In June and July, CATIE is presenting four webinars that focus on new developments in HIV and hepatitis C (HCV) research, integrated approaches to HIV treatment and prevention, and the integration of HIV, HCV and other sexually transmitted and blood-borne infections in frontline work. 

These webinars are designed as a good orientation to the issues that will be discussed at the CATIE Forum: New Science, New Directions in HIV & HCV, September18-19, and CATIE recommends that all those planning to attend the Forum, or follow it via live-streaming, sign up for all four webinars.

These webinars will be of interest to many healthcare providers, community-based and public health workers, and program planners, so we encourage anyone who works in HIV and HCV frontline work to join us.

Register now to attend the CATIE Forum Webinars

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Durant les mois de juin et juillet, CATIE présente quatre webinaires qui font le point sur les nouveaux développements en recherche sur le VIH et le VHC, les approches intégrées du traitement et de la prévention du VIH, ainsi que l’intégration du VIH, du VHC et des autres infections transmissibles sexuellement et par le sang dans la pratique de première ligne.

Ces webinaires ont pour but d’orienter les sujets qui seront discutés lors du Colloque de CATIE : Nouvelle science, Nouvelles orientations en matière de VIH et de VHC, qui se déroulera les 18 et 19 septembre; CATIE recommande à toutes les personnes qui ont l’intention d’assister au Colloque, ou de le suivre par l’entremise des webémissions en direct de s’inscrire à chacun des quatre webinaires.

Ces webinaires intéresseront de nombreux fournisseurs de soins de santé, des professionnels de la santé publique et communautaire et des responsables de l’élaboration de programmes;  nous incitons donc à se joindre à nous toute personne qui travaille dans la pratique de première ligne du VIH et du VHC.

Inscrivez-vous maintenant pour participer au webinaires du Colloque de CATIE.

As I write this, I am sitting on a train, making my way back to Toronto after spending two days at Concordia University (in Montréal), which housed the premiere (and potentially only) Beyond Failure! Symposium.

The purpose of the symposium was to provide a space to discuss the various areas within HIV which we have failed at, whether that be research, policy, activism, prevention or frontline services. The HIV and AIDS industry (and this is not exclusive to HIV) strives for success in all areas – in proposing projects, in the work done by AIDS service organizations (ASOs), in grant writing, etc. While striving for success and achievement can be viewed positively, the fixation placed on succeeding rarely provides the opportunity to reflect on challenges, shortcomings, or failures. 

Failure is uncomfortable. In evaluating failure, we are forced to examine our flaws, slip-ups, and transgressions under a microscope. Perhaps this is why many shy away from this kind of evaluation. Sometimes it’s easier to sweep our faux pas under the rug and move on. Unfortunately, in failing to address the failures, the opportunity to learn from these mistakes is lost and we run the risk of replicating our mistakes over and over again, never having learned the lesson in the first place.   

Failure is threatening and often personal as we (occasionally) tie our successes to our identities and by default, our failures have the potential to negatively impact how we understand ourselves. When failure is conceptualized so closely to our identity or sense of self, it’s no wonder it has the potential to create considerable discomfort.

Beyond being uncomfortable and depending on your role and/or relationship to the HIV movement, failure can mean the loss of funds, the end of a research project or ASO or in a far more corporeal sense, the difference between life and death.   

As Tim McCaskell so eloquently stated in his keynote address at the symposium, “AIDS is like a lens: when you look through it, all of society’s problems are magnified.” From here, Tim provided an insightful way of re-framing the concept of failure within the context of HIV by asking: is the goal to destroy or break the lens? Or is the goal to challenge the social conditions that create HIV? The point? Failure can be determined by the perspective applied to the circumstance or scenario and the often imaginary line between failure and success is both arbitrary and subjective.  

A call for abstracts for the symposium was released in fall 2012; anyone interested in submitting an abstract was asked to briefly outline what aspect of failure they would like to discuss. Abstracts were categorized into small groups (5-7 people per stream) based on common themes including prevention, risk, community, and social policy & state. For those whose abstracts were accepted there was the expectation of completing a paper in advance of the symposium that would be distributed to other members of your group. The intention was for everyone to read the papers in advance of the symposium and come prepared to address commonalities, divergences, and of course, failures. This symposium format created the space and possibility to have rich meaningful dialogue, which allowed for a more nuanced engagement with other presenters’ work.   

