Living
Gay, bi men remain key to HIV epidemic
After 30 years of AIDS, many breakthroughs but infection rates on the rise
On June 5, 1981, the U.S. Centers for Disease Control and Prevention published an article in its authoritative journal Morbidity and Mortality Weekly report that experts now consider the first signal that an unprecedented worldwide epidemic had begun.
“In the period of October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carini pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died,” the MMWR article stated.
“Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients,” said the article. “The occurrence of pneumocytosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual.”
It would take another few years before scientists named the condition detected in the men discussed in that MMWR article as Acquired Immune Deficiency Syndrome or AIDS. The name AIDS followed an earlier term used by some researchers and the media – Gay Related Immune Disorder or GRID.
In reflecting on the tumultuous developments surrounding AIDS over the past 30 years, leaders of AIDS advocacy organizations and LGBT activists in the U.S. who lived through the early years of the epidemic say that, to some extent, the MMWR article of June 1981 still has considerable resonance for gay men.
They acknowledge that so much has changed for the better over the past 30 years, including breakthroughs in biomedical research resulting in highly effective drugs that transformed AIDS from a death sentence into a manageable, chronic illness like diabetes.
But AIDS activists also point out that HIV and AIDS continue to disproportionately impact gay men or men who have sex with men (MSM) in the United States and other countries.
And although the perception of AIDS as a “gay disease” has largely receded from the minds of most Americans, AIDS activists say they find themselves in the ironic position of having to remind Congress and state and local governments that more resources and funding are needed for HIV prevention programs targeting gay and bisexual men.
“MSM is the only group for whom, according to the CDC, new infections are still increasing,” said Ronald Johnson, vice president for policy and advocacy for AIDS United, a national group formerly known as AIDS Action.
“So there continues to be a concern that there is not enough targeted prevention resources to MSM, particularly MSM of color and young MSM of all races and ethnicities,” Johnson said.
According to the CDC, while MSM account for about 2 percent of the U.S. population, more than half of all new HIV infections in the U.S. each year (53 percent) occur among MSM. CDC data also show that MSM make up nearly half of all people living with HIV in the U.S. – 48 percent.
CDC figures show that white MSM “account for the largest number of annual new HIV infections of any group in the U.S., followed closely by black MSM,” according to a CDC fact sheet released last month.
“There are more new HIV infections among young black MSM (aged 13-29) than among any other age and racial group of MSM,” the fact sheet says.
The Obama administration, with input from AIDS advocacy organizations, released a National HIV/AIDS Strategy document in July 2010 that, among other things, calls for an aggressive effort to develop better HIV prevention programs targeting MSM.
Johnson and Carl Schmid, deputy executive director of the AIDS Institute, a national advocacy group, praised the administration for developing the strategy document, which they say covers most of the bases needed for addressing HIV prevention programs for MSM.
But the two said the proposals in the strategy document have yet to be fully implemented. They note that delays in its implementation are due, in part, to the U.S. economic situation that has prevented needed increases in federal AIDS funds and severe cutbacks in state and local funding for AIDS-related programs.
Phill Wilson, president and CEO of the Black AIDS Institute, said in a commentary last week in the Washington Informer, a black community newspaper, that he fears the horrors of the AIDS epidemic of the 1980s, when friends and family members watched loved ones die due to a lack of effective medical treatment, could return to some degree in the next few years.
According to Wilson, if the federal government fails to boost funding for the federal-state AIDS Drug Assistance Program (ADAP), low income people who rely on the program to provide them the medications they need keep the AIDS virus in check could become casualties just as their predecessors became casualties years earlier. But this time, he said, an inability to gain access to medicine due to funding shortfalls would be responsible for their fate at a time when effective medicine is readily available.
He called such an outcome “immoral.”
The ADAP program was created under the Ryan White AIDS Care Act to provide life-sustaining drugs for low-income people with HIV and AIDS who are under insured or don’t have any health insurance to help pay for the drugs.
ADAP funding cuts by states and a large increase in the number of people applying for ADAP assistance has resulted in nearly 8,000 people being placed on state waiting lists for the AIDS drugs they need to remain healthy.
