Voices from the Front is a powerful film about the first era in AIDS activism. It documents early non-violent warfare waged against our government’s criminally slow response to the emerging epidemic. But rather than coming across as a trial, agit-prop or a bore, the film unfolds like a circus of joyous political theatrics. Audiences want to step out of their chairs and start dancing in the streets while singing “Health! Care! / Is a right/ Health care is a right!”
Screening Voices from the Front during AIDS Education Month was no simple cineaste task. Although we filled the room with popcorn, pizza, and soda pop, watching this documentary isn’t like an ordinary Wednesday night at the movies. Ever since Voices came to the attention of the AIDS Library we’ve heard the movie called everything from exhilarating to “a tool box for changing the world.”
Scribe Video Center, a community-media education organization, hosted the screening. Scribe Program Coordinator, Boone Nguyen, spoke to us about Scribe resources ranging from filmmaking classes to community documentary projects. Adam Feldman, librarian at the AIDS Library, introduced the film as part of AIDS Education Month. John Bell, a Treatment Education Activist Combating HIV, has long seen the power behind what this film represents. He brought this screening to AIDS Education Month and he brought his insights and passion for this movie to the night of the event.
Dooley House in Camden brought the largest segment of the audience. However, the room was peppered with AEM volunteers, former members of ACT-UP, medical students, and the curious. After the credits rolled, John Bell lead a moving discussion among the collected strangers about breaking down the barriers that keep us as citizens from making positive change together.
Follow those links for articles about issues around HIV/AIDS and these religions/sects, profiles of what different religious communities are doing, and more.
RELIGIOUS ORGANIZATIONS WORKING ON HIV/AIDS & LINKS TO THEIR PUBLICATIONS
The Balm in Gilead works on HIV/AIDS and other health issues among the African diaspora and publishes:
DignityUSA, an LGBT Catholic alliance, has an National AIDS Project (with articles and prayers on the topic), as well as some useful related resources, including:
For scholarly research into the effects of faith on people living with HIV, see the literature review, ”Spirituality/Religion and Quality of Life in Patients with HIV/AIDS.” (Some of the articles listed will require scholarly database access to read in full. If you need help with this, contact me.)
For religion and prevention The Kaiser Family Foundation has an archive of the session Is Religion a Barrier to HIV Prevention? from the 2008 International AIDS Conference. This includes full transcripts, videos, and podcasts.
For an international perspective, The Joint United Nations Programme on HIV/AIDS (UNAIDS) has a webpage about Religion & AIDS, which includes reports on many faith-based initiatives.
The AIDS Law Project of Pennsylvania is the primary source of pro bono (free) legal counsel for HIV+ folks in Philadelphia. People seeking assistance should call the AIDS Law Project at (215) 587-9377 between 9:30 a.m. and 1:00 p.m., Mon-Fri. Spanish is available. In addition, AIDS Law Project offers:
For pro bono legal counsel in Philly, not necessarily related to HIV/AIDS, see Community Legal Services. Go to the CLS intake page for intake phone numbers by legal issue.
For LGBT legal counsel in Pennsylvania, not necessarily related to HIV/AIDS, see Equality Advocates Pennsylvania. (EAP is going to become part of the Mazzoni Center by 2010, but for now is still its own organization.)
The biggest web resource for U.S. legal information is The Center for HIV Law and Policy, which has a searchable Resource Bank that’s overflowing with legal information. The resources are sorted into 33 topics – Confidentiality and Disclosure, Employment, Housing, Public Access Benefits, Youth, and many more. Within each topic, you can sort by type of document – Laws, Court Decisions, Advocacy Documents, Legal Guides, Journal Articles, and Training Materials, and more.
Highlights from the Center for HIV Law and Policy website include:
David Webber, the former executive director of the AIDS Law Project, edits a book called AIDS & The Law, which we have the 2008 edition of in the library. You can read the table of contents at Webber’s website, or come down to the library and check it out!
For international resources, see the Canadian HIV/AIDS Legal Network’s AIDSLEX, which includes:
an e-Library of resources which can be browsed by topic (Prisons, Sex Work, Prevention, Disability, etc), as well as access to bibliographies, lit reviews, judicial decisions, and other topics of particular interest to those doing scholarly research
For general legal resources, the American Bar Association’s ABAlawInfo.org is an invaluable collection, LexisNexis’s LexisONE allows you to search for individual legal rulings, USA.gov has a page on all Federal Laws and Regulations, and the U.S. Law Library of Congress has a wide range of freely accessible Legal Resources.
The AIDS Library has several legal resource books, including:
The Rights of People Who are HIV Positive by the ACLU
The RIGHTS of Lesbians, Gay Men, Bisexuals, and Transgender People by the ACLU
Represent Yourself in Court: How to Prepare & Try a Winning Case
HIV-SIV PHylogenic Tree from Los Alamos National Laboratory
From time to time even the most experienced case managers might get thrown a curve ball. Since HIV-2 is very uncommon in the United States, an American HIV/AIDS Case manager is likely to be surprised when a client gets an HIV-2 diagnosis. Fortunately, the AIDS Library is here to dig up both technical and non-technical background information on this understudied virus which also leads to AIDS.
