So November 6th was our big election day here in The States. Americans went out in record numbers to vote! On the ballot? President, Senate, local government, legalizing marijuana, gambling and same-sex marriage.

Well, Barack Obama was re-elected president; we have our first openly gay congress woman.  Two states legalized marijuana, but the big news is we now have three more states in which gay marriage is legal! WHOOP WHOOP!

Maryland has the distinction of being one of those states; we also have the distinction of being the first state ever to win gay marriage on a ballot, meaning it was not done by politicians; it was done by the people!! Well done Maryland.

Now I have written about gay marriage here before, a couple of times I believe. And was pretty clear and adamant about my stance.  I felt very strongly that anyone wanting to get married should have the right, regardless of their gender or sexual orientation , but in the same tone, marriage was something that I had never wanted for myself.

Now that gay marriage has passed, I have come to believe that I was shamming myself all along. I think it was easier to say I didn’t want something I thought I could never have than to admit to the disappointment of not being able to have it. (I hope that made sense, it seemed to have worked when it was  in my head, anyway.)

In short this victory for gay marriage has turned out to be bittersweet for me. While I am ecstatic that my fellow gay Marylanders have the right to go out and get married, I have to admit that I have cried many, many, many tears over the last week.

I can’t help but think “what if Kyle were still alive?” And if I asked him to marry me would he say yes? What would our wedding be like? I always joked that if I ever got married it would be a beer keg and a bag of Fritos Corn Chips. The more I think about it, I would want it to be a beautiful grand affair, as beautiful and grand as the love that Kyle and I had together.

I can picture my mother in a stunning lavender taffeta gown, her hair perfect, wearing the pearls my father gave her. And my father, looking very sharp in a white dinner jacket tuxedo (hopefully) walking me down the aisle. All of my closest friends who are more family than friends, and my family of course, (those that don’t think I’m the devil for being gay anyway). I can smell the mountains of white roses, tulips, and calla lilies everywhere. And I can see Kyle standing up front in a smart cut white silk tuxedo waiting to take my hand and promise me forever. I can see it all so clearly, yet it’s just forever a dream.

But dreams are such good medicine. And perhaps one day this dream will come true, minus Kyle of course. I may yet meet someone so special that I will want them to promise me forever, and I’ll see my mother in her beautiful lavender dress, my father  in his tux (still hopefully) walking me down the aisle.

I picture my family and friends sharing with me the most special of days, and I know that wherever Kyle is on that day he will be watching and smiling, sending all his love and best wishes to me and the man standing with me holding my hand in marriage. Oh what a beautiful dream indeed.

 I wish you all so much love and then just a little bit more!! Thank you for reading. XXOO Danny  

May 4, 2011.

I was hired last year, April 2011, to be a training consultant for the MTN (Microbicide Treatment Network) to help create and facilitate a series of trainings for their clinical trial staff in South Africa, Uganda and Zimbabwe. The trials were trying to assess the effectiveness of microbicidal vaginal gels, products that could someday help women protect themselves from HIV in situations where condoms were not an option.

My colleague R and I were asked to deliver trainings that focused on client-centered approaches to adherence counseling, strategies that would move away from simply directing women to use the gel but instead explore their experience of using the gel; what made it easy, what was challenging. I decided to write daily Facebook updates of my African adventures for my friends and colleagues back home. Since Facebook at that time only allowed 420 characters in their updates, I had to make my entries short and to the point. Here are all my entries, combined, and aptly entitled: 

Africa 420

March 30 

Returned to San Francisco from Washington, DC last night, where I met a lot of new colleagues who are involved in the MTN (Microbicide Treatment Network). They’re studying vaginal gels that could someday protect women from HIV while still allowing pregnancy. Will be going to Africa next week to be a part of the counseling training portion of the clinical trials, along with A and R. A big honor, and very exciting. 

April 7

Off to Africa in a few hours. 3 countries, 4 cities, 6 trainings, 150+ participants. My 2 colleagues and I will teach a client-centered approach to assist adherence counselors. I'm excited, apprehensive, emotional. Bringing laptop and camera; will post updates. Found this African saying: ‘If you want to go quick, go alone. If you want to go far, go together.’ So, if only electronically, I'm taking you all with me! 

April 9

29 hours have elapsed since I locked my door on Folsom St. in San Francisco and entered this hotel room in Johannesburg. Exhausted, but happy to be here. The hotel is right next to the old police headquarters. My cab driver said that up until 1994, if you were black and found in Jo'berg after dark, you were taken there and interrogated. If they didn't like your answers, they threw you out the 10th floor window.

my first sunset in South Africa

April 10

9 hour sleep, then out to the Apartheid Museum. Strong visual history of the long struggle for independence, achieved less than 20 years ago. Sat on a bench with a black youth, watching a video about Mandela. When 2 white men entered, the young man stood and gave up his seat. Feeling awkward, I stood up and offered him mine. He wouldn’t look at me. Am still thinking about what to have done differently in that moment. 

