Totally outRIGHT is a free leadership workshop series for young gay and bi guys in the Toronto area interested in sexual health. Sponsored by ACT, these workshops are for a cross-section of young gay and bi guys (ages 18-29). They are open to HIV-negative and HIV-positive guys, trans guys and guys from different ethnic backgrounds. 

The workshops consist of 17 modules over four days that build resilience and community. They are based on the success of the Totally outRIGHT program that was pioneered in Vancouver by Health Initiative for Men.  

Totally outRIGHT is a great way to meet other young gay and bi guys and connect with leaders in our community. It’s for guys who identify as gay or bi, want to learn about love, life, sexuality and sexual health and who want to apply that knowledge in their community. 

For more information go here.  

Want to be part of this amazing experience? Registration is now open for the workshop series being offered over four Saturdays: May 4, 11, 18 and 25, 2013. (Registration closes on Thursday, April 18, 2013 at 5:00 pm.) Register at http://www.actoronto.org/to.

I’m trying to put out here this time around a little about me personally. Not my HIV, not my health kicks, not my words of encouragement, or anything about getting your life in order. This time, it’s just a little about the boy some people call Nate, others call Nathaniel, and some even just call ‘N’.

Recently I have really struggled trying to get my head into writing. By nature I’m not a writer. I have never really gotten in to it. I have tried, and actually would enjoy being able to just sit down and write something worthwhile. Sometimes when I do get into a writing mode, I have to admit that I can write some fairly decent stuff. I have even been called a poet once or twice, which I find amusing, because I have never really written any form of poetry. I even started writing a story many years ago when I was a lot younger with grand visions that it would be published in to a book one day. That story is still there, put away somewhere with the plan and hope even that I would be able to write more on it and even finish it.

I started writing my blog to get some thoughts out of me and in to the wide world. It has been great, but I sometimes feel that I have dried up and have nothing else to say. I know this is not true, and we all have something important to share with the world.

Over the last year and a bit as I write for PositiveLite.com, I struggle and panic when it comes to putting something down in writing. I get caught up on my self-imposed expectation that I have produce something worth reading. And then get all panicked when I know I need to submit something. For me personally it’s more than writers block, its losing focus quickly and being distracted by the pretty things around me. I was never good at school assignments, and always tended to be the guy who did them at the last minute, but who hasn’t done that, right?

I wish I had the patience to do more with my life… (I want chocolate now)… and be one of those people who is able to sit down and write. Don’t get me wrong! I sometimes get in to a zone and write away, with some fairly good results, but these are rare times. I usually get stuck on topics, or things that would be of interest. I read quite a bit, and find that I try to write on things that either haven’t been written or try a different perspective on a known topic. Maybe this is why I find it such a struggle to write?

My thought process is also very scattered, and I find myself writing one thing, changing it, writing it again, changing it again, and then moving it into a different section of an article. I have already done this a few times with this article, and still it is all over the place. SMILEJ! I guess I want you to see what happens in my mind a little without scaring you off too much.

In my work, I need to be acutely focused on the task at hand, and have to manage a team that needs clear and  precise direction This is very draining on me, and I often get home from work so exhausted and tired that the best thing for me is that down time. Hmm, maybe that’s why I get so distracted by the little things. It’s just my mind and body’s way of winding down, and relaxing or zoning out.

 Many years ago I was taught that when you walk out of the office or your work environment at the end of the day, you need to switch that off. This is something I have practised for so many years now, I don’t even think about it.

Trying to stay focused on the important things is hard on its own. Trying to be less distracted by things of little importance is also very hard to do. I get easily distracted by these so called less important things. Way beyond down time. Way beyond sensibility. Way beyond the perceived normal. Maybe I have a form of ADD (Attention Deficit Disorder), but this has never been considered or diagnosed... (Oh look at the pretty bird)… In the grand scheme of things, we are all a little crazy, and this is what makes us who we are. I do love hanging with my friends, and spending time with them, but I tend to get bored quickly, and start to zone out. I don’t do it on purpose, it’s just me.