I submitted an abstract which used my undergraduate and graduate experiences in international HIV research as a case study to highlight failure. Within my larger paper, I discussed how in both cases (undergraduate and graduate research), I felt unprepared, untrained and naïve yet I was situated as the research “expert” regardless of my inexperience both in HIV (particularly as an undergraduate) and in Namibian culture and history (where both my research projects took place). For more details on this work, check out my previous PositiveLite.com article here.  

I was grouped within the community stream along with another young female activist from Toronto, a delightful Parisian, and a post-doc from Montréal. The groups were facilitated by the symposium’s organizing committee (our group was lucky enough to have Viviane Namaste in it), which allowed for bilingual and cultural exchanges.   

Many important and critical reflections arose from our group discussion including who is “community” and who defines it? Can we belong to a community if you don’t share the same lived experiences as other members? In identifying competing definitions of community, do we inadvertently exclude people from various communities? And how do we negotiate multiple social locations and identities in the context of community? 

I found that my own work (using anecdotal experiences as a young researcher) drew close parallels to another group member who spoke about the role of allies in the HIV movement and encouraged people who might take up the identity of “ally” (both with the context of HIV and beyond) to critically reflect on what motivated them to engage in this work. Comparing the work of researchers and allies, I found many convergent points including: that the choice to do research or join a movement often starts from a place of “good intentions”; the failure to meaningfully involve and incorporate PLWHA creates situations of tokenism; the existence of the insider/outsider dilemma (who can be a researcher and/or ally?); and that often if advantages or benefits are up for grabs, it is usually the researcher (sometimes the ally) who is on the receiving end of them.   

As someone who identified both as a researcher and as an ally (in various movements), it was uncomfortable to put my failures on the table and bring into question my role as an ally. The more and more I engage in critical work, the more I relish in the circumstances which force me into those uncomfortable corners. I believe that when we’re in these places, we have the potential to radically re-vision ourselves, the work we do, how we show up in the world and how we engage with it.

I think one of the biggest learnings that came out of the symposium (and through engaging in thought-provoking conversations with other participants) was the re-realization that becoming an ally* (and a critical, ethical researcher) is a continuous process which requires of us that we always put ourselves uncomfortably under the microscope to examine our privileges, how much space we take up (physically, intellectually, verbally, etc.), how we are oppressed and how we oppress others.

Many of the same principles of doing ally work can easily transfer to the role of researcher, particularly when the researcher isn’t working within a community they immediately/wholly identify with. In addition to the constant assessment of social location and privilege, when locating yourself as ally or researcher, it’s important to recognize that that will usually mean not taking a leadership role in either the movement or the project, taking your cues from those community members with lived experience and working collaboratively. 

Though I didn’t necessarily encounter any earth-shattering revelations at this symposium, I did very much appreciate the fact that it took place and am grateful to have been able to participate in it. Creating space to talk about our collective and individual failures is rare but frankly, shouldn’t be. So many crucial lessons can be learned through failure and if we spend our time hiding/trying to forget where we went wrong, we’ll miss the important opportunity to learn how to do things differently –and hopefully better - next time.   

* If you’re interested in reading more about becoming an ally, check out Anne Bishop’s website here .

The title quote was written by George Bernard Shaw in ‘Saint Joan’ in 1923 but if ever a saying is timeless it’s this one.

The reason I’m dragging it out of the cliché locker is because I feel I have to take issue with a couple of articles that have appeared on PositiveLite.com recently.  

They are IS HIV TRANSMISSION POSSIBLE WHEN VIRAL LOAD IN THE BLOOD IS UNDETECTABLE? from CATIE and INFECTIOUSNESS coming from Aidsmap.com

I respect the work that people in HIV organisations put in to the struggle to control the virus and I appreciate the time and effort put in by writers who do their best to provide us with information – we’d be in a sorry state without them. I also know the perils of one article writer criticising another but I genuinely mean no disrespect. These two articles are pretty representative of what you will find all over the net and therefore my problem is more with the genre than the individual articles themselves.

