HIV no longer considered death sentence
by Saundra Young
Justin Goforth was just a 26-year-old nursing student when he had unprotected sex with another man and, as a result, got the diagnosis that changed his life.
"I started to feel like I had the flu -- aches, pains, chills, fever, swollen lymph nodes, that kind of thing -- and so I went to my doctor ... we did a viral load test, which was rare back then ... and he called me and said, you know, it came back (HIV) positive."
It was 1992. Goforth's doctor immediately sent him to the National Institutes of Health, where research was being done, but treatment options were, at the time, still few.
Patients were being treated with AZT, the first drug approved by the Food and Drug Administration in 1987 to treat HIV/AIDS in the United States -- by then known for its serious, even life-threatening side effects.
The reality of the diagnosis set in.
"I was so sick," Goforth says. "I was sitting silently and crying because of my circumstance ... and the nurse came over and was trying to console me, I believe, and said ... 'Because you were just infected, you may have, you know, six or eight years before you die.'
"I think she was trying to cheer me up," he says. "Didn't work very well, but that's just a good commentary on where we were at the time"
That was then, but what does it mean to have HIV today, after years of research and advances in treatment?
"It means likely you can have a normal lifespan and have a similar life to someone who does not have HIV," says Dr. Ray Martins, chief medical officer at Whitman-Walker Health in Washington, which provides health care services for the lesbian, gay, bisexual and transgender community.
"For people who had to deal with the medications and stuff from the '80s and '90s, it was a bit of a rough road there, so figuring out the virus and the medications that would work effectively with the least side effects, it took a while," Martins says. "But now we're at the point where we have three options for one pill, once-a-day regimens with very little side effects."
In 1981, when the virus was discovered, being HIV-positive was considered a death sentence. For most patients today, it's a chronic disease, much like diabetes or heart disease.
Goforth is a perfect example. He has been living with the disease for 21 years and today is a healthy 47-year-old.
Instead of the difficult treatment regimen he was on back then. which included some 40 pills five times a day with "horrific" side effects, he now takes five pills twice a day "with virtually no side effects," he says.
For the last 7½ years, Goforth, who is a registered nurse, has worked at Whitman-Walker in a variety of positions, including director of nursing and in case management.
He sees potentially thousands of patients each year, and has personally delivered the same news he got two decades ago to more than 200 patients. But he tells them living with HIV today means that you can be healthy, thrive and live a normal lifespan without complications.
"You can go to your doctor two, three times a year, get some tests done and make sure everything's on track, and then just live the rest of your life as you would," he says. "Follow your dreams ... have your career, your family, or whatever it is that you'd like to do with your life, and that is the truth of where we are."
Today's science, he said, supports that.
Interactive: World AIDS Day 2013
"We are at a place that we actually have the tools we need to stop the epidemic and then just get to a point where we're just taking care of the people who have HIV throughout their life," he says.
"But because of how horrible the first 10, 20 years of this (epidemic) was, we have collectively this culture of what it means to be infected and affected by HIV that still is this huge block, this huge barrier for people understanding that they can get into care and they can be OK and that it's not something to be afraid of."
About 1.1 million Americans live with HIV, according to the Centers for Disease Control and Prevention. But because of improved treatments, they're living longer and their quality of life is better.
"If a person is HIV infected today, it is important that they put themselves under the care of a physician experienced in caring for HIV-infected individuals," says Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. "Depending on the stage of infection, it is highly likely that it will be recommended that the person begin antiretroviral therapy (ART)."
ART is a combination of at least three antiretroviral drugs that prevents the virus from replicating. It can also help reduce virus transmission.
Unlike years ago, when effective treatments were not available, HIV patients now benefit significantly from ART, Fauci says.
"These drugs are highly effective in suppressing HIV replication and, if taken as directed, can result in the HIV-infected individual having an almost normal lifespan without experiencing serious illness related to their HIV infection."
And so, on this 25th World AIDS Day, Goforth has mixed emotions.
It's a day that, in the past, has been incredibly sad and traumatic for him. Now, he says, he has tremendous hope.
"I see the freight train being slowed down so that we can turn it around," he says. "Even five, six years ago, I'm not sure that I could have said that I had the hope that that was going to happen, but I think we're at that point we're at a really historical moment with this."