I find it so much easier to zone the world out for hours, and sometimes days. I love watching all forms of movies, but mostly the classic ‘B grade’ horrors and thrillers. These types of movies are sometimes so bad, that they are brilliant. The video store I go to knows me very well. I oftenfeel like a little kid in a toy store when they call me over and say, ’I have something you may enjoy’. These can keep me entertained for hours on end, and before I know it another full day doing nothing has come and gone, and still I have so much to accomplish… (How did that fork get there?)...

Can you smile and accept this crazy boy for who he is? Most will say yes, until they spend some time with me and realise, that maybe they really meant no. It doesn’t bother me, I actually think it’s okay. Everyone has their own likes and dislikes. As much as I am not a mean person, I tend to grate on people, but it’s just me, so they can either accept it or not. My thought process is also one that can take people time to work out. I don’t think in straight lines, and process my surroundings in a very quick manner. This is what sometimes bothers people, and that I do it alone, then get them to join me on my journey.

I love being with people, especially with some of my closest friends to just hang out. We only see each other every few weeks, but when we do, it’s like we only saw each other yesterday. This is what it’s about, just living life. These friends of mine are honestly the closest friends I have. They are the same ones I came out to first, and also the ones who have been through it all with me. I think we all need these people in our lives. I love them also, because they help my distractions, and get me focused sometimes, rarely, not enough, maybe not really.

 So there you have it. Something to either laugh at or not. I hope you actually got a little smile out of my craziness, and scattered thought process. I have tried to keep this one as raw as possible, although me and my anal retentiveness have changed it a few times already. (Did I wash the dishes this morning?)

I decided to submit this blog because I am sure there are plenty of you out there who have a friend like this. Someone who can't hear because they are so busy talking…. 

It's about 3:15 AM on March 25th, 2013. I am scheduled to go back to Toronto today. I am so looking forward to holding my husband when I get home.

It's been an interesting trip to NYC. A lot of my friends are going through a lot of personal drama....from health issues to relationship problems. But one in particular was talking to me and his words kept ringing in my ears the whole visit. He said that my delivery can be a little harsh sometimes. 

He's said this to me before, but this time for some reason it really stuck out. Then I started thinking about my own evolution over the years. If you were to talk to people who knew me back in the 80's, they would tell you about "harsh deliveries". They would tell you that I have mellowed over my years. I guess from early sexual abuse as a child and holding all that in until I was a teenager has made me realize that I don't have the time or luxury of candy coating my thoughts. I say what I mean and I mean what I say.

Every since I let the pain and shame go with all of my early life go I have been pretty open with my thoughts. I have learned diplomacy over the years. And tact has become a friend, but I pretty much still say what I need to say. 

Then I started examining the friend who said this to me, as he was drinking his fourth beer and smoking another cigarette. He talked and talked and talked. I barely got any words in at all. So, I can see how he would feel that when I did say something it was harsh. He is used to doing all the talking.

But then I started examining what was missing from our many talks......quiet moments. It is difficult to really have a conversation if there are no quiet moments. No TV on. No music playing. Just sitting and actually listening to each other. It is a very healthy thing in any kind of relationship.....be it a lover, a husband or close friend. 

One of the things I love about my husband is that we have plenty of quiet moments. He realizes that I work in a very social environment. Lots of loud talking. Lots of drinking. Lots of egos. So, when I get home from a night at the club it is nice to have some real down time. We can sit enjoy a television show like "True Blood" or "Banshee" or "Bugs Bunny Cartoons" together. Or we can just have some quiet time without saying a word. It doesn't mean that there is something wrong. It doesn't mean that we are angry or mad. It just means that we are sharing a space with understanding and no noise.

I need quiet time when I get home from a loud bar. Sometimes I just don't want to talk at all and he understands that. 

But looking at my friend, he doesn't seem to have quiet moments. There has to be something going on. He has to have a few beers and smoke a joint to wind down after being out. The other thing I don't think he realizes is that I have never spent a complete 24 hours with him where he did not have a beer or a joint in his hand. I have been completely sober every moment that he and I have ever spent together. So, watching him drink and smoke (which my mother had problems with drugs and my father had problems with drinking) over the years has really been a tell-tale sign of what is going on.