My colleague A and I decide to walk through the hotel's neighborhood. We're the only whites we see. Very powerful, being the only one, the other. I’ve felt it as a homosexual, but rarely as white. We saw many churchgoers and can feel history in the streets, memories in the buildings. We saw two amazing birds in the street: a magnificent stork with a giant blue head, and a huge multicolored duck. Tomorrow: Soweto! 

April 11

Spent morning in Soweto, a vast area outside Jo’berg. It has a long history before, during and after the worst of apartheid. Today it’s a thriving community of over 3 million. Visited the Chris Hani Baragnawath Hospital, the largest hospital in the Southern Hemisphere, possibly the world. Met many of the staff who will be coming to our 1st training tomorrow. Feeling the importance and honor of what’s about to begin. 

April 12 

Off to the training this a.m.: 65 nurses, counselors, pharmacists and physicians will be in attendance. We’ll end by 5, hop in airport shuttle and fly to Durban, where I plan to take a dip in the Indian Ocean, shark nets and all. We received a Travel Security Alert last night: Ugandan activists protesting rising food costs were tear gassed by police. We’re hoping things will calm down soon — we fly there on Sunday! 

Soweto

April 13

Our 1st training was very successful. The passion that the staff has for these microbicide trials is palpable and moving. The hope is that at the end of 3 years, products will (finally!) be available for women to protect themselves from HIV. We arrived in Durban 2 hours ago. The hustle and bustle and huge energy of Jo’berg has been replaced with a tropical mellowness. It feels like an African Key West. 

Visited 2 clinics today; powerful interactions with staff. 5 thousand women will be enrolled; hopeful results should be available in January 2013. Last night, as we arrived at the airport, I walked thru the most diverse crowd of people I’ve ever seen.  The varieties of clothing, skin colors, headdresses, languages, saris, Indians, blacks, and Afrikaners was incredibly heart-opening. Got to my room and had a good cry. 

Went to the Indian Ocean. Shark talk had me nervous. The waves were high, the current strong. The water was perfect though; I went in waist-high. It was warm and welcoming. We hurried back to the road, hailed a taxi, got home before dark. When I checked all my pockets, my beautiful camera was gone! As I toss and turn and try to sleep, I know what I must do, especially in this country with its long history. Let it Go! 

April 14

Our 1st Durban training went very well. Counselors are responding positively to the key concept of our approach, i.e., the client is the expert on her life and her abilities to use the study products (tablets or vaginal gels.) I left home one week ago. Thanks so much to all of you for your wonderfully supportive responses. I really appreciate it. We’re here for two more trainings before we head north . . . to Uganda. 

April 15          

The heat and humidity were oppressive today (air conditioning broke down) as we did our 2nd Durban training. Drank a gallon of water to get through the day. We’re closely monitoring the situation in Uganda which is our destination on Sunday. We won’t go if the situation worsens. Thinking positively, we started our malarial drugs today, a necessary precaution for Uganda. 

Went to an incredible mall to replace my camera. The malls are unexpectedly grand, with lots of security; everyone can go and feel safe. You’d think you were in the US due to their size and selection, except for the unbelievable diversity of the shoppers. Black and white Africans, bi-racial and East Indians, Asian tourists, white Europeans; (we’re not seeing other Americans tho) . . . it’s absolutely fascinating! 

One of the training participants today was a woman living with HIV. She told me that in 1999 her AIDS medications became so expensive (980 rand a month; about $160) that her family chose to cut back on food so she could live. She said they were all starting to starve to death . . . and then the Bill Gates Foundation began providing the medications free of charge. Her spirit was very strong. I’ll never forget her. 

Another powerful moment: an African man practicing his counseling skills as I circulate round the room, offering suggestions, etc. I sense he’s stuck, so I approach, reaching out to touch his shoulder. He sees me out of the corner of his eye and moves quickly from his seat, towards the floor, hand raised, like I’m going to strike him. I feel terrible and apologize. So does he. I wish I could take that moment back. 

April 16

Rainy Durban day. We Just finished our 4th training and have gotten the green light to proceed on to Uganda. It’ll take us most of tomorrow to fly there. We’ll check into our Kampala hotel tomorrow night, conduct the training on Monday, and then fly out early Tuesday to Zimbabwe. We’ll be in Uganda a total of 32 hours -- and we’re feeling confident that we’ll be fine. We’re glad we started our malarial drugs. Onward! 

Had our last dinner in Durban at a great Thai restaurant. Feeling really good about the trainings here, and what we’re bringing north to Uganda and Zimbabwe. We saw a newspaper headline this a.m. that read: “Lion Spotted on Local Beach.” I don’t know if it’s true, or just a way to sell more papers. But I love that image: a lion walking along the sand, looking out to sea. I hope he’s in my dreams. Good night . . . 

