The Real Crime Isn’t HIV—But Stigma

On World AIDS Day, we are asked to remember those before us and those amongst living with HIV/AIDS. The LGBT community in particular has a connection to this disease through the long and tenuous history of our community and its liberation movement. So many amongst us live with HIV and with its stigma; many others live in fear that one day they might. The HIV/AIDS crisis of the 80s and 90s scarred our community and many of our community leaders, activists and role models died in its wake.

From pill cocktails that required a burdensome regimen of 10 or more pills a day to sustain a few years of life living with the disease to a world w here a pill a day can prevent its transmission, the world has come a long way in our fight to end HIV/AIDS, but many of our laws surrounding it have not. In our modern world, with HIV preventatives like PrEP and the un-transmissible status of people who are undetectable, it’s hard to imagine how we coexist in a world that criminalizes HIV; an act that promotes stigma and may be a detriment to public health.

Recently, in the UK, hairdresser Daryll Howe was sentenced to years in jail for deliberately infecting several men with HIV. A disgusting act that sparked controversial conversations and whispers in many of my gay circles about what this means for the community as a whole and what happens now.

Cases like Daryll’s are egregious acts of violence filled with malicious intent that should be qualified as such, but they are the exception and not the rule. However, the public stigma and perception that represent gay men as wildly deviant predatory beings allow people see Daryll’s case as the norm and wish to address it as such. In the US, many states have HIV criminalization laws on the books that make it a criminal offense, not just for cases of intentional transmission, but also for not disclosing your positive status even if the person who raises the claim did not contract the virus from an encounter you had with them. These laws make it dangerously ambiguous about what it is it about HIV that we are punishing. Is it the weaponizing of HIV intentionally, failure to disclose, or simply being HIV positive? It seems the answer is all of the above.

No one is debating the benefit of and responsibility one should have in maintaining their own personal health, but criminalizing non-disclosure of HIV status creates a larger public health risk. By criminalizing the failure to disclose HIV status, these laws incentivize not knowing one’s status. This loophole operates on a troubling notion that “ignorance is bliss”. By exonerating those who are unaware of their status, these laws put the very same people they are purporting to protect at risk. If anything, we should be doing everything possible to incentivize people to know their HIV status, as almost all new infections occur when people do not know their status. People who know their HIV-positive status are more likely to be actively receiving treatment and, as such, remain dramatically less likely to transmit their infection than someone who is unaware of their status.

Putting the onus on people living with HIV to disclose to their status puts those living with the infection and its stigma in the precarious position of being solely responsible for preventing future transmission. It’s a practice that perpetuates stigma by codifying the notion that people who are living with HIV bear the sole responsibility for preventing transmission to their HIV-negative sex partners, which only increases stigma. It forces those living with HIV to entrust private information to their partners who, quite honestly, have done very little to earn that trust. Meanwhile, it raises the stakes for disclosure.

If there is a conversation about criminality and HIV that demands engagement with, it’s not about the disclosure or lack thereof of those living with the virus: it’s the ways we’ve failed to protect the lives and dignity of people living with it and the education of those who are not.

Public HIV knowledge and education is lacking – and that’s being kind. Real, science-based information about HIV is so underrepresented in our sexual health discussions that it could be considered criminal. The regressive policies and the stripping of funding from programs that make it easier for those living with HIV to get access to treatment are criminal. Martin Shkreli raising the price of an HIV medication by 750% is criminal. Mike Pence CREATING AN AIDS EPIDEMIC IN HIS HOME STATE OF INDIANA is criminal.

Living with HIV is not.

What’s also criminal about HIV criminalization laws is that these laws, like many others, disproportionately affect socio-demographic groups that are already discriminated against. Black gay men are the most at risk for HIV and are disproportionately more likely to be living with HIV, and these laws will unduly and unjustly impact them. As we, as a nation, begin to finally reckon with the reality that communities of color are over-policed, HIV criminalization should be a part of that conversation.

As a black gay man, I represent one of the groups most at risk for contracting HIV. It is appalling to me how little access and education about things like PrEP have been afforded to my community. I know gay men who said they have had to educate their own healthcare providers about the existence of Truvada, the pill approved by the FDA in 2012 for PrEP. I was fortunate to have friends who worked in the HIV field who informed me about the effectiveness of PrEP and how I could get it at reduced cost through the drug manufacturer. I had to find out through similar networks about the Center for Disease Control’s endorsement of the U=U consensus: that someone with HIV who is undetectable on medication (meaning that HIV is so suppressed by medication that it cannot be detected by blood tests) cannot transmit HIV to their HIV-negative sex partners.

HIV is a real issue. HIV can be scary. But don’t criminalize the infection and DEFINITELY don’t stigmatize the people living with it. Stigmatize its ignorance and shame the people who seek to perpetuate that ignorance.

Photography: GettyImages

POZ 4 POZ: Sorry, Just My Preference

We are officially two days into our relationship when Darrell tells me he hasn’t been on his meds for about four months. He says it with a smirkand I get it. It’s not so much that he believes what he said is humorous, but rather, this is just how this goes sometimes.

