Radical Way of Increasing Awarness and Lowering STDs

In Judith Levine’s article entitled “Community: Risk, Identity and Love in the Age of AIDS,” she speaks a great deal about prostitution in the section of the article about respecting each person’s choices as a rational decision. Additionally, a great deal of the article deals with education about AIDS and how to expand the reach of knowledge of the disease. Considering the “matter of fact” nature of the article, and its acknowledgement how reasoning behind prostitution, I began rationale prostitution.

It is no secret that prostitution occurs despite legality constraints against it, and  as we can see in the article, “street kids” are using it to barter. Levine points out that many of these street kids are vigilant enough to know that they should condoms, yet there is a high bartering price for sex without a condom. Undeniably, contracting HIV/AIDS is the surest way to make you less desirable to barter with and limits you to who you can barter with through sex. A very similar notion can be applied for prostitutes [1].

In response to this article, there is a very simple way to increase knowledge about not just HIV and AIDS but STIs as a whole and to eliminate this whole concept of bartering for sex. Actually, allow me to be clear, it is simple in theory, and far too extreme to be applicable in today’s society. Nonetheless, legalizing prostitution, with a few regulations and guidelines, could solve many issues here domestically for us.

Due to the black market conditions of prostitution, several key factors emerge such as: minimal standards of sexual health, non-taxable income and safety. For a relative comparison, I will limit most my scope to within the United States, but there is data to be gathered from international areas outside the US that do allow prostitution as well. In the US, the only legalized prostitution is allowed in Nevada. Nevada state law requires that each week a registered prostitute must be tested for the absence of gonorrhea and Chlamydia and each month be tested for HIV and syphilis. By legalizing prostitution, we would at least have a regulatory mandate that would provide a “safer” environment (in terms of sexual health) through such testing regulations. These regulations also bar a prostitute from ever working in a legal brothel is HIV is contracted and is not permitted to work if tested positive for any other disease until properly treated [2]. I think implementing these regulations could create a true incentive for aiding increasing awareness by utilizing this multi-million dollar a year industry (that is legally speaking). In Nevada alone, prostitution rakes in state economic revenue of $400 million dollars a year [3]. Last time I checked the US has a large debit that they needed to pay off, and by taking a portion of this revenue, the government could allot more money to research and awareness programs. Not to mention, if it was legalized, there would also be a decrease in violent crimes committed against prostitutes. The profession is dangerous enough, in terms of disease, but it also one of the most violent professions where rape is common. I understand that some may have a moral issue with the idea of legalizing this, but at the root of it, it helps provide a safe haven for those who engage in the practice, and it can help stimulate economic growth.

[1] https://classes.emory.edu/bbcswebdav/pid-1642090-dt-content-rid-262294_2/courses/FA12_AMST_385_DTROKA_Combined/risk%20identity%20and%20love%20in%20the%20age%20of%20AIDS.pdf

[2] http://prostitution.procon.org/view.background-resource.php?resourceID=749#21

[3] http://www.thedailybeast.com/newsweek/2008/06/15/feeling-the-pinch.html

Problems of Chronic Illnesses to Self and Identity

Talks with S

11/03/2012

Sexually Transmitted Diseases, such as HIV/AIDS, HPV, Genital Herpes and the like, are infections that once contracted can never be fully cured. Contracting such a disease can be a testament of involvement in a sexual activity, promiscuity, irresponsibility, or culpability, and its consequences have been tagged as “life altering”. Having “safe sex” is attributed as always “using a condom” when engaging in sexual intercourse, however, this may not always safeguard one from contracting an STD. Furthermore, STD’s present a threat to an individual’s “sexual self”. Nack in Damaged Goods, writes about, “transformation of their [infected individuals] “sexual-selves”- how they see themselves as sexual beings- and how they understood and made choices about sexual health issues” after contracting such an infection (498).

