Connect with us

Opinions

The intergenerational impact of aging with HIV

Dec. 1 is World AIDS Day

Published

on

World AIDS Day 2023 at the White House (Washington Blade Photo by Michael Key)

BY TERRI L. WILDER | Today, Dec. 1, 2024, the global HIV community marks the 37th annual World AIDS Day (WAD). Here in the U.S., the face of HIV looks quite different than it did on the first WAD in 1988. It is estimated that more than 50 percent of people living with HIV (PLHIV) in the U.S. are aged 50 and older ā€” an age that must have seemed impossible to the countless young people diagnosed during the height of the epidemic. Some were diagnosed later in life, whereas others have lived with HIV for many years ā€” in some cases, since birth. 

While their stories differ, PLHIV all face a common challenge: facing the impact of aging with HIV. The theme of WAD 2024 is ā€œCollective action: Sustain and accelerate HIV progress.ā€ A key to this progress is uplifting and understanding the real stories and lived realities of those growing older with HIV and using their experiences to guide proactive policy.

The spread of misinformation

In 1981, the first cases of what would later be identified as HIV (human immunodeficiency virus, the cause of AIDS) were reported. Three years later, Nathan Townsend was diagnosed with HIV at age 30.

When he got the call with the news, he was shocked. Early reports of HIV often suggested that only specific communities ā€” most notably white gay men ā€” were vulnerable to HIV. However, widespread misinformation contributed to the Black community later accounting for nearly half of all AIDS-related deaths, according to a 1999 CDC report.

Then, Nathan received more grim news: He was told by his doctors he only had two years to live. Believing he was going to die, Nathan purchased a casket and paid for his future funeral ā€” one that thankfully didnā€™t come.

Today, Nathan is one of the growing number of older people  who live with HIV, with researchers estimating that 70 percent of those living with the virus will be 50 and older by 2030

The stigma of HIV diagnosis

As awareness of HIV grew in the late 1980s, many Americans expressed stigmatizing attitudes. A 1985 Gallup poll found that 28 percent of Americans reported that they or someone they knew had avoided places where gay men might be present because of HIV; by 1986, the percentage had grown to 44 percent.

This was the beginning of the endless stigma faced by those living with HIV ā€” something Porchia Dees and Grissel Granados experienced.

Porchia was diagnosed at two months old through perinatal transmission and is part of the first generation of children born with HIV. Doctors indicated that Porchia wouldnā€™t live to see her fifth birthday. Fortunately, Porchia would prove them wrong.

Porchia still remembers the stigma she felt when she learned of her diagnosis in sixth grade from a social worker at the Childrenā€™s Hospital in Los Angeles. She recalled being pulled aside and asked if she was sexually active before being explicitly warned against having any sexual activity. The next time she heard about HIV was in a sex education class, which furthered the stigmatizing message that she would never live a ā€œnormalā€ life.

Today, Porchia is an advocate, changing peopleā€™s perspectives on what it means to live with HIV, but it does not come without challenges. At 38-years-old, Porchia is more focused on her health after witnessing long-term HIV survivors battle kidney failure, renal failure, bone density issues, cognitive issues, breast cancer, and shortened lifespans.

Grissel, another lifetime HIV survivor who acquired HIV through perinatal transmission, considers herself lucky that her mother explained the diagnosis to her at a young age. Despite her familyā€™s support and honesty about HIV, a now 38-year-old Grissel still had to grow up with fear and uncertainty while now facing the fear of early mortality. 

Social isolation

When Rev. Claude Bowen was 33 years old, he received a phone call that would change his life: His HIV test came back positive.

Believing he only had two years to live, he hid himself away, self-medicating and isolating himself from his support systems. These coping mechanisms served as an escape from his reality. But eventually, he realized that this was his reality and wanted to fight. He started getting involved in HIV education and advocacy work after his best friend disappeared in the late 80s. He would soon get a phone call, learning his friend had died of complications related to HIV.

For the LGBTQ+ community, losing friends and chosen family during this time became all too common. From 1984-1986, over 42,500 people in the U.S. died from HIV-related causes, which doesnā€™t account for individuals who died from complications related to HIV whose families or loved ones asked that the cause of death not be disclosed. For older PLHIV, this devastating loss of community has contributed to social isolation and loneliness.

