Peter's POZ Blog

So now we're hearing that the public option plan is in serious trouble, and that Rahm Emanuel is telling Congress behind closed doors that they can compromise it away.  What I find so sad about all this is that even the most progressive reforms being discussed in Washington don't come close to providing the type of hassle-free health-care we need -- a single-payer Canadian/French/British-style system.

I finally watched Michael Moore's Sicko on cable TV this weekend.  I've never been a fan of his head-clubbing style of film-making, but this doc makes a very convincing case about how Americans have been fooled into fearing a French-style health-care system.  Compared to what we have now in the U.S., France offers a health-care nirvana.

Our current debate almost makes me sick with sadness.  Sure, almost any reform passed this year will be an improvement over the current travesty we have now, but it won't come close to fulfilling the dreams of those who correctly chant "health-care is a right."

A memo.  Just a memo.  No executive order.  No health insurance.  No retirement benefits.  Just what are we getting here?  (And by we, I mean only those gays and lesbians who work for the federal government as civilians -- the rest of us, including those Obama has been kicking out of the military, will have to wait).  He's paying our relocation fees when we move?  Um... okay.

We're getting table scraps.  This was obviously put together very quickly in response to the tidal wave of queer anger hitting the White House this past week.  Rahm finally told the president he had a problem with the gays, and fell back on tried and true Clintonian window-dressing to calm us down.

It won't work.

Stop firing our gay soldiers.  Stop defending DOMA by equating our love to incest.  Stop banning people with HIV from entering the country.  Start offering up some change we can believe in.

That's my excuse for not posting here lately.  The bf and I and the two cats have got a new addition to our family...  a puppy!

She's a lovable yellow English Labrador Retriever.  Her name is Stella...

Last week, our nation's largest AIDS organization, the Los Angeles-based AIDS Healthcare Foundation, launched a cable TV and Internet ad challenging President Obama's silence on AIDS during his first 100 days in office (watch it below).  I've had my disagreements with AHF in the past, especially when it launched misleading treatment-related advocacy campaigns, but this time AHF got it right.

I know the man has his hands full, but Obama has ignored AIDS to such an extent that even the easy, no-cost policy fixes haven't happened.  Take the long-standing, stigma-inducing HIV ban on travel and immigration to the United States.  President Bush, to everyone's surprise, pushed for its repeal.  Last year's Congress passed legislation that allows the Department of Health and Human Services to remove the ban, and Bush signed this legislation into law. 

That only left one last step -- HHS had to publish a rule to remove the offending language.  The Bush administration did this, although not fast enough to have it become law before Bush left office.  All Obama had to do was let the Bush ruling stand and take effect after a period of public comment.  Instead, it got swept aside during Obama's heavy-handed halt to all of Bush's end-of-term regulatory initiatives.  Now it's back to square one -- an almost identical rule has been prepared and published for public comment, again...months later.

If someone, anyone, had spent 30 seconds explaining the significance of this easy fix to Obama, he'd have his first tangible victory in the fight against AIDS.  But this probably didn't happen.

Why?  Because the field of U.S. AIDS advocacy is largely impotent, and has been since the early 1990s.  With the possible exception of AHF, none of our national AIDS organizations has a vision or presense in Washington, DC, that amounts to anything meaningful for people living with HIV.  The last major AIDS legislation passed in the United States was Bush's PEPFAR, and that was pushed largely by the religious right, not AIDS advocates.  Regardless of its warts, PEPFAR has saved millions of lives.  But it's an international program, not a domestic one.  People living with HIV here haven't seen help from Washington since the Ryan White CARE Act passed in 1990.

Because of our impotence, it's hard to blame Obama.  And besides, by a long mile, the most important thing any president could do for Americans living with HIV is pass legislation that guarantees healthcare for all.  If Obama does this, we can certainly forgive his 100-day silence on AIDS.

This happened almost two weeks ago, but I'm having blogger's block, so this will have to do.  Does having my pic on The Daily Beast's home page mean I've arrived?  Judging from the comments left, I'd say no.  [Is there an emoticon for "tongue in cheek"?]