In my quiet moments I have clear visions of what it is I need to do. If I'm not mistaken, pot makes you forgetful. And I'm sure beer goggles don't help either. In my quiet moments I have seen the problems and determined what my next move is going to be. I love my quiet moments because the clarity is sharp and silence is deafening. You cannot escape the truth in a quiet moment. Most of your answers are right there in front of you and all you have to do is acknowledge them. But with all the distractions going on in the room, you will never hear or see what is going on.

My sanity is wrapped in quiet moments. 

When was the last time that you just sat and listened to yourself breathe? When was the last time you just sat across from someone and completely gave them the floor? I mean...really just sat and listened to someone without interrupting? Those are quiet moments. Moments that allow intimacy on the deepest levels to arise. 

I swear....intimacy and a human touch are the keys to keeping healthy relationships. If you don't have quiet moments, you can't have either. 

I know when my friend reads this he is going to need a minute to think about what I have written here. At first he might think that I am taking a swipe at him, but I hope that after he lets this all sink in he takes the time to really have a quiet moment and think about our conversations over the years. I still love him like a brother and would do anything for him, but I don't think he could be quiet long enough for me to say all of this in person.

The party: Code Black. The mood: boisterous, fun, and sexually-charged. The rules: wear leather. And be happy. 

Admittedly, happiness wasn’t so much of a rule as a given: why would you stay if you weren’t having fun?

The time is midnight, and my friend Jonathan is experiencing that wonderfully seasick moment of depression where you feel alone in a roomful of people you know. The bigger the crowd, the louder the solitude.

He treads water on the dancefloor, aware of his sinking mood like a slow leak from a paddling pool.  The darkness of the room was stabbed by the occasional laser, giving Jonathan only glimpses of faces around him; silhouettes and shapes.

That’s when he saw him.

Over in the corner, a man stands alone, slowly enjoying a beer.  Oddly Christ-lighted by an overhead halogen bulb, he nods to the music and surveys the crowd.  He smiles, pleased with what he sees.  He is grounded, happy, and precisely the opposite of how Jonathan feels.

He is also very attractive.

“I wanted to go over and talk to him so much,” Jonathan tells me a few days later as we catch a train into town for lunch. We’re surrounded by a cosmopolitan bunch of travellers, including two Japanese women in striking traditional yellow dresses with giant red bows on the back.

“Why didn’t you?”

“I looked over at him, and my mind started racing,” he replies.  “Where will this go, I thought.  Something might happen, we might hook up, it might get serious, it might go somewhere…but then I’ll just end up back here again.”

Jonathan has recently been through a break-up.  It’s left him feeling a bit futile about his future happiness.

In cognitive behavioural therapy, psychologists have identified a number of thinking patterns that hold us back from happiness in life.  Jonathan has fallen prey to one of them: jumping to conclusions.

When anxious or depressed, our minds become soothsayers, predicting the future with perceived certainty but little precision.  We also lose the power to reason rationally, instead letting our emotions take over: simply because we think it, we assume it to be true.

Jonathan keeps his eye on the man in the corner, who disappears for a while then returns with another beer.  Still alone.  Still smiling.  Still bathed in an ironically angelic light, in sharp focus while the room around him dissolves into a Gaussian blur.

This is my second chance, thinks Jonathan.  Should I take it?

Overgeneralisation is a big word.  Psychologists like big words.  For the rest of us, it’s merely a term for another unhelpful thinking style where we take the outcome of a single situation we’ve experienced in life, and apply it to all future instances.

We scratch ourselves from the race before it even begins, because we believe that the same fate will befall us again and again.

And that’s what Jonathan did.  He scratched himself from the race and was home by 3am, plagued by a troubling sense of melancholy that lasted through the rest of the night and into an alien afternoon, as we climbed an escalator at Parliament station.

“What was so attractive about him?” I ask.

“He just seemed so confident, so peaceful, just enjoying being there,” Jonathan answers.

When he next looked up, the man in the corner was gone.  The light was still there, but a little dimmer.  The lasers continued to pulse their rhythmic, hypnotic patterns.

“Maybe you imagined him,” I say flippantly, thinking this might be vaguely reassuring, or at least amusing.  “You projected everything you wanted and created an angel in the corner that was a figment of your imagination.”

Jonathan raises an eyebrow and considers his missed opportunity.  “Well, he was a very handsome figment.”

