Transition to Hope

A nightmare for some and a godsend for others, some people become addicted to opioids because opioids have become their recreational drug of choice, while others become addicted because their pain symptoms are so severe that they have no choice. Either way, a problem has arisen which threatens social stability in whole communities, especially in North America, and makes authorities unsure which way to turn.

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The Centers for Disease Control (CDC) recently released its report on Sexually Transmitted Diseases for 2011. Sadly, there are few surprises. With a total of 1,412,791 cases, Chlamydia trachomatis infection remains the STD leader. This figure is the largest number of cases ever reported to CDC for any condition and represents an increase of 8.0% compared with the rate in 2010. The national gonorrhea rate increased as well after over a decade of fluctuation and/or decline. However, the greatest concern about the "clap," as we used to call it, is its increasing resistance to the medications commonly used to treat it, cephalosporins and azithromycin.

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Saturday was the 25th commemoration of World AIDS Day. The theme this year was "Getting to Zero: Zero new HIV infections, zero deaths from AIDS-related illness and zero discrimination." While these may sound like lofty goals, the last year has shown some real progress.

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As we reach a certain age, many of us long for the vitality of youth without, of course, the consequences for our youthful indiscretions. It is a time of learning and discovery. For many, it is also a time for sexual exploration. Adolescents in 2012 have lived their entire lives with the HIV epidemic. They may have learned about it in health class, read about it on the Internet, or perhaps learned that someone close to them has been infected. Now, imagine that at age 15 or 16 you are told that you are HIV positive, not because you became infected through risky behavior, but because you have had it all of your life. More troubling: what if you have been sexually active before you found out?

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Ever heard of chagas disease? Well, you're not alone. There may be as many as 10 million people, including an estimated 1 million in the United States, who have it.

Chagas is a disease cause by a parasite; Trypanosoma cruzi, which lives inside a certain insect native to Central and South America. This insect, the Triatomabug, thrives in tropical areas, especially poor housing conditions where they come out and infect their victims at night.

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There are many well documented benefits to reducing the viral load of an HIV+ individual to an undetectable level. Unfortunately, there also remains a some haziness about the term "undetectable." In actuality, it is somewhat of a misnomer. For someone to truly have undetectable HIV would mean that the battery of sophisticated tests available could not find any virus in a person's body. Thus far there is only one case of an HIV+ individual, an American living at the time in Germany who received a bone marrow transplant from a donor who had a genetic resistance to the virus, who seems to have cleared HIV entirely from one's system. An undetectable viral load means that the HIV virus in one's blood has been suppressed to the point where either the HIV RNA is not present in your blood at the time of testing or that the level of HIV RNA is below the threshold needed for detection. Another factor is the sensitivity of the specific test that is utilized.

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According to Webster's Dictionary, "Contraception" is defined as the deliberate prevention of conception or impregnation by any of various drugs, techniques, or devices or; birth control. However, with the prevalence of sexually transmitted infections, many people tend to incorporate their contraceptive and sexual health prevention methods under a concept of risk reduction.

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As the controversy about HIV criminalization continues to rage, the state of Maryland has decided to 'up the ante,' so to speak, by proposing to add more teeth to their current HIV-specific criminal law, according to a recent article in the American Independent newspaper. Presently, a person convicted of knowingly transmitting or attempting to transmit HIV to another person may result in an $2500 fine and up to a three year prison sentence. However, Maryland state legislators are considering changing the law from a misdemeanor to a felony with an up to 25 year sentence. Despite the absence of evidence that these types of punitive methods are a deterrent and that people who know their HIV status, especially if they have achieved viral suppression with anti-retroviral therapy, are less likely to infect others, fear and and the desire for retribution continues to reign.

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In May 2008, a homeless, HIV+ man was sentenced to 35 years in prison for assaulting a police officer with a "deadly weapon," his saliva! Willie Campbell, who was clearly intoxicated at the time, has been HIV+ since 1994 and has a history of aggressive behavior with public servants, will have to serve at least 17.5 years to be eligible for parole. The police officers were not infected. According to the Centers for Disease Control (CDC), although there have been a few rare cases of transmission through severe bites, "contact with saliva, tears or sweat has never been shown to result in transmission of H.I.V."

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Recently, someone named Curtis Cost wrote an article assailing the importance and validity of African Americans knowing their HIV status. Since the first widely reported cases in 1981, HIV has been mired in controversies, ranging from its origin to the possible existence of a cure. Sadly, over thirty years later, we continue to have many of the same conversations. What should NOT be in doubt any longer is that HIV disease is having a devastating impact on the African American community.

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