Wearing a condom does not 100% protect us from infections such as HIV/ AIDS, however, wearing protection can adversely reduce the risk of contracting this virus. Nevertheless, one may contract another STD even after using a contraceptive. Thus the question that comes to my mind is the possibility of contracting an STD under circumstances beyond ones control. What if one has done “everything right” or in other words, has taken all the necessary precautions (wearing a condom, asking their partner about their “sexual script” etc.) before involvement in a sexual activity, and despite that has contracted an STD? Many of us may think: “Can this actually happen?” The answer to which is yes, it can. One such infection is the Human Papillomavirus (HPV). This virus is unfortunately not always visible on an individual, thereby limiting our capabilities to avoid its contraction from a sex partner, and making it one of the most common sexually transmitted infections in the U.S (Nack 487). Often individuals think that since they always wear a condom during sexual intercourse, there are never at risk of contracting an STD. While contraception can safeguard us from numerous STD’s, their potential is not limitless, and we are still susceptible to a number of STD’s.

An individual, who has contracted an STD, has to undergo severe ramifications. Nack in Damaged Goods, creates a “6-stage model” that attempts to include the different stages an individual may undergo before and after contracting a STD. This can be seen as: “self invincibility, self anxiety, immoral patient, damaged goods, sexual healing and reintegration” (498 & 499). These infected individuals may undergo an “identity dilemma” after contracting an STD. The virus enters our body and brings with it physical risk and discomfort, psychological repercussions and societal stigma. It changes or alters, an individuals “sexual-self”- a private self-shaped by emotions, cognitions, and memories of sexual experience (Nack 491).

Therefore, steps need to be taken to minimize the negative consequences of those already infected with the virus, as well as those who are at “high-risk” usually identified as : gay men, haitian immigrants, intravenous drug users and their sex partners and babies (Levine 624). Levine in Community, talks about successful AIDS prevention to include, “the recognition of the urgency of the problem of HIV and the exigencies, both personal and structural, of the people it is targeting; and respecting their social norms, identities, values and desires, expressed in the relationships between individuals and within communities” (621). He further adds,

“In AIDS prevention, the challenge is to find people where they affiliate and speak to their sense of belonging for the purpose of instilling and reinforcing safe-sex values and habits” (620).

There is no luck in the process of finding a cure for HIV/ AIDS. This is mainly because the HIV virus doesn’t kill its host, but in fact reduces ones immunity to such lows that the host contracts every virus or infection out there. He or she ultimately dies due to one of the deadly viruses he or she may have contracted. Furthermore, no accurate screening test is available for making sure that one does in fact have the HPV (Nack 487). Although an HPV vaccine does exist in the market today, it’s ultimate impact remains to be witnessed. In regards to HSV (herpes),“Medical researches are not sure whether a safe and effective one [vaccine] will be developed” (Nack 490).

Every year billions and billions of dollars are spent on conducting research, however, no cure has been found yet. The average sexually active human can only continue to take necessary precautions before involvement in sexual intercourse, and do all in his or her power to look after his or her “sexual health”. The rest has to be pinned down on mere hope that researchers will ultimately find a cure for such “life altering”, and sometimes even fatal viruses.

 

 

Citations:

Levine, Judith. “Community: Risk, Identity, and Love in the Ages of AIDS”

Nack, Adina. “Damaged Goods: Mixing Morality with Medicine”

 

 

The Silent Killer

General human papillomavirus, more commonly referred to as HPV, is the most common sexually transmitted infection.  There are more than 40 types of HPV that infect the genital areas of both men and women.  Although there are cases where HPV can infect the mouth and throat, most people are unaware that they are affected with the virus and are most likely infecting their sexual partners (CDC).  It is disconcerting that when individuals do seek sexual health exams, “less than one-third of US physicians consistently screen these patients for the full range of sexually transmitted diseases, leaving many patients unaware of their infection status with regard to either HPV or HSV” (Nack, 489).  HPV is one of the few STIs that there has been a vaccine developed for and that has underwent a widespread advertising campaign to promote its benefits.  I personally received the series of three Gardasil shots when I was in high school and know that the majority of my friends did so as well.

