Regan's POZ Blog

This monday, I was a guest on NPR's "Talk of the Nation" to discuss the criminalization of people living with HIV. Host Neal Conan spoke with Jon Wells, a reporter in Canada who interviewed Johnson Aziga (an HIV-positive man who was convicted of first degree murder for non-disclosure of his HIV status prior to allegedly intentionally infecting several woman, some of whom died), Jonathan Turley, a professor of law at George Washington University (check out his great blog here) and yours truly. Please click here to listen to the show.

I am so grateful that the conversation about the increase in the criminalization of people living with HIV is continuing on more fronts. Your comments on this issue have been helpful and fascinating. Please keep 'em coming. There seems to be a little confusion as to my position on the issue, so I'll reiterate it here. I agree that people who know they have HIV and do not disclose their HIV status to their partner and engage in unprotected sex intending to harm their partner (like Johnson Aziga) should be punished.  I also think the laws around the transmission of STDs, if they are to remain in place for people living with HIV, should be consistent and clear and applied across the board to all sexually transmitted diseases that can lead to ill-health or death (like hepatitis, syphilis and human papillomavirus, to name just three). For example, if I am HIV positive and have unprotected sex with someone who has HPV and neither of us discloses that we have our respective diseases and I get HPV but my partner doesn't get HIV, I could go to jail for 25 years - and nothing would happen to them though we did the same thing and even if they transmitted a potentially deadly disease and I didn't.

While I understand our desire to punish people like Aziga, it is worth discussing what impact the criminalization of people with HIV has on the general population, the stigma surrounding HIV and our ability or inability to prevent the spread of what is, essentially, a preventable disease. When we criminalize people with HIV, it makes people afraid to talk about, get tested for or get treated for HIV, all of which increase the odds that the disease will spread. Criminalization, then, can backfire because it is a deterrent to encouraging widespread and routine testing for HIV/AIDS. It's estimated that there are 1.2 million people living with HIV in the U.S. About 1/4 of them are not aware of their HIV status and the majority of new infections result from people who don't know they're living with the virus. We want to encourage people to get tested for HIV so, if needed, they can get onto treatment and save their lives. Also, because being on treatment can lower your viral load to undetectable, which can reduce how infectious you are, treatment itself is being considered as a measure of prevention (read more about this topic in the July/August issue of POZ!). And, while I agree that people with HIV have responsibility to share that information with potential partners, the entire burden of responsibility should not sit solely on the shoulders of the HIV positive person. Everyone, every time they have unprotected sex, has the responsibility to realize that they are potentially putting themselves at risk and should own some responsibility if something happens to them. And, finally, consider this: aren't people who have unprotected sex and don't get tested for HIV arguably as dangerous as those who have been tested and fail to disclose and have unprotected sex with others? Not knowing your HIV status is dangerous for you and your partners. So...especially since June 27th is National HIV Testing Day, may I suggest that if you are sexually active and haven't been tested in the last 3 months, you go get an HIV test. You could save your own life - and the lives of others.

To find a testing center near you, click here to peruse our list of nearly 8,000 AIDS Services Organizations. Many of them conduct testing, or, they can refer you to a testing site near you.

This morning, I was a guest on the Brian Lehrer Show on WNYC radio (WNYC.org - search for my name or click here) We discussed whether or not people living with HIV should be criminalized for knowingly (or not), intentionally (or not) exposing and/or potentially transmitting HIV to another person. I won't go into the nuances of the discussion here ... please listen and let me know what you think. (Quick summary: I agree with UNAIDS' recommendation that the criminalization of people living with HIV be limited to those people who know their HIV-positive status and intend to and manage to transmit the virus to another person.)

During the show, a listener called in and asked about a case in which an HIV-positive woman was sexually assaulted by more than one man. He described how, at the time of the attack, the woman, who was aware of her HIV status, was too afraid to tell her multiple assailants that she was HIV-positive (though it occurred to her that it might be an effective deterrent) because she was afraid that, given the stigma surrounding HIV, the men would kill her when she told them. Then, post-attack, she lied to the police and told them she HAD disclosed her HIV status to the the attackers SO SHE WOULDN'T BE PUT IN JAIL FOR NOT DISCLOSING HER HIV STATUS TO THE MEN WHO RAPED HER. The criminalization laws around people living with HIV are so convoluted and poorly written that she worried that going to jail was a real possibility.