Each November in advance of World AIDS Day, POZ, an award winning magazine started in 1994 to provide education and information for people living with and affected by the disease, names its "POZ 100" -- HIV-positive people who are unsung heroes in the fight against AIDS, and committed to ending the epidemic.
This year, Goforth is on that list.
Transformation of Community Policing Into Military Policing Sanctions Government Violence
by BOB KOEHLER
What goes around comes around . . . and around, and around.
Last month, the day after I left Santa Rosa, Calif., a 13-year-old boy carrying a toy replica of an AK-47 was shot and killed on the outskirts of that town by a Sonoma County deputy sheriff with a reputation for being trigger-happy. The officer had ordered the boy to drop the “gun,” then in a matter of two or three seconds opened fire, giving him no chance to comply.
This is not an isolated incident, which is why it's yet one more tragedy I can't get out of my mind — one more logical consequence of the simplistic militarism and mission creep that's eating us alive. This is gun culture running unchecked from boyhood to manhood, permeating national policy both geopolitically and domestically. This is the trivialization of peace. It results in the ongoing murder of the innocent, both at home and abroad, at the hands of government as well as criminals and terrorists.
“That's America, we say, as news of the latest massacre breaks,” Henry Porter wrote in September in the U.K. Observer. The massacre of the moment was lone gunman Aaron Alexis' slaying of 12 people at the Washington Navy Yard.
“But what,” Porter asked, “if we no longer thought of this as just a problem for America and, instead, viewed it as an international humanitarian crisis — a quasi civil war, if you like, that calls for outside intervention?”
This begins to get at the American lunacy, its out-of-control certainty that authorized violence has things under control. We need some kind of outside intervention. I fear the death of Andy Lopez in Santa Rosa won't bring about the fundamental changes we need, any more than the tragedies that preceded it. We lack systems capable of holistic assessment of our problems; we lack systems that are not part of the problem.
Lone-nut massacres and increasingly militarized police departments are parallel phenomena, both emerging in a social climate of depersonalization. Both bring the war home.
“Whatever the reason, not a week goes by without more reports of hair-raising incidents by militarized police imbued with a take-no-prisoners attitude and a battlefield approach to the communities in which they serve,” John W. Whitehead wrote recently at Huffington Post.
Deputy Sheriff Erick Gelhaus, the officer who killed Andy Lopez, instantly firing seven rounds at him, was a firearms instructor for his department and an Iraq war vet. Strikingly, “the deadly encounter recalled how soldiers might confront an insurgent in a war zone,” Dennis Bernstein wrote recently at ConsortiumNews, quoting a former member of the military police who lives in the neighborhood where the shooting took place. Military training seeks to override recruits' moral compunctions about taking human life and establish “muscle memory” that allows them to kill on command. Such a quality is alarming to contemplate in local sheriff's deputies, putting residents of the neighborhoods they patrol at the same risk as those who live in occupied territory.
As Whitehead notes, however, the problem isn't isolated bad cops but something “far more pervasive, arising as it does out of America's obsession with war and all things war-related, which is reflected in the fact that we spend more than 20 percent of the nation's budget on the military, not including what we spend on our endless wars abroad. The U.S. also makes up nearly 80 percent of the global arms exports market, rendering us both the world's largest manufacturer and consumer of war.”
“The transformation from ‘community policing' to ‘military policing' began in 1981,” Michelle Alexander wrote in The New Jim Crow , “when President Reagan persuaded Congress to pass the Military Cooperation with Law Enforcement Act, which encouraged the military to give local, state and federal police access to military bases, intelligence, research, weaponry, and other equipment for drug interdiction.”
A couple decades later, local police were also enlisted into the so-called war on terror, and the U.S. Defense Department began bequeathing “billions of dollars' worth of free weapons, armored vehicles, protective clothing and other military items” on U.S. law enforcement agencies, Whitehead writes.
The benefactors even include campus police departments. Ohio State, for instance, “recently acquired a Mine Resistant Ambush Protected vehicle (MRAP), a hyped-up armored vehicle used on the battlefield to withstand explosive devices, land mines and other sneak attacks,” Whitehead goes on. “The university plans to use its MRAP for crowd control at football games.”