The health insurance reform law that President Obama proposed and Congress passed two years ago was expected to relieve the ADAP funding pressure on states when it takes effect in 2014. However, some states that oppose the law have filed lawsuits seeking to prevent its provision requiring all citizens to buy some form of health insurance from going into effect, making its outcome uncertain.
Nearly all AIDS advocacy groups support the law, saying it would strengthen medical care for large numbers of people with HIV/AIDS.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, an arm of the U.S. National Institutes of Health, has been the leading federal government official monitoring the AIDS epidemic and directing AIDS-related research since the disease burst on the scene in 1981.
In a speech commemorating the 30th anniversary of AIDS at NIH headquarters in Rockville, Md., on Tuesday, Fauci said he’s optimistic that an AIDS vaccine can be developed in the near future.
“We have scientific evidence that a safe and effective HIV vaccine is possible,” he said in a statement released on May 18.
“In 2009, a clinical trial in Thailand involving 16,000 people demonstrated for the first time that a vaccine could safely prevent HIV infection in a modest proportion of study participants,” he said. “Many of the best minds in HIV vaccine science are examining blood samples and data from the Thai trial to learn how the vaccine candidate prevented HIV infections and to consider how it could be modified to be more effective.”
Fauci said NIAID is also optimistic about development within the next few years of effective vaginal and rectal microbicides that can be used to prevent the transmission of HIV during sexual contact.
Fauci and other researchers have also pointed to studies showing the effectiveness to a certain degree of prescribing HIV drugs for use by non-infected people believed to be at high risk for HIV infection, such as men who have sex with men.
Known as pre-exposure prophylaxis, or PrEP, the use of this prevention measure is said to have the drawback of being less effective if people fail to take the drug as required. Some also have expressed concern that people using this prevention method are subject to potential side effects of the drugs and may be discouraged from using condoms, which experts say is one of the most effective methods of HIV prevention.
Events and developments in the early years of AIDS
• 1981: The CDC reports in its June 1981 edition of MMWR and subsequent editions that year that an estimated 170 gay men had succumbed to Pneumocystis carini pneumonia and Kaposi’s sarcoma, a rare skin cancer, over the preceding two years. The CDC studies of these cases cited a serious malfunctioning of the body’s immune system in those who contracted the conditions.
• 1982: Gay Related Immune Disorder, or GRID, became the first name to describe what is now known as AIDS. Cases reached epidemic proportions in the U.S., moving beyond clusters of gay men in New York, San Francisco and Los Angeles and into groups with no obvious risk factors.
• 1983: Gay leaders, independent medical researchers and health and social services agency officials testify before a congressional committee that the federal response to AIDS was highly inadequate. They issue a plea for the federal government and the Reagan administration to increase federal funding and federal initiatives to fight AIDS.
• 1985: In late July, actor Rock Hudson stunned the nation when he issued a statement saying he had AIDS and was receiving treatment in Paris that he said he couldn’t get in the U.S. He died three months later at age 59. His announcement and death drew massive mainstream media attention to AIDS. His death prompted his close friend, actress Elizabeth Taylor, to help found the American Foundation for AIDS Research to raise funds for AIDS causes.
• 1988: The NAMES Project AIDS Memorial Quilt makes its second trip to Washington in the spring, where it’s displayed on the Ellipse near the White House. Later that year, about 1,100 AIDS activists staged a protest at the headquarters of the U.S. Food and Drug Administration in suburban Maryland outside D.C., denouncing the FDA for taking too long to approve new drugs for people with AIDS. Police arrested at least 176 of the protesters after they blocked access to the FDA building’s main entrance.
Advice
We’re getting married but our parents object
Will their disapproval and shortcomings derail our hopes for a happy life?
Dear Michael,
My girlfriend and I are getting married! We’re really excited, but we’ve got some big concerns as well.
All of our parents have had multiple marriages. I think 10 between the four of them. So we don’t have much in the way of role models for a successful marriage.
Also, we don’t have any parental support. Except for one of my ex-stepmothers whom I’m close to, none of our parents are happy that their daughter is getting married to another woman. That’s an understatement. Religious objections, moral objections, being angry that we’re “embarrassing them,” these are some of the things we’ve been told.