A part of me wanted to think this story was the clever concoction of a radio listener trying to make people understand the damaging impact of laws surrounding the criminalization of HIV (they prevent discussion, awareness, testing, treatment and disclosure) ... but when I got back to my office, I had e-mails from several HIV-positive women who had also worried about their legal fate for not disclosing their HIV-positive status to the men who had raped them. One asked me to imagine how it felt to educate the man (whom she knew, vaguely, before the attack) about the availability of PEP (post-exposure prophylaxis). Despite what he had done to her, she felt guilt about potentially exposing him to the virus, so much so that she ensured that he was aware of a medical protocol that could save his life after he had possibly been exposed to HIV when he forced himself on her.

And this is the kind of woman who some courts would deign to put behind bars for not disclosing her HIV status to a "sexual" partner.

Jeez.

If that's not an endorsement for how broken the system is and how gravely misunderstood and deeply feared and stigmatized HIV still is, I can't imagine what would be.

Moments like the one in which I opened the woman's e-mail, read her story and understood her regard for another person's well-being -- even after he terrorized her and put her life at risk -- are why I do what I do. I can not sit idle and watch the world continue to misperceive the moral character of people living with HIV when I know, personally, the exceptional characters of many who fight for their lives every day against the virus -- in spite of a sometimes uneducated, misinformed and unfairly judgemental world.

As HIV-positive, South African judge Edwin Cameron says, "HIV is not a crime." (Check out his piece written in a Norweigian paper posted on poz.com). What is, arguably, criminal, is the lack of compassion, appropriate legal recourse (if and when needed) and clarity around the complicated nuances surrounding the issue of potential HIV transmission between two serodiscordant adults consensually engaging in sex.

Hi...I'm back!

Click here to check out this piece I wrote for TheDailyBeast.com:

The Dallas Morning News also picked it up.

And please go to TheDailyBeast.com, search for my name and add your comments!

Thanks!

Using horses to cope with HIV

Just wanted to direct you all to a piece that the Newark Star Ledger did this past week on me for World AIDS Day. The reporter spent some time with me at the barn...and met my horses, who play a big role in keeping me sane, relaxed, healthy and outdoors. As I write this, I'm contemplating whether or not I really want to go spend two hours in the freezing gloaming...but then I think about how I'll feel when I walk into the barn and my horses whinny because they're happy to see me (and know I will be giving them carrots and Cracklin' Oat Bran ((their favorite cereal))) and it makes it possible to suit up in my winter gear and brave the cold. I always feel better after fresh air and exercise...though when the temperature dips below 30 degrees as it has tonight, I skip the riding...

I thought you might like to see the article, pics and video. To read the Star Ledger piece, click here.

Okay. That was the "ponies" part (even though my horses are horses, not ponies). Now, the "pirate" part is a reference to HIV-positive friend and former POZ coverboy Bob Bowers (who refers to himself as a pirate of sorts). He is founder and president of HIVictorious, Inc. and was featured in a BBC radio show called "How AIDS Changed America." It's available online ONLY through next Tuesday morning. Bob says the program is a "powerful and poignant recollection of AIDS in America from the likes of Larry Kramer (Founder of ACT UP), Cleve Jones (AIDS Activist and Founder of the AIDS quilt) and others. It is hosted by Paul Michael Glaser (Starsky) who lost his wife and daughter to the disease."

To hear the broadcast, click here.

Happy viewing/listening!

Off to brace myself against the frigid air!!!

December 1st, 2008 was my third World AIDS Day as the editor of POZ. The day is always so bittersweet-it cooks up a cauldron of conflicting emotions for me.

On the one hand, it is a day to pause and recall all those we've lost to AIDS and renew our resolve to keep millions of others from joining them in the hereafter. In that sense, it is a day full of grieving and grim determination. It is a day to acknowledge all the hurdles we still must clear: too many people who are living with HIV who don't know their HIV status, too many people in need of support and treatment who can't access it, too many children orphaned by the disease, too much stigma, too little comprehensive sex education, too many people behind bars or living homeless on the streets with HIV, the particular vulnerability of African Americans and the Latino community to AIDS, a lack of a federally-sanctioned needle exchange program, wait lists for the AIDS Drug Assistance Program, underfunding of AIDS services relative to the rising need, an increase in the criminalization of people with HIV, AIDS fatigue in the activist sector, setbacks in our quest for vaccines, microbicides and still no cure in sight.