Living and aging with HIV

With access to care, HIV is no longer a death sentence, thanks to scientific advancements in medications and treatments. Whether in your 70s like Nathan or 38 like Portia, many health challenges now faced by people living with HIV are more related to aging than to HIV-related illnesses.

Aging with HIV comes with a greater risk of health problems from inflammation from the virus and the long-term use of HIV medications. Many people aging with HIV also face the ā€œdual stigmaā€ of ageism and HIV-related stigma, leading to high rates of anxiety, depression, and substance use disorders. Furthermore, many have lost friends and family to the HIV epidemic, leading to loneliness and increased risks of cognitive decline and other medical conditions in older adults, as found in a 2023 study from Frontiers in Aging Neuroscience.

Acknowledging the challenges that people aging with HIV face helps ensure they get the necessary support to live a fulfilling and thriving life.

Taking action

The Older Americans Act (OAA) funds aging services and supports for older people across the country to age-in-place. In 2024, the federal Administration for Community Living (ACL) issued new regulations ensuring that LGBTQ+ older people and older people living with HIV could have more equitable access to the programs funded under the OAA. Yet, there is still more work that could be done to ensure equitable access for those living with HIV. Congress is currently in the process of reauthorizing the law.  

While we face a challenging time in modern politics, we must urge our legislators to do whatever they can to ensure that the OAA and similar laws support PLHIV. And all of us must work with our state and area agencies on aging to robustly implement the latest OAA regulations, to ensure that all older people, including LGBTQ+ older people and those living with HIV, get the services and supports they need to remain independent.

States can also do more to protect people living with HIV by passing state-level LGBTQ+ and HIV Long-term Care Bills of Rights, as advocated for by activists and organizations, including SAGE, the worldā€™s oldest and largest advocacy organization dedicated to improving the lives of LGBTQ+ elders. These laws ensure that LGBTQ+ older people and those aging with HIV receive equitable treatment in long-term care facilities. For instance, one long-term survivor, 82, who asked to remain anonymous for this piece, credits his doctor for his excellent treatment and care, saying, ā€œIt is tremendous to have someone in your corner that you can talk to openly and ask questionsā€ without fear of judgment.

Finally, we must advance policies that address the needs of all those living with HIV and AIDS, no matter their ages.

The time is now

The impact of living with HIV is different for every generation. From lifetime survivors like Porchia and Grissel to those aging with HIV like Claude and Nathan, access to community support, services, and HIV-specific healthcare is essential for quality of life across generations.Ā 

This WAD, HIV advocates, aging organizations, and stakeholders must stand with local legislators to ensure care, protection, and support for all PLHIV.

Terri L. Wilder (She/Her), MSW, is the HIV/Aging policy advocate at SAGE, the worldā€™s oldest and largest advocacy organization dedicated to improving the lives of LGBTQ+ elders. In her role, she implements SAGEā€™s federal and state HIV/aging policy priorities. 

Terri has worked in HIV care since 1989, providing social services, directing education programs for clients and medical providers, and advocating for policy change. She is an experienced public speaker who has presented at conferences worldwide on various HIV topics. Terri is also an award-winning writer who has published on multiple HIV-related topics through The Bodyā€™s website, among others. Terri served on the New York Governorā€™s Task Force to End AIDS (EtE) and the New York Governorā€™s Hepatitis C Elimination Taskforce, where she contributed to the development of state plans to end the HIV epidemic and eliminate Hepatitis C. 

She is a member of the New York State Department of Health AIDS Advisory Council EtE Subcommittee, and the Minnesota Council for HIV/AIDS Care and Prevention (MCHACP). Terri has been recognized for her work through the POZ 100: Celebrating Women edition of POZ magazine (2017), as well as awards from the NYS DOH AIDS Institute, AIDS Survival Project, and Bridging Access to Care, Inc.

Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Opinions

Will RFK Jr.ā€™s ideas cause illness and death?