The CATIE article addresses a question which is in the back of everybody’s mind. It’s crucial, both for positive and negative sex partners. The title suggests that the question will be answered but unfortunately that’s anything but the case. The first paragraph sums up what viral load actually is but hardly gives hard and fast rules which we can hang our hats on. It talks about the viral load being measured in the bodily fluids of a positive person. Surely it’s not. It’s measured in the blood and only very rarely is semen, saliva etc.

“Research shows that successful HIV treatment can reduce the viral load to “undetectable” levels and this can reduce the risk of HIV transmission. However, HIV transmission may be possible when the viral load is undetectable…The risk of HIV transmission when taking antiretroviral treatment may increase if sexually transmitted infections (STIs) are present…This risk may also be higher for anal sex than for vaginal sex.”

What do they mean, ‘can’ and ‘may’? We’re thirty years into the history of the virus. We should be hearing ‘does’ and ‘will’, not bet-hedging to cover all possibilities!

The following is something we’re all very aware of but what does a statement like this actually tell us?

“Viral load tests used in Canada cannot detect HIV in the blood if there are less than 40–50 copies/ml. Therefore, an undetectable viral load means the amount of virus in the blood is too low to detect, it does not mean that there is no virus present.”

First of all, we know the testing procedures are still limited but surely we’re entitled to ask why? Secondly, what the hell are we supposed to take from such a statement? Getting everybody to undetectable status is the universal aim but is pretty pointless if we don’t know how much of the virus has escaped detection because the procedures are lacking. Of course ‘undetectable’ suggests ‘less infectious’ but thirty years into the disease and its treatment and we still don’t know whether that’s entirely true. Until other bodily fluids are routinely tested we’re no closer to an answer and even then, the virus may be hiding in bone marrow, organs and brain tissue. Testing every susceptible piece of the body may never be possible but telling us we’re undetectable but maybe still dangerous, tells us almost nothing; we deserve better.

Another pretty meaningless statement is:

“Research shows that a lower amount of virus in the blood is usually associated with a lower risk of transmitting HIV to others, and a higher viral load is associated with a higher risk.”

Duh! And by the way, what research? We probably all accept the truth of this statement but what research proves that? Far too often the words ‘Research shows…’ are thrown at us in the expectation that we’ll accept that as gospel. Very often research is so small-scale and out of date that it is barely relevant. It is wrong to assume that the reader can’t cope with references to the exact piece of research and it should be expected that research is looked at with a critical eye but very often, ‘research shows…’ will back up a multitude of assumptions.

CATIE quotes HPTN 052 research to back up theories that a lower viral load reduces risk but that research was conducted amongst tiny groups of sero-discordant heterosexual partners in Africa and Thailand. The research is ongoing but trials to measure the same risk reduction when it comes to homosexual, anal sex…well you can whistle for that one! A lot of people hang a lot of credence on HPTN 052 but for HIV+ gay people, it suggests absolutely nothing and proves even less. To be fair, the CATIE article does point this out and even questions the relevance of the research but still draws conclusions that say we can reasonably assume that the same applies to anal sex. Uhm sorry, no it doesn’t!

When a paragraph begins with:

“Successful antiretroviral treatment can lower the viral load in the blood and other bodily fluids to undetectable levels and this can reduce the risk of sexual HIV transmission...Antiretroviral treatment may be much less effective than 96% when these conditions are not met.”

You know that it means very little. We want to know that in the majority of cases, ‘it will’!

More woolly information follows:

“A higher level of HIV in the semen, vaginal fluid, and rectal fluid may increase the risk of transmission when the blood viral load is undetectable. However, it is unclear how often this happens and how significant it is in terms of HIV transmission. Research shows it may be more common if a person has an STI, but can also happen in the absence of STIs.”

There they are again: ‘may’ and ‘can’, plus a ‘research shows’ and an ‘unclear’. How exactly is this useful information? The fact is that the research in all areas of HIV is still shockingly lacking and in the meantime we have to put up with guesswork. That's not good enough in 2013. If there’s no more money for  extensive and indisputable research; or no plans are on the table; or government and scientific bodies are standing in the way; or moral objections are blocking funds it’s the responsibility of HIV sites and organisations to say so and tell their readers the truth. “We just don’t know and this is why we don’t know,” is far more acceptable than ‘cans and maybes’. At least then we know where we stand.