But it is also a day of celebration and joy. On the day of my diagnosis, if you'd told me I'd be around 12 years later to celebrate World AIDS Day, I wouldn't have believed you. There is much to celebrate. And I am always amazed at the endless energy and relentless commitment of the AIDS community that seems to shine extra bright on World AIDS Day. People with HIV can now live long, full, healthy lives. They can have children without passing HIV onto them. We have drug regimens that are easier to take, and that have more manageable side effects. We have new classes of drugs, and progress in studies exploring whether treatment can render people non sexually infectious and whether treatment can serve as a preventative tool (PrEP). The needle is moving in terms of the public's acceptance of people living with HIV and their understanding of how HIV is-and isn't-transmitted. More and more people have come forward to speak of their HIV status, overcoming shame and discrimination. South Africa has a new health minister. And faith based communities around the world are beginning to embrace people living with HIV, seeing the power of their support and as an existing infrastructure to distribute information, support and maybe one day, condoms and treatment.

And perhaps most importantly for the domestic AIDS crisis in America, we have a President Elect who speaks openly with conviction about his determination to develop and implement a National AIDS Strategy for the United States.

See President Elect Barack Obama's message on World AIDS Day here:

This year, for World AIDS Day, I headed south of the Mason Dixon to Washington, D.C. to have dinner sunday night with Frank Oldham, CEO of the National Association of People Living with AIDS. We caught up and hypothesized about who may be chosen as President Elect Barack Obama's AIDS Czar. Just the fact that we will again have a federal governmental department responsible for addressing domestic AIDS offers so much hope for change on the front lines of AIDS in America. We also raised our margarita glasses to those we've lost to the virus.

Monday morning, after a sleepless night at the Hotel Rouge on Embassy Row (there had been a chance I'd meet President Bush and I was agonizing over what I'd say to him if I had the chance), I headed over to the Newseum for the Saddleback Civil Forum on Global Health. (Yes, Saddleback as in Rick Warren's Saddleback Church.) Pastor Rick Warren (author of "A Purpose Driven Life") was presenting President George W. Bush with the first International Medal of PEACE from the Global PEACE Coalition in recognition of President Bush's contribution to the fight against HIV/AIDS. The medal is given for outstanding efforts towards alleviating the five global "giants" recognized by the coalition including: "pandemic disease, extreme poverty, illiteracy, self-centered leadership and spiritual emptiness."

The Global PEACE coalition is a web of churches, businesses and individuals working in unison to solve global humanitarian issues through their "PEACE Plan"-an effort to mobilize one billion Christians to: "P" (promote reconciliation), "E" (equip servant leaders), "A" (assist the poor), "C" (care for the sick) and "E" (educate the next generation).

Pastor Warren gave the medal to President Bush for his President's Emergency Plan for AIDS Relief (or PEPFAR) program. Despite the caveats that restrict how the PEPFAR funding can be applied (it doesn't fund needle exchange and supports sex workers only if they sign a pledge stating, basically, that they don't believe in sex work) the program has saved millions of lives around the world. Since 2003, it's provided $18.8 billion to fight global AIDS and Congress has recently authorized an additional $48 billion to apply to future efforts to combat AIDS, TB and malaria.

Rick said, "As my wife Kay and I have been implementing the PEACE plan in 68 developing countries, we have seen firsthand many of the hundreds of thousands of lives that have been saved through PEPFAR and the President's Malaria Initiative. I hope this Forum will show the American people that our global health programs represent more than compassionate humanitarian efforts, but are also a strong, prudent pillar of American foreign policy."

We could use a little help on the foreign policy platform, no doubt about that.

Having traveled myself to the Pacific Rim and Africa in the last year, I have to say, there is no doubt that PEPFAR dollars are working and that the people whose lives they say are obviously extremely grateful. There's no question that the rules of how PEPFAR is applied need revision, and hopefully Obama will do that. There's no question that we need higher levels of spending on domestic AIDS, and hopefully Obama will ensure that as well. But President Bush and his administration do deserve a lot of credit for PEPFAR.

It was fascinating to see President Bush, who was joined onstage by First Lady Laura Bush, speak candidly about his AIDS work. Even to have the opportunity to see him talk for nearly an hour not through the prism of the media was worth the 7 hours it took to get through the Sunday night post-Thanksgiving traffic. He was quite funny, and self-effacing. He is obviously very proud of his wife, who is a lovely, smart and seemingly very compassionate woman. When asked to recall one of his favorite moments of seeing PEPFAR's impact, President Bush remembered being in Africa and being greeted by a throng of children who "were waving at the Americans with more than one finger."