A danger to the children of the nation, and the world, if confirmed

Published

on

Robert F. Kennedy, Jr. (Photo by ITLPhoto/Bigstock)

We are looking at having our ideas of good healthcare turned upside down. This will happen if RFK Jr., whose ideas on healthcare have been widely discredited, is confirmed as Secretary of Health and Human Services. 

Kennedy thinks vaccines hurt people. He believes a measles epidemic in our country is better than children getting a measles vaccine. Brian Deer writes in the New York Times, during a measles outbreak in Samoa, ā€œKennedy sent the prime minister of Samoa a four-page letter. In it, he suggested the measles vaccine itself may have caused the outbreak.ā€ He wrote in his role as the chairman of Childrenā€™s Health Defense, an anti-vaccine group. ā€œBy the time a door-to-door vaccination campaign brought the calamity to a close, more than 80 children had died.ā€ Imagine him writing that letter as U.S. Secretary of HHS. 

Kennedy supports the discredited theory that childhood vaccines cause autism. In 2023, he even said the polio vaccine, which has basically eradicated polio, ā€œdid more harm than good.ā€ The Times wrote, ā€œMr. Kennedy, an environmental lawyer, has also spent years working abroad to undermine policies that have been pillars of global health policy for a half-century, records show.ā€ 

Today most people donā€™t even know what diphtheria is, outside of the historical context. If they do itā€™s most likely because they have scrutinized a childhood immunization schedule and know itā€™s the ā€œDā€ in the DTaP vaccine. ā€œVaccine breakthroughs over the past two centuries have cumulatively made the modern world a far more hospitable place to be born. For most of human history, half of all children died before reaching age 15; that number is down to just 4 percent worldwide, and far lower in developed countries, with vaccines one of the major drivers of improved life expectancy.ā€ So, one has to question how someone like RFK Jr., with his warped view of vaccines for children, will impact their lives. How many will become ill, or die, because of him? 

Itā€™s not just childrenā€™s vaccines we have to question Kennedy on. What will he do if we have another pandemic, and there surely will be one. Will he agree the government should support research to develop a vaccine, or will he oppose funding? Will he support the World Health Organization, or will we see the United States withdraw from it? What about the continued research at NIH, which supports development of a vaccine to end HIV/AIDS? What does he now believe is the cause of AIDS? Will he end the studies at NIH to aid in the search for a vaccine to end prostate cancer? Or will he determine it is better to let millions die, rather than develop these vaccines. 

We have to ask whether he will stop Medicare and Medicaid from covering the cost of vaccines for those who want them, and canā€™t otherwise afford them. Will he work to stop mandates to have children vaccinated before they enter school? These are just some of the questions the Senate Health, Education, Labor, and Pensions Committee, and the Senate Finance Committee, which typically hold the confirmation hearings for Secretary of Health and Human services nominees, should be asking RFK Jr. They must grill him on where he gets his medical information, and what research he bases his positions on, with regard to all these issues. Add issues like his position on removing fluoride from the water, and allowing raw milk to be sold. Letā€™s be clear: Our childrenā€™s lives are literally at stake here. 

It might be interesting to ask him whether he asked Trump if his children were vaccinated, and if Ivanka and Jared have had their children vaccinated. I have yet to hear any media person ask Trump about this, or ask Ivanka and Jared their thoughts on RFK Jr. The committees must ask whether he believes vaccines should be available for children whose parents want them, and whether he will mandate insurance pay for them? 

Yes, RFK Jr. has some positions I agree with. He wants to get dyes out of our foods as California Gov. Gavin Newsom is doing in his state. RFK Jr. has promoted healthier diets for children, more fruits and vegetables, something Michelle Obama has been doing for years. But we must recognize doing these things will be worthless if we let children get ill, or die, by not vaccinating them. RFK Jr. is an embarrassment to his own family with his unsubstantiated claims on a host of issues, and he will be a danger to the children of the nation, and the world, if confirmed. 