April 17

A white airport shuttle driver this morning said the apartheid years in Durban were not as bad as those in Jo’berg, that even in the worst of it, there was enough work for everyone in Durban, which helped keep the violence in check. He asked if I’d noticed how many black men in Jo’berg had scars and burns on their faces and arms. I told him I had, but that I hadn’t really understood the past those wounds reflected. 

I asked the driver what he wanted for South Africa. His response: Stability! I suddenly saw a big spider monkey on the side of the road. Then we saw a dozen more under the trees. He pulled the van over and we watched the mothers and their babies and some older males as they ran along and then jumped up onto a wall. We were amazed to see them, just running free. We thought they were amazing. His response was: Pests! 

We’ve arrived in Kampala, Uganda. The airport sits right on the shores of Lake Victoria. There’s one road that goes into the city and it meanders through an incredible series of neighborhoods: sounds, smells, sights, stores, smoke, soldiers, scooters; it’s a hypnotizing hour-long ride. As we pulled up to our hotel, some armed men came out and checked the bottom of our cab, looking for bombs. What a day it’s been!

This article by  Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services, origiinally appeared on AIDS.gov Blog here. 

Across the country, many people are preparing to take an important step to improve their health today; they are planning to quit smoking. Why today? It’s the 37th Great American Smokeout. Organized annually by the American Cancer Society, the observance encourages smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By doing so, smokers—including those living with HIV—will be taking an important step towards a healthier life – one that can lead to reducing cancer and other health risks.

Smoking and People Living with HIV

In the HRSA Guide for HIV/AIDS Clinical Care it is stated that smoking prevalence among people living with HIV/AIDS (PLWH) is estimated to be two to three times greater than in the general population, with estimates ranging from 50% to 70%. This higher smoking prevalence persists despite more than two decades of research that has concluded that smoking is a widespread problem and a major modifiable risk factor for disease and death in PWLH. That research has demonstrated that smokers with HIV/AIDS are more likely than PLWH who do not smoke to:

• Be at higher risk of a variety of tobacco-related conditions such as lung cancer, head and neck cancers, cervical and anal cancers, oral candidiasis, and oral hairy leukoplakia;
• Be more likely to develop bacterial pneumonia, Pneumocystis jiroveci pneumonia, other pulmonary conditions, and cardiovascular disease;
• Have a decreased immunologic and virologic response to antiretroviral therapy;
• Be non-adherent to treatment;
• Report lower quality of life than do non-smoking persons with HIV/AIDS; and
• Have a greater chance of being diagnosed with an AIDS-defining condition or dying. 

(HRSA Guide for HIV/AIDS Clinical Care and Harris, 2010)

In a study of over 5,000 persons with HIV from over 30 countries, Dr. Alan Lifson and colleagues concluded that “current smoking represented a significant risk factor for both all-cause mortality and several serious clinical disease outcomes, such as cardiovascular disease, non-AIDS cancers, and bacterial pneumonia. Significant reductions in morbidity and mortality among HIV-infected patients achieved by advances in HIV therapy may be undercut by increases in adverse clinical outcomes attributable to smoking.”

In other words, quitting smoking may be one of the most important steps toward better health that a person living with HIV can take. If you are a smoker and would like to quit, our colleagues at smokefree.gov recommend that you START by taking these five important steps:

S = Set a quit date (even if it’s not tomorrow, use the Great American Smokeout as motivation to set the date that you’ll quit)

T = Tell family, friends, and coworkers that you plan to quit.

A = Anticipate and plan for the challenges you’ll face while quitting.

R = Remove cigarettes and other tobacco products from your home, car, and work.

T = Talk to your doctor about getting help to quit.

Health Care Providers

That last tip underscores the important role that health care providers can play in encouraging and supporting people living with HIV to quit smoking. The Lifson study also concluded that encouraging smoking cessation should become a high priority for clinicians and other HIV service providers to promote health and reduce morbidity and mortality in their patients. Similarly, in its chapter on Smoking Cessation in the Guide for HIV/AIDS Clinical Care (2011), the Health Resources and Services Administration’s HIV/AIDS Bureau observes, “Although many care providers may feel that they can do little to affect the smoking behaviors of patients, evidence suggests that brief interventions by physicians are quite effective. Studies indicate that smoking cessation interventions as brief as 3 minutes in duration, when delivered by a physician, have a positive impact on abstinence rates of current smokers. Furthermore, studies have found that more than half of current HIV-infected smokers have expressed interest in, or have thought about, smoking cessation.”

To get ready to support PLWH who are prompted by the Smokeout or even a New Year’s Resolution to make the decision to quit smoking, HIV care providers may wish to review the Smoking Cessation chapter since it contains information on behavioral and pharmacologic interventions that may be useful in supporting patients seeking to quit.

Resources to Help You Quit Smoking

As you consider taking the health enhancing step of quitting smoking—or if you are supporting someone else in doing so, the following are some resources that may be helpful: 

CDC’s Office on Smoking and Health offers a wealth of information and tools including fact sheets, e-cards to encourage friends and loved ones who have chosen to quit smoking, FAQs, and other resources.

