October 2008 Archives

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...