The appearance of trends amongst those who are carrying STIs is frequently linked to gender and race (Nack, 493).  I would argue, though, that the two most important factors in determining if one would get an STI vaccine is one’s socioeconomic status and knowledge of the disease and vaccine.    The fact that these factors usually do not coincide with one another is where the issue arises.  Gardasil is currently marketed at $120 per single dose.  Three doses are required over a six-month period, making the final cost for the HPV vaccine $360.  On top of the cost for the shot, many doctors charge for the office time when the vaccine is being given.  Most large insurance companies cover the Gardasil vaccine, but most only do so for females that are ages 9 to 26, the age group in which the vaccine is FDA approved.  Gardasil is now part of the Vaccines for Children Program, a federal program that provides free vaccines to children under the age of 18, whose health care does not cover the shots (http://www.gardasil.com).  Therefore, getting vaccinated is a huge chunk out of many people’s pockets that cannot afford insurance.  Although the Vaccines for Children Program in place, one must be aware that it even exists to be able to take advantage of the opportunity.

It all stems down the amount of sexual education being taught in our education program.  We see here at Emory that this department was the first to be cut, so it is obvious that our University does not think that this is a priority for college students.  As I said in my last post, the 1980s was a time of heightened teen pregnancies, STIs, and the emergence of AIDS as a serious issue.  There are articles in the Wheel that suggest that the reason these things were occurring in such a prevalent manner was that there was a lack of sexual education at the time.  In 1988, Jerry Falwell, an American evangelical fundamentalist Southern televangelist,  attacked public school in America by saying that sex education promoted teen pregnancy and we would live in a more moral land if sex education as forbidden in schools.  An Op-Ed piece featured in the 1988 Wheel calls Falwell naïve and ignorant and goes on to say that, “people who think they can be sexually active without taking precautions to prevent pregnancy or disease are the contribution to the high illegitimacy rate in this country” (“To Prevent” 8).

It is interesting that over twenty years later, we still see the backlash from the socially conservative members of our society to drugs such as Gardasil.  When the drug was originally marketed it was advertised as a vaccine to protect against several strains of sexually transmitted HPV.  In actuality, this is what the drug really is.  The Family Research Council equated Gardasil and its advertising campaign to “a license for young people to have premarital sex” (Nack, 487).  Both socially conservative groups and the CDC advised Merck, the maker of Gardasil, to advertise the product as a preventative to cervical cancer.  In reality, though, Gardasil protects against four HPV strands that are associated with only 70% of cervical cancers.  Therefore, this drug is not a true preventative for cervical cancer but is really a drug to prevent the spread of the STI HPV.  I think that it is extremely telling that the CDC told Merck to market the drug as a cancer rather than an STI preventative (Nack, 487).  This again stems back to the lack of sexual education in this country and how many are oblivious to the fact that they are too at risk for STIs and that they are much more common than one would think.  When one hears the word cancer, though, they would act in a heartbeat to be able to protect themselves against it and feel as if it is a much more relevant issue to their lives.

WORK CITED:

“GARDASIL.” Gardasil: Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]. Merck & Co. Inc., 2011. Web. 04 Nov. 2012. <http://www.gardasil.com/>.

Nack, Adina. “Damaged Goods: Micing Morality with Medicine.”  Speaking of Sexuality: Interdisciplinary Readings. New York: Oxford University Press, 2010. 487-502.

“To Prevent Teenage Pregnancy, Sex Education In Schools Needed.” The Emory Wheel 11 October, 1988, 8.

 

HIV/AIDS

Human immunodeficiency virus, HIV, causes acquired immunodeficiency syndrome, AIDS. This is a serious condition where affected individual’s immune system fails on them. According to the CDC, there are about 1.1 million Americans who are living with HIV, and 21% of them do not even know they have it [2]. The biggest problem with HIV/AIDS is ignorance and people unaware that they can spread it. As for most sexually transmitted disease, the best way of prevention is just abstinence. Safe sex can never be 100% safe, and people should always be aware of the consequences, even if they can be slim. You never know when you can be a part of the 1%. Sometimes your partner might not even know that he or she has AIDS. It’s better to just be safe and test yourself and your partner before intercourse. “Silence has equaled death” [1].

By the 1990s, one person would be infected with HIV every hour everyday. HIV/AIDS has become the leading cause of mortality for people aged 25-44 [1]. Many of those people actually are infected with HIV in their teenage years.

Experts have determined that AIDS largely affect populations with poor health, education or housing. Living conditions determine a lot about a person and the type of education they are exposed to. Also people in lower living conditions might not even have access to common contraceptives or even know what they are.  They might not even know what HIV or AIDS is and have no way of testing themselves. Also some of these patterns are seen globally. HIV/AIDS is seen a lot in Africa and slowly coming in South Asia.