Doesn’t this next sentence just sum it up?

“Although there have been no studies among gay men and other MSM, there has been one report of HIV transmission occurring between two men when the HIV-positive partner had an undetectable viral load.”

Pitiful, really! Are we going to have to take to the streets again to demand efficient and relevant research which will end up saving the state millions in health care and why aren’t our large HIV organisations leading the charge?

The second article comes from aidsmap.com, which is generally regarded (just like CATIE) as a reliable and up-to-date source of information. The introduction is as follows:

“Aidsmap.com reports about 10% of gay men taking antiretroviral treatment have low levels of HIV detectable in their semen, according to new research. Whether or not this level of HIV in semen is associated with transmission is unknown.”

Now I thought this was interesting and went in search of this new research. It stemmed from a University of California study into the effect of the herpes virus on HIV transmission (read more here (http://www.centerforaids.org/pdfs/spring2013ta.pdf)) It involved 46 people, split between so-called HIV transmitters and non-transmitters and could hardly be called ‘large scale’. The Aidsmap article refers to 114 men in the study but even that’s hardly a significant research group. The point is that Aidsmap presents this as fact, based on ‘a US study’ when in fact it’s a little more complex than that and to state that 10% of men on HART have low levels of HIV in their semen seems pretty conclusive, yet it is based on a small study concentrating on the Herpes virus. Again, the statement may be true; it may be relevant and important but we need more evidence to back up global statements like that. (Editorial comment. PositiveLite.com says: even more important is whether such low levels of virus have any significance, i.e the ability to result in transmission. Is in fact the semen issue a complete red herring? We suspect yes, given the transmission history -  or lack of it -  in people with undetectable viral load in their blood.)

PositiveLite.com has quite rightly questioned the accuracy of aidsmap's references to the HPTN052 research, which is trundled out yet again yet proves practically nothing for gay men.  (Editorial comment; PositiveLite.com has since received acknowledgement from aidsmap that the aidsmap information was incorrect and that a retraction (apology?)  will be issued shortly. The moral is, as Dave says, question EVERYTHING you read.)

The article then goes on to say:

“But there have been rare case reports of HIV transmissions in the presence of an undetectable viral load”.

What rare case reports? How many? Why isn’t this being investigated right now, on a large scale, to actually establish some facts? It’s almost as if HIV organisations and sites have become so accustomed to writing generalised pieces that repeat the same old suspicions and assumptions, that it has become a new truth of its own. Why aren’t they screaming out for new research and not settling for worn out cliché responses?

It goes on:

“Untreated bacterial sexually transmitted infections (STIs) such as chlamydia and gonorrhoea may cause viral load to increase in genital fluids, even if a person is taking effective antiretroviral treatment.”

‘May’! Why don’t we know for sure?

Finally, statistics are rolled out:

“They also found that 36% of study participants with a detectable viral load were shedding HIV in semen compared to 6% of participants with an undetectable viral load…A urethral bacterial STI was diagnosed in 4% of men, but these untreated infections were not associated with the presence of HIV in semen.”

Okay, let’s assume that the study involved 114 men and not 46. 36% of 114 is 41. Is it really valid to come to wide-reaching conclusions based on the results of 41 people? The urethral bacteria numbers are even less relevant: 5 people out of 114!

The point is that readers take headlines and believe them to be true, when in fact they’re often based on such small-scale studies that they barely merit a mention. Of course, all these studies may be revealing vital information and should be reported but if one (small) study suggests a trend then it should be replicated on a wide scale across the HIV community in order to establish whether it is more than just a medical soundbite. It’s the responsibility of authors and their organisations to look at these things more critically and if necessary make readers aware of the scale and validity of studies, statistics and suppositions.

The reader also needs to question anything that’s not clear, or seems to be stated as fact when it’s not proven. The problem is that life’s just too short to take the time to do that. So the promulgation of half-truths and loaded headlines becomes the easy way out, eventually leading to mistrust and suspicion.