I've said it before and I'll say it again: We lose every war we fight. Actually, “lose” does not adequately describe the nature of our ongoing defeat. Every war we wage implodes, destroying the integrity that sustains us.
“Drop it, kid!”
Being able to bring violent, overwhelming force to bear on a given situation complicates matters immeasurably.
Robert Koehler is an award-winning, Chicago-based journalist and nationally syndicated writer. His new book, Courage Grows Strong at the Wound (Xenos Press) is now available. Contact him at firstname.lastname@example.org, visit his website at commonwonders.com or listen to him at Voices of Peace radio.
Immigrants need licenses, not detention
by Marcela García
Immigration reform is dead — or maybe not, depending on whom you talk to.
Yet, in a refreshing response to Washington political sclerosis, some Massachusetts lawmakers are following the lead of a handful of states that have recently implemented measures to fill the void left by the ghost of immigration reform.
Two very different bills are in play at the State House, but both draw on the fundamental, yet controversial, premise that undocumented immigrants are a fact of life and require sensible policies, rather than purely exclusionary or hostile treatment. This is the same notion that animated the recent nationwide immigration debate — the growing awareness that longstanding denial about undocumented immigrants is getting the country nowhere.
One widely supported Massachusetts reform is a rebuttal to the Secure Communities program, which has the unintended consequence of making many communities less secure. Secure Communities gives federal immigration officials the authority to insinuate themselves into local police enforcement. This is the program mostly responsible for the highest rate of deportations ever in the country — 400,000 a year. Since Massachusetts officially implemented it last May, and immigrant communities became aware that the local police at times have become an extension of federal enforcement, Secure Communities has cast a pall in community policing.
Immigrants' fear of the police breeds less cooperation and less public safety. A recent national report confirms Latino immigrants are less likely to contact police because of their involvement in immigration enforcement: More than 4 in 10 Latinos are less likely to report a crime.
At its worst, local and state law enforcement officers' assistance with federal immigration enforcement has resulted in the unlawful seizure and detention of Massachusetts residents without charges or probable cause to detain them.
State Senator Jamie Eldridge and Representative Carl Sciortino have proposed the Massachusetts Trust Act. It would release local law enforcement from routinely detaining and reporting to federal officials the many undocumented residents whom they stumble upon, such as a Mexican woman named Guadalupe who was shopping on Black Friday at the Holyoke Mall last year. She tried to pay for her merchandise with a debit card. When she could not produce an ID, security was called, and she was charged with shoplifting. The charges were quickly dropped by the judge, but police refused to release her to comply with Immigration and Customs Enforcement rules. She was deported four weeks later, leaving her daughter and her life behind.
In essence, the bill would liberate local police from being an arm of ICE and follows similar legislation in several states, including California and Connecticut. It has the support of Boston Mayor-elect Marty Walsh, Governor Patrick, and an assortment of other mayors. Walsh even said he wants Boston to pull out of the Secure Communities program, if he can get around it.
Safety is the goal of another bill aimed to address a hazardous situation: undocumented immigrants without drivers licenses and thus without insurance. When an accident occurs with an undocumented immigrant, the other driver must pick up the pieces.
No one knows this better than Carly McClain, a community organizer at the New Lynn Coalition. On her way to visit the Science Museum with her husband and son, a driver ran a stop sign and rammed into her car. When police arrived, says McClain, “the officer was asking for license and registration and he didn't have that, he [the officer] was trying to tell him, ‘you should go to the hospital,' and the guy didn't understand him. He was really terrified.”
After the officer wrote him a ticket, the driver fled on foot. It took much aggravation and three months for McClain to work things out with her insurance company.
The Safe Driving Bill would remove immigration status as a barrier for a license or learner's permit, and generate a special type of driver's license and, along with it, the requirement to have insurance. The bill, sponsored by state Senator Patricia Jehlen and Representative Tricia Farley-Bouvier, is awaiting a hearing in the joint Transportation Committee.
McClain sees no reason why Massachusetts shouldn't join the 12 states that require all drivers, including the undocumented, to be properly trained, licensed, and insured. “Maybe if this man had been able to go to the RMV and take a permit test so that he knew the rules of the road . . . he might not have hit me, and he might not have been hurt,” she says. “And all of this might not have happened.”