He spoke of the importance, from both the perspectives of foreign policy and national security, of helping the rest of the world fight disease. And he spoke of the necessity of helping the world's orphans. Kay Warren poised some rather pointed questions to the President regarding his attention to the domestic AIDS crisis. He replied, "PEPFAR is part of a comprehensive strategy to deal with AIDS at home and abroad. PEPFAR was never intended to pirate money from domestic funding. [The funding levels for AIDS in America] should give a sense of our commitment. To date, we've spent 99 billion dollars on AIDS in America and funding has increased 40 percent since 2001." I wanted to raise my hand and mention that while that may be true, we still have people dying on AIDS Drug Assistance Programs and that it is my belief that part of the reason people are afraid to come forward and get tested for HIV is because they know they can not afford treatment or care and who wants to be told they have a deadly disease for which there is treatment but that they will die from it because they don't have the money to save their lives, but it wasn't the forum for that. The President continued, "People in America should not think that PEPFAR means we don't care about them."

I don't know whether or not that's true, but it doesn't undermine PEPFAR's impact on AIDS in general or in terms of what it has done to help the rest of the world see that America can indeed be benevolent. And, regardless of the motives behind the program, it has spread a huge swath of healing through parts of the world that you have to see with your own eyes to believe the dimensions of the horrors that exist there. To me, not a penny should be taken from this amazing program. That said, we need to find additional funds for AIDS at home too. It is unthinkable to me that Americans are dying of AIDS In 2008 and that the rate of infection in the District of Columbia is 1-in-20--a rate that rivals that of some sub-Saharan countries and could, arguably, qualify the District itself for funding under PEPFAR.

Rick Warren spoke about using the church to help end the AIDS pandemic. He showed a slide of Western Rwanda. On it were three blue "Hs" indicating the three existing hospitals. He said it was a two day walk, one way, to get to a hospital. The next slide showed about 20 "Xs" marking the locations of the health clinics. It was a one day walk to a health clinic. The third slide showed the 728 churches that exist in that part of Rwanda--it was a ten minute walk for most people to their church. Regardless of attitudes about any particular faith-based organization, or the specifics of what they believe or preach, there is no doubt that organized religion does indeed offer a system that could be used to distribute information and possibly, one day, treatment, counseling and condoms. It is an interesting idea: rather than spend time and money building and staffing clinics, why not employ the help of local religious leaders? (As long as they are willing to talk turkey and acknowledge that people have sex and do drugs and are willing to talk openly about how to do those things safely.) Imagine people in developing nations going to a service at a house of worship of their choice and getting a polio vaccine, a treated mosquito net to ward off malaria, a TB vaccine and information about safe sex, condoms or an AIDS test and, if they are HIV positive, treatment?

Rick Warren said, "Some problems are so big you have to 'team tackle' them. The combination of public and private partnership is a two-legged stool. For stability, you need three legs. You need for-profit organizations, non-profit organizations and the faith-based community. Most of the world has some kind of faith. [Given the way people trust their spiritual leaders] the church brings things [to the fight against AIDS] that government and business can't. 2.3 billion people worldwide claim to be a member of some kind of church. I could take you to 10 million villages in the world and all they have is a church. The church speaks more languages and is in more nations than the United Nations. People of good will of all faiths-or no faith-have to work together or we will never be able to eradicate AIDS."

The was a series of video congrats from Prime Minister Tony Blair, President Kagame from Rwanda (representing all African presidents), Bill and Melinda Gates, Michel Kazatchkine, UN Secretary-General Ban Ki-Moon, Bono and President Elect Barack Obama. I have to say, I got a chill when Bono, who refered to himself as a "friendly neighborhood rock star" said that "3 million people owe their lives to the United States...it's a day to give thanks. God Bless America." Bill and Melinda Gates spoke of the necessity to keep investing in the fight against AIDS saying, "Having made so much progress, it's no time to turn back." Obama said, "I salute President Bush for his leadership in crafting a plan for AIDS relief in Africa and backing it up with funding dedicated to saving lives and stopping the spread of the disease. In my administration, we will continue this critical work to address the crisis around the world. But we must also recommit ourselves to addressing the AIDS epidemic here in the United States with a strong national strategy of education, prevention and treatment focusing on those communities at greatest risk. This strategy must be based on the best available science and built on the foundation of a strong healthcare system. In the end, the epidemic can not be stopped by government alone and money alone is not the answer either. All of us must do our part. This year's slogan, "Stop AIDS, Keep the Promise," is a timely one. In the Apostle Paul's letter to the Corinthians, he asked,'"If the trumpet does not sound a clear call, who will get ready for battle?' We as leaders must continue to sound that call and encourage others to see themselves as leaders in this fight."

