" situation--is a powerful and likely growing disincentive to taking an HIV test.

Most new infections are caused by sexual contact with persons who have not been tested and are unaware that they have HIV, yet only those who have taken responsibility and gotten tested are subject to prosecution.

Prosecuting the failure to disclose one's HIV status undercuts the most basic HIV and STD prevention message: that every person must take responsibility for his or her own sexual health.

Prosecuting the failure to disclose values the "right" to an illusion of safety, for those who are HIV negative or who do not know their HIV status, over the privacy rights of those who have HIV.

A legal obligation to disclose one's viral status prior to intimate contact creates a particular inequity for those who were born with HIV. If we are all born equal, why is it that this group must carry throughout their lives a legal obligation to disclose their viral status prior to engaging in intimate contact?

Examples of Prosecutions
The most publicized HIV criminalization cases are often driven by politically ambitious prosecutors and inflammatory or hysterical media coverage. These prosecutions feed into the public's ignorance and anxiety about HIV, reinforce negative stereotypes about people with HIV, and send conflicting messages about the real risks of HIV transmission in a given circumstance.

They depict people with HIV as dangerous potential infectors who must be controlled and regulated, making it more difficult to create a safe environment for people at risk to get tested and people with HIV to disclose their status.

The Iowa case provides a sobering illustration of the problem. The person with HIV who was charged with failing to disclose his status to a sexual partner was a 34-year old gay man who had been a volunteer with a local AIDS organization. He met a male partner online and went to his house. The person with HIV was on anti-retroviral therapy, had an undetectable viral load and used a condom when anally penetrating his partner. He posed little or no risk of transmitting the virus to his partner.

When the partner later heard that the man he had been intimate with had HIV, he went to the county prosecutor and pressed charges. The person with HIV was convicted under Iowa's extreme statute and sentenced to 25 years in prison. Fortunately, advocates were successful in getting the sentencing reviewed and after serving eleven months, he was released on five years' probation.

However, he still must register as a sex offender for the rest of his life, is subject to wearing an ankle monitoring bracelet and cannot leave his home county without permission from the court. He may not be around children (including his nieces and nephews) without adult supervision. He must, for the rest of his life, take lie detector tests every six months that ask intimate questions, including whether he wears women's clothing and if he is attracted to children or animals. He is prohibited from viewing any kind of pornography or even visiting social networking sites, like Facebook.

Iowa's statute is particularly broad--in theory, it could cause a person with HIV who kissed another person without disclosing their HIV positive status to be sentenced to as much as 25 years in prison--but other state's statutes and sentencing are equally as absurd.

Texas convicted Willie Campbell, an HIV positive man, for "assault with a deadly weapon" and sentenced him to 35 years in prison after he spat on a police officer who was arresting him for public intoxication.

Gregory Smith was within a year of his release from a New Jersey prison (after serving time for burglary) when he was charged with attempted murder, assault and terroristic threats following an incident in which he allegedly bit and spat on a guard at the county jail where he was held (Smith denied the charges). An additional 25 years was added to his sentence; he subsequently died of AIDS while incarcerated.

In late 2009, Michigan charged Daniel Allen, who has HIV and was involved in an altercation with a neighbor, under laws designed to combat terrorism, including "possession of a harmful biological agent". Prosecutors equated his HIV infection with "possession or use of a harmful device."

A man in Ohio is serving 40 years for failing to disclose to a girlfriend that he was HIV positive. He claims she knew he was positive and only went to a prosecutor after he stopped dating her and moved in with another woman.

An interesting note about the cases described above: none of them resulted in anyone actually acquiring HIV.

 

 

Out of Context: "cure" of infant could lead to misuse of ARV's.

Out of Context: "cure" of infant could lead to misuse of ARV's. 