An article from the journal AIDS, published in 2001, offered the broadest review that I could find. Unfortunately, the article isn’t on the “visible web“. You can chase the citation yourself, or ask your local librarian.
Paul J. Bock and David M. Markovitz “Infection with HIV-2” AIDS 2001Vol. 15 (Suppl. 5): S35-S45
We, of course, tracked it down and sent it to the case manager.
If you’d like to read abstracts of more recent research, I suggest searching PubMed (https://www.pubmed.gov). The following search string will return highly relevant results:
(“HIV-2″[MAJR] ) NOT (“HIV-1″[Mesh])
The above “search string” makes use of Medical Subject Headings (MeSH) which are worth investigating if you want to become a skilled searcher of the scientific medical literature.
Here’s a couple of abstracts from the above search which looked interesting to me:
Medical Research Council Laboratories, Fajara, Atlantic Road, PO Box 273, The Gambia, West Africa. srowland-jones@mrc.gm
In the past 25 years, life survival curves of many countries have been remodeled owing to HIV infection. Both HIV-1 and HIV-2 can cause AIDS, yet patients infected with HIV-2 fare much better clinically and most will never experience detrimental effects of the infection. Despite over two decades of comprehensive research into vaccine development, a prophylactic vaccine is not yet realized. An essential missing link in the innovation of a successful vaccine strategy is the description of a favorable immune response that abolishes virus replication. Lessons learned from studying the role of the immune system in the long-term nonprogression characteristic of HIV-2 infection will offer insight into how a balanced immune response can protect from the destruction of the immune system associated with chronic HIV-1 infection.
Infectious Diseases Discipline, Federal University of São Paulo, São Paulo, SP, Brazil.
Human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) are the causative agents of AIDS. HIV-2 is prevalent at moderate to high rates in West African countries, such as Senegal, Guinea, Gambia, and Cape Verde. Diagnosis of HIV-2 is made with a positive HIV-1/HIV-2 ELISA or simple/rapid assay, followed by one or two confirmatory tests specific for HIV-2. Following CD(4)(+)T cell counts, HIV-2 viral burden and clinical signs and symptoms of immunodeficiency are beneficial in monitoring HIV-2 disease progression. Although non-nucleoside reverse transcriptase inhibitors are ineffective in treating HIV-2, nucleoside reverse transcriptase inhibitors and protease inhibitors can be effective in dual and triple antiretroviral regimens. Their use can decrease HIV-2 viral load, increase CD(4)(+)T cell counts and improve AIDS-related symptoms. HIV-2 resistance to various nucleoside reverse transcriptase inhibitors and protease inhibitors, including zidovudine, lamivudine, ritonivir and indinavir, has been identified in some HIV-2 infected patients on antiretroviral therapy. The knowledge of HIV-2 peculiarities, when compared to HIV-1, is crucial to helping diagnose and guide the clinician in the choice of the initial antiretroviral regimen and for monitoring therapy success.
On the “Open Web” I found HIV-2 addressed by a few trustworthy government and non-profit websites. I’ve quoted a few interesting parts and included the full links below each extract.
Until recently, the origins of the HIV-2 virus had remained relatively unexplored. HIV-2 is thought to come from the SIV in Sooty Mangabeys rather than chimpanzees, but the crossover to humans is believed to have happened in a similar way (i.e. through the butchering and consumption of monkey meat). It is far rarer, significantly less infectious and progresses more slowly to AIDS than HIV-1. As a result, it infects far fewer people, and is mainly confined to a few countries in West Africa.
In May 2003, a group of Belgian researchers led by Dr. Anne-Mieke Vandamme, published a report12 in Proceedings of the National Academy of Science. By analysing samples of the two different subtypes of HIV-2 (A and B) taken from infected individuals and SIV samples taken from sooty mangabeys, Dr Vannedamme concluded that subtype A had passed into humans around 1940 and subtype B in 1945 (plus or minus 16 years or so). Her team of researchers also discovered that the virus had originated in Guinea-Bissau and that its spread was most likely precipitated by the independence war that took place in the country between 1963 and 1974 (Guinea-Bissau is a former Portuguese colony). Her theory was backed up by the fact that the first European cases of HIV-2 were discovered among Portuguese veterans of the war, many of whom had received blood transfusions or unsterile injections following injury, or had possibly had relationships with local women.
– https://www.avert.org/origins.htm
Is the clinical treatment of HIV-2 different from that of HIV-1?
