The 13th September/October 2000 International AIDS Conference Amandla!—Power to the people The transgender community at world AIDS Mbeki fails to break the silence September / October 2000 • Volume 11 Number 5 Table of Contents 7 Editor’s Note Departments 9 From TPAN 10 Readers Forum 12 News Briefs Features 17 Amandla!—Power to the people by Charles E. Clifton 27 HIV lipid guidelines good for your heart by Enid Vázquez 33 Back to work drug screenings by Glen Pietrandoni, R.Ph. 35 Cutting edge research by Frank Pizzoli 36 Defending the castle by Stephen J. Fallon, Ph.D. 41 The transgender community at world AIDS by Lorraine Sade-Baskerville 42 Douching is bad for you by Laura Jones 47 HIV rights for teens by Justin Hayford 49 Salvage conference highlights by Enid Vázquez 50 Give us morality or give us death by Jim Pickett 54 Mbeki fails to break the silence Cover Photo: AP/Wide World Photos by Charles E. Clifton A model, photograph, or author’s HIV status should not be assumed based on their appear- ance in Positively Aware. You can view these (and other stories from pre- vious issues) online at http://www.tpan.com www.tpan.com Positively Aware • September / October 2000 5 Test Positive Aware Network 1258 W. Belmont Ave. Chicago, IL 60657-3292 phone: (773) 404-8726 fax: (773) 404-1040 e-mail: [email protected] http://www.tpan.com Interim Editor/ Associate Editor Enid Vázquez Advertising and Distribution Manager/ Editorial Assistant Jeff Berry National Advertising Representative Rivendell Marketing 908-232-2021 Executive Director Dennis Hartke Business Director Rick Bejlovec Contributing Reporters Kelly Harmon Laura Jones James Learned Jim Pickett Art Directors John Auterman Russell McGonagle apparatus © 2000, Test Positive Aware Network, Inc. For reprint permission, contact Jeff Berry. Six issues mailed bulkrate for $25 donation; mailed free to TPAN members or those unable to contribute. Special Readers Forum TPAN is an Illinois not-for-profit corporation, providing information and support to anyone concerned with HIV and AIDS issues. A person’s for HIV status should not be assumed based on his or her article or photograph in Positively Aware, membership in TPAN, or contributions to this Positively Aware’s journal. We encourage contribution of articles cover- ing medical or personal aspects of HIV/AIDS. We 10th Anniversary reserve the right to edit or decline submitted arti- cles. When published, the articles become the property of TPAN and its assigns. You may use Positively Aware readers have been intregal to its growth and your actual name or a pseudonym for publica- tion, but please include your name and phone development. As the November/December issue will be number. 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Belmont, Chicago, IL 60657 presents, Positively Aware staff and volunteers, TPAN, or the institutions and personnel who pro- or e-mail [email protected]. vide us with information cannot be held respon- sible for any damages, direct or consequential, that arise from use of this material or due to errors contained herein. 6 Positively Aware • September / October 2000 www.tpan.com Cleaning your own house ur tour guide stopped the van by the other man who had contributed to a marriage side of the highway in Capetown, dowry could have sex with the bride first. O South Africa. He pointed to a hut at This, also, is found to spread HIV. the side of the road, off in the grass, not tall enough to stand up in. I’m a great respecter of culture. But cultures often need to change out of necessity. In so There, he told us, teenage boys anywhere many ways, we are all alike. I’ve heard of so from ages 13 to 17 were recovering from cir- many men and women in the United States cumcision, a tribal rite of passage to manhood who don’t tell their sexual partners that they that’s done in cold blood, with the same blade have HIV. I’ve also heard of so many people used without sterilization from boy to boy. who’ve been infected this way, some of whom “What does that do for the spread of HIV?” were out and out lied to about their partner’s our guide asked rhetorically. HIV status. I thought this must be an urban legend, like We all have our ways of spreading HIV. alligators living in sewers. But a week later I Everyone—including South Africans—thinks saw a television documentary on Nelson South African President Thabo Mbeki is crazy Mandela’s life, and he talked about going for not supporting HIV therapy to fight the through this painful ritual. I talked with a astounding epidemic in his country. But here Capetown woman who’s living with HIV. She in the United States, the government practices said—and I don’t know where she gets her genocide by not supporting and funding numbers—that of 10 boys undergoing the ritu- syringe exchange for drug users. al, two come out with HIV, two are mutilated and maybe one dies. Yes, there are talks going Cultures need to change, wherever, however, on to change the practice, but it doesn’t seem they’re killing people. like things are changing soon enough. I couldn’t believe that a conscientious person like me hadn’t heard of this ritual, especially since it clearly spreads HIV. I had heard of circumcision on young girls, also done in cold blood, and much more brutally. At the International AIDS Conference, I learned of a Enid Vázquez practice in another African country where the Interim Editor father of a groom, the groom’s uncles or any www.tpan.com Positively Aware • September / October 2000 7 If not now, when? have talked with a few people who attend- achieved. For at least a few days, for at least the ed the International AIDS conference in moment, sufficient attention was created to I Durban, South Africa. Each of them tells a move governments and drug companies to similar story—disappointingly little new infor- pledge more support to South Africa and the mation on treatments and a country, a conti- entire continent. Hundreds of millions of dol- nent, so ravaged by HIV and AIDS that it is lars in additional aid have been promised from almost impossible to comprehend. numerous drug companies as well as several governments. A global realization has started The statistics from South Africa are numbing. to be achieved that we are losing a generation One in five adults are positive, 1,700 new infec- of people in Africa, with Southeast Asia and tions each day, nearly 600,000 newly infected Eastern Europe not far behind. people each year. More than half-a-million orphans. 50,000 deaths per year. And these are The breadth of the epidemic in Africa is over- statistics for South Africa only. Not for all of whelming. Even with the millions of dollars in Africa, just South Africa, a country of about 43 aid now promised, and the dropping of resist- million people. ance by drug companies to locally produced generic drugs, the outlook is grim for Africa. Look at those numbers again. One-in-five The numbers of HIV positive people are enor- adults are positive. Think about that. Think mous. The economies and health systems of about a office of 25 workers. In South Africa, the affected countries are often minimal and five of them are likely to be positive. And given fragile. And the social norms of the populations the lack of access to treatment, all five are likely often are in opposition to proven practices for to die before they are 40. 600,000 newly infect- reducing HIV infection. Yet it is wrong to sim- ed each year. That is equivalent to the entire ply turn away. Progress can be made, as population of Boston, Seattle, or Washington, proven by Uganda, where the HIV infection DC becoming infected this year. 50,000 deaths rate has been reduced. Education, working to each year. That is nearly equivalent to all change certain social norms, and the imple- United States soldiers killed during the Vietnam mentation of relatively low-cost treatment of war. And 500,000 orphans, many themselves HIV positive pregnant women to reduce the HIV positive. Nearly all with only a slightly rate of infants born with HIV are all feasible. older sister or brother, or aging grandparent, to care for them. An African proverb that I read in another mag- azine seems most appropriate. “The best time The numbers are overwhelming. to plant a tree is 20 years ago. The second best time is now.” The world cannot afford to let the In the face of this, doctors, scientists, HIV HIV epidemic in Africa go unchecked for activists and leaders from around the world another 20 years. Action must be taken now. gathered to share information and shine a spot- light on this ongoing tragedy.