By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Almost immediately upon news that a child had "cleared" the virus that causes AIDS, news stories captured everyone's attention. It is captivating due to the fact that people want so badly to have a cure and the media sensationalizes anything that can get ratings and viewership. I am not saying that the media is bad however there was one thing that stood out to me when I first read the story. A 2 1/2 year old girl that was treated within 30 hours of birth and subsequently was able to clear the virus within her immune system. How long will it be before patients get the idea that they will be able to increase their antivirals and somehow get "cured". While this may sound like a crazy thought, it can also be a deadly thought since the medications that we take are highly toxic when taken in large amounts. 

My fear is that it will only be a matter of time before we see patients that deviate from the prescribed dosages of their medications and subsequently cause catastrophic damage to their renal system as well as liver damage. I hope that my fear is unfounded and that people will not take the information provided out of context. 

The greater message that needs to be relayed to the community is that 1 in 5 people who are infected with HIV are unaware of it. HIV is well managed with early detection through testing and treatment. Additionally there is no reason why in 2013 a person is not getting tested and treated for HIV or that people progress to AIDS. In the United States there are still approximately 50,000 AIDS related deaths each year and approximately 50,000 new HIV infections. 

If you are a patient that has read the stories regarding the toddler from Mississippi and you are even considering changing your medications arbitrarily please don't. While the child was given large doses of ARV's it was done under medical supervision and this is not appropriate for all patients. The child was able to clear the HIV virus due to her immune system lacking memory T Cells that develop in a mature immune system. The report will undoubtedly impact how we treat pediatrics which will greatly reduce the 330,000 mother-to-child transmissions that occur around the world annually. 

Patients need to continue their medications as prescribed with complete compliance and adherence. I will continue to preach the gospel of "test and treat". To find a testing center near you text your zip code to "knowit" and the closest testing site will be texted to your phone. 

What does a child "cured" of HIV mean for you?

What does a child "cured" of HIV mean for you?
By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Today, 3/3/13, news came that a 2 1/2 year-old child has been considered "cured" of the HIV virus. As soon as the story hit the wire it began to bounce around via social media and other media outlets around the world. So what exactly does this mean for the those of us living with HIV? While this is great news that supports researchers ideas regarding HIV reservoirs it does not mean that the treatment for an adult currently living with HIV will change. 

The announcement regarding the child's clearance of HIV is important since it goes to the direct issue of a child's immune system versus the adult immune system. Additionally the child was treated with abnormally large amounts of ARV drugs and treatment began immediately, within 30 hours of birth; that indicates that she was most likely infected in utero. Most patients will not meet these same conditions however this supports the philosophy that early detection supports improved outcomes. 

The doctor treating the child gave higher-than-usual "therapeutic" doses of three powerful HIV drugs rather than the "prophylactic" doses usually given. In the months following treatment the child showed no signs of the virus. Due to the mother's living situation the child fell out of care and treatment was stopped. Once Mississippi state health authorities tracked the mother/child down they discovered that she had stopped giving the girl antiviral drugs six or seven month earlier. 

Doctors expected to find that the daughters immune system was showing signs of HIV infection however to their surprise they could detect no sign of the virus. Almost immediately the treating physician took steps to rule out specimen contamination and other considerations that could account for a negative test from the daughter. Since August of 2012 labs in San Diego, Baltimore and Bethesdahave ran ultra-sensation tests on the baby's blood. While intermittently pieces of HIV DNA and RNA have been found there is no indication that the virus is actively replicating in the child's cells.

The importance of this discovery is that it goes directly to theories that researchers have regarding HIV reservoirs. Since the child was treated approximately 30 hours after birth this effectively stopped HIV reservoirs from developing. 

While this research is a move in the right direction towards a cure there is a need for guarded optimism as well as context. For those of us living with HIV this news does not mean that we can stop medications or that we will be cured tomorrow. It does however mean that our understanding of HIV is improving. 

Arrest all men, women and children with the flu!