Smokefree.gov provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking. Among their services is SmokefreeTXT, a mobile service designed for young adults providing 24/7 encouragement, advice, and tips to help smokers stop smoking for good. A Spanish language version of the site is available at http://espanol.smokefree.gov/.

It’s Time to Live: HIV and Smoking  is a 12-page brochure, developed by the New York State Department of Health, that shows how HIV and smoking work together to harm your body. It explains how your health gets better as soon as you quit smoking and gives you advice on how to quit.

You can read Part One of Ed's story here. 

Monday morning, October 22^nd

The grey mist of the last two days here in Kiev disappears and the sun shines bright. The screening of “We Were Here” isn’t til tomorrow night; I have most of the day free and decide to take a city bus tour. Everywhere posters announce that Marilyn Manson, Seal, and the next Twilight movie are ‘Coming Soon.’ The tour guide describes the great battle of Kiev in 1941, how when the city fell, 600,000 soldiers were marched out, most never to return. There was a large Jewish neighborhood here then as well, 200,000 inhabitants. When the Nazis left two years later, 125,000 had been shot and killed. My spirits start to sink, feeling that the bus tour may not have been the best thing to do today. I find myself thinking of the screening tomorrow, worrying about whether the homophobic journalist from yesterday will be there. I reflect too on the eloquence and courage of the queer speakers on yesterday’s panel, how committed they are to fight the oppression they experience in their own country, how determined to stand up against the pending legislation that will make any positive images of gay people illegal. 

The tour ends where it began, at the Film Festival headquarters. I’m supposed to meet with the people who are sponsoring tomorrow’s screening of “We Were Here.” As I wait for the taxi to take me to their office, I see the man who sat next to me on yesterday’s panel. I call him over and ask about the journalist who was so disruptive. He says he’s one of Kiev’s most influential film critics, is a bright and educated man and, for some reason, when the issue of gay rights comes up, he goes ‘crazy.’ I ask him if he thinks this critic will be at tomorrow’s screening and he says it’s possible. My taxi arrives and I’m taken to the offices of FULCRUM, a social service organization that serves Ukranian gay men. I meet the executive director, a young man named Bogdan, and three of his colleagues. There’s also a wonderful woman who will provide translation for our meeting today. The translator takes me on a tour of the offices where I see many beautiful paintings of gay men leaning against the walls. She tells me that the artist is afraid to keep them where he lives and has donated them to the agency. She says they're unsure if they will be able to display them or not. 

We all sit down and talk about tomorrow’s screening. (The interpreter translates the following discussion.) They’ve decided to sponsor “We Were Here” and bring me to Kiev based only on what they’ve been able to find in print about the film. None of them have seen it, or read or speak English. I can hardly believe it and am incredibly moved by their trust in the film and in me. They tell me the situation for Ukranian MSMs (men who have sex with men) is very dire and even moreso for those who are HIV+. The stigma against gays is immense and when someone becomes infected, many in the gay community turn away from them as well. They then become isolated, some afraid to seek treatment, some dying alone. (I am crying as I write this to you in my hotel room because I could not do so in front of them.) They have planned a three-hour event before the screening and I am their guest speaker. They have invited HIV+ men from all over Ukraine along with a number of medical providers. They have bought everyone tickets to see the film and have paid for their travel to Kiev, some travelling long distances. They’re all coming to see “We Were Here,” and discover how San Franciscans rose up to take care of their own in a difficult and terrifying time. 

We meet for several hours and together create an agenda for the meeting tomorrow. They want me to talk about the early days of the epidemic, how we San Franciscans found ways to work together and eventually overcome some of the obstacles for caring for those who were ill, connecting those who were isolated, protecting those who were uninfected, and creating bridges to the larger community. They’re not sure if what we did in the US will work in Ukraine. One of the men at the table lamented their lack of community and described how stigma keeps gay men isolated from one another. The government will not allow gay parades or other events that could bring gay people together. I ask about the bars, the saunas; is there some way to get support from businesses where gay men gather. But the lack of compassion, both by the establishment and within gay culture itself, seems insurmountable. A sense of helplessness comes into the room and I reassure them that the most important step has already happened; the four of them are there, sitting at the table together, trying to find ways to solve their problems. There have to be others out there, ready and willing to join them in their efforts. The challenge is going to be finding them. 

It gets late and we’re all tired. The interpreter is exhausted and tomorrow is going to be a huge day for all of us. As we draw the meeting to a close, I remember to ask them where they get their funding. They tell me the Elton John AIDS Foundation. (At that moment I vow to never roll my eyes again when hearing “A Candle in the Wind.”) I gather up my things and head to the lobby. They call a taxi and as we wait, I tell them how proud and honored I am to be here with them, thank them for giving me the opportunity to help them however I can. The taxi arrives and as I prepare to leave, they hold their hands out to shake mine. I hug them all, closely, more, perhaps, for myself than them. They walk me out to the taxi and say good night. The driver is an older man and we sit in the traffic together, neither speaking the other’s language. The reason why I’ve come to Kiev has become so clear to me in these last few hours and I become overwhelmed with the situation here and the hopes these people have that tomorrow’s meeting and the screening of the film will somehow make a difference. I so want it to be so and I start to cry. The driver doesn’t know what to do, so we drive silently back to the hotel, his eyes on the road, me crying into a United Airlines napkin. Please send us all good thoughts tomorrow. Good night! 