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

Continue Reading

Opinions

Protecting trans rights is a moral duty, not a liability

Incoming administration seeks to define us out of existence

Published

on

Activists picket outside of the United States Supreme Court during oral arguments for the U.S. v. Skrmetti case on Wednesday, Dec. 4. (Washington Blade photo by Michael Key)

Nov. 20 marked Transgender Day of Remembrance ā€” an international day of mourning where the trans community and its allies come together to honor and mourn those lost to violence, hate crimes, and suicide. Much of this violence is fueled by discriminatory policies and deep-seated hatred against transgender people.

Yet, just two days before TDOR, Rep. Nancy Mace (R-S.C.) introduced HR1579, a transphobic resolution aimed at prohibiting ā€œmembers, officers, and employees of the House from using single-sex facilities other than those corresponding to their biological sex.ā€ The resolutionā€™s definition of ā€œsingle-sex facilitiesā€ goes beyond restrooms to include changing rooms and locker rooms within the Capitol or House Office buildings.

This resolution is a blatant attempt to ban Rep.-Elect Sarah McBride (D-Del.), the first openly transgender congresswoman, from using womenā€™s bathrooms and locker rooms in Congress. Far-right Rep. Marjorie Taylor Greene (R-Ga.) claimed that Speaker of the House Mike Johnson (R-La.) expressed support for the resolution behind closed doors, stating, ā€œHe committed to me, there in the conference, that Sarah McBride will not be using our restrooms.ā€ In an interview, Rep. Mike Johnson doubled down: ā€œFor anyone who doesnā€™t know my established record on this issue, let me be unequivocally clear: a man is a man, and a woman is a woman, and a man cannot become a woman.ā€

Both Greene and Mace repeatedly misgendered McBride on social media and in comments to reporters. On Transgender Day of Remembrance itself, Speaker Johnson declared McBride would be treated as a man under House rules, forcing her to use menā€™s restrooms or gender-neutral facilities.Ā 

Mace claimed her actions were about ā€œsafety,ā€ even suggesting McBride could pose a threat of sexual assault. However, during an appearance on Greg Kelly Reports, Mace went full mask off, calling it ā€œoffensiveā€ that McBride could consider herself her equal.

This decision and language is more than offensive ā€” it is outright discriminatory. McBride will have no other choice but to walk to her office every time she needs to use the restroom, unable to access the common bathrooms like her colleagues. Additionally, the resolution jeopardizes the safety of hundreds of transgender staffers, all of whom lack McBrideā€™s visibility or privilege. Trans staffers have long used restrooms matching their gender identity without issue, but this policy opens the door to increased harassment and exclusion, with reports of such incidents already surfacing. 

McBride issued a statement saying that while she ā€œdisagreesā€ with the rules, she will comply. Unsurprisingly, McBrideā€™s compliance was not the end of the conversation. Mace introduced a bill to ban transgender people from using bathrooms matching their gender identity in federally owned spaces, from national parks to major airports. Mace declared on social media, ā€œThis fight isnā€™t over just yet. We want to ban men from womenā€™s spaces in EVERY federal building, school, public bathroom, everywhere.ā€

Adding to this, Congressā€™s gendered dress code could also be weaponized to further degrade and bully McBride, targeting her presentation or honorifics. This was never about bathrooms, safety, or fairnessā€”it has always been about control and erasing transgender people from public life. 

Despite these attacks, multiple studies have found no evidence supporting claims that transgender people pose safety threats in bathrooms. Yet transphobic rhetoric dominated the 2024 election, with anti-trans ads like ā€œKamala is for they/them; President Trump is for you,ā€, signs targeting McBride at polling places in Delaware, and violent vitriol aimed at dehumanizing transgender Americans.

This tidal wave of hate culminates in the upcoming Supreme Court case, U.S. v. Skrmetti, a case that will determine whether bans on gender-affirming care for youth are unconstitutional. The stakes are high: 27 states already ban gender-affirming care, and 26 have implemented restrictions on trans youth in sports. With Donald Trumpā€™s return to the White House and a Republican-controlled government, the situation doesn’t look great.

In the Delaware State Senate, Sarah McBride championed policies like paid family leave. The idea that sheā€™s a danger to others is laughable. The real danger to others lies in the multiple Republican cabinet nominations with histories of sexual assault and abuse.Ā 

If a respected lawmaker who happens to be transgender is considered a threat, where does that leave the rest of the trans community?