It was estimated that in 1990s that “20 to 30% of gay youths would be infected by their 30th birthday” [1]. Out of all the HIV-infected Americans in 1998, 63% of them were African American. A survey conducted by the CDC, determined that from 1998 to 200, about a third of gay black men in their 20s are HIV positive [1]. Another one of the major causes of HIV/AIDS is intravenous drug use. About half of the people in New York City with HIV were intravenous drug users.

The search for a cure is still ongoing. But there is an increase in new effective drug therapies that keep people with HIV healthy and increase their life span. The CDC has implemented a variety of programs in order to improve treatment, care and support for people with AIDS. Some of the divisions of HIV/AIDS Prevention groups include the Prevention-Intervention Research and Support, Prevention-Surveillance and Epidemiology, Global AIDS Program and more [2]. In an article in the Wall Street Journal, there is mention of finding a vaccine for HIV. Research is extremely important with HIV and there are many advances globally trying to find a cure or prevention. Researchers from the Center for AIDS Program of Research in South Africa found out a key change in the “outer coating of the HIV virus that has enabled two HIV-infected women to develop broadly neutralizing antibodies” [3].  This can greatly advance the field of HIV research. The problem with the HIV virus is that it is always changing, but they were able to create one antibody that was able to kill up to 88% of HIV strains from around the world” [3]. This study represents a “key advance in the vaccine field” [3]. It will take a long time to really find a solid cure for HIV, as most research takes a long time. But with slow steps, I am optimistic that large strides will occur in this field.

Successful AIDS prevention is based on two principles: “It must recognize the urgency of the problem of HIV and the exigencies, both person and structural, of the people it is targeting. And it must respect their social norms: their identities, values, and desires, expressed in their relationship between individuals and within communities” [1]. I feel with proper awareness, education and research, we can strive towards a better future with curing and preventing AIDS.

 

[1] Community: Risk, Identity, and Love in the Age of AIDS by Judith Levine

[2] http://www.cdc.gov/hiv/aboutDHAP.htm

[3]http://online.wsj.com/article/SB10001424052970203400604578070861813226462.html

No one should be invisible

Over the past 25 years, the acquisition of HIV/AIDS knowledge has been extraordinary. The research and development of drug therapies has been extremely successful and that success has only been distilled by the financial obligations surrounding the pharmaceutical industry. Despite all of this progress, the most important aspect of epidemic control – prevention – has been difficult to promote.

Originally, the disease arose in an isolated population. In the United States, a sub-group of the general public were the predominant victims. As a result, the disease gained an irrevocable association with homosexuality and injection drug use. The treatment of these individuals was targeted and preventative measures focused on promoting a decrease in sexual partners, increasing advocacy for protected sex, and a somewhat conflicted campaign for clean needles.

As HIV has become recognized as a disease of the people, through it’s spread across the United States and its global affects, categorizing the victims has become a lot more difficult. In any epidemic, the public will always find a scapegoat. In the case of HIV, the blame has been passed around and depending on the region of the world, it may have settled on prostitutes, injection drug users, men who secretly engage in sex with other men, or poor men who are exposed to the disease through deviant behavior while traveling for work. These are some pretty specific groups. In contrast to the early days, people aren’t empathizing with the victims. They never really blamed rich white homosexuals in America and they’re not blaming them now in most of the world.

They’re also not blaming women.

Despite the fact that 50% of HIV infected individuals are female (Mukherjee 380), women are usually portrayed as victims of the men who transmit the infection to them. While authors such as Joia Mukherjee, Diane Richardson and Jenny Higgins all make great arguments about the victimization of certain groups and they provide copious research data to emphasize their points, I think they fall into the same trap as everyone else. By promoting the victimization of specific groups, they all continue to propagate the blame applied to other groups.

Everyone with HIV/AIDS is a victim.

That’s it. There’s no other way to explain this. The “terrible” husband who comes home from migratory work and transmits HIV to his wife is just as much a victim of the virus as his wife. He didn’t have extramarital sex with the intention of becoming infected with HIV. Whether or not he should be condemned for having extramarital sex in the first place is not a healthcare provider’s place to say.