Tuesday morning, October 23^rd

The day of the screening arrives. Kiev is cold and gray. I’ve tossed and turned all night, restless, thinking about today and hoping that all goes well. I eat breakfast with two men from Warsaw Poland, tell them about the repressive law that may soon be passed here and about the awful homophobic journalist from earlier this week. They tell me they’ll come to the screening tonight to see what happens. As I get ready in my room, I try to think of something to use as a mantra today, something that is greater than fear, repression, or hopelessness. As I’m tying my shoe, this quote from Margaret Mead comes to me: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” These are the words I will hold close today. I look in the mirror before heading downstairs. I look a bit tired, but I’m ready. 

I arrive at the Film Festival Headquarters and participate in the  ‘Sunny Bunny’ (queer film program) press conference. I’m relieved to see that the rude journalist is not present. I provide a brief synopsis of the film when asked, talk about the importance of maintaining queer visibility, especially in Ukraine’s fight against AIDS. I point out the catastrophic numbers of people living with HIV here, over 450,000 in Ukraine compared to 1.4 million in all of the U.S. During the press conference, however, I am acutely aware that on the other side of town, the community HIV event that I’m supposed to be speaking at has already begun. I slip out of the conference when it’s polite to do so. One of the men I met yesterday has arranged a cab and we crawl through terribly congested traffic and finally arrive at the hotel where the event is taking place. He says the meeting’s been in progress for about an hour and leads me into a large room. A man is speaking about the importance of finding straight family members of HIV positive Ukranians to help support AIDS efforts nationwide. When I look around the room, I see many gay men, some obviously with HIV/AIDS, and lesbians, and am suddenly very much at home. 

I take a seat and Bogand, the director of FULCRUM, a Ukranian social service organization that serves gay men, introduces me. I describe how the film we’ll all be seeing together tonight will tell the story of how San Francisco responded so compassionately at the very beginning of the AIDS epidemic.

Someone asks why the documentary was made and I relate David’s story of a younger partner suggesting the idea to him. I explain how so many gay men of my generation are dead and gone, how important it was to capture our stories and memories from that time. Someone describes the rural region where they come from, how difficult it is to organize there. I describe the recent experience that David and Eileen and I had at a screening in Oklahoma of "We Were Here", how gay men at the university found each other there, started a radio show, create events celebrating coming out, drawing attention to issues like bullying and HIV. Many questions are asked and I respond as best I can. Mostly, I find as many ways as possible to reflect back to them the importance of both queer and HIV visibility, how powerful it is for me to come into this room and see them all here at the table together, sharing their concerns and strategies. I tell them I will remember their courage, admire their commitment to the causes they hold so dear. I tell them I will take their stories home with me and share them (with all of you!). Suddenly the event is over, and we take a dinner break before reconvening at the theatre for the screening. 

The event organizers take me out to dinner. (I order Chicken Kiev, of course. It’s quite good!) Everyone’s very happy with the turnout for the meeting today. They so appreciate my repeated emphasis on gays and lesbians finding ways to work together to remain visible and united, even in such oppressive times as they are living in. They say there is great anticipation for the film tonight and remind me that many have traveled to Kiev from outlying regions. The wonderful woman who has been doing all the translation for me these past few days turns out to be Bogand’s mother. She is as dedicated to the causes of gay rights and HIV support services as her son. It’s all so incredibly moving I can hardly eat. When I first received my invitation to the Festival I was told that there would be an “International Drinking Party.” Everyone attending the Festival was asked to bring a bottle of their ‘Favorite National Drink.’ I brought a big bottle of Jack Daniel’s Tennessee Whiskey in my luggage, but was so jet-lagged I missed the party. At the dinner table, I pulled the bottle out of my backpack and presented it to the organizing team. I said the next time they’re feeling hopeless or frustrated in their efforts, to take a drink from this special bottle. I told them it was a magical elixir from my country, guaranteed to help them through difficult times. I could see in their eyes that they were moved by the sincerity of my gift. 