Perhaps a change in insurance is now prompting ADAP to request more information before shipping out your daily communion. Or perhaps your doctor insists on a check-up before renewing your prescription. Either way, you should be fine. You feel okay, at least. Not sickly, like spoiled fruit runneth through your veins or anything. These are all just formalities.

You’re not going to allow a formality to scare you away from treatment, are you? That would be silly. That would be ridiculous. That would be dangerous, irresponsible, selfish: Do you not care about your mother? Haven’t you put this family through enough? Haven’t you put your body through enough? Enough. Enough. Enough!

Darrell is still waiting for me to respond so I roll my eyes and I tell him, “I’ve been off for about two weeks.” He scoffs, jokingly, as if to say, “amateur.” I push his forehead with my palm as he grabs for my waist giggling. I snort, “Nigga, you bout to die! I ain’t with that necrophilic shit.” He cranes his head up towards the ceiling and lets out a cackle as large as his diseased bodyand this is a joke only our kind could share.

They call couples with opposing HIV statuses “serodiscordant.” Which, to me, just means that if I leave some pills in the Triumeq bottle I keep on the dresser, I would not be asked any questions, because it would just be presumed that I’m “on top of my health.”

Very often negative folks are clueless. It is only those like Darrell and me who share this particular undoing who know that pill bottles aren’t proof of anything and that sometimes it isn’t a phone call or a doctor’s visit, but rather the act of having to put the pill to your mouth that is the deterrent to your own treatment.

We, who are warned by our doctors to not f*ck each other raw because our combined HIV strains could “speed up the process”as in our deathsunderstand it all. But we f*ck how we like anyway because our bedroom is the only place where we can allow death to be a joke we tease each other with. It is this particular kind of dying that I cannot share with anyone else.

There is something special about having a partner with your same diseasebe it HIV, or loneliness, or abandonment issues. There is a freedom therea mirror to scream into. I wonder if there is a word as precise as “serodiscordant” for that kind of love. Granted, many would say the word I am looking for is “dysfunction.” They would call our humor around not taking medication “enabling.” Yet, this is why we find each other in the first place.

Only we know the cost of such living. Only we understand that the true “dysfunction” began in 1980 when Ronald Reagan decided to ignore all thebodies dropping to the floor. Only we understand that the true “dysfunction” lives today in thedisproportionate rates of HIV in black communitiesdue to deterrents such aspovertyand access tohealth care.

A life with HIV is a life in response to a world that has done all it possibly can to enter and regulate your body. For years, the world has attempted to quarantine us. To tell us that we will only be able to date those who are “dirty” like us. But what magnificent irony it is when they realize that the whole time we were all we wanted in the first place. I contemplate this as Darrell leaves the bed to take a shower.

He turns back to me and says, “Naw, but for real. We got to do better. We got this, babe.” I reply, “I know.” That was all I needed to say for him to continue on his trip. Had he been my mother or my best friend or my HIV negative ex-boyfriend, that conversation would’ve required more heavy lifting.

The statement “I know” would’ve necessitated an explanation as to why I knowor how: You do understand that this your life you’re playing with, right? So what, you’re just gonna not take your medication? You telling me you want to die? Are you just giving up, is that it?

A few weeks later, I was tired. I am generally tired every day, but this particular day I convinced myself that the exhaustion felt “different.” Immediately, I began to think about my pills, the nurse’s voice when she read the word “positive,” Tom Hanks’s role in the moviePhiladelphia, my brother’s disdain for funerals, my own disdain for graves, death, death, and more death.

I text Darrell the words “flare up,” to which he replied with a paragraph worth of laughing emojis. He asked me if I coughed, and I told him, “No, this time it was a yawn”he sends more emojis. Flare up is the term we used for this particular kind of anxiety.

Sometimes your brain undermines the rest of your body’s progress in healing. Sometimes you can be virally suppressed, but your mind still tells you that your ten-second sneezing fit is a direct manifestation of your “tainted blood.” Flare up is how we learned to laugh at this paranoia that on occasion kept us up at night, or kept us inside during flu season.

“Did it pass,” he eventually asked. “Yeah,” I reply, “I’m beginning to calm down.” And I was. With him I was.

(Photo by Getty Images)

For World AIDS Day, INTO Lets People With HIV Lead the Way

December 1 is World AIDS Day. Every year, the day comes around and the community those living with HIV and those fighting to end it reflect on a year’s worth of losses, gains and challenges. And though we don’t know when the epidemic will end, or if it ever will for some people, we renew our efforts.

The leaders in the fight against HIV must be those living with the virus. If you want to fight against a health care system that erases people with HIV, you must first listen to them. If you want to fight for them, they must be uplifted.

In that spirit, INTO has asked people living with HIV of different races, genders and experiences to share some words and stories with our readership today. These stories act as a bridge between people with disparate experiences. They talk about being undetectable, about loving and having sex with HIV and about having faith while living with the virus. Hopefully, they challenge you. And in that challenge, you’ll find your inner spark reignited.


POZ 4 POZ: Sorry, Just My Preference

Writer Timothy DuWhite reflects on his experiences as an HIV+ person who only dates other HIV+ people.

Read more here.

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