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July is National HIV Awareness Month. Increasing awareness is one of those concepts that has a nice noncontroversial quality, and there are all manner of things happening to that end. There’s the International AIDS Conference coming up July 22-27 in Washington, D.C., the paraders and booths that will populate PRIDE San Diego (July 20-22), even the sociable North County Connection ad in San Diego Gay & Lesbian News, which links to lots of HIV information.
But is awareness enough?
If you’re approaching 45 years or more, you might remember the discovery of AIDS in 1981 and its cause, HIV, shortly thereafter. Remember the controversies? Remember the panic? Remember the prejudice? Remember the deaths?
A lot of us lost loved ones — gay and straight — in the early days of HIV/AIDS awareness.
Then testing and treatment progressed, we learned more about the virus and its transmission — most commonly through anal or vaginal sex or sharing needles with an infected person — and a whole lot of us were more careful. We got tested regularly, we practiced safe sex, we insisted our partners get tested before we bedded them down.
Now a lot of us have loved ones — gay and straight — who are living long lives with HIV treatment, having families even.
So, is awareness enough?
According to San Diego County Public Health Services (PHS), on average we have 500 new cases of HIV in the county per year and 350 new cases of AIDS. At first glance, this is sad. With the insight of Terry Cunningham, chief of the HIV, STD and Hepatitis Branch of PHS, we understand it is worse.
It is worse than sad, because 500 documented cases of HIV is not all of them: Right now, an estimated 4,353 local people are HIV positive, but don’t know it because they haven’t been tested. Their partners don’t know it either.
Cunningham: “We have such a large number — the 4,000 people — who don’t know they’re HIV positive, who are most likely sexually active and could be spreading the disease.”
It is also worse than sad, because 350 documented cases of AIDS “means they’ve been sick for a long time,” Cunningham explained. Had they been tested regularly, they would have been diagnosed with HIV and begun treatment before it progressed to AIDS.
This is where all that great awareness has gotten us?
Oh, there are certainly plenty of people aware of HIV, not the least of whom are men who have sex with men (MSM, the largest HIV-positive population nationwide) and their partners, families and friends. Unfortunately, denial tends to be a powerful inhibitor of awareness — as does fear, prejudice and ignorance. But awareness does not stop the spread of HIV. Taking action does: being tested, being educated, protecting and informing partners — that’s what stops the spread of HIV.
Problem is, action can be tough to take.
Cunningham has been working in HIV/AIDS for nearly 30 years. He’s seen it all, and he sounds tired: “I never expected it to last this long. I figured we’d have a cure or a vaccine by now. I think people have gotten into a complacent mode about the disease, and when you add in the incredible amount of substance abuse and homelessness issues and poverty, it’s a vortex. We’re holding it at bay, but I just don’t think that’s good enough. … They need to be tested. They need to inform their partners. We have a whole unit that does partner services — talking with partners about [being] HIV positive, running through scenarios. They’ll be there with the person when he discloses to a partner. We provide a knowledgeable person to talk to and immediate testing.” And notifying partners can be anonymous. “We’ll contact an individual and say, ‘We’ve been informed that there’s a potential you’ve been exposed to HIV. Would you like to come in and get tested?’”
Cunningham’s comments reflect an array of services throughout the county, even in North County, once a desert of resources for the gay community.
North County Connection (NCC), for one, provides free HIV testing and counseling. Although NCC’s focus is on testing and educating MSM, the program is one among many provided through the Vista Community Clinic, which offers a broad spectrum of HIV, healthcare and support services for people of all sexes, ages and gender identities, regardless of ability to pay.
The newest agency in North County, the North County LGBTQ Resource Center, which opened in Oceanside last December, is partnering with NCC to provide an HIV testing site that complements the center’s social and support activities.
The center’s executive director, Max Disposti, recalls the days before the opening in a lovely Italian accent inflected with his passion for the community’s issues.
“Every time the Vista Community Clinic took a grant for [HIV] prevention, we saw the benefit in the community — how much it helped and connected the community. Since then, we’ve had a very strong connection. … The Resource Center gives [NCC] access to our population. Before, there was no gathering place in North County.”
And it is a lovely gathering place, warm and welcoming and loaded with anti-bullying artwork created by students at Carlsbad High School. On a recent Saturday evening the center was open for business, with music by The Lovebirds, food and conversation — and free, rapid HIV testing by NCC.
One of the center’s regulars, John Jones was doing a little stoop-setting, and the sweet-faced 22-year-old shared a bit of his coming out story — a mother who accepted him, a father who disowned him.
“Nothing can really fill the void of a father,” Jones said, “but definitely through my experiences and research and connecting with organizations such as this, it’s helped me understand it more, cope with it better. Meeting more people, sharing experiences, it helps.”
Jones has grown into a leadership role in the community since he came out at 16, serving as president of the LGBTQ club at Palomar College for two years and, in the fall, he’ll be president of the LGBTQIA student organization at Cal State San Marcos. He’s also at the forefront of testing.
“I do it to lead as an example, and then, by me doing it, I can actually talk about it more, from experience. The problem is, if you’re not out, you don’t want to be out, so you wouldn’t come here, which is a big problem. The socialization, meeting other people, which is really what it’s all about — you feel that no one else can relate to you about that, when in reality there are a lot of people here going through the same things.”
For those folks not out or not identifying as gay but having sex with men — for anyone in fact — there are plenty of options for confidential testing. As Jones said, “If you look for it, you’ll find it.” (See the list of resources below.)
But if we’re really honest with ourselves, we know that some people will simply not be tested and an unknown number will withhold positive results from their partners. These people are potentially deadly.
Want to avoid the deadly? First, we have to get tested, get our partners tested, get treatment if needed, and get wise — so we can still get some, safely.
Because awareness is not good enough.
Then, of course, you can always have a little fun with a negative test result. Get it in print, tuck it in a nice love note or a bit of erotica, a sex toy, whatever. Use your imagination. …
Kit-Bacon Gressitt's commentary and political fiction can be read on her blog Excuse Me, I'm Writing and is republished by SDGLN, The Ocean Beach Rag and The Progressive Post. She formerly worked for the North County Times. She is also host of Fallbrook's monthly Writers Read open mic and can be reached at firstname.lastname@example.org.
San Diego County resources for confidential HIV testing, counseling and partner services, and treatment:
North County Connection
760-631-5000 ext. 7000
San Diego County Public Health Services (including San Diego city locations)
Vista Community Clinic (six locations throughout North County)
Note: Words Hurt art by students of Carlsbad High School.