We all arrive at the theatre. The lobby is full. There’s a camera crew; I do a quick interview. There’s much excitement. Some of the people who were at the first panel I participated in are there and laughingly recall the rude journalist. We look around the lobby, but he’s nowhere to be seen. Hallelujah! The screening is supposed to begin at 7:30, but at 7:45 the doors to the theatre are still not open. 8:00 comes and goes. One of the festival organizers, Victoria, comes to find me, explains that they are having some technical difficulty getting the film to operate, but they’ve almost got it working. I can hear the sound of my own voice coming from behind the closed doors of the theatre and am relieved. She explains that this cinema is the oldest in Kiev, built in 1931, and there’s a small problem with the projection equipment. 8:15 comes and goes. I’m getting worried. The audience is restless. 8:30 . . . and suddenly the doors open and we all go inside. The woman from the festival, Victoria, welcomes the audience and then Bogand introduces me. I get up, thank them for coming, and then appreciate that they had to wait. I say, “We’ve all just had an opportunity to practice one of the most important skills necessary for social change . . . patience.” There’s much laughter and applause and then a voice is heard from the back of the theatre. Everyone gets up and starts to leave. “What is it?” I ask Victoria. “There’s a problem with the copy of the film we have. I’m so sorry Ed . . . there will be no screening tonight.” 

As the last of the audience leaves, I stand with Bogdan and his mom, other staff members from FULCRUM, and Victoria. Everyone is stunned. There’s an awkward silence. Bogdan and his team have worked so hard to organize the event today, bringing so many people from outlying areas Kiev . . . and now this! Victoria is obviously shaken. She says she feels so guilty and is terribly sorry. I tell them that I am disappointed, yes, of course, but I’m not angry. There is no blame. Victoria says they’ll contact David Weissman, get another copy, be sure to screen it before the festival is over. I can sense they’re trying to make me feel better and I work hard to tell them that I’m fine, really. I say that the most important part of the last 4 days for me is that I was able to come to Kiev and meet them all. I’ve seen how hard the Festival organizers work to keep queer films as part of their program. And that I am so profoundly moved by the work the agency is doing for the rights of gay men and those living with HIV in Ukraine. “It’s you, the people I’ve met, that have made my experience here so wonderful.” It’s late now, and everyone’s exhausted. I say goodbye to each of the FULCRUM staff. Bogdan’s mother gives me a big hug. Bogdan has told me at dinner that there will be an HIV conference here next fall and he’ll have me return, so I assure her that we will meet again. After they leave I stand in the lobby with Victoria, waiting for my cab. She’s tearful and I reassure her again that I am fine. And as I’m driven back to the hotel for the last time, I’m aware that I REALLY AM fine. People here will see “We Were Here,” in their own time, in their own way. My experience in Kiev has been spectacular and the people all so inspiring. I know I will return. We may not have been able to watch “We Were Here” as a group, but it definitely has achieved something else, something greater . . . it has brought us all together. 

Wednesday morning, October 24^th

I’m in my hotel room, packing, getting ready to go down to the lobby and take the shuttle to the airport. I’ve received an e-mail during the night, stating there will probably be a screening of “We Were Here” today after all. I’ve check with the airlines, but it’s impossible to reschedule my flight now . . . I leave in 3 hours. I have to let go, and so I do. After everything that’s occurred in the past 4 days, I think I can’t possibly be surprised by anything else. But just now, through a window I opened earlier this morning, a little bird has flown into my  room. It’s small, black and brown and grey, but with a bright green streak on it’s chest. It’s sitting on my suitcase right now, looking at me. I know it sounds unbelievable, but there it is. I get up slowly, speak quietly to it, try to get it to fly back out the window. It flies further into the room instead. I go to the balcony door, open it wide, and sit back down. Slowly it sticks its head out from under the bed, looks at me, and then hops across the rug and out the door. I stand and watch it on the balcony railing. It chirps at me and then flies out across the river. I don’t know what to make of this final encounter, but it feels like a good omen to me. I gather up my things and head to the lobby. I’ll be home tonight, in my own bed. Thank you dear friends, for all your kind words and good thoughts. They’ve meant a lot to me.

I’ve been very busy lately with photographing various HIV events here in Los Angeles. This is how I had the pleasure of meeting Nina Harawa. She was one of the guests in attendance at the Leadership Awards put on by the Los Angeles Women’s HIV Task Force which I wrote about recently. She is also the reason I was able to photograph and video the Breaking the Silence event in Los Angeles.

I know you’re wondering what is Breaking the Silence and let me start by saying, no I did not complete my HIV documentary that shares this name. However it is because of this, plus the fact that so many people I admire and respect were involved with this event that I said yes I would capture it. However what I would later discover is just how amazing Nina truly is.

On October 17 my friend Carlos and I made our way from Hollywood toward Charles R. Drew Magnet High School in Los Angeles to cover Breaking the Silence. It’s an annual event for Black women and Latinas designed to help them address wellness, health, relationship and sexuality issues.

I have not been to this area of Los Angeles in a very long time. Not since I was around 13 years old and my cousins lived down the street at 124 and Wilmington. I share this story with Carlos on our drive over. We spoke about how as a kid I attended the Jazz at Drew event and even spoke of the King/Drew Medical Center and Hospital which is now closed, but construction on a new medical center is under way and is much needed for this area.