So I propose we design a HIV/AIDS prevention plan that incorporates everyone’s good ideas while negating their judgments of who can and cannot be helped. In a study of the effectiveness and efficiency of HIV prevention programs by the CDC, the investigators found that behaviorally based prevention programs are most effective when they are supplied with sufficient resources, operate at a high level of intensity and display cultural competency. As such, I believe that continuing education and support of women’s rights and their personal advocacy is necessary. I think increasing the education of men about their susceptibility is also necessary. Giving every individual a chance to avoid infection requires cultural understanding. In collaboration with government officials, healthcare providers should advocate the promotion of laws that allow individuals – men and women – access to education and the right to choose what risky activities they engage in.

Murkherjee, Joia. Sex Matters: The Sexuality and Society Reader.  Ed. by Mindy Stombler, Dawn Baunach, Elisabeth Burgess, Denise Donnelly, Wendy Simonds, Elroi Windsor. Boston: Allyn & Bacon, 2010. 379-385

HOLTGRAVE, David R., PhD, NOREEN L. QUALLS, DrPH, MSPH, JAMES W. CURRAN, MD, MPH, RONALD 0. VALDISERRI, MD, MPH, MARY E. GUINAN, MD, PhD, WILLIAM C. PARRA, MS. An Overview of the Effectiveness and Efficiency of HIV Prevention Programs. Public Health Reports 1995

Higgins, Jenny A., PhD, MPH, Susie Hoffman, DrPH, and Shari L. Dworkin, PhD, MS. American Journal of Public Health. March 2010, Vol 100, No.3. 435-445

Richardson, Diane. Rethinking Sexuality. London: Sage Publications, 2000. 127-138.

Abstinence, Homeless, Aids..

In Risk, Identity, and Love in the age of AIDS, Judith Levine describes the risk group theory. This theory included two distinct populations; the “high risk groups included gay men, Haitian immigrants, and intravenous drug users and their sex partners and babies. In the low risk or no risk groups were suburban teens, heterosexuals, white yuppies…” This was new and interesting information to me, how a group of people can be treated almost like a different species. The concept of risk groups becomes a little more complicated when you have inter-crossing between the groups. Levine uses the example of how a man who has sex with a teenage hustler in a downtown park, could have sex with a man from a random bar, and that man could then have sex with his suburban wife at home. This is a perfect example of how misleading this risk-group theory can be. In my opinion, it needs to become on the individual level, rather than the group level which can lead to rejecting certain types of people. A perfect example of this is how promiscuity is tied together with being gay. Besides how false that is, this societal belief leads people askew from actual AIDS preventative measures (e.g safe sex, not sharing needles and syringes).

Levine gave examples of homosexual youth coming out to their family, and getting a hostile response, often leaving them eating out of a dumpster. One in particular was Stephen Graham, who was banned from his family and church, and left in state institutions and friend’s houses. Being homeless doesn’t mean you get to do the most safe activities (e.g. prostitution, sex for drugs). I found an interesting CNN article about a homeless women in Atlanta (Crystal). She is HIV/AIDS positive like many homeless in downtown Atlanta, and is barely concerned with treating her disease, but more concerned with where she is going to sleep, eat, and stay clean. This leaves little time to avoid spreading her HIV/AIDS, sometimes having sex for drugs, and sharing needles. Elizabeth Landau states in the CNN article “Poverty, sex trafficking, food  insecurity and continued stigmas attached to the disease all help make Atlanta a center of the southeast epidemic. AID Atlanta, and the Jerusalem House are both organizations that provide clinics, housing, and education to people living with AIDS. These organizations both have the goals to reduce/prevent spreading infection, and to improve health of those with HIV/AIDS.

Sexual education at a young age can be very influential later on in life. There are two different types of sexual education, abstinence base and comprehensive. The abstinence approach to sex education primarily teaches youth not to have sex before marriage – preaching that it is best to ensure that they will avoid infection with HIV/AIDS, other STI’s, and pregnancy. This approach is a wrong approach in my opinion. It teaches kids to not have sex before marriage. The problem with that is this approach doesn’t teach kids how to have safe sex. It also leads to kids thinking that oral and anal sex are other options to explore, which isn’t exactly the most healthy mentality to have. Abstinence advocates also do not teach about condoms, because they feel it encourages sex. The comprehensive approach does not focus on teaching kids they should refrain from sex until marriage. instead, it explains the benefit of delaying sex until emotionally/physically ready. This approach makes sure the kids know how to protect themselves from infections and pregnancy.