This article of mine nay seem like an attack on two highly regarded HIV information sources; it’s not meant to be. I have used them as examples of what we see every day in articles and discussions throughout the HIV community. We really do deserve better than to be fed meaningless conclusions based on ‘maybes’ and ‘possibilities’ but it’s not the fault of the authors. News has to be reported, no matter how tenuous the facts.

Unfortunately, it looks like the HIV community has to start demanding again. Demanding proper, well, funded and large scale research at home and abroad. The World Health Organisation has a responsibility (and the finances), as does the pharmaceutical industry and every other research or research-funding facility across the globe, including the major philanthropists like Bill Gates etc.

I’m fed up with endless arguments as to whether an undetectable status is safe or not, or whether TASP, PrEP, PEP and various other acronyms are the way forward, or whether the viral load in your blood reflects the true levels in your body. Just how safe is condomless sex between sero-positive people on HART? The questions are endless but I would like answers and soon. Some people and organisations are dragging their feet in providing them. It’s a question of having the political will to do the necessary research and damn well prove things once and for all and if the ‘climate’ makes it difficult to instigate the discussion and find the evidence, then we’ll just have to scream and shout until that changes. If it doesn’t happen then confusion drives apathy and stigma grows.

When you next read an article about the latest theory concerning HIV treatment and transmission; count up the number of ‘statistics, if’s, may’s, possibly’s and researches show’ and ask yourself if you are being presented with new facts and are you learning anything new. If the answer is negative then you may well be being short-changed!

I’m fully aware that some people will be irritated by this article but then I hope they’ll respond and widen the discussion. If I’m talking out of my backside, I hope you will say so  - but you’re going to have to prove it! 

My partner and I were both diagnosed HIV, around about the same time.

2003 was the worst year ever. I can remember it like it was yesterday. I didn't even get my bum on the seat and the doctor had blurted out "your results have come back positive". I sat there numb, in shock, then started crying. I had only ever heard of Freddie Mercury from Queen dying from AIDS so I instantly thought I was going to die. The doctor told me I was being stupid. Ten years later, here I am, still alive writing this guest blog

My partner and I managed to keep the diagnosis quiet, like a dirty secret, for three years until it all came to a head.

My partner took seriously ill. He was rushed to hospital in an ambulance ,with blue lights flashing and sirens wailing. It was the talk of the small village where we lived at the time. The rumour mill went into overdrive. Even a cashier in the local supermarket had the nerve to ask his dad if the rumours were true. She ended up with half a dozen eggs on her head, free range at that.That’s a small village for you.

In any event, he was taken to Ward 42 at the Western General Hospital which is where HIV patients are treated. i knew then it was all going to come out.

His sister and dad arrived at the hospital. She knew in her gut what I was about to say before I even said it. I just blurted it out then started crying. I am known for liking a good cry. You should see the state I get in watching "Beaches"

He was put on fluids, taken for MRI scans and put on antiretrovirals - Kaletra if I remember. He had a lumber puncture which missed the diagnosis of a brain virus. By the time they did a second lumber puncture it was too late. His CD4 count was down to 4. About four weeks after his admission he was put on life support when his lungs collapsed and he went into a coma which was said to be irreversible. That was the worst time ever. We had to plan a funeral  - I still have the disc of 4 songs that were picked -  as the consultant said there was no way back from the coma

But eight days later he was awake. It was like a miracle. He was put on feeding drips and had to have a catheter fitted. He would sleep all day and be awake all night. He was having up to 24 showers a night; in his mind he needed to shower to be warmed up. For the first four months he had no idea he was even in the hospital, no knowledge of anything that was happening around him. Without the staff on the ward and his consultants Dr Wilkes and Lisa, I don't think he would have made it

Life insurance policies and mortgage insurance in the U.K do not cover HIV, unless you are prepared to pay mega huge premiums, so in between all the hospital stuff we had to get a lawyer to do a bankruptcy on him. We lost the apartment and the business, three shops that my partner had built up to a worldwide business via the web. It was a terrible time. Apart from with his sister, the HIV was never spoken about. His illness was always referred to as "the brain virus". Why I don't know, but it was. Still to this day, eight years later, it’s called "the brain virus"

The brain virus affected the memory part of his brain so to this day he still has no short term memory. Everything has to be written on sheets of paper or he will forget in seconds what he has just been told.