Carlos and I were joined by over 400 women of all ages, incl;uding youth for an 8-hour conference that featured guest speakers, breakout sessions, role play and an interactive performance piece from T.A.D.A. (Theater Actors Discussing AIDS) created by my friend Michelle Simek and featuring my friends Shellye, Andrea and Lynenia . Additionally the participants left with a self-esteem kit “lovingly” assembled by Shellye and Zoyla who were guest speakers.

Featured guests included author Gail Wyatt, PhD. Who spoke about child sexual abuse on women, risky behaviors, as well as the long term affects this could have on women’s mental health and wellbeing. She spoke candidly about sexual habits and even sexual behaviors that many view as normal.

Celebrity guest was Cookie Johnson, the wife of basketball and Laker legend Magic Johnson. After a clip from a recent documentary, Mrs.Johnson took to the stage to discuss how they’ve been dealing with HIV in their relationship as well as offering valuable life lessons to women concerning their health, self-respect, love, HIV and AIDS.

For me this was a very important part of the conference when it comes to people of color. Especially Black people, because some like to believe that Magic Johnson has been cured of HIV.  Cookie’s presence blew this right out the water. Just looking at some faces of people in the audience I could see “you sank my battleship” type expressions on their faces.

“One of the most difficult challenges for women is maintaining their own health while addressing a myriad of other demands – as mothers, wives, girlfriends and workers,” said Dr. Nina T. Harawa, Associate Professor of College of Medicine, Charles R. Drew University of Medicine and Science and Event Chair. “Sexual health is an important but rarely talked about aspect of this. The event is about breaking this silence in order to both highlight unhealthy patterns in our communities and to facilitate dialogue and information sharing that promotes healthier approaches.” 

Nina is unlike any leader I’ve ever met. While she is brilliant, very accomplished and has an unmatched record of compassion and great care as well as a commitment to healthcare and HIV services for populations hardest hit by HIV and AIDS, she is not arrogant, nor does she display any insecurities about who she is and what she has accomplished by asking people to address her as Dr. Harawa or reminding people how many letters she has behind her name.  She’s down to earth and content to allow other people to shine.

Moreover she commands the respect of her team and colleagues by being a kind, gentle, educated and socially aware leader. She knows the strengths of her team and allows them to blossom under her leadership. My Ma use to say you can judge a great team by its outstanding leader and that the sign of a true leader is one who is willing to take advice and delegate leadership responsibility to their team. A good leader fully understands that there is no “I” in team.

As I’ve said many times before, you cannot help people you don’t speak to and you certainly cannot help people you don’t care about. Under the leadership of Nina, this conference IS what others should strive to be. It is held in the heart of populations hardest hit by HIV and AIDS as well as those who do not have adequate access to care. It’s FREE, offers FREE childcare, located in their neighborhood, speaks to them, not above or at them. It is FREE from judgments, guilt or shame. It is respectful, but most of all it is UNDERSTANDABLE!!! It provides real life answers to real life situations facing women of color in a supportive environment that is respectful, but challenging. It meets people where they are.

Lastly, Nina made certain that the people presenting and offering suggestions and resolutions looked just like the people they were speaking to. They live in neighborhoods just like the one where the conference is located, they fully understand what struggle is and that when you don’t have money to get on the bus this is not an excuse, it is a barrier. When you don’t have food to eat or a place to stay you are not lazy or worthless, but deserving of love, respect and help that meets your immediate needs. They were kind, informed and fully aware of the situations facing these women.

I feel strongly that this conference should be the ONLY conference for woman of color here is Los Angeles and until we retire the old guard with their old ideas that have never worked and replace them with real, effective leaders like Nina, issues such as poverty, homelessness, access to care, HIV and AIDS as they pertain to Black and Latino populations will never change.

It’s time for new ideas, new leaders who truly care about the final outcome. It’s time for real change, real progress It’s time for Nina and conferences like Breaking the Silence.

This article by Gus Cairns first appeared on aidsmap.com here. Republished with permission. 

HIV campaigners reacted with dismay today to the issuing of a report by a Norwegian Commission on HIV and the Law which, while making one significant concession in the shape of allowing condom use as a defence, in some other ways strengthens the options the state has to prosecute individuals who infect, or expose others to, HIV.

Until now individuals were prosecuted in Norway under a 1902 law intended to be used against people who negligently or deliberately spread contagious diseases such as tuberculosis (TB) but which has, in practice, only ever been used in cases involving HIV, and only since 1991, apart from one isolated case in the 1930s.

A coalition of HIV activists had campaigned for the law to be revised, hoping that an examination of the law would lead to it restricting HIV transmission prosecutions to clearly deliberate ones or at least only to transmission rather than exposure, as has happened in some other countries such as The Netherlands and Denmark – which suspended prosecutions under its own criminal code last year. The occasion to do this was prompted by a revision of the 1902 act, the legislative framework for which was voted through in 2005.