Arrest all men, women and children with the flu!
By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Criminalization of those living with HIV has seemingly set  a new precedence for how the CDC (Center for Disease Control) chooses to address public health issues. While the tactics of arresting those with HIV/AIDS are more in keeping with Hitler's Third Reich than a democratic society; arrest, prosecution and imprisonment is an ever-present fear for the approximately 1.2 million living with HIV/AIDS in the United States. If you are living with HIV/AIDS and you are not concerned about criminalization then you are clueless.

Policy makers, politicians and law enforcement serve of the Gestapo enforcing fear through the use of imprisonment, forfeiture of civil rights and public-shaming should an HIV positive person even be accused of looking in the direction of a negative person. In many ways it is very reminiscent of the deep-south at a time when African American men would be strung up simply on the accusation of a white woman that he had done something inappropriate. In the United States you are not innocent until proven guilty... You are guilty until proven innocent. Proving your innocence is something that requires money, lots of money. Even if you ultimately are proven innocent (which doesn't happen that often), you will be financially ruined. Your reputation will forever be that of a person who "intentionally tried to infect someone with HIV" regardless of the circumstance.

Thirty -four states and two U.S. territories have criminal statutes that punish people for exposing or transmitting HIV to another individual. Punishments range from a fine to up to 30 years in prison, according to the Center for HIV Law and Policy. In some states, exposure or transmission is a felony, and convicted individuals are sometimes forced to register as sex offenders. In my home state of Missouri simply exposing another person to HIV (through ANY sexual contact) or by through saliva  is viewed by the law as a Class B punishable by up to 15 years in prison. Disclosure of your HIV status and the use of a condom is no defense. I repeat, the use of a condom is no defense according to Missouri law.


To date there has been no data that supports the idea that criminalizing HIV prevents exposure and infection. The contrary has actually been noted that criminalization practices impede getting people tested for HIV and ultimately treated. The reality is that criminal statutes that are out-dated and draconian only perpetuate fear and ignorance regarding HIV/AIDS.

Those infected with the flu should be arrested!

In 2006-2007 up to 49,000 people died in the United States as a result of complications related to influenza. If criminalizing HIV is seen as a prevention strategy then why not apply this same practice to address  influenza outbreaks? Arrest people who do not wash their hands, who cough without covering their mouth and those who place others at risk of infecting others with inluenza. Arrest children, women, the elderly... Arrest everyone since anyone can be a potential carrier of the influenza virus which could lead to death.

Obviously you can see the flaw in the previous suggestion however  criminalization is viewed as acceptable when applied to those living with HIV/AIDS?

Society has no problem quarantining marganlized populations however that must be seen as a slipper-slope that has greater implications for other groups. Today, it is criminalizing those living with HIV/AIDS but tomorrow it could be people living with Hepatitis. After that it could be criminalizing anyone who is a carrier of influenza. Ultimately where does it end? As long as we allow fear to dictate policy regarding public health, we will never acheive

You can either accept that criminalization of HIV/AIDS is the way it is, or you can fight against it. Contact you representative in Congress and urge them to sign on as a co-sponsor of the " REPEAL HIV Discrimination Act" introduced by Barabara Lee, (D) California.

Also you can learn more about efforts to end the criminalization of those with HIV by visiting The SERO Project at www.seroproject.org

Pope should be charged in International Court for HIV/AIDS policies

Pope should be charged in International Court for HIV/AIDS policies
By: Aaron M. Laxton, HIV-Infected Queer, Activist & Blogger

Child-sex abuse scandals have without doubt tarnished the Catholic church's reputation but are these cover-ups the only crimes that have been enabled by the Vatican? Recently the church's one billion faithful were shocked at the announcement of Pope Benedict XVI's abdication from power, the first in over 600 years. Although the immediate word from the Vatican was that the announcement came as a result of health issues of the Pontiff, stories after the fact paint a picture of a man, and a church, scrambling to protect against charges for crimes against humanity. It is my position however that enabling child molestors was only one of the major crimes that should be answered for. There is one other crime against humanity that has been perpetuated by the Vatican that deserves equal attention and a zeal to prosecute; the consistent misinformation regarding the use of condoms to protect against HIV/AIDS without doubt has led to countless exposures and subsequent infections not only today but during the previous thirty-two years.