Here are two photos from the program:

After the forum, I joined the Warrens and a crew of other people from the AIDS world to chat with Rick about recommendations he could make to Obama and his new administration. It was so encouraging to see a very diverse and very determined group of people coming together despite ideological differences and differences in their missions to try to collaborate on a strategy to better combat AIDS in America.

Then, I hopped in my car and drove like a madwoman back to New York City to rejoin the POZ staff on Broadway. We hosted a Broadway show of top performers singing Burt Bacharach songs to benefit Broadway Cares/Equity Fights AIDS. The house was full and the singing robust and inspiring. World AIDS Day ended with a standing ovation under a sea of floating bubbles and a stage full of people singing, "What the world needs now, is love, sweet love" and "That's what friends are for."

Indeed.

Two nights ago, while flipping around the channels, I came across an old (Season 3) episode of Seinfeld in which Kramer gives George some free, promotional condoms he was given. George uses them and has a scare with a new girlfriend because her period is late and they think she might be pregnant (she wasn't). I remembered seeing the show when it first aired and being amazed that in 1992, on prime time cable, on a hit TV show, people were talking openly about condoms. And it made me wonder: Where are the condoms on TV today? Has anyone seen one brandished recently?

Not only are we missing educational and prevention opportunities by avoiding talking about condoms in the context of cool, sexy shows, I don't get how today's TV writers can resist having fun with the latest technological developments in the world of condoms. I, for one, am amazed at the volume of choices we have now (One of my new faves? Planned Parenthood's totally prettily packaged sets of condoms...try the "Dots" version for a subtle sensation enhancer...).

I'm not a big TV watcher, so I could be missing condom's guest appearances, but I'm pretty sure that mention of them is more scant then the outfits worn by The Girls Next Door. Even on shows where sex is central to the plotline (like Gray's Anatomy, Gossip Girls, Entourage, etc., etc.) the conversation almost never turns to condoms. Just once, I wanna see a TV hottie whip it out (the condom I mean) when things get super steamy.

Earlier on the night I saw that Seinfeld, I went to the 50th anniversary celebration for Harlem's Iris House which benefits folks living with HIV/AIDS. There was faux-gambling and Wii bowling and billards and awesome '80s music and cake - and speeches by people whose lives have been turned around in the right direction by the mighty Iris House. There were also little black velveteen pouches that they passed out on your way out the door containing three NYC condoms (the packaging is designed to look like the signage in the New York City subway; they were produced and given out for free by New York's Department of Health) and two shiny packets of lube. On the pouch, gold lettering read: Power in Prevention. It made me think about the notion of "power in prevention" and how I've journeyed from being embarassed to buy condoms to feeling totally empowered and badass every time I do.



Recently, I stopped at a Walgreen's (okay, I'll admit I intentionally chose one far away from my home town but when I explain you'll see why) to get some condoms. Several of my friends had confessed that they were "uncomfortable being seen buying condoms." So, I volunteered to go get the goods for them. Let me remind you, we're talking middle-aged women here...like the folks on Seinfeld. I found their discomfort a little shocking in a way I would not, say, had they been awkward teens, but if it meant they'd use 'em, I'd buy 'em for 'em. And who was I to judge? I'd once been just like them. Too scared sometimes to save myself. I wonder how many people would rather risk their lives having unprotected sex with a partner of unknown status than they would face the pain of a few tense moments at the drug or grocery store check out?

I cruised the aisles, made my selections based on my rather long and elaborate list (the greatest part was seeing what everyone else preferred. Did so-and-so really need the Magnums? Hmmm.) While I was at it, I took a good close look - for the first time - at all the options. In the past, I'd done the quick "grab and go" approach to condom selection. But somehow, perhaps because I knew I was shopping for others too, I let myself linger and study the lineup of latex. I threw a few new options into my cart (e.g. Trojan's vibrating ring condom and some sort of his-and-hers lube that I think heats up when things get hot and heavy - or maybe it generates the heat; I'll have to report back later)

It was funny that even though I was miles from my home town in a strange drug store minutes before they closed (so I was one of the last people there) I found myself justifying to myself what I was doing. I told myself: I was protecting my body. Saving another person's life. Preventing an unplanned pregnancy. Being responsible, disciplined, health concious and mature. And I wasn't only doing it for myself...but my girlfriends as well.