In the wake of Kamala Harrisā€™s election loss, trans people have been used as scapegoats, with moderate Democrats and political pundits alike calling them political liabilities. For the past few weeks, weā€™ve seen op-eds in the New York Times and Washington Post claiming that trans rights have gone too far and are political bombs.Ā 

How dare they? In the face of violent transphobia in our nation’s Capitol, now is the time to strengthen support for our transgender siblings. The moment the public and political establishment abandon transgender Americans, is the moment weā€™ve entered the last steps of the waltz into fascism.

The mere presence of a transgender woman in power asking to be treated as an equal has sent the GOP into a media frenzy. Mace has been running to Fox News and Newsmax to attack her future co-worker. Sheā€™s been obsessively posting on X (formerly Twitter) about Sarah McBride and ā€œmen in women’s spaces.ā€ 

Mike Johnsonā€™s seeming endorsement of a ā€œseparate but equalā€ framework also evokes painful memories of segregationists during the Civil Rights Movement. This behavior is not only unacceptable but shines a light on the long history of white far-right politicians from the South fighting for their “right” to discriminate.

This isnā€™t a culture war thing; this is a fight for our very right to exist. Transgender Americans are facing a crisis. The incoming administration seeks to define us out of existence: they want us to detransition, to hide, to live in fear. They want us to remain in the closet. 

For many, the closet is deadly. Trans people already die by suicide at higher rates, denying us the right to exist will only skyrocket the mental health crisis in America. Since Nov. 5 alone, the Trevor Project, a crisis organization for LGBTQ youth, reported a heartbreaking 700% increase in calls. People are dying now, and now is the time to protect trans people.Ā 

Defending McBride is the easiest way to signal support for trans people. This is about more than supporting one congresswoman ā€” itā€™s about standing for the safety, dignity, and respect of every transgender American. We need leaders who will defend us in the face of the fascistic far-right.  

As trans people, we recognize the emergency facing our community and are screaming our lungs out to a party that is considering abandoning us. Itā€™s been said again and again but we need each other now more than ever.

LGBTQ voters pay attention to which representatives support and fight for their right to exist. According to the 2022 U.S. Transgender Survey’s Civic Engagement data, 82% of eligible transgender individuals are registered to vote. In the 2020 presidential election, 75% of eligible respondents reported voting, compared to 67% of the general U.S. population. Furthermore, initial exit polls showed that LGBTQIA+ voters overwhelmingly supported Kamala Harris.

The Democratic Party is at a crossroads: Will they fight for equality or allow the GOPā€™s attacks to stain their legacy and lose a vital and engaged voting bloc? 

The truth is stark: transgender Americans deserve to exist without fear. This fight is about more than politics ā€” itā€™s about life and death. In the reality we woke up to on Nov. 6, trans people and LGBTQ rights in general are on the chopping block. 

Democrats have the chance to make history by standing on the right side of it. The fight for trans liberation is far from over, but this moment demands strong, progressive leadership. The future of the party ā€” and our countryā€”depends on it.


Vienna Cavazos (they/them) is the Diversity Lead and LGBTQIA+ Public Policy Specialist at Bulletproof Pride.

Continue Reading

Opinions

Ozempic: Is it worth the risk?

Semaglutides have innumerable benefits, but should be taken properly

Published

on

(Photo by CarolinaR/Bigstock)

When my partners and I opened ProMD Health, an aesthetic medicine clinic in City Center, I anticipated my “glow up” would include less wrinkles, more volume, and smoother, healthier skin. What I did not expect was to lose 37 lbs. in just five months. Offering injectables such as botox, sculptra, and filler, along with IV therapy, body contouring, and various spa treatments ā€” I was eager to try all of our treatments except one: Semaglutide. I too was one who believed the things I heard, from upset stomach to hollowness in the face. It wasn’t until I was left without a choice that I embarked on the journey. 

What is semaglutide?