We do have some supportive siblings and step-siblings, which is great, although they’re getting pushback from parents about attending our wedding.
Given all this, what suggestions do you have for how we can make a go of our marriage? The divorce rate is over 50 percent for everyone. With all this baggage, we’re worried that we have even less of a chance. Thank you.
Michael replies:
First, congratulations!
Regarding your lack of family support: I’m sorry that you both have to deal with so much criticism, disdain, and judgment. Please don’t let your parents’ negativity influence your own views of yourselves and your relationship. Focus instead on the love and caring you will get from friends, community and the family who are present on your big day (I hope your siblings are brave enough to make it!). Being the recipients of that support is one of the sweetest parts of getting married.
Don’t worry about the high divorce rate. While some couples really shouldn’t stay married, lots of people get divorced because they don’t know what is required to have a good marriage, or don’t put in the effort to do so. That does not have to be your fate.
Similarly, your parents’ terrible track record doesn’t mean you have to repeat their marital histories. The skills to have a strong marriage are learnable.
To that end, here are the best tips I can offer the two of you:
- If you want a loving marriage, be a loving partner. Don’t snipe, sulk, or do the silent treatment when you’re mad. Unconditional love is largely a myth. Even our dogs won’t love us if we are mean to them.
- Don’t spend much time or effort focusing on what your spouse is doing wrong or how she is letting you down. Doing so leads to resentment and feeling like you’re a powerless victim. Instead, ask yourself what your own contribution is to the problem, and what you can do to make things better. You don’t have much power over your partner, but you have a lot of power over yourself.
You can certainly ask your spouse for what you’d like from her, but don’t expect to always get it. And don’t base your own wellbeing or good behavior on what your partner does or doesn’t do.
- Because any two people are always different in some important ways, there is no way that you both can always want the same things, or think the same way, or have the same priorities. Accept this! There has to be room for each of you to be an individual, not only part of a couple.
- Be generous as often as you can be, and have a boundary when it’s important for you to have one.
- When your spouse states that she has a boundary, respect it. Do not push her to back off from something that is important to her.
- Don’t keep score, including how much more you do or how often you don’t get your way. Instead, work together to have a collaborative marriage where you work together to make decisions and get things done.
- Strive not to weigh the relationship down with neediness. Once we’re grownups, it’s mainly our own job to soothe ourselves. You don’t want to burn out your partner’s empathy.
Of course you can ask for a hug, love, reassurance, support, advice, and a shoulder to cry on when you’re down. Just aim be the first person you turn to when you’re upset, and do your best to keep your own mood steady.
- Do not wait for your significant other to go first. Not on planning a date, not on apologizing, not on loading the dishwasher or cleaning the bathroom. If you wait for her to make the first move, you will have a resentful relationship where nothing good ever happens.
Keeping these principles part of your operating system, even — and especially — at those moments when your spouse isn’t doing her best, will go a long way toward helping you build and maintain a loving and happy marriage.
Michael Radkowsky, Psy.D. is a licensed psychologist who works with couples and individuals in D.C., Maryland, Virginia, New York, and all PSYPACT states. He can be found online at michaelradkowsky.com. All identifying information has been changed for reasons of confidentiality. Have a question? Send it to [email protected].
Technology
E-INFOSOL leaders encourage youth to pursue tech careers
Service-disabled, veteran-owned business based in Rockville
The technology field can be a gateway to economic mobility.
At E-INFOSOL, a service-disabled, veteran-owned business based in Rockville, Md., CEO and co-founder Fredy Pesante and Vice President of Service Delivery Charles Barnett say internships, mentorship and free online resources can help young people break into IT. The U.S. Bureau of Labor Statistics projects an average of 317,000 job openings per year in the field until 2034.
Led by Iraq War Army veteran Pesante, E-INFOSOL stands out for its efforts to increase opportunities for veterans, people of color and others in under-resourced communities to find careers in tech and its mental health support for employees.
Pesante and Barnett spoke with Youthcast Media Group about technology careers. The executives also talked about the value of government security clearances, stressing that the choices youth make today — including their digital footprints and personal conduct — can shape tech workforce opportunities.
