Pop a Pill and Prevent HIV??

Post originally published on Change.org:

Pop a Pill and Prevent HIV?

Researchers on the HIV front discovered that a widely-used medication used to treat HIV disease (Truvada) can also be effective in helping to prevent HIV infection. Maybe you’ve heard the rumors, read the stories.  This is huge news in the HIV prevention and research world. In fact, Time Magazine referred to this as the #1 Medical Breakthrough of 2010.

Yet, for the average person looking to be safe and protect themselves and their partners from HIV, this may be nothing more than a dangerous and expensive mirage.

Researchers studied 2,499 gay and bisexual men in six countries, half of whom took Truvada on a daily basis and half took a placebo. They found that among the men who were on Truvada, 44 percent had a reduction in HIV infection rates. For those who were most compliant with taking the medication (those who took it consistently each day without any missed doses at all), they found a 73 percent reduction in HIV infections.

(I couldn’t help but wonder as I read this: they stood by as men engaged in risky behavior for purpose of research? That’s a whole other discussion, and clearly I’m not a researcher so I will refrain from further comment. However as a Philosophy/Medical Ethics major in college I couldn’t resist at least asking the question. I digress…)

From a medical standpoint, this is truly remarkable news in HIV research and prevention. It shows just how far we have advanced in the prevention of this virus. The power of this small blue pill can be viewed as a “turning point” in this epidemic. It allows for further study and perhaps can open the door to more effective treatment and prevention options. Plus it provides an invigorated sense of promise and hope. Hope that one day we may just witness a cure to this devastating disease.

As Mitchell Warren, director of the AIDS Vaccine Advocacy Coalition, said: “I don’t know of a day where so many pieces are beginning to align for HIV prevention and treatment, and frankly with a view to ending the epidemic. This is an incredibly opportune moment and we have to be sure we seize it.” Even President Obama expressed his hope at us entering into a “new era of HIV prevention.”

That’s the good news. The not so good news is that this is not a quick, easy, or even cost-effective prevention measure. Notice the greatest HIV infection reduction rates were experienced among those who took the pill without fail each day. For many people, it’s incredibly difficult to be on point 100% of the time. Compliance is a serious issue and can drastically affect the potential of this medication, as a treatment measure and clearly as a prevention option. Then there’s the expense. Truvada is not cheap, potentially costing anywhere from $5,000 to $14,000 a year. That’s rather steep, especially if it’s not providing 100% protection.

Any advanced prevention option is promising news. Especially among men who have sex with men (MSM), a group that has seen a surge in HIV infection rates. For those MSMs who are at an even higher risk of contracting HIV due to even more complicated factors, including intimate partner violence, rape, and homelessness among others, this could be a life-saving option. Those without much power and control may see condom negotiation as as a far off, unobtainable dream. A pill like this provides some sense of control and protection. That is a huge advance.

The real world is so much more complicated than a controlled study. There are countless additional factors involved that influence a person’s HIV risk at any given moment. Because of this, condoms are still the most effective option to help prevent sexual transmission of HIV – outside of the big A-word (Abstinence), of course. Plus, let’s not forget that there are other sexually transmitted diseases (STDs) out there. It seems the ideal would be to further develop medical prevention measures that could be used in conjunction with condoms.

As Dr. Robert Frascino, “Dr. Bob”, HIV Physician Specialist and Community Forum Expert at TheBody.com, asserts: ”Condoms remain absolutely essential. Truvada does ‘lessen’ the risk of HIV transmission, but it certainly doesn’t completely eliminate it.” So please, don’t abandon your condoms or use them as water balloons. Well, some can be used for silly condom games, but save plenty for intimate games.

To read the post on Change.org, click here.

 

One and Done: Reducing the Stigma of Having an Only Child – Updated

Below is a piece I wrote back in July about my family’s decision to have one child. All of it still rings true today — in fact, I’m feeling even more stigma now that Mia is getting older, and that I’m getting older. Just the other day, a person I see on a regular basis said to me, quite firmly, “So when are you giving Mia a little brother? She needs a playmate, you know.” Seriously. All of the elements of the Procreating Rules & Regulations Handbook were in these two sentences. Not only was it assumed that I would no doubt have another child, but it was also implied that I would just automatically have a boy. It’s the whole “one of each” rule that’s explicitly stated in the Handbook. Not to mention that I would be a terrible mother to cheat Mia out of a “playmate.” Because, as every parent knows, the role of the sibling is solely to provide entertainment to the first born. It’s also in the Handbook – look it up.