Semaglutide, a GLP-1 known as the brand name Ozempic, has become a global phenomenon that can help individuals lose up to 10 pounds a month with consistent diet and exercise. It works by sending signals to our hypothalamus (the part of the brain that controls hunger and sex drive) to be satiated with less food, regulating our cravings and urges. The drug is currently being studied for addiction therapy as patients with existing substance abuse have also noticed a reduction in their inclinations.Ā 

Why I joined the celebrity craze

In January 2023, I had learned from my primary physician that I was pre-diabetic, with a BMI of 30, and had alarming triglyceride, cholesterol, and blood pressure levels. At only 33 years old, I felt defeated. On one end, I was a young entrepreneur celebrating the opening of a new business, where on the other, we were discussing medication to help me lower my blood pressure and analyzing my diet (which consisted mostly of nachos, red wine, and chocolate ice cream.) The stress of life was consuming me, where each time I craved something unhealthy ā€” I rationalized that it was deserved for all the many things I was doing.

My mental and physical health was in a bad place, where the more I’d work out ā€” the hungrier I would get, where ice cream was my reward for stepping on the treadmill. Due to my inability to regulate my cravings and intake, I decided to finally start semaglutide, as a change was needed to happen or illness diagnosis would follow.Ā 

The journey

The first week was horrendous. I was puking endlessly. I had completely ignored our provider’s advice, continuing to eat what I normally did which semaglutide rejected. I realized then that me eating in the way I did was not only based on hunger, it was emotional. Food was my boyfriend, my comfort, and gift to myself. The puking was like a self-induced hazing process, because after that ā€” I no longer craved foods that were not compatible with the drug. Essentially ā€” fatty foods, highly processed meals, and foods high in sugar will leave you sick. 

The nausea and sickness went away after a week (probably would have never come had I made the diet change on day one) and I started to have to force myself to eat as the hunger signals I relied on were no longer there. After eating half of what I would normally consume, I would feel satiated and full. 

As my body got used to the drug, we would go up in dose ā€” where I started to have to force myself to eat. The well balanced diet of protein, vegetables, and carbs gave me the nutrients needed to sustain my day of meetings and post-work gym sessions.Ā 

In just one month, my clothes are slipping off and my face had became noticeably slimmer. I started receiving levels of attention I hadn’t since my early 20s, and my confidence and belief in myselfĀ skyrocketed.Ā 

Getting to my goal weight month four, we decided to lower the dosage and taper off while incorporating more whole foods in my diet to supplement my workouts. With the weight off, my current focus is muscle growth. 

With social media misinforming viewers on a daily basis ā€” I have put together a list of myths, do’s, and don’ts from my experience.

Myths:

– Ozempic Face: The drug does not make your face cave in. When folks lose a lot of weight in a short period of time (with or without GLP-1), they will experience volume loss. One of the few aesthetic benefits of being overweight is fullness in the face, where our wrinkles and signs of aging are less noticeable. Eating too much sugar and having a high fat intake can also cause acne ā€” so it is a double edged sword. Our providers usually recommend slowly increasing the dosage where treatments such as mid-face filler can address new concerns around visible aging. 

– You will need to be on it forever. 

– Your GI will be ruined. 

Do’s:

– Take a probiotic daily.

– Drink a lot of water to help with your digestion and to flush your system. 

– Take an anti-nausea prescription, nauzene, or fresh ginger in the first two weeks.

– Make sure you are eating a well-balanced diet of protein, carbs, and vegetables. Even if you have to force yourself to eat it ā€” without the nutrients, you will have no energy for the gym and could experience hair loss or malnutrition symptoms.

– Eat fruit: Although the cravings will decrease, if a sweet tooth has its requests ā€” eat fresh fruit. It is somehow way more refreshing and satisfying while on semaglutide and will aid in digestion. 

Don’ts: 

– Get semaglutide from an inexpensive online retailer ā€” the price you pay will match the dosage and quality of product.

– Eat foods high in sugar. You will pay for it. 

– Eat oily foods. 

– Binge drink.

– Be inconsistent.

– Stop abruptly. It takes time but worth the journey! 

Continue Reading
Advertisement
Advertisement

Sign Up for Weekly E-Blast

Follow Us @washblade

Advertisement

Popular