Still, as good as I felt, I couldn't help but be a little self conscious when the cashier dumped my bounty out on the counter and slowly lifted each box, turning it over and over, on purpose, I'm sure, searching for the price. A middle aged man stood in line behind me. I could see his neck craning to see my items. In the old days, I would have stood, uncomfortably looking at the floor, begging the cashier silently to hurry up. But, since I try to practice what I preach, I straightened my spine, dropped my shoulders and, with a little flip of my hair, turned and looked at the surburban man who wore a wedding ring and was in his fifties and, judging from the children's cough syrup he was holding, was probably a dad and therefore had had sex, looked back at the counter, looked back at him, and smiled and nodded slightly. As in: Yeah, daddy, they're all for me! (Which, of course, they were not.)

I wasn't ashamed. Why should I be?

I don't think he knew what expression to wear, which may have explained why his face contorted under my stare. It was really satisfying to realize that I'd made that critical transition from shame to power that must happen if we, especially women, are to be in a place to protect our health.

Thinking back, I so wish I'd had that little satchel from Iris House. If I had it in my purse as I do now, I would have handed it to him on the way out and whispered in his ear, "Here ya go. Prevention is power. Pass it on."

I can only imagine what his face would have done then.

Maybe I'm not giving the guy enough credit. Maybe - as I did when I saw that George was willing to lay on the latex - the guy in Walgreen's thought I was cool for caring to use condoms. Even better, maybe, someday, he'd tell his own kids how he once saw a middle aged blonde lady not yet quite past her prime buy every condom in his local Walgreen's. And if so, maybe his kid would grow up thinking that buying, and using, condoms was anything but embarrassing.

I'm sitting in my office in New York with an eye on the clock knowing that I need to leave soon to be home in time to watch the final debate between the presidential candidates. (As if I need any further proof of my choice...but I would like to see Obama strike a final blow...) Before I head out, I wanted to share this video with you in case you haven't seen it. Click here to see a CBS News segment comparing the presidential candidates' positions on HIV/AIDS hosted by Dr. Sanjay Gupta. (How much do we love Sanjay for his continual and well informed coverage of HIV? A lot. I will never forget my interview with Paula Zahn. We were talking face-to-face in the studio and suddenly...I could hear Dr. Gupta's voice in the air ((he was in CNN's Atlanta studio, joining us by live feed)) and all my anxiety melted away.)

In the video, Dr. Gupta points out that while both Senator Obama and Senator McCain have said they will continue to support the President's Emergency Plan for AIDS Relief (PEPFAR, currently slated at $48 billion), they differ greatly on how they will address the domestic AIDS epidemic.

McCain's "sex education" plan is to emphasize abstinence (an approach that has been documented to result in higher levels of STD transmission and unwanted pregnancy). He says he will guarantee access to care for those with preexisting conditions and will reduce the cost of drugs through market competition. And he will offer a $2,500 tax credit for expenses related to health (hello! $2,500 is about 2 months worth of meds if you don't have a prescription plan and are on antiretroviral drugs to fight AIDS).

Obama, who actually said the words "HIV" and "AIDS" more than once, also said he is committed to offering universal health care, that he will actively prevent HIV, that he is in support of comprehensive sex education nationwide and HIV testing initiatives in minority communities. He is also prepared to develop a National AIDS Strategy.

Any further questions?

If you haven't already read the current issue of POZ yet, please read the feature story about a National AIDS Strategy for America here. It highlights our recommendations to the next inhabitant of the Oval Office for how to save tens of thousands of lives during the first 100 days of the next presidency.

Never before has the full support of the HIV community been so critical to ensuring our future health, civil rights and longevity. So, be sure you are registered to vote! And get out to those polls! There are approximately 750,000 of us living with HIV in the United States of America. And that's a pretty big swing vote...

I got a call this morning from a friend who believed she may have been exposed to HIV, "by accident" she said, a week ago Friday night. She asked me what she should do; the only advice I could give her was to take an HIV test, now, and again in several months, to have protected sex from here on in and to try to mitigate situations in the future that might "accidentally" expose her to the virus. There was nothing else I could do for her. Had she called me within 72 hours of her potential exposure, I would have also recommended that she go to a doctor, or, over the weekend, the emergency room, and try to secure a course of "PEP" - post-exposure prophylaxis, or a series of anti-HIV meds that, if taken within that 72-hour window, can prevent seroconversion (and therefore potentially keep someone HIV-negative).

