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.

ARTICLES ABOUT HIV/AIDS AND RELIGION

TheBody.com has a collection of articles about Coping with HIV/AIDS: Getting Support from Religion/Spirituality, with articles such as:

• How Spirituality Can Heal What Meds Aren’t Made to Mend
• AIDS is Not a Punishment: Overcoming Guilt and Shame
• and more

TheBody.com also has a collection of articles on Religion & HIV/AIDS, broken down into:

• Protestant Christianity
• Roman Catholicism
• African-American Churches
• African Churches
• Other Churches
• Islam
• Judaism
• Buddhism
• Hinduism

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:

• Pamphlets, Posters, and a Pastoral Counseling Manual for HIV/AIDS
• A YouTube Channel of Religious Figures Talking About HIV/AIDS
• A handbook called Who Will Break the Silence: Liturgical Resources for the Health of AIDS

The National Catholic AIDS Network is no longer staffed as of 2007, but published a Parish Manual for AIDS Minstry (available in English and Spanish), which is presumably still relevant.

The National Episcopal AIDS Coalition has a website that publishes:

• Understanding and Challenging HIV Stigma: Toolkit for Action
• a YouTube Channel
• a page to Search for HIV/AIDS-Supportive Episcopalian Churches
• and more

The NGO Family Health International has a page of Faith-Based Initiatives that includes:

• Family Life Education: Teaching Youth about Reproductive Health and HIV/AIDS from a Christian Perspective
• HIV/AIDS Prevention, Care and Support Across Faith-Based Communities:  An Annotated Bibliography of Resources
• and more

The AIDS Ministry of the Greek Orthodox Metropolis of San Francisco publishes an AIDS Ministry Manual for Greek Orthodoxy.

The Christian AIDS Bureau of Southern Africa has a number of resources for Christian HIV Ministries, such as:

• Sermon Guidelines, which includes dozens of sample sermons
• Prayers that relate to HIV/AIDS
• Christian Thinking about HIV/AIDS
• and more

The Ecumenical Advocacy Alliance takes a more international perspective, but also includes resources that could be useful for faith communities in the US, including an
HIV Faith Advocacy Toolkit, and a book free for download called HIV Prevention: A Global Theological Conversation (in English, Spanish, and French), with essays on such subjects as:

• Behavior change and the role of the Church: towards reducing and eliminating risk
• Jesus, community compassion and HIV prevention
• The virus and the Bible: how living with HIV helps the Church to read it
• and more

The Statewide HIV/AIDS Church Outreach Advisory Board publishes Healing Begins Here: A Pastor’s Guidebook for HIV/AIDS Ministry through the Church

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:

• An FAQ on Catholicism and Homosexuality
• A Collection of Liturgical Readings, Homilies, and Inspirational Writings
• Recommended Readings on Homosexuality and Faith (not only Catholicism)
• A Page to Find a Chapter of DignityUSA
• and more

In a similar vein, The Metropolitan Community Churches Alliance has a set of downloadable pamphlets on Homosexuality and the Bible (from a pro-LGBT perspective), and a place to Search for LGBT-Welcoming Ministries in the USA and around the world.

RESEARCH ON RELIGION AND HIV/AIDS

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.

LEGAL REPRESENTATION

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:

• Seminars for people who are HIV+ about legal issues
• Trainings for case managers and medical providers
• Several useful publications, including the third edition of AIDS and the Law: Your Rights in Pennsylvania (which we have five hard copies of in the AIDS Library!)

For folks not in PA, consult the American Bar Association’s Directory of Legal Resources for People with HIV/AIDS that lists organizations like AIDS Law Project in all U.S. states and territories.

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 other pro bono counsel in PA, see the Pennsylvania Legal AID Network.  For free legal resources in Pennsylvania on a wide range of topics, see PALawHelp.org.

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.)