 

http://www.mayoclinic.com/health/hiv-aids/DS00005/DSECTION=risk-factors

http://www.cnn.com/2011/11/30/health/conditions/crystal-hiv-aids-atlanta/index.html

All are Accountable.

Reading “Rethinking Gender, Heterosexual Men, and Women’s Vulnerability to HIV/AIDS” helped open my eyes to really see both sides to the vulnerability of the contraction of HIV/AIDS for both male and female genders.

Since the evidence of women contracting HIV came to the public, there has been a growing movement of the vulnerability paradigm as the reason for so many women contracting the disease. Page two of the article states “an unsuspecting woman is infected not through her own behaviors but as a consequence of her partner’s wrongdoing.” This is basically saying it is hardly the woman’s fault for contracting AIDS. It talks of gender based violence, nonvolitional sex, and relationship power imbalances as causes for increased vulnerability to HIV in women. These situations and causes are verry real in the world, but at the same time, many women have plenty of choice in the practices they choose to use to ensure they do not contract and/or spread HIV. For example, the article talks about how researchers explained that sex workers, pregnant women, and migrant women were the vectors of this disease. being a sex worker is not the most respected profession, and many women are pushed into this field of work. However, many are not. They chose to sell their bodies for a profit, and being in this field, you are in danger of contracting every single thing out there.

 The article brings up great points, and I agree with many of them, but is this all that we want to say for the women of today? We are either saying that they are spreading the disease because of being sex workers or they do not have the power to tell their sexual partner to use a condom. We are making an entire half of the population sound pathetic. The truth is women today more than ever have the ability to say no to unprotected sex. Many just choose not to. To go back to Keith Boykin’s “10 Things you Didn’t know About the DL,” he says as point number 10 “stereotyping women as victims will not keep them safe,” and this is the truth! All we are doing is saying “yes, you as a woman are at risk of getting the disease alot more because you are weak.” To me that seems like more of acceptance and holding women down than trying to help them. There needs to be more empowerment among women. There needs to be not a vulnerability paradigm but an empowerment paradigm. Use those statistics in a way to not let women feel helpless, but to feel like it really is their choice and they do not have to be at risk for this horrible disease.

To slightly change the subject, I asked my roommate “Why isn’t there Men’s Studies?” and she correctly answered “because everything is men’s studies!” Now to think about this vulnerability paradigm and see how it makes all men look like they are the all powerful and at the same time do not choose to wear condoms is complete bologna. There are plenty of men who are raped and have been the person in the relationship with less power, but we do not bring them to the light like we do women’s vulnerability issues. If we are to really take a hold of trying to kill this epidemic, all sides must be accounted for. Women who are empowered and say no to unprotected sex, women who are in situations where there is a possibility of violence, women who knowingly choose the wrong practices, men who choose to wear a condom, men who are in vulnerable situations, men who knowingly choose the wrong practices, and everything in between. All are part of the epidemic. All must be cared for.

 

Sexual Health- HIV/AIDS

The reason AIDS presents such a difficult disease to manage from a public health aspect is due to its ability to cross a wide range of behaviors and identities within communities still somewhat uncomfortable talking about sexuality. The challenge is effectively informing such diverse populations with targeted messages that are able to change their beliefs and, ultimately, their sexual behavior. As Dr. Del Rio stated in his addressing of AIDS, when the disease first came out in the 1980s it was primarily one that affected affluent, white, males (1). The resultant public chatter about the disease made it one that only could present from homosexual activity, which, as we know now, is very far from the truth. Now a completely different population is at the highest risk to get HIV and develop AIDS.

So while we need to combat AIDS on a public health stand point, it must be done with message that cross many different identities. As Judith Levine describes, “In AIDS prevention, the challenge where they affiliate and speak to their sense of belonging for the purpose of instilling and reinforcing safe-sex values and habits”(2). It must convey that this is disease that can affect anyone who is performing unsafe sexual or drug activities. It must be presented in a concise, easily understood way which effects change in the people it serves to target.