The situation reminded me of the frustration that I felt when I read recently that New York Governor David Paterson vetoed an essential piece of legislation critical to the HIV community and to those at greater risk for infection. Had bill A.9915/S.7306 passed, it would have allowed sexual assault survivors to be given PEP free of charge post assault if they could not afford the treatment themselves through private health insurance.

The idea of the bill was to provide $80,000 of financial assistance from the state budget to the Crime Victim's Board to help those who could not pay for potentially life-saving PEP. The bill was introduced earlier this year by Assemblywoman Ellen Jaffee (D-Rockland) and Senator Thomas Morahan (R-Rockland) and passed both houses. That's $80,000 total for one year to cover the cost of all those estimated to need this type of post trauma care versus the hundreds of thousands of dollars it costs, per person, to treat a sexual assault survivor who contracts HIV and has no health insurance.

Regardless of the economics, which seem to make perfect sense, it seems criminal to me that a woman who is unable to afford medication that can save her life should be denied access to it. Especially when she has just suffered huge mental and physical trauma, in some cases, probably just barely escaping with her life.

I wrote about this same issue last summer in an Op-Ed piece that ran in Newsday (read it here.) When I wrote that piece, Eliott Spitzer was the governor of New York. It was before we had heard about his extramarital transgressions. At the time, his suggestion was that rape survivors only get access to PEP if the state located, caught and correctly identified a rape suspect, convinced the suspect to agree to HIV testing and collect a positive HIV test result - all within 72 hours of the attack. The chances that all those things would happen, within 72 hours, seemed slim. If they were not accomplished, then a woman who, through no fault of her own, had potentially been exposed to HIV would be denied access to medical care that could save her life. The rationale for denying PEP to women who had been raped was the same then as it is now - supposedly, saving the state money.

Can you imagine the uproar if the same thinking shared by the current and ex-governor was applied to how we handle the post-exposure treatment of health care workers? Let's see, why don't we recognize that there are cases when surgeons, doctors, nurses, paramedics and nursing assistants are potentially exposed to HIV. And, rather than providing them with immediate free access to medication to save them, let's tell them that first, we're going to have to locate the person they operated on or cared for in a hospital bed or ambulance, convince that person to agree to be tested for HIV, wait for the result and then offer the health care worker PEP all within 72 hours of potential exposure, or else...or else they would just possibly have to become infected with HIV. And what if they couldn't afford if - even after all of that? Well, we'll just have to let nature take its course.

In a nation where we have recently revised the number of new HIV infections we see each year (up by 40 percent from the previously reported 40,000 to the new 56,300) and where an increasing number of those cases are among women, why we would not vehemently protest ANY local, state or federal policy that prevented people from accessing medication that would save people from becoming HIV-positive, thereby stemming the future spread of HIV is a question I can't seem to answer. Anybody have any ideas? Help me understand this one...

An alleged photo of vice presidential candidate Sarah Palin

By now, you’ve likely heard that Bristol Palin, the 17-year-old unmarried daughter of Republican vice presidential candidate Sarah Palin, is five months pregnant. Perhaps you’ve also heard that this bit of news was released to prove that Sarah Palin’s own fifth child, Trig, who is about five months old, IS actually her own child—and not that of her daughter, as some liberal blogs unofficially linked to the Obama campaign (e.g., barackoblogger.com) have hinted. The allegation was that Sarah Palin had faked her own pregnancy to cover up the fact that her teenage daughter was with child. In order to dispel that myth, Sarah Palin admitted that her teenage daughter is currently with child. Got that? (Perhaps someone should remind the Palins that Juneau is a town in Alaska, and not license to be a teenage mother.)

A senior McCain official stated that though they had no evidence that Obama and/or his campaign was behind the allegations, the “blog rumors circulating on websites that appeared to support Obama had the effect of being ‘a real anchor around the Democratic ticket.’” For his part, Senator Obama denied the connection, saying he considered people’s families “off-limits” vis-à-vis political campaigning.

“We don’t go after people’s families,” Obama said. “We don’t get them involved in the politics. It’s not appropriate and it’s not relevant. Our people were not involved in any way in this and they will not be. And if I ever thought there was somebody in my campaign that was involved in something like that, they’d be fired.

“It has no relevance to Governor Palin’s performance as a governor or potential performance as a vice president,” he added. “So I would strongly urge people to back off these kinds of stories.”