I lived in the hospital for eight months while he was being treated. I was suffering from stress and my own health was suffering. I lost loads of weight and was looking ill, just as he was beginning to look healthy. But after eight months he was sent to a respite unit for brain injuries. Most people in there had been in car crashes and had severe injuries. He was only there for a month just to get him used to simple things like shopping and exercise.

After a total of eight months in hospital and a month in the brain unit, nine months in total, he was allowed home. It was the best day ever when he got out. We had rib-eye steak with fries to celebrate. After that, we had to live with his parents as we had lost our apartment. It was stressful for them too as they were used to living by themselves and here they were with two grown adults.

We had to apply to the state to see what benefits he was entitled to. He was entitled to Disability Living Allowance as he is classed as having a severe disability. Myself, well I suffer depression for which I get treatment and my HIV results are always good when I get my blood drawn every three month. My consultant Dr Gordon Scott is a living legend. Without his wise words and help I think I would have given up a long time ago.

It’s been five years since he was in hospital. He can’t work as his short term memory is non-existent.He keeps in touch with everybody through his Facebook account. I work part time in an HIV respite centre in Edinburgh. It’s a great job where every day is different. It was opened by the late Princess Diana 20 odd years ago when AIDS was a big taboo. She came and touched AIDS patients.

We lost everything we had to HIV. Gone are the six times a year visits to the States. You learn to live with what you have. Apart from our families we don't really keep in touch with anyone, apart from my dearest friend David in Toronto, whom we have visited. It seems to have made us very withdrawn. We are quite happy in our small house with our two cats, Fluffy and Lucky and our garden. I like to bake cakes.

We still keep our diagnosis to ourselves. It’s nobody's business but ours and in Scotland. especially in the small village where we live, it still has a large amount of stigma attached to it. If it was cancer we would get loads of sympathy but HIV gets no sympathy, as in Edinburgh, it's still thought of as that gay disease.

Small town mentality I call it. It’s still our dirty secret.

About the author: A gay man, happily partnered for 20 odd years, living in Edinburgh  - or Auld Reekie as some people call it.

March 15, 2013 - 11:30 pm

Met a guy last night online who was visiting LA for the weekend. We meet up this evening and found we had more than just a simple mutual attraction. He's newly POZ (just six months) so when he got an eyefull of the tattoo he was a bit confused but being in the medical field he quickly connected the dots. His reaction, like many, was supportive yet I got the distinct feeling it wasn't for him. Coming from a more traditional background I think being openly gay and now POZ was more than enough for him to deal with though he did have a nice tribal tattoo.  I wonder if the tattoo would have been an issue for him if we wanted something more serious or maybe he would want one as well ... there's a thought.  

March 17, 2013 - 12:30 am 

We decided to meet up late this evening but because I presently have roommates and like my privacy we chose a more ‘interesting’ venue to hang out at, the local gay bathhouse.  To be honest I have avoided the bathhouses for many years as they no longer hold much appeal. But lacking a place, seeing how he had never been to one before and me desiring to gauge the reaction of people to the tattoo in a sexually charged environment, the bathhouse on a late Saturday evening was the perfect place. 

We did the grand tour of the smallest bathhouse in LA and while he was filling his eyes with the sights - bathhouses by nature defy description so I will not attempt - I was focused on the patrons and their reactions … which was nothing.  That said, we were never approached, nor did we approach anyone to get any sort of reaction.  After a thorough once over of the place we retired to our room and later headed out to West Hollywood. 

March 17, 2013, 2:30 am 

We arrived at one of my old haunts, the now remodelled Mickey’s bar for after hours but instead of dancing we found ourselves on the patio talking.  He attended small high school where he was openly gay, a handsome guy who was into weightlifting at the time and had the respect of his fellow classmates.  Now in his early 30’s he was having to quickly come to terms with being HIV+, something he was having issues accepting and this caused him difficulties disclosing.