The interview has been edited for clarity and length.
Can you describe what E-INFOSOL does and what your role is there?
BARNETT: We focus mainly [on] providing IT services to the federal government. And those IT services consist of cloud engineering, cloud development, cloud security, app development and cybersecurity, and a lot of infrastructure virtualization-type work. My role is [vice president] of service delivery, responsible for ensuring that we are providing great customer service to our customers [and] that we are meeting our deliverables and our requirements to our customers. But also, one of the key focuses is ensuring that our employees have the tools [and] resources to be successful, and that includes coaching, training and developing our employees, and obviously treating them like they want to be treated.
Is IT a career that can help reverse the cycle of poverty in low-income parts of the D.C. area? What more would need to be done to potentially get more youth access to the right technology and training?
BARNETT: One thing we’ve got to ensure is that we, as professionals that have been through it, that have had a lot of experience in the IT space, provide that mechanism to bring folks along with us. That is, exposing our youth to information technology at a young age. If we can show that it’s very interesting, and it’s beneficial, and if they are committed to it and they show a sense of pride and commitment, I think it works out for a lot of people that are coming up from disadvantaged communities that don’t have technology within the house and who don’t have mentors that come from the technology field.
PESANTE: I still think internships work well for high school, even college. IT certifications are still something in demand in specific areas … Charles and myself, we’re part of the Technology Advisory Board at [Montgomery College] and they offer free resources as well to give an advantage to students that don’t have a career path. So find a way to leverage those local resources that are available and try to capitalize on those. IT is such a great field because even though it’s great to have an undergraduate (degree), that is not always a full basis into having an IT career. So you could start in high school … There’s a lot of free stuff online. There’s a lot of YouTube videos. There’s so many resources. To be honest, there’s even now AI that can really teach you [and] it’s free to a certain level that you could use.
As a veteran-led company with a significant veteran workforce, how does E-INFOSOL support employee well-being and mental-health awareness?
PESANTE: Approximately 35 percent to 40 percent of our employees are veterans. Veterans often gravitate toward working with one another because we share a mission-focused mentality and a commitment to getting the job done.
Mental health has always mattered to us, but it became even more personal after we lost one of our respected leaders, a fellow veteran who had battled mental illness. I worked closely with his family to help honor his story and legacy.
That experience reinforced the importance of supporting mental health across our entire workforce. We encourage managers to maintain meaningful contact with employees, provide appropriate training, and connect people with available resources. We want our actions to match what we say about being a people-first company. Our employee retention has remained strong, and I believe the way we care for our people has contributed to that.
How does getting or having a U.S. government security clearance help? How would a young person pursue getting a security clearance, and what should they keep in mind if they plan to do so?
PESANTE: We live in a world of social media. Make sure you’re … not going to be concerned with somebody finding you on the Internet behaving a certain way. Even though, in some locations, drugs like medical marijuana and what not are considered legal, [that is] not [the case] in the federal government. The use of any substances that could be mind-altering, that’s not a thing [that’s allowed] in the federal government. Also, from a legal perspective, from a criminal background perspective, that’s something that any checkup is going to come up [with], so [make] sure that you’re behaving in a manner exemplifying honesty, reliability, sound judgment, responsible conduct, and trustworthiness. The best thing for getting clearances at that early jump is internships. We’ve been able to get people clearances through the internship process. After a person fits a specific requirement, you train them and they get a government clearance, and that helps them have a head start. When I moved out here after living in Puerto Rico and I was in the Army, I had a clearance. I was able to find a job quickly.
Any other advice for young people considering this path?
PESANTE: I would say go for it. As minorities, there are a lot of external factors we can’t control, but nobody can ever stop you if you’re great at what you do, if you have a strong work ethic and if you put a lot of effort into making the best out of yourself. It’s never too early to work on yourself and look for ways to work on your professional career, work on your soft skills… Make sure you are working with peers and surrounding yourself with the right people throughout your whole life. I had a mentor myself when I started in the business — Carlos Rivera. He’s from Puerto Rico. He was a veteran. And that always helped me out, having somebody that you want to aspire to [be].