Just as a leader of a country would face charges of genocide for killing his own people, so too should the Pope face charges. The Vatican, which is the worlds richiest country per capita, enjoys unprecendented luxuries as a result of the power. Additionally the deeply-rooted beliefs of the believers create a situation in which church members are placed in a no-win situation that pits faith against practical health prevention practices that are known to greatly reduce the exposure and contraction of HIV. Believers can be swayed towards or away from any particular agenda that the Catholic Church. The church and it's leadership would never place people in harmful situations that are known to cause harm such as placing child-molestor priests into parishes with children... Oh wait, that is exactly what they did!

During the plague era rather than embracing the best science that was coming to light, the Catholic church embraced a policy of "no contraceptives". Those who would choose to use condoms were not simply breaking a rule, they were placing their souls in danger of eternal damnation since the Pope speaks with a Heavenly-authority.

With great ability comes great responsibity; it is not only appropriate but also ethically responsible that the world hold the Vatican accountable? If people were murdered as a result of doctrines perpetuated  by the church then without doubt the public would decry the church's failure to protect its congregants. By condemning the use of condoms and safer-sex practices the church is guilty of murder! As such, the church as led by the Pope should be brought to face charges for crimes against humanity as a result of the needless exposure and infection to HIV/AIDS through the teaching, support and furtherance of church law and policies. The abdication of Pope Benedict XVI does nothing to change the dangerous teachings of the catholic church regarding the use of condoms unless the church as a whole demands that the doctrine is changed.

Murdered or Martyred: Spencer Cox's Final Contribution

Murdered or Martyred: Spencer Cox's Final Contribution
By: Aaron M. Laxton, HIV-Infected Queer Activist and Blogger

Weeks ago the status feed on my Facebook and other social media was captivated by one particular name... Spencer Cox. Throughout the days following his death activists from around the world shared stories and articles in reference to Spencer. As I opened up my email there was a plethora of condolence emails which all began something like this: "Loss of a pioneer...", most shared in what capacity the person sending the email had interacted with Spencer. 

As information regarding his drug addiction and personal struggle with post-traumatic stress became public, the world got a glimpse of the bruised and battered warrior who stood valliantly behind the armor. Spencer saturated himself in the science of HIV and is directly credited by Peter Staley, a fellow AIDS activist who was featured on "How to Survive a Plague", for saving the lives of over eight-million patients; a result of his efforts to standardize protocols which were adopted by the FDA (Food and Drug Administration) which brought about the protease inhibitor.

In the plague era, Cox found himself in a time before society had a name for what is now called AIDS. It first appeared as a rare cancer seen in eleven gay men, for a time it was called GRID (Gay Related Immune Deficiency) and finally would become AIDS (Acquired Immune Deficiency Syndrome). Friends and lovers were falling one by one at first and over time those numbers increased to staggering, alarming rates. Although everyone wanted to believe that they would live, the reality was that while death called upon a vast majority relatively quickly, others would be left forever scarred by pain, suffering and misery. Just as with any masscre or distaster the toll of the event is long-lasting and life-changing.

Political inaction which left those living, or rather dying, with AIDS was tantamount to  goverment-sanctioned death for patients during the plague years. Cox, a genius and pioneer was sentenced to death long ago by such politicians who turned a blind eye to an entire community that was being ravished by AIDS. Although today the political climate has, to a great deal, embraced HIV/AIDS, this certainly was not the reality of the plaque era. Cox and his fellow activists directly challenged not only the New York City Hall but also the White House and almost every major establishment in Washington, D.C. A politician's disinterest and lack of desire to become involved only further motivated activists such as Cox to blaze a trail into unknown territory. 