Knowing he came from a small southern community I asked if he had told anyone of his family he was positive, something I have yet to do.  Upon his diagnose he called his siblings and told them, “I am HIV+, I need you to go on the web tonight and learn about it because when I call you tomorrow I am going to need your support!” and hung up.  He called back the next evening and when they answered the verdict was unanimous “you are not going to die!”  I have to be honest, this was one of the most simple yet powerful disclosure stories I have ever heard.  

March 17, 2013 - 4:30 am 

We spoke some more and being the night was still felt young to us we decided to retire to LA's largest bathhouse to round out the evening.  If I was going to get a reaction to the tattoo I imagined it would be at this location. Though it was late, there were still lots of people awake and looking to connect. We got a room on the ground floor and made a quick tour of this location; it had changed a bit since my last visit years earlier but the general layout remained the same, with a basement, ground floor and upstairs. 

My guest had a mind to get a third to join us, so we set out on a search. There was no shortage of guys and though we made several attempts, whether being a couple was too intimidating or the tattoo worried the players or the general luck of the evening, we were unsuccessful. Neither approached nor shunned, without actually interviewing someone I couldn't say for certain what was the root issue, if any. So much for testing the tattoo at the bathhouses. 

March 24, 2013 - 10:00 pm 

Yet another in my series of my trips to the Korean spa with the tattoo, one guy struck up a conversation about it saying it looked like the Olympic symbol (it does have three semi concentric rings), I corrected him saying it was actually a biohazard symbol and left it at that.  I was not particularly interested in informing him of my status as this was still the Korean spa and I didn't feel entirely comfortable just announcing my status randomly, sort of defeats the idea of limiting disclosure.  However if he pressed me I would have willingly explained why I was wearing the tattoo as it’s purpose is to promote discussion and it definitely empowers me to disclose. 

March 26, 11:45 pm 

Sitting in the spa at the gym before closing, just myself and another guy (seen him before never talked to him), when out of the blue he commented on the tattoo saying it looked like a gay symbol. (In fact the biohazard tatt is rainbow coloured so it serves to ID me as gay to the observant).  In context this was the day of the US Supreme Court hearing the arguments regarding the Defense Of Marriage Act (DOMA) and the following day they were scheduled to hear Proposition 8 arguments and he was curious how I felt about it as well as the possible outcome.  This was fascinating, as the tattoo appears to get people talking about things that are close to my heart other than just my status. This was a great and most unanticipated result. 

March 30, 2013 9:00 pm 

Arrived late to the Korean spa. I had problems applying the tattoo that evening; the skin seems oddly irritated but I ignored this and off to the spa I went. Only ten minutes into my visit I notice the tattoo, a thin sheet of acetate glued to my skin, was bubbling up. Argh! I pressed hard to get it to adhere and thought it would just stick ... it didn't.  The temporary tattoo that I usually wore for three to five days without any issues was coming unglued.  By the time I was done with my 70 minute session it had peeled up to the point that once I returned to my locker to change I needed to remove it.  It appears my skin has built up an allergic reaction causing the temporary tattoo to not only bubble up but actually cause physical pain to the application site.

So no more temporary tats, the universe has spoken! 

April 1, 2103 10:45 pm 

In the shower at the gym the following evening, a sexy young black guy is one shower over and is clearly looking for some action. Never been one for public play but without the tattoo I felt oddly more naked than I already was ... interesting that the tattoo appears to work for me both as a shield as well as a warning. 

April 6, 11:30 am 

Finally I made contact with Jill Jordan, a highly respected and innovative tattoo artist! Set an appointment with her for April 14th at 1:00 pm. My gym buddy Alonso is so excited he also wants to meet Jill (he has a tattoo of his own in mind). 

April 7, 2013 9:00 pm 

I meet up with my first former bf David while he was visiting LA and being that he was one of the inner circle of people who knew I was poz I wasted no time telling him about my desire to get the biohazard tattoo. Why open with the tattoo? David and I have also had a very deep connection on a spiritual level and I wanted to hear him ask "what is your intention?" 

I gave him my canned answer - it will make it easier to disclose, show solidarity to the HIV+ community, etc., yet I was merely buying time to really look deeper and see if I could find an even more tangible answer. This was always the way with us because of our connection and frankly it's quite refreshing to speak about life in terms of spirit and action.  Oddly I rarely avail myself of such opportunities anymore ... makes me wonder why. 