The figments of our imagination are not always handsome, and sometimes we need to have the courage to ignore them.

This post originally appeared on Christopher Banks' own blog bipolarbear here.

This article by Michael Carter first appeared on aidsmap.com here. 

The long-term effectiveness of antiretroviral therapy means that many HIV-positive people should be eligible for affordable life insurance, European investigators write in the online edition of AIDS. Even though HIV-positive people doing well on treatment had a higher mortality risk compared to insured HIV-negative individuals, this excess was within acceptable limits for life insurance cover.

“Our study provides evidence that could allow life insurance up to 20 years term to be offered to lower risk HIV positive individuals at affordable premiums,” write the authors. “Whole life insurance at guaranteed rates may become feasible when data on mortality with longer duration of ART [antiretroviral therapy] become available.”

Improvements in HIV treatment and care mean that the life expectancy of many HIV-positive people is now approaching the average. A small number of life insurance products offering limited cover are now available to people deemed to be 'low risk' – those doing well on treatment with no history of injecting drug use or hepatitis C co-infection.

Despite this, access to life insurance still remains limited.

Investigators from European Antiretroviral ART Cohort Collaboration (ART-CC) were concerned that fair access to life insurance was being denied to people doing well on HIV therapy.

They therefore estimated the relative mortality risk for HIV-positive people from six months after starting antiretroviral therapy compared with the insured population in France, the Netherlands and UK, and with adjusted mortality rates for Italy, Spain and Switzerland.

The analysis was based on data provided by approximately 35,000 people who started HIV therapy between 1996 and 2008. Most (70%) were male and aged between 30 and 49 years (65%). Three-quarters had a CD4 cell count below 350 cells/mm3 when they initiated treatment. None were infected with HIV via injecting drug use or had baseline hepatitis C co-infection.

There were 1236 deaths during 174,906 person-years of follow-up, a mortality rate of 0.71 per 100 person-years of follow-up. Mortality rates fell with age (p < 0.005) and duration of antiretroviral therapy (p < 0.005) and were lower for people who started treatment after 2001 (p < 0.005).

The investigators compared mortality risk between the insured HIV-negative population and the subset of the lowest-risk HIV-positive people – individuals with an undetectable viral load and CD4 cell count above 350 cells/mm3 six months after starting treatment and no history of AIDS-defining illness.

People with these characteristics aged between 30 and 39 years had a relative mortality risk of 459% compared to insured HIV-negative individuals.

The investigators emphasise that this risk was well within the 500% limit normally used as the threshold for insurability.

Mortality risk fell with increasing age and duration of therapy. Individuals in their 40s who had been taking treatment for over seven years and who had a CD4 cell count between 200 and 349 cells/mm3 had a relative mortality risk of 238%.

“Relative mortality compared with insured HIV negative lives declined with increasing duration of ART, and decreased with age despite increases in mortality rates with age, a phenomenon that has been observed in other studies of HIV populations,” note the authors. “The lives of people with HIV tend to become more insurable with increasing duration of successful ART.”

Overall, 61% of people taking treatment had a mortality risk below the 500% threshold and 28% had a risk below 300%.

“Our results imply that more than 50% of patients – those with lower relative mortality – in an HIV positive population with similar risk profile to that analysed in this study cold be insurable,” comment the investigators. They believe their estimates are likely to be conservative as modern HIV therapy is much more tolerable and effective than that taken in the late 1990sand early 2000s. “People newly diagnosed with HIV can be expected to survive longer than those recruited to cohorts between 1996 and 2010: studies such as ours necessarily provide trailing indicators of mortality rates.”

The investigators conclude that the lack of insurance products for people doing well on HIV treatment can no longer be justified, “since the excess mortality of those with HIV is comparable to many other groups with morbidities that are insured…our study provides data that will allow the insurance market to open up to people living with HIV.” The authors intend to communicate their findings directly to insurance companies so that they can amend their policies, “with consequent improvements in the quality of life for HIV positive people”.

Reference

Kaulich-Bartz J et al. Insurability of HIV positive people treated with antiretroviral therapy in Europe: collaborative analysis of HIV cohort studies. AIDS 27, online edition: DOI: 10.1097/QAD.0b013e3283601199, 2013.