Another interesting factor to consider will be the effect that the new drug Truvada will change the way people act. Truvada is a drug that is given to healthy people and, along with other safe sex procedures, has been shown to prevent the contraction of HIV. While this is an important step in the controlling and hopeful eradication of HIV/AIDS, it also may have some negative consequences. Firstly, it must be taken every day to actually impart immunity. Incorrect use of it could lead to the development of strains of HIV resistant to Truvada. Secondly, although it was not shown in the preliminary clinical trials, the use of the drug may cause people to take part in more risky sexual behaviors because they feel they are protected. Truvada is not 100 percent effective in stopping the spread of HIV and this well intentioned drug could actually cause the disease to spread because of the invincibility factor it provides (3). 

It is plausible that a cure for AIDS may be invented within our lifetime. However, its high mutation rates and the resulting high evolutionary selective pressure make it unlikely candidate for a universal cure. This emphasizes the importance of effective public health management of the disease. I think the effort needs to occur on 3 fronts. Grade school health education must express how important it is to use safe sex procedures as well as the risks of intra venous drug use. This early exposure will hopefully create young adults more aware of the disease. Secondly, public health marketing campaigns must continually stress the universal nature of the disease. This is not a disease that only affects certain races or sexualities; anyone can get AIDS if they are not being safe. And finally, primary care physicians need to be a resource willing to talk about sexual practices and the appropriate ways to stay protected. AIDS is unlike any other disease of humankind in that so many different societal aspects contribute to its spread. This requires social efforts to fight back against it.


1- Del Rio, C. Viral Cultures lecture 02/20/2012  
2- Levine, J. Community: Risk, Identity, and Love in the Age of AIDS. Speaking of Sexuality:  Interdisciplinary Readings. New York: Oxford University Press, 2010. 619-630. Online at https://classes.emory.edu/bbcswebdav/pid-1642090-dt-content-rid-262294_2/courses/FA12_AMST_385_DTROKA_Combined/risk%20identity%20and%20love%20in%20the%20age%20of%20AIDS.pdf  
3- Park, A. Truvade: 5 Things to Know About the First Drug to Prevent HIV. Time (July 17, 2012). Online at http://healthland.time.com/2012/07/17/truvada-5-things-to-know-about-the-first-drug-to-prevent-hiv/ 

Sex and Disease

I’m on the soccer team. That’s how I identify myself to people. I don’t know why that became my first identity but before “I’m a Virginian, I’m a blond, I’m in ADPi, I’m a student, etc.,” that’s how I introduce myself. Everyone’s looking to belong to something; they’re looking to associate with a bigger group or identity. But when someone comes out of the closet, they’re no longer a frat bro or team member, they’re known for not being straight. When being interviewed, a 16 year old lesbian activist she said, “I love being queer… but sometimes I want to be Jenny, not Queer Jenny” (Levine 622). Why is that a different kind of sexuality automatically becomes the official new identity? This terrifies many adolescents attempting to identify their sexuality as LGBT.

When families, friends, and the community ostracize LGBT teens just coming out of the closet, it leads teens to be desperate to gain a support system. “Family hostility is in fact a leading cause of homelessness among teen youth” (Levine 622). Homeless teens are forced to extreme actions… if they’re not old enough, they can’t work, they can’t go anywhere. “Parent’s abandonment of overt rejection is partially responsible for the dramatic rise of teen male prostitution in the United States” (Levine 622). Any type of prostitution is dangerous for any kind of human, let alone teens with the lack of confidence from societal rejection.

Homeless homosexual teens are looking for a place to stay, eat, and any kind of comfort they can grab. Prostituting themselves becomes a easy way to have a temporary home for a night or two. They live day to day never looking at the future; losing respect for their souls and body in the meantime. These unsafe actions have a high risk of getting and transmitting sexually transmitted diseases and infections; among them, HIV.  There are groups attempting to reach out to “street kids” to teach them about the hazards of a risky sexual lifestyle and how to prevent the transmission of diseases.