It was the introduction of the Denver Principes which boldly proclaimed that those infected were "AIDS patients" rather than "AIDS victims" and to this end Cox was no victim at least in the short-term. In the long-term Cox was merely the tip-of-the-iceberg regarding a marginalized and disenfranchised community who was viewed by politicians as "acceptable losses". 

There are followers and then there are leaders and those abilities are as much a gift as they are an art. Spencer Cox without doubt would forever changed the landscape of AIDS in the United States and Globally. His death however also serves as one last action. An action, like any successful action, brings to light an injustice and inequality through public awareness. An action also involves the potential for personal sacrifice through arrest, detention, or in this case... Death.

Much like the images we have seen of Tibetan Monks who set themselves on fire in one final act of protest, Cox so too has made a statement. A person who had been so instrumental is reforming how those living with HIV/AIDS received medications stopped taking his own. This was the equivalent of cutting an artery and allowing it slowly bleed out. The cestation of his medications meant one thing... death would finally come for this wounded warrior. For all of the things Cox stood for, such as empirical data, quantifiable-numbers and research, it was the latent-affects of living through the plague era which proved just as detrimental as the virus.

Our understanding of the psychological and emotional damage caused as a result of surviving the plague are not well understood. How many more Spencer Cox's are out there? How many more are survivors who through their own actions hasten death through self-destructive behaviors or attitudes? An addiction to crystal meth was merely the means by way Spencer self-medicated. The addiction was only a symptom of a greater problem that is not isolated to just Spencer. A greater problem that is running rampant throughout the gay community and within the AIDS community. I myself have battled with an addiction to Crystal meth as well as other self-destructive patterns of behavior. 

Why did he survive when so many others had died? The grief and grieving that seemingly over-shadowed being alive has been hidden away as a dark secret and is not spoken of near as often as it should be within our communities. What is focused on is improved drug therapies, longer life expectancies and "normal" lives however ignoring the catastrophic and debilitating emotional wreckage in plague-era patients is a travesty and it must be stopped.

Spencer Cox's death can be viewed as a murder which was sanctioned long ago but that only recently occurred or it can be viewed as the ultimate action and political statement to decry an injustice and inequality, only you can be the judge.

One HIV-Infected Queer’s Response to the State of the Union

One HIV-Infected Queer’s Response to the State of the Union

By: Aaron Laxton, HIV-Infected Queer Activist and Blogger

Recently the news of a school massacre with twenty children killed galvanized media outlets around the world. In the days and weeks after, politicians from both sides of the aisle dug in for what would without doubt be a long fight regarding gun reform. As a person that is living with HIV I am left to question, where is this same passion and fervor regarding a CURE for HIV/AIDS?

With an aging group of activist and an ever changing-political environment comes a change in priorities and the government’s ability to put issues that we hold as valuable as a lower-priority. It is true that therapies and treatments for HIV/AIDS have vastly improved; the fight is far from over. The rates of new HIV infections within the African-American and Latino populations are staggering and barriers regarding access to care still abound.

During President Obama’s State of the Union address those of us living with HIV waited for a renewed sense of vigor and determination, marking a move towards a CURE for HIV/AIDS. Sadly, in the end, it was a vague phrase that seemed like an ingenuous attempt to court voters rather than an actual plan to get to an AIDS free generation. By the numbers, those living with HIV/AIDS have seen catastrophic cuts to programs and funding under the Obama Administration that only serve to prove that lip service is alive and well in the White House and Washington, DC.

Twenty white-children are killed in a school shooting; subsequently the instantaneous response from the White House is a stark-contrast to the determination and attention given to HIV/AIDS, an epidemic which has killed millions of people including at least 290,000 gay men. I suppose it makes sense since dead votes do not count on Election Day!