To me, this is all still very humorous. I still get the strange looks when I tell people that Mia is enough. Let’s just say my inquisitor mentioned above looked at me as if I had voluntarily swallowed my own foot. Yet I’m okay with that. I can laugh and move along, knowing that my husband and I are making the best decision for our family. So in case you missed it the first time around, here’s the original piece. Enjoy!

One and Done: Reducing the Stigma of Having an Only Child

People seem to be bothered that I’m not pregnant. By people, I mean everyone but me and my husband. We have a beautiful 3 year old daughter who is healthy, happy and just a bundle of energy.  We have no plans of having any more children.  We are content in our decision. Others are not as pleased.

I never realized just how much people care about our procreation plans.  And it seems to be more intense now that we have a child.  When we were first married, we had the occasional questions about starting a family.  Now that we have a family, everyone seems preoccupied with our making it larger.  Maybe since they assume we are fertile, we’re going to continue breeding.  Especially now that Mia is approaching 4, they think time is running out.  Like if I don’t get pregnant soon, we’re going to miss some magical window.

When I tell people that we’re done with having children, I get a mix of emotions from the inquirer, all of them intense.  The conversation usually goes something like this:

Nosy person:          How is Maya? (A few people are convinced this is her name.)

Me:                            It’s Mia.  She’s great!

Nosy person:          Soooo, when are you going to start trying for another?

Me:                            Another what?

Nosy person:          Another baby!  Maya needs a little brother.

Me:                            Not a little sister?

Nosy person:          Oh no, you must have one of each!

Me:                            Well, actually we’re done.

Nosy person:          Done with what?

Me:                            Done having children.  Mia is plenty.

Nosy person:          (long pause with look of shock and confusion) Oh.

That’s usually where the conversation ends.  I certainly don’t want to extend it and the other person is usually shocked into silence.  Ok, I admit I may be exaggerating a bit, but only a little.  This seems to be a heated topic for some people.

Sometimes if I know the person well, they will ask follow-up questions after they regain composure.  The questions are usually about me and trying to find reasons for my awful decision to have only one child.  Questions like, were you an only child, or did you hate your siblings, or did you not receive the American Culture Handbook on Having More Than One Child?

I never realized how much people care about having more than one child.  Apparently it’s a topic that is getting more attention as it was the cover story of the July 8, 2010 issue of Time Magazine .  The writer shares my feelings regarding this issue and seeks to debunk all the many myths out there.  These myths have been repeated to me dozens of times by all those people who fear for the sanity of my daughter if she really truly does stay an only child.

My favorite is the myth of the playmate; that we need to have another child so Mia has someone to play with.  It’s a big assumption to assert that Mia and her potential sibling will get along or even want to play together.  Not to mention that the new baby would be immobile and more focused on eating and pooping for quite awhile.  Not sure if Mia would enjoy that much at all.  Mia has plenty of friends and cousins her own age.  Yet, the myths prevail and they are powerful.   Almost all of my friends and acquaintances who have children have more than one.  Or they are trying to conceive in the hopes of not having their child be an “only”.  All of this makes me incredibly curious about this insatiable need for parents to have more than one child.  And curious as to why all those parents of only children get the flack that we do.

Here’s a little background on our decision; maybe this is my way of helping people better understand our decision (I’m not being defensive or anything, really).  When Rich and I got married and started talking about having children, we envisioned having 2 or 3 or even 4.  We wanted a big family with lots of kids. When I got pregnant with Mia, it was an amazing, intoxicating experience.  I had an uneventful pregnancy and could imagine myself being pregnant over and over with no problem.

Then I went into labor.  That’s when it all changed.  Looking back now, I realize I was experiencing an intense Perinatal Mood Disorder. In an instant, I became intensely anxious and overwhelmed and was full with panic and dread.