Many people are just ignorant of STD’s are feel invincible. “It won’t happen to me… I won’t get a STD…” Why is that we feel invincible? In “Damaged Goods,” Nack reports a story of a 20 year old college student who received phone call from a former sexual partner informing her that he has an STD and that she should get checked (Nack 488). It can happen to anyone. The statistics make it clear: the CDC estimates that there are 19 million new infections every year in the United States (STD Trends, CDC). Everyone needs to open their eyes, get informed and practice healthy and risk-free sex. The CDC recommends to get tested for sexually transmitted diseases in order to prevent infertility, and even death. “Less than half of people who should be screened receive recommended STD screening services” (STD Trends, CDC).

In Carlos Del Rio Viral Cultures lecture, he talks about the realization of AIDS & HIV. In the 80’s there was a disease spreading and no one knew about it until years later and it’s too late. He identifies what a person with AIDS looked like in the 80’s as white, male, middle-class, and gay. In 2012, he identifies a person with AIDS as African American, male or female, poor, with possible mental health problems.  But really do STD’s have a particular image of a person to them? Sexually-active people are all at risk.

http://www.cdc.gov/std/stats10/trends.htm

Levine, Judith. “Community.” Sexuality and Public Policy. Print.

Nack, Adina. “Damaged Goods.” Sexual Health. Print.

Rape and HIV

In my previous blogs, I definitely had a skeptical attitude towards sexually transmitted diseases In fact, I even mentioned that the spread of HIV is over emphasized and that it is only transmitted 1/300 times for women and 1/1000 times in men. Although this is true, I think my confusion was why people would want to falsely exaggerate a problem. The suspicions I had about statistical manipulation are completely separate to the feelings I have about the spread of infections through rape.

My parents were born and raised in South Africa, so I’ve been there a couple times. I’ve walked into plenty of public bathrooms with a container saying “Take a free condom, help fight AIDS”. The old me would have assumed free condoms would be the answer to everything. Condoms would cut down the spread of numerous diseases. I’ve learned a lot about HIV/AIDS this year through multiple classes that integrated the material into the curriculum- so rather than focusing on the articles about transmission rates, I read more about HIV in Africa as that was unfamiliar to me. It was this year that I realized my view was too simplistic, there are too many stigmas associated with condoms- cultural and social. For instance, people may not carry condoms with them because of people assuming they are sexually active, fear that a partner will get upset because of trust issues, or men dictating condom use in a male dominated culture. Just because they are available doesn’t mean they will be used.

Regardless of all that, I still assumed that knowledge and availability were the only two factors involved in safe sex. Unfortunately I never accounted for rape. What caught my eye in Structural Violence, Poverty and the AIDS Pandemic by Mukherjee, there was a comment on rape being used as a political tool in war. Mukherjee mentions, “in Rwanda, the systemic sexual molestation, rape and mutilation of women and girls were an integral part of the Hutu plan to annihilate the Tutsi population”(381). The statistics continue that 70% of the women who were raped (that survived the genocide) had contracted HIV. In some cases, women were taken to HIV positive soldiers on purpose to be raped and infected. The difference between rape pre-1990 and in the present is the transmission of HIV to the victims [2].

The main thing I realized from these articles is how ignorant my generation in the US can be. The genocide in Rwanda happened while we were growing up, yet none of my friends knew much about the history for instance. Similarly, we know about HIV, but none of us really understand all the vantage points. Part of it is lack of awareness, but I think a huge factor is being in an environment where we don’t experience these situations nearly as often. I really liked reading Mukherjee’s article because you realize that HIV transmission isn’t so easily prevented. In many cases, African women don’t have a say in the use of condoms. In the case of rape or even multiple partners, the infection gets passed on and on. Surprisingly, there are so many other facets that affect the spread including poverty, drugs, and even men who get raped. I was just focused on women who were raped after reading this chilling quote by a refugee:

For 60 days, my body was used as a thoroughfare for all the hoodlums, militiamen and soldiers in the district… Those men completely destroyed me; they caused me so much pain. They raped me in front of my six children… Three years ago, I discovered I had HIV/AIDS. There is no doubt in my mind that I was infected during these rapes.

Quotes like this make me realize that so much in the world is preventable and wonder how things would change if people were properly educated. If rape didn’t exist, I believe that transmission rates of HIV would decreased dramatically too, with the biggest impact in Africa.

[1] Structural Violence, Poverty, and the AIDS Pandemic. Mukherjee

[2] http://unu.edu/publications/articles/rape-and-hiv-as-weapons-of-war.html