For legal counsel for the incarcerated in Pennsylvania, contact the PA Institutional Law Project, and/or the Lewisburg Prison Project.  To see resources for other states, consult the American Civil Liberties Union’s Prisoner Assistance Directory.

RESOURCE COLLECTIONS

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:

• The Americans with Disabilities Act and the Rights of Persons with HIV/AIDS to Obtain Occupational Training and State Licensing
• Reproductive Choice and Women Living with HIV/AIDS
• Housing Rights of People Living with HIV/AIDS: A Primer

• How to Litigate an HIV Confidentiality Case

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
• an open discussion forum and an Ask the Experts section

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

Another useful resource collection is The Body’s assemblage of legal documents and suggestions about Wills, Guardians & Powers of Attorney & HIV/AIDS.

LAWS and LEGAL NEWS

There are a number of key laws that are relevant to the HIV/AIDS community.  Among them are

• Act 148 – the Pennsylvania law on HIV-related confidentiality
• Americans With Disabilities Act – federal rules prohibiting discrimination of the disabled
  • David Webber’s AIDS & The Law website has an interesting essay about HIV and the ADA Amendments Act of 2008
  • The PA Human Relations Act – prohibiting discrimination in Pennsylvania
  • Family & Medical Leave Act – allows unpaid work leave for people caring for family members
  • Lambda Legal has a list of State-by-State Statutes on HIV Exposure
  • AIDS Law Project lists and discusses several other relevant laws at their Legal Information page
  • The AIDS & The Law website has a similar list, with interpretation, of several more laws

The American Civil Liberties Union has a regularly updated collection of legal stories on HIV-Related Discrimination, HIV/AIDS Privacy/Confidentiality, Access to Health Care, Major HIV/AIDS Court Cases, and more.

The Body has collections of stories on Legal Rights for HIV-Positive People, HIV/AIDS-Related Discrimination Cases, U.S. Laws/News Regarding HIV Disclosure, and several more topics.

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:

Expert Rev Vaccines 2008 Apr;7(3):319-31

Leligdowicz , Rowland-Jones .

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.

– Braz J Infect Dis. 2003 Feb;7(1):7-15. Epub 2003 Dec 2.

Hightower , Kallas E.

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.

– https://www.cdc.gov/hiv/resources/factsheets/PDF/hiv2.pdf

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.

– https://www.medscape.com/viewarticle/412453

– indinavir (Crixivan)
– lopinavir (in Kaletra)
– saquinavir (Invirase)
– tipranavir (Aptivus)

– https://www.catie.ca/en/home

DATING

For those looking to start a relationship, there are a number of good HIV+ dating websites:

Poz Personals: https://personals.poz.com/
Positive Singles: https://www.positivesingles.com/
HIVpoz.net: https://hivpoz.net/
Poz Match: https://pozmatch.com/
HIVnet.com: https://hivnet.com/

For the MSM population, the library has a documentary on the subject of online “cruising,” Hooked. You can read about the movie:
https://www.babalupictures.com/hooked/Pages/synopsis.htm

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

That page is also available in Spanish:
https://www.projectinform.org/info/reinfection/index_sp.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 publishes a series of FAQs on Mixed-Status relationships with sections on Disclosure, Testing, Safer Sex, Having Children, and more:
https://www.thebody.com/content/whatis/art39442.html

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.

Online, clients can read an older man’s moving biographical sketch about his experiences with relationships and HIV:
https://www.thebody.com/content/whatis/art48993.html

Or an interview with a 16 year-old girl who was born positive, talking about dating and HIV:
https://www.thebody.com/content/whatis/art1145.html

The library has a film about women dealing with HIV and relationship 
issues (among other things), All of Us: 
https://www.allofusthemovie.com/aboutthefilm.php

You can follow that link to learn more about the movie, or come down to the library and check it out.

The library has a novel, Tweeds, about “both telling and loving a man with AIDS.” Recommend it to someone, or come down and check it out yourself.