Just as it was in the early days of the epidemic, it was not until white children began to become infected did the public develop a bad taste in their mouth. What will it take now for the public, for those living with HIV/AIDS to rise up and demand a CURE to an epidemic that has been raging more than 32 years, with more casualties than all the wars put together?

I am simply on queer living with HIV who is using his voice but if we are to succeed it will demand that once again we get angry over a lack of governmental response, funding cuts to HIV/AIDS Programs, cost containment measures affecting ADAP recipients and the list goes on. Who is this generation’s Larry Kramer to rally the troops and boldly proclaim that without action we are dead?

HIV will not kill you but your passivity and laziness will!

 

HIV will not kill you immediately but your passivity and laziness will!

By: Aaron Laxton, HIV-infected Queer activist and blogger

Last summer I had the amazing opportunity to speak at the ADAP Association Summit in Washington, DC. It was during my remarks that I posed the question, “If we simply provide medications to those living with HIV/AIDS yet we do nothing to improve their quality of life, what have we ultimately achieved?” The reality for those living with HIV is that quality of life is directly being threatened. It is being threatened and it must not be allowed to continue! Any meaningful existence for HIV/AIDS patients is directly being threatened in the form cost-containment measures with ADAP (AIDS Drug Assistance Program), reduction of HIV/AIDS program funding, increased HIV Criminalization efforts and outrageous pricing for new Anti-Retroviral Drugs in the name of research and development, just to name a few. In 2010 Gilead Sciences controlled at least 40 percent of the market share for HIV/AIDS therapies and showed profits of over $6.3 billion.

While some may call me an alarmist and radical, the fact remains that those of us living with HIV/AIDS are simply viewed as a “past-epidemic; a closed chapter- a black mark on our history marked by political-inaction, marginalization and demoralization”; take your medications and do not rock the boat is the current mentality! It is my opinion; big-pharma has bought the silence of a new generation of HIV patients thus quelling outrage over the lack of a CURE after thirty-two years. All of the advancements, therapies and medications we currently have came as a direct result of action from a generation that knew they would never be alive to see it. So please spare me the rhetoric that says, “We have never been closer to a cure as we are right now.” Where is the damn cure?

The Journal of the AIDS Society published new research that projected life-expectancies to approximately 69 years. One key challenge is that an aging population of patients living with HIV present researchers and clinicians with more questions than answers. Our understanding of AIDS-related malignancies has improving unfortunately patients that survived the earliest days of the AIDS epidemic are now staring a new insidious-challenge in directly in the face. Is it related to aging, anti-retroviral drugs, HIV/AIDS or all the above?

While aging populations of HIV/AIDS patients face significant challenges, the HIV/AIDS movement faces profound challenges which could prove fatal if not addressed. We must address philosophical questions regarding where we have been and where we are going if we are to ultimately achieve the Holy Grail, a CURE.

A previous HIV population had quite possibly the purest reason for fighting… a will to live. Today however, there is seemingly a lazy attitude among a younger HIV-community that directly translates into passivity and acceptance of the status-quo. Where is the fight?

Politicians will keep chiseling away at HIV/AIDS funding and programs until there is nothing! Twenty-five years ago, activists and AIDS Service Organizations would raise hell to stop this. Unfortunately many AIDS Service Organizations have lost their sense of direction and consequently no longer serve the populations that they were once determined to help. Those organizations which still have an interest in serving those living HIV are so afraid of advocating for specific issues lest their funding get cut.

We cannot depend on AIDS Service Organizations to place pressure on politicians on issues such as CURE Research, HIV/AIDS program funding cuts or issues such as HIV-criminalization. It is going to patients who are currently passive and lethargic to awaken from their dazed, lackadaisical-slumber and fight for their lives.  It you have ever heard me speak I always say the same thing… politicians do not change things out of the kindness of their hearts. They change because people place pressure on them and they do it out of self-preservation.

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