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Along the Latex Highway
Depressed? You're Not Alone

By David Salyer

February 2000

David SalyerRecently, my infectious disease specialist spoke to me candidly about depression. My depression. I've been depressed for the better part of a year now and the addition of an anti-depressant to my drug regimen last summer has made little impact. What the hell is my problem anyway? I can get a date, but my love life looks like some homo version of "Party of Five." I finally have an undetectable viral load again, but my T-cells remain in the what's up with that? range. I felt motivated and strong enough to return to work from a year of long-term disability in 1999, but my old company, a local cable network, shunned me and ignored the Americans With Disabilities Act. For those of you who are curious, litigation takes longer than an episode of "The Practice." Much longer.

So I could be depressed about one of the above, any combination of the above, or all of the above. Sure. I admit my life resembled a really bad melodrama last year, or maybe a dark situation comedy something along the lines of "That AIDS Show." But my problem, aside from being single, horny, unemployed and living in a city where people who can't drive become absolutely reckless with a cell phone in one hand, is that I am obsessed by HIV. My HIV. Your HIV. Africa's HIV. Pediatric HIV. HIV prevention. HIV vaccines. HIV notification laws. HIV health costs. HIV reservoirs. HIV myths. The origin of HIV.

Maybe I read too much. Or maybe I just read too much about HIV and AIDS. And, frankly, sometimes what I read depresses the hell out of me. For instance, The Washington Post and UNAIDS report that an estimated 2.6 million people worldwide died of AIDS in 1999, the highest number since the epidemic began. UNAIDS also estimated that there were about 5.6 million new HIV infections in 1999. Sub-Saharan Africa is home to 70% of people living with HIV. Kenyan President Daniel arap Moi announced the formation of a National AIDS Council (finally), insisted that free radio and television air time be given for AIDS awareness broadcasts, and mandated AIDS education in all schools and colleges in 2000. Ironically, President Moi calls AIDS a national disaster, but refuses to promote condom use. I just want to fly to Kenya and shake the snot out of him.

Wanna talk bizarre myths? Testing for virginity in young girls is being revived in South Africa as a way to enforce abstinence and curb the spread of HIV. If a girl or young woman is examined and a sexually transmitted disease is found, she is sent immediately to a health clinic. It's a well-meaning, but ultimately intrusive, practice that shares little in common with an actual prevention message because it ultimately fails to undermine a persistent, irrational South African myth about virginity. In South Africa, traditional myth claims HIV-infected people who sleep with a "clean" virgin will cure themselves of the virus. Doesn't this make virgins targets?

Another devastating belief that cripples AIDS prevention and treatment efforts in parts of Africa is that HIV is a myth. El Hadj Sy, a Senegalese sociologist for the United Nations AIDS Program for Central and Southern Africa believes that denial about AIDS is moving from the private arena to the professional arena. Denial and conspiracy theories are growing popular in sub-Saharan Africa because many Africans see the theory that AIDS originated in chimpanzees as racist. Even segments of the media are denying the origins of AIDS and abandoning prevention and treatment news. (The AIDS theory in question was published last year claiming HIV was first transmitted to humans in Africa during large-scale clinical trials of an oral polio vaccine using chimpanzee cells. Microbiologists and immunologists have since been debating this theory, an argument with only slightly more relevance than whether Santa Claus exists.)

Meanwhile, back in this country, our very own Senate passed a measure that helps guarantee African countries access to inexpensive AIDS drugs. AIDS activists praised the measure, a loss for the pharmaceutical industry (maybe we should hold a candlelight vigil for them). Nevertheless, South African Health Minister Manto Tshabalala-Msimang told Fox News last November that his government would need to spend $47 billion a year to provide AZT to the country's estimated four million HIV and AIDS patients . . . that is, of course, if a review by the Medicines Control Council concludes that AZT is effective. Regardless, Tshabalala-Msimang says South Africa still can't afford the drug even though Glaxo-Wellcome, the manufacturer of AZT, has offered them a 70% discount on the price of the drug.

Then, just when I thought it couldn't get any more grim, the United Nations released information suggesting that Asia could overtake Africa in the AIDS epidemic by 2005. Yep, cases of HIV and AIDS in Asia are increasing rapidly, with an annual growth rate of about 20 percent in 1998. Since India and China are the world's most populated countries, well, you do the math. Xu Hua, associate secretary-general of the China Sexually Transmitted Diseases and AIDS Foundation, stated that a census would be helpful to determine the extent of the problem. Fortunately, someone with considerably more testicular fortitude than Xu Hua decided to begin airing, for the first time ever, condom advertisements on a Chinese television station that reaches hundreds of millions of people. Since an estimated 400,000 Chinese are infected with HIV, condoms might ultimately be more practical than a census.

Fortunately, just when I think I can't read another gloomy statistic or harrowing tale of government-sanctioned stupidity, I stumble across an item that makes me almost perky. Like the American Medical Association's recent conclusion that school programs promoting abstinence for teenagers are "of limited value," while programs that hand out free condoms actually do reduce teen pregnancy and sexually transmitted diseases, safer sex programs can change attitudes and behaviors, and school-based condom availability programs do not encourage teens to have sex sooner. Better still, the Durex 1999 Global Sex Survey found that half of the young people surveyed buy condoms to prevent contracting HIV or other sexually transmitted diseases as opposed to simply preventing pregnancy.

Finally, late last year, the San Francisco AIDS Foundation launched a campaign to encourage gay men to ask their sexual partners about their HIV status. Experts have been telling us for a long time that gay men usually guess or assume their partners' status rather than talk about it, often leading to poor decision making about condom use. As someone who advocates the truth, I think this "Do Ask, Do Tell" campaign is a great idea. I reminds me that good work is still being done in the area of HIV prevention.




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