BARNETT: Do not be afraid to fail. You know you’re going to make mistakes. People around you are going to make mistakes. Learn from it, and learn from that, and don’t allow people to impact your goals and objectives. You set your path and if you set your path, you’re going to go a very long way, and if you’re really committed and continue to establish relationships along your entire path, you’re going to reap the benefits of ensuring that you are in a position to take advantage of opportunities that are in front of you.
Joseph Jackson is in the class of 2027 at Bard High School Early College DC, one of Youthcast Media Group’s partner schools. Shreya Jyotishi, YMG Assistant Manager of Content and Programs, also worked on this story.
Remember when buying a new car didn’t require the financial stamina of a “Succession” character? This summer, the average new-vehicle price hit $49,758—basically $50,000 with a little lipstick on it. That makes the Kia K4 hatchback and Nissan Kicks especially refreshing. Neither requires a second mortgage, a trust fund or a makeover to look good. And both prove you can still buy a new vehicle without selling your soul — or your vacation plans.
KIA K4 HATCHBACK
$25,000
Mpg: 28 city/34 highway
0 to 60 mph: 9.1 seconds
Cargo space: 22.2 cu. ft.
PROS: Edgy exterior. Roomy interior. User-friendly controls.
CONS: So-so base engine. Pricy turbo. No all-wheel drive.
WHAT’S NEW: Basically everything. The K4 hatchback debuted earlier this year, joining the K4 sedan.
Kia’s stylish five-door K4 boasts three trim levels. The first two use a capable four-cylinder engine, while the top-of-the-line model comes with a turbo.
That turbo provides some genuine zip, though it won’t blow your socks off. Think Janelle Monáe in a tailored suit, not Brad Pitt arriving at the F1 racetrack in a fireproof jumpsuit.
The real star, though, is the design. Sleek. Upscale. A tad mysterious.
Inside, another surprise: vast legroom and storage. Fold the backseats and you can toss in the usual road-trip clutter, plus that regrettable piece of furniture you bought after watching one too many HGTV shows.
Technology is also a bonus, including a digital key that lets you use a smartphone or smartwatch as a direct key fob. You can even share this digital key with friends or family. Just don’t share it with anyone who often loses their actual keys.
Despite some SUV vibes, the K4 remains unapologetically car-like. It sits lower. Feels more conventional. And offers hatchback practicality without itching to conquer the Rockies.
The biggest downside? No all-wheel drive.
Still, for shoppers who crave style, space and gadgetry, the K4 won’t break the bank. To me, it’s like finding a designer jacket at a thrift shop.
NISSAN KICKS
$23,000
Mpg: 28 city/35 highway
0 to 60 mph: 8.9 seconds
Cargo space: 23.9 cubic feet
PROS: Dashing design. Safety gear galore. All-wheel drive.
CONS: Bit pokey. Noisy engine. Limited rear visibility.
WHAT’S NEW: Redesigned last year with a bit more power, bigger cabin and bold looks, Nissan leaves the winning formula alone.
Like the Kia K4, the Nissan Kicks comes in three trims levels. But it also includes all-wheel drive — a nice plus when navigating snow, sleet or cratered alleys.
There’s an extensive suite of active and passive safety features. And the high ground clearance improves driver visibility, which is somewhat hindered in the back by thick roof pillars.
Styling is tastefully flamboyant. Dramatic lighting. Two-tone finishes. Cheerful, without being cartoonish. Miranda Priestly would approve.
Power, though, is more akin to Miranda’s art director Nigel Kipling. Dependable. Functional. Just not enthusiastic.
Inside, the mod cabin has large 12.3-inch displays, wireless smartphone connectivity and charging, and “zero gravity seats” designed to reduce driver fatigue and stiffness. Add in the stunning Bose Personal Plus audio system, with 10 speakers—including those integrated into the headrests—for an immersive 360-degree sound experience.
The Kicks doesn’t try to be rugged or luxurious. It simply offers a lot of everyday usefulness in a small package.
There is a trade-off. The engine gets noisy when pushed, and there are sportier (often pricier) competitors. But that’s hardly a crime. Not every vehicle needs to perform catwalk struts down the street.
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