But it was good for a laugh.  Stirring the gay marriage pot with Rupert Everett was kind of fun.  Read all about it here.

"Obama Administration Announces New Campaign to Refocus National Attention on the HIV Crisis in the United States."

That's the headline from yesterday's CDC press release announcing a five year, $45 million HIV prevention campaign called Act Against AIDS.  Phase one of the campaign, called "9 ½ Minutes," uses a series of video, audio, print and online materials to "increase knowledge about the severity of the HIV/AIDS crisis in the United States."

Thank god they're planning additional phases, because the videos bored me to death.  Phase II sounds much more promising, and will focus on African-Americans, including "targeted communications to encourage increased HIV testing among the two groups of African-Americans most severely affected, gay or bisexual men and women."  Let's hope they spend most of their budget on this next phase.

See if you agree with me.  Here's one of the two English-language videos released yesterday that almost put me to sleep:




I'm of the belief that prevention campaigns only work if they invoke an emotional response in your target audience.

Let's compare and contrast.  Have you seen the new anti-smoking TV ad from New York City's Health Department?  I'd bet good money the ad below will convince some parents to try to quit smoking cigarettes:




What would a good national HIV prevention campaign look like?  Should we even try broad-based campaigns, or focus on smaller, targeted audiences?  I'd be interested in what readers of this blog think.  Comment below.

A must watch (hat tip Andrew Sullivan), especially for the "vagina full of AIDS"...

Some interesting new research indicates that direct CD4 cell to CD4 cell contact might be a leading method by which HIV infects these immune system cells.

Scientists have known for years that CD4 cells can be directly infected by free-floating HIV particles in the blood, and have taken pretty pictures of this viral attack (to see one, click here).  Treatments called entry inhibitors (like Fuzeon and Selzentry) effectively block this attack.

But now a team of scientists from UC Davis and Mount Sinai School of Medicine have actually filmed CD4 cells directly infecting other CD4 cells, and speculate that this might be "the predominant mode of [HIV] dissemination."

Why is this important?  It might explain why HIV is able to elude many of the vaccines tested thus far (direct cell-to-cell infection avoids those pesky, free-floating antibodies).  And it might lead to new treatments as well by defining a viral pathway which researchers can try to block.

The study was made possible after experts inserted a protein into HIV's genetic code which glows green when exposed to blue light.  Check it out...

I must admit, I've become deeply cynical about people with AIDS. I hate that I feel this way. The community I've always felt a part of - Americans living with HIV - has, in my mind, become impotent. Stigma seems to rule us, and we now find it easier to compartmentalize or hide this significant health challenge we all face.

Maybe it's not cynicism I'm feeling, as much as a deep sense of loss. I mourn the days when we were bound by anger and willing to fight together for our dignity and our place in the world. We used to suffer far more external stigma than we do today, but it only made us angrier and stronger. We'd yell out to all who would listen and to those who tried not the listen, "WE ARE PEOPLE LIVING WITH AIDS."

The stigma we live with today seems far more internal than external, as if we no longer feel we deserve to be heard or respected. We wrap ourselves in stigma, convinced that being uncloseted will lead to lesser rather than fuller lives.

I mourn the days when we would stand up and be counted. We would organize and act-up. We had power. Some of the very first AIDS organizations were local People with AIDS Coalitions. People with AIDS San Francisco was the first, when Bobbi Campbell and Dan Turner started meeting in Dan's house in the Castro hills in 1982. Then came People with AIDS New York (later called the People with AIDS Coalition), with Michael Callan, Richard Berkowitz, Phil Lanzaratta, Artie Felson and others leading the way.

Then, in June, 1983, people with AIDS from New York, San Francisco, Los Angeles, Minneapolis and Houston came together in Denver to strategize. They wrote a manifesto - a blueprint for a people with AIDS self-empowerment movement - which would come to be known as The Denver Principles. (For a great read of this history, and the text of this manifesto, click here).