The next year of her life was a blur to me.  All the symptoms of severe PMD fit me perfectly.    Thankfully I have an amazing husband who got me the help that I needed.  It was a rough recovery and I’m still receiving services.  I’m a firm believer that PMD, especially Post-Partum Depression, just doesn’t magically end when your child begins to walk.  Parenting is unlike any other experience and for those of us who have compromised mental health, there are challenges every day.  Through my treatment I have had 3 gynecologists, 2 psychiatrists, 1 psychologist, and 2 clinical social workers tell me what I already know – that if we decide to have more children I will almost certainly have PMD again.  And the next time may be worse.  That’s not a situation I’m willing to risk giving Mia a playmate for.

Rich and I made the decision that Mia is enough.  Given my medical condition and a few other major factors in our life, having another child is not the best choice for us.  It is not realistic for us to have a large family like we originally planned.  We are completely at peace with our decision.  We love our little family.  Mia is amazing and we know we are better parents to her now than if we had more children.

It seems that having one child is becoming more popular and less of a stigma. We certainly aren’t the only parents with only children.  People are realizing that only children are wonderful, happy kids; not at all fitting the stereotype of the “lonely only”.  It’s clear that Mia is a vibrant and well-adjusted child with plenty of friends and great sharing skills.  She seems more interested in getting a cat or a dog than a sibling.  That works for us!

DC’s New Mayor to Cut Services to Most Vulnerable Residents

Post originally published on Change.org:

DC’s New Mayor to Cut Services to Most Vulnerable Residents

Earlier this month Washington, D.C. got a new mayor, Vincent Gray, and he’s already getting off to a poor start.

At a recent D.C. City Council meeting, a plan was approved that would cut off direct public assistance to recipients who are in the program longer than five years. Mayor Gray claims the reason for the cuts is financial.

The plan will cut and over time eliminate benefits to city residents who receive Temporary Assistance for Needy Families (TANF) benefits for over five years.

What makes this plan most frustrating for those of us organizing around poverty issues is that it is coming from someone who has worked with families in need as the former Director of D.C.’s Department of Human Services. One would think with those years of experience he would understand what families are going through – especially during this recession time.

“Clearly Mr. Gray knows what the harm will be to families,” said Judith Sandalow, Executive Director of theChildren’s Law Center. “He has a lifetime of experience of working with low-income families, so I don’t understand why he felt a need to do this.”

In a related story, “bureaucratic inaction” has also led to the closing of D.C.’s City Gate Merrick Center, a vital after school program for working families. Without consistent and secure child care, working families are forced to make impossible decisions regarding their employment and the care of their children. Many parents will be forced to cut back on their hours or leave their jobs completely. Without childcare, many parents cannot work. Without work, poverty deepens and the vicious cycle continues.

Unfortunately, many people in power have a myopic view of how to treat issues associated with poverty. Cutting life saving benefits may save the city some money in the short term, yet without these benefits, a family is faced with more obstacles to overcome in order to achieve stability. Families are at a greater risk of becoming homeless and/or losing their health insurance. Providing shelter and/or medical services through an emergency room to a family would create an even larger financial burden on the city. Prevention is always more cost effective than trying to manage larger issues associated with poverty and homelessness. Mayor Gray’s claim of “financial” reasons for these cuts doesn’t make financial sense.

As a nation, aren’t we working to end the dangerous cycle of poverty? But by cutting TANF, Gray would be fueling this cycle and providing little means for families to becoming more self-sufficient. People must have their basic needs met in order to remain stable and build towards further prosperity. Cutting benefits becomes counterproductive to the overall goal of helping people overcome poverty.

Many living in poverty do not have the means or ability to voice their concerns. Working together, we can create a collective, powerful voice to influence real change. Let’s welcome Vincent Gray to his new position as Mayor of Washington, D.C. with a petition demanding that he overturn the decision to cut this vital funding!

To read post on Change.org, click here.

 

I Heart Cory Booker!