Okay. I get it. But she offered up the news. Okay, I get that she offered the news in response to people trying to make up nasty lies about her family. And while I agree with Obama in theory, I also think these types of things are relevant to know about someone who could be the first female president of the United States (if McCain were to realize people’s fears of falling ill). How, for example, would she lead this nation on the issue of Roe v. Wade (well, we know; Palin is a staunch anti-abortionist and pro-lifer).

But as a female AIDS activist, I want to know how Palin feels about offering comprehensive sex education to young Americans in this era when one in four teenage girls has at least one STD (and we have no idea how many have HIV, because the ones screened for that study weren’t tested for HIV) and when 34 percent of new HIV infections are among people younger than 30.

I find it amazing that the Republicans think that the same kids who are too young, impressionable and fragile to be taught the facts of life are capable of determining whether they are ready to become parents. How is it that kids can’t be taught about condoms even when they can have babies? And how will those kids parent their own kids if they themselves were not given proper sex ed? When will we stop the cycle of refusing to divulge lifesaving information to America’s youth?

If the fact that Bristol plans to keep the child and marry the father makes her pro-life poster-girl material, couldn’t she also be used as evidence that America’s teens are having unprotected sex and are therefore at risk for contracting HIV? Has anyone mentioned to Sarah or Bristol that anyone who has ever had unprotected sex is at risk for contracting HIV? Has Bristol ever been tested? Will she?

I can get down with Obama and agree to leave the Palins alone, but only under one condition: We use Bristol as an example not just of the right to life but also of the lack of widespread and complete sexual education in America. “Children” who are old enough to become parents deserve to know the whole truth about human health as it relates to their sexuality.

Bristol Palin is living proof that America’s kids are sexually active. The issue is not whether or not abstinence works to prevent the spread of sexually transmitted diseases and unwanted pregnancies (it does), but whether or not it’s possible to keep people, particularly teens with raging hormones, from having sex (apparently, we can’t). Bristol is proof-positive of our nation’s failure to realize that abstinence is a farce.

We need real leadership at the highest levels of politics on the issue of comprehensive sex education if we hope to save the lives of our children—and our children’s children. Being pro-life is not the only way to save a child’s life.

We’re not the only ones who find this subject saucy...

Check out the Black AIDS Institute’s press release from today.

Sexologist and friend of POZ Logan Levkoff blogged about the issue on the Huffington Post.

When I first heard that the Chinese government was promoting safer sex at the 2008 Olympic Games by distributing information and condoms in hotels throughout Beijing, I was psyched (yeah, I know, I’m so ’80s). (Read the story here: http://www.asiacatalyst.org/DJpr0808.html and and http://www.abcnews.go.com/Blotter/story?id=56038308&page=1). Their reasoning? They want to crackdown on potential protesters. Detainees will not be allowed to leave the country while the Olympics are taking place. Which begs the question of whether the Chinese still fear that admitting that they have an AIDS epidemic will taint their reputation.

“None of the Asia Catalyst fellows planned to speak to the media or protest while overseas,” Meg Davis of Asia Catalyst said. “As always, Chinese authorities generate more bad press when they detain peaceful AIDS advocates than when they simply allow them to get on with their work.”

One of the AIDS advocates who was kept from traveling is Duan Jun—the 35-year-old founder of AIDS Care Home (关艾之家), an organization in Henan province providing support to children affected by AIDS. He has been prominent as a national advocate of AIDS treatment access, and as a representative to the Country Coordinating Mechanism of the Global Fund to Combat AIDS, Tuberculosis and Malaria.

A good friend of my family was an executive for Johnson & Johnson during the time when someone tampered with Tylenol. Do you remember the hysteria? His approach to the news—which is now a case study at many famous business schools—was to embrace the truth that someone had messed with Tylenol and, in order to protect the American people, yank every single bottle of Tylenol off the shelf. It cost J&J millions both in the wasted product and in the expense of replacing it. But, in the end, admitting that there was a tainted product and owning the truth that these things happen and openly dealing with it, they possibly saved countless lives. And, ironically, in what could have been a trust-eroding episode, J&J secured the people’s belief in their brand; they are still one of the most trust-worthy American brands today.

Perhaps the Chinese government should consider the impact of what it does to their public face when they punish and detain those who are trying to help the people that The People’s government has so long ignored. Perhaps they should study the Tylenol case and imagine how much better they might look if they embraced the fact that AIDS is an epidemic in China, and if they were willing to focus as much on treatment as they seem to be on prevention.