We had both been through some serious life events, broken relationships, health and financial issues, yet we seemed to be better off for it all.  By the end of the evening I was feeling very comfortable with David again and was ready to give him a better answer with regards to my intent of getting the tattoo. 

First, I wasn't branding my soul, only the body. It reminds me to be mindful of the infection but not overwhelmed by it. A few years ago I might have found such a reminder very disturbing, a constant reflection of a mistake I made and was unable to undo. But now much, like knowing I will die, I am coming to terms with it. The tattoo reminds me my life and time on this earth is precious as well as short and to embrace life at every opportunity. 

Second, the tattoo is a method of communication of not just my HIV status or that I am gay (the rainbow flag has many people identifying as a gay symbol) but purely as an art form with a language all its own.  I trust many will appreciate it on many levels but haters will hate and how I deal with such situations will be a measure of my own growth.  Most reactions have been good and I predict that though this seems like a bold act now it will be passé in 10 years but no less important to me! 

Lastly, it memorializes the freedom of my mind if not body from HIV (my spirit has always been free and I am beginning to appreciate that more and more). David applauded my intention and asked me to meditate further on this act. II told him I would and let him know what conclusions I reached. 

April 10, 10:00 pm 

Over the following days I considered what David and I talked about and we shared more messages over FaceBook when it dawned upon us - damn this tattoo really does get people talking. That’s when it hit me this was an immerging aspect, not just to communicate to other people but to get people talking - about HIV, about gay issues, breaking down the barriers we put up in our daily lives.  I am not so naïve to think this tattoo will change the world but getting people talking is a great start! 

Contrary to some hysterically hyped headlines this past week, HIV is not on the verge of being cured in the next three months, nor have scientists found an effective vaccine.

The truth is that a hopeful compound to force HIV out of hiding is under study, and the results should be known in the near future. Unfortunately, however, even if researchers hit a home run with this drug, it won't likely be a cure by itself and we will still be waiting for the day that we have a vaccine or other types of immune therapy to help the body kill any remaining infected cells. 

Let's unpack the hype. Last week the London Daily Telegraph ran a story on this new compound, but claimed that a cure was just around the corner. The reporter apparently misquoted the researcher and overly hyped what he'd been told. The reporter has since toned down his piece and changed the headline due to pressure from a prominent activist in England and likely due in part to a piece the researchers themselves felt compelled to post to refute the article's claims. Unfortunately, the press outside of London grabbed hold and has been retreading the original uncorrected story since then.

Here is the real story. First, contrary to some reports there is no actual vaccine involved at this point. That's probably the most mystifying and frustrating thing. Instead, there is a class of drugs that helps cause HIV that is bound up inside the DNA of resting immune cells to begin reproducing. If we want to cure HIV, then that's the first thing we'll have to do -- to unmask the hidden HIV. The class of drugs is called HDAC inhibitors.

Thus far, there have been four studies of this class of drug. Two were conducted with a very weak form called valproic acid that ultimately had no effect. Two more recent studies were with a drug called vorinostat and showed at least transient increases in HIV RNA production from latent cells, indicating activity, but the effect was also somewhat weak and didn't have the ultimate effect we'd want to see, which is to reduce the amount of HIV DNA there. That would tell us that we are actually reducing the size of the HIV reservoir.

The researchers in Denmark are using a more potent HDAC inhibitor called panobinostat. All of us in the cure advocacy arena have good hopes about the drug, but it is a very, very long way from being a cure all by itself and the very small Phase I study being run by the Danish researchers has yet to publicly report any results. Panobinostat may turn out to be a potent way to kick start HIV replication, but we'll probably have to pair it with a vaccine in order to kill those latent cells that panobinostat has woken up. Unfortunately, we're quite a ways away from having such a vaccine.

It says something quite sad about the state of science journalism in general that articles like this make it out the door. The hype that never pans out ultimately makes people so skeptical about the kind of work Project Inform advocates for and reports on. It's also sadly the case that stories like this, where the reporter, or the researcher -- or both -- hypes a study and claims a cure is just around the corner are all too common. We'll do our best to set the record straight when these arise.

This article original appeared in TheBody.com here.