In the event the document produced by the 12-person commission will make it easier rather than more difficult to prosecute cases of HIV transmission or exposure.

The commission's report are only recommendations, but given that all recommendations were endorsed by a minimum nine-to-two majority, considerable pressure will be needed to change them.

By an eleven-to-one majority, the commission rejected one proposal, which was to abolish disease-specific legislation and to use the general law on assault, as is the case in the UK. 

 "In short, they wish to make it clear that the prosecution is for bad moral behaviour as much as it is for its effects."

They specifically reject this as making prosecutions for HIV transmission or exposure too difficult, as Norway’s assault legislation requires proof of intent – and because it would make it too difficult to prosecute people who have behaved towards others “in a blameworthy, extremely indifferent or reckless manner”. In short, they wish to make it clear that the prosecution is for bad moral behaviour as much as it is for its effects.

The Commission also makes a clearer distinction between the “spread of disease” and the “transmission of disease” – the former applying to contagious diseases like flu and the latter largely to sexually transmitted diseases.

The most significant disappointment is that, by a nine-to-two majority, the commission decided to retain a criminal offence of HIV exposure, i.e. that transmission would not be necessary in order for there to be a crime. They give public health reasons for retaining exposure as a crime, namely that if only transmission were a crime, the law would not act as enough of a disincentive. They say: “Only by ensuring that the penal provision also covers exposure to another person to the risk of infection will it promote a change in behaviour and thereby contribute to infection control".

 "The Commission has found little scientific evidence of the effects of criminal regulation of infection transmission and exposure".

The commission, on the other hand, dismisses arguments that the law might have negative effects on public health, for instance by making people afraid to test or to disclose their status, by saying: "The Commission has found little scientific evidence of the effects of criminal regulation of infection transmission and exposure".

The commission makes one major concession in the shape of condom use, saying that no offence would be committed “When proper infection control measures (such as use of a condom in connection with sexual intercourse) have been observed.”

It also makes a fairly significant concession in saying that a single case of exposure, without transmission, would probably now not be prosecuted, wishing to allow some latitude for what it calls “slip-ups”. However single exposures would still be crimes if transmission occurred or if there were other aggravating circumstances such as direct lying about HIV status.

The commission says that the condom defence would apply regardless of other risk factors such as the HIV-positive person’s viral load. This directly contradicts the recent judgement of the Canadian Supreme Court, which said that condom use alone was not a sufficient defence against prosecution as there was still a “realistic possibility” of infection: only in cases where condoms were used and the HIV-positive person had an undetectable viral load would HIV exposure without disclosure not be regarded as a crime.

The Norwegian commission, also in contradiction to Canada, does not regard undetectable viral load even as part of a valid defence. Nearly five years after the Swiss Statement that asserted that people with stable undetectable viral loads and no sexually transmitted infections could not transmit HIV, and 15 months after the results from the HPTN 052 study, which found that HIV treatment reduced the chance of infection between heterosexuals by 96%, they assert that “The knowledge available about the risk of infection at any given time associated with an HIV-positive person under medical treatment remains too uncertain to conclude that the description of the offence in the penal provision is not met.” They say that viral undetectability may be taken into consideration during sentencing, but not during prosecution: “The probability that the risk of infection is reduced may, depending on the circumstances, be given weight during sentencing.”

It is of note that, even though Norway has a small HIV epidemic concentrated overwhelmingly in gay men, most prosecutions have been of heterosexual transmission.

Finally, the commission makes mention of disclosure. The attitude toward disclosure in Scandinavian law is unusual as it regards assaults as offences against the state – against the body politic, if you like – and not as such against the individual. Harm is harm, therefore, even if one person has consented to the risk of harm.

The 1902 law does not mention disclosure and it has never been a valid defence: transmission or exposure are still indictable offences even if the partner is fully aware their partner has HIV. The only concession in this field is that transmission or exposure are not automatically indictable offences between 'next of kin', meaning spouses, which has included male/male couples since Norway legalised gay marriage in 2009. Next of kin have to specifically make a complaint and therefore in theory there would not be an indictment if they do not find out their partner has HIV.

The commission, for the first time, allows a specific defence of disclosure, but one whose practicality is questionable: it says that if a partner (which doesn't have to be a spouse) truly consents to the risk of infection via unprotected sex, then no offence is committed – but that to avoid unprovable assertions that partners assented to this risk, says that consent would only be valid if it is witnessed by a medical professional, presumably envisaging that serodiscordant couples would choose to make a clinic appointment to do this.

Louis Gay, the Norwegian activist who is publicly fighting a prosecution for a single case of oral sex – even though he disclosed and which, ironically, might not be indictable under the proposed new legislation – simply commented: “Welcome to my world”.

Indicted in March, Louis’ trial has now been postponed because his complainant – whose HIV has been shown not to come from Louis – has left the country.

Reference

A summary in English of the report of the Norwegian Commission on HIV and the Law is here .

Thanks to Edwin J Bernard for help with this article.