From there, the National Association of People with AIDS (NAPWA) was born; many of us founded the first AIDS service organizations in each city and state; we were instrumental in ACT UP. And we changed the world.

Anyone living with HIV today owes their life to this self-empowerment movement. Conversely, most of the issues we all still deal with, like treatment access, a rising rate of new HIV infections, and overwhelming stigma, are all made worse by the waning of this movement.

I mourn the waning of our power.

But recently, I've found reason for hope. There's a project in the works that has the potential to revive our self-empowerment movement. As before, this project is being driven by people living with HIV - people like Sean Strub, Regan Hofmann, Tim Horn, and Frank Oldham. AIDSmeds.com, POZ Magazine, and NAPWA are all involved, along with nearly 400 AIDS service organizations (and counting) around the country.

It's called The Denver Principles Project - a three-part campaign to recommit our community to the principles of self-empowerment, raise awareness of the Denver Principles amongst service providers and the communities they serve and to build a large national membership for NAPWA to give them the voice and authority they need to be most effective.

Imagine if we could turn NAPWA into the MoveOn.org of people with AIDS. Imagine if NAPWA could sit down with a senator or president and say "we represent 100,000 Americans living with HIV - all NAPWA members - and we demand to be heard." Imagine if tens of thousands of us participated in anonymous surveys and an ongoing database that could finally provide a true picture of the issues we face. Imagine if 100,000 of us could be called to action when important legislation is up for a vote or when someone attacks our dignity with stigmatizing falsehoods (I mourn the loss of highly effective ACT UP phone zaps).

All of this could happen if each of us was willing to join together, stand up and be counted again. This isn't about telling the world you're HIV positive - the NAPWA membership list will never be disclosed or sold. If you're HIV positive and can't afford the $35 membership, NAPWA will find sponsorship funds to cover your fee (just check the "I would like to be sponsored" option during the sign-up process). If you or your family and friends can afford it, please join and donate so NAPWA can sponsor as many members as possible.

I joined today. The goal is to have 100,000 of us join by December 1st, World AIDS Day. You can join here.

I want to shed my cynicism and believe in our power to create change again. Trust me, there is nothing like the feeling of true self-empowerment, and our collective action is the only way to achieve it.

Tucked away in the massive stimulus package signed by President Obama last week is the largest budget increase in the NIH's history. Thanks to Senator Arlen Specter, the budget of the National Institutes of Health will go from $29 billion to $39 billion -- a whopping 34 percent increase (see this NYT story for details).

I called Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and the top federal official responsible for AIDS research, and asked him how much of this increase would go to AIDS. Short answer, we don't know the exact amount at this point, but it should get approximately the same boost as all the other research areas. The current AIDS research budget is $2.9 billion. That could go up by another $1 billion, give or take a couple hundred grand. That's some serious stimulus.

Here's how it will work. The NIH will get an additional $10 billion, which it has to spend within two years. About a quarter of this amount is to be spent on classic infrastructure projects, like new buildings and laboratories at the NIH and university campuses. $7.4 billion will go directly to research, paying for as many as 15,000 additional grants submitted by scientists at universities across the country.

Each NIH institute will get a share of this $7.4 billion equal to their current allocation of the NIH grants budget. Then it will be up to each institute how to allocate their share. Fauci and the other institute directors will need to scour their current grant programs to find projects that can be funded quickly (within the next two years). They'll do a combination of new grants and increasing the size of some current grants. For new grants, they'll first look at recently submitted grant requests that were scored as worthy of support, but fell just below the previous budget cut-off lines.

So as each institute director looks at their current and potential grants portfolio for AIDS (there is no AIDS institute, but NIAID does more AIDS research than all the others), they'll be looking for what they can fund quickly, or within two years. If their AIDS portfolios offer lots of quick funding options, we'll get our fair share of the new stimulus money.

Fauci was hopeful that AIDS research would get the approximately one-third increase that other disease groups are hoping for. That would mean about $1 billion more over the next two years. That's huge. Combine this with some new found energy among activists and researchers to actually figure out a "functional cure" for AIDS, and we could be entering a golden age of AIDS research.