For those who don’t know, Cory Booker is the Mayor of Newark, NJ. This large city has been a scapegoat for struggling cities for decades. Cory Booker has worked tirelessly to overcome the myths, the discrimination, and the bad reputation. In the process, he has been an amazingly hands-on mayor who has done a tremendous amount of work to improve this amazing city.

What makes Cory Booker that much more accessible is that he is incredibly active on Twitter and other social media outlets. I’ve been following him for months and I see him personally respond to the majority of people who write to him. He’s inspirational, down-to-earth, and just plain cool. I decided to write to him as well as I work in Newark and have seen the progress. Plus, I just think he’s amazing. And best part – he wrote me back! For those outside the Twitter universe, the below exchange is quite remarkable. Check it out!

Cory Booker

@CoryBookerCory Booker
Thank you! RT @elombino: Thx 4 all u do. I’m a Social Worker in Nwk & I see 1st hand all the progress u are making. U’re a real inspiration!

“I Talk Because…” An “It Gets Better”-Style Campaign for HIV Awareness

Post originally published on Change.org. Check out this amazing campaign!

I Talk Because, An It Gets Better-Style Campaign for HIV Awareness

Here’s the setup for an innovative awareness campaign: various celebrities, advocates, allies, and other supporters sharing their thoughts and feelings via YouTube videos. They talk of being different, of stigma, of discrimination. They urge togetherness and hope. All who are involved share the belief that their words may touch another person feeling vulnerable and hopeless. They believe their messages will inspire change, and they are.

This sounds exactly like the It Gets Better campaign, right? Actually it’s the format of another influential, yet less known video campaign entitled I Talk Because…which strives to raise awareness around HIV/AIDS.

I Talk Because… was started on World AIDS Day, December 1, 2009 and is spearheaded by New York City Council Speaker Christine Quinn. Several NYC-based HIV/AIDS organizations collaborated with this effort, including AIDS Community Research Initiative of America (ACRIA), Gay Men’s Health Crisis, and Harlem United.

The mission of this campaign is simple: to get us all talking about HIV/AIDS.

Participants can submit their homemade videos to the YouTube site. Just talk about HIV, what it means to you, and why it’s important for all of us to be talking. That’s it. It’s free, it’s simple, and it’s powerful.

Some of the celebrities and public figures who have created videos include Rosie Perez, David Mixner, Kelly Ripa and Mark Consuelos, Wendy Williams, Alan Cumming, and Tony Kushner. In October 2010, I Talk Because… was named one of the “Top 5 YouTube Projects That Are Making a Difference” byMashable. Also in the top 5 was the It Gets Better campaign.

Speaker Quinn wrote about the project on the day of its launch:

” … I want to talk about HIV/AIDS more and I want other people  to talk about HIV/AIDS more because there was a time in this city when people literally stopped everything else they were doing, put their jobs on hold, put their personal lives on hold, put their families on hold to go out and change the government perspective on HIV/AIDS, to change the scientific community’s  perspective, the pharmaceutical community’s  perspective and we have an obligation to honor all of that work and sacrifice and all of those people who have died by not getting complacent. One day we will wake up and things will be as bad as they ever were if we end up being complacent so I urge all of you to talk more … “

ACRIA’s executive director Daniel Tietz told TheBody.com: ”The campaign debunks HIV myths and gives the facts, not just amongst peers, but across generations. It encourages conversations within families. And ultimately a willingness to talk is worthwhile because it breaks down boundaries and stigma.”

These words are so true. For a variety of reasons, conversations surrounding HIV and AIDS are not as abundant as they once were. Truth be told, HIV and AIDS has never really been a top conversation topic among people outside of the HIV community. Personally I can attest to this. My social circle knows what I do and who I work with, and let’s just say the topic of HIV is more of a conversation stopper rather than starter. We all have a lot of work to do.

Get involved! Watch some of the videos, make your own video, or just talk about HIV/AIDS with someone, anyone. Support this amazing campaign and hopefully it will gain some of the same momentum as It Gets Better. Maybe then we can all walk into a nice cocktail party, declare that we do indeed talk about HIV, and rather than be given strange stares, be swarmed in conversation.

To read post on Change.org, click here.

 

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