Little is known about the best approach to the clinical treatment and care of patients infected with HIV-2. Given the slower development of immunodeficiency and the limited clinical experience with HIV-2, it is unclear whether antiretroviral therapy significantly slows progression. Not all of the drugs used to treat HIV-1 infection are as effective against HIV-2. In vitro (laboratory) studies suggest that nucleoside analogs are active against HIV-2, though not as active as against HIV-1. Protease inhibitors should be active against HIV-2. However, non-nucleoside reverse transcriptase inhibitors (NNRTIs) are not active against HIV-2. Whether any potential benefits would outweigh the possible adverse effects of treatment is unknown.
Not all of the drugs used to treat HIV-1 infection are as effective against HIV-2. In particular, HIV-2 has a natural resistance to NNRTI antiretroviral drugs and they are therefore not recommended. As yet there is no FDA-licensed viral load test for HIV-2 and those designed for HIV-1 are not reliable for monitoring the other type. Instead, response to treatment may be monitored by following CD4+ T-cell counts and indicators of immune system deterioration. More research and clinical experience is needed to determine the most effective treatment for HIV-2.25
– https://www.avert.org/hivtypes.htm
In the past 25 years, life survival curves of many countries have been remodeled owing to HIV infection. Both HIV-1 and HIV-2 can cause AIDS, yet patients infected with HIV-2 fare much better clinically and most will never experience detrimental effects of the infection.
– https://www.aidsmap.com/cms1032123.asp
In a recent small study from the United Kingdom, HIV-2 viremia was only detectable in patients with CD4+ cell counts < 300 cells/mm3.[3] Data such as these would suggest that progressive immune depletion can occur at very low levels of viral replication. On the other hand, the low levels of viral replication probably explain, at least in part, the typical slow progression to clinical disease.
CL has many movies and documentaries in its collection. In addition, we maintain a list of online videos that we recommend to learn more about HIV/AIDS, activism, medical news, and other topics, from reliable sources including the National Library of Medicine, Planned Parenthood, PBS, and our very own YouTube page.
Click on the links below to get our printer-friendly handouts about these recommended videos. We update this information regularly, but we do not control any of this content (other than our YouTube page), so we cannot guarantee that it will be available when you try to access it. If you find broken links, please contact us so we can remove them
Or come down to the library and check it out yourself.
SEX IN RELATIONSHIPS
For people in relationships in which both partner is positive, it’s important to recognize that safer sex is still important. Project Inform has a good webpage of info about re-infection https://www.projectinform.org/info/reinfection/index.shtml
For people in relationships in which only one partner is positive, see the section “Serodiscordancy,” just below. The first link there includes the answers to most questions about safer sex in these situations.
The library has many books with information about safer sex. Here are just a few that may be of interest:
The Ins and Outs of Gay Sex (with a section on STDs)
Love and Sex After 60 (with a section on “Practical strategies for finding new relationships and solving sexual problems”)
Hot Living: Erotic Stories About Safer Sex
SERODISCORDANCY
A big issue in relationships and dating can be serodiscordancy – when one person is positive and the other negative.
The Body also published a forum on Mixed-Status relationships, which is actually no longer active, but which has archived expert answers on such useful topics as “Guilt and Fear of Infecting a Partner,” “I Am HIV Positive and My Partner Won’t Get Tested,” and “One or Both of Us Are Positive and We Want to Have a Baby.” Check out the full list: https://www.thebody.com/Forums/AIDS/Couples/index.html
The UCSF Center for AIDS Prevention Studies has published a presentation on “The Management of HIV, Sex, and Risk Among HIV Serodiscordant Heterosexual Couple.” It summarizes a study of trends and might be interesting for those who work with clients dealing with serodicordancy issues. It’s available online: https://www.caps.ucsf.edu/projects/CApartners/CPSLAposter.php
The World Health Organization has published a study, “Gender Dimensions of HIV Status Disclosure to Sexual Health Partners: Rates, Barriers, Outcomes,” which may also be a good resource for those of us working with clients in discordant relationships who may not have told their partner their status. It also has a large annotated bibliography, for further resources. It can be downloaded here: https://www.who.int/gender/documents/en/genderdimensions.pdf The library has a graphic novel (also known as a comic book) about a serodiscordant couple, Blue Pills, and a book called Couples of Mixed HIV Status: Clinical Issues and Interventions.
We also have a documentary about two serodiscordant couples (one homosexual, one heterosexual), One+One, which you can read about and watch a clip of here: https://www.newday.com/films/OneplusOne.html
Come to the library and check any of these out yourself.
NOTIFICATION
Making former partners aware of HIV status can be a challenge. Folks can do this anonymously through the website InSpot: https://www.inspot.org/
Those working with clients dealing with notifying former partners might want to read the Center for Disease Control and Prevention’s report, “HIV Partner Counseling and Referral Services – Guidance.” It can be downloaded as a PDF, here: https://www.cdc.gov/hiv/resources/guidelines/pcrs/index.htm
[**I should add that any FIGHT staff member who doesn’t feel comfortable with downloading or with using Adobe Acrobat to read PDFs should let me know. I’ll be glad to show you how to do this.**]
PERSONAL STORIES
Personal stories may be inspiring for clients dealing with relationship issues.
