FOLIO
Justin Bell doesn’t look sick. As we sat down at Lutheran Social Services last week, he came across like any other mid-40s professional: well-kept, articulate and healthy.
But Bell is sick; he has a deadly disease, one that is preventable, treatable and killing far more people than it should. After very nearly dying in 2007, he was diagnosed with HIV. When he was finally released months later, doctors gave him a 90-day expiration date.
When he didn’t die, Bell dedicated his life to advocating for testing, awareness and treatment for the disease that nearly took his life and still might.
It’s valuable, important work that our community desperately needs. In 2014, Duval County had the third-highest HIV and AIDS infection rate in the nation. That year, African-Americans accounted for 66 percent of newly reported local cases.
But today our community as a whole is not testing for HIV and AIDS (enough), talking about HIV and AIDS (enough) or seriously (enough) trying to prevent HIV and AIDS.
According to Bell and others, we’re letting people in our community die in part because of stigma, in part because of fear and in part because we impose our morality on others.
It’s this big, ugly bear that lives in our house, but we keep walking past it with our gaze averted, as if by looking away, we can will it into non-existence. We know it doesn’t work that way, but it’s easier to pretend … until it isn’t possible to pretend, until it’s you, or your sister, best friend, lover, child, parent or even grandparent who is diagnosed. Yes, Granny can get HIV from her bridge partner; in the U.S., people ages 55 or older accounted for 17 percent of all new HIV diagnoses in 2014 and 26 percent of all cases in 2013, according to the Centers for Disease Control and Prevention.
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Bell said that the rate of infection, as high as it is in Duval County, is likely even higher than the statistics show because too many people aren’t getting tested because they’re afraid of the stigma and the results. (Alarmingly, among those who haven’t been tested, some also engage in high-risk behaviors, such as intravenous drug use or having unprotected sex with multiple partners.)
He wishes for a day when an HIV test is as routine and commonplace as a blood pressure screening.
“I wanna know that when you go in for your annual checkup, I wanna know that that primary care provider is running an HIV test on you. That’s not happening,” he said.
Bell said that too few doctors realize that they can provide HIV tests without generating paperwork. And, in spite of the fact that medical information is strictly confidential, Bell said that the paper trail fear is keeping many from getting tested and others from getting treated.
“The fear that someone is going to see that I’m taking this medication and find out that it’s for HIV,” Bell said, “and that happens often.”
Medical science has advanced treatments for HIV and AIDS to the point where a man who is HIV-positive recently said to me, “I will probably not die of AIDS.” And he’s right.
There are drugs that cannot only prevent the disease from overwhelming the immune system, but also from spreading. According to the CDC, when taken consistently, Pre-Exposure Prophylaxis, or PrEP (brand name Truvada), can reduce the risk of infection among those who are high-risk, such as sex workers, intravenous drug-users and those in sexual relationships with infected persons, by up to 92 percent. If PrEP is coupled with condom usage, the risk of infection can be reduced even more.
These drugs don’t do any good if people aren’t taking them. If we want to get serious about stopping the transmission of HIV and AIDS, we could start by making PrEP available to sex workers and intravenous drug-users, who are more likely to contract and spread the disease. Regardless of how we feel about intravenous drug use and prostitution, people will continue injecting drugs and having sex with prostitutes.
Is it more moral to let people contract and die from preventable, treatable diseases because we don’t agree with the behaviors that spread the disease or to make drugs that can prevent its spread readily available?
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We’re also letting “morality” get in the way of eradicating HIV and AIDS because we’re not effectively educating young people about the risk, and we’re legislating ignorance disguised as virtue by requiring teachers to promote abstinence to rooms full of kids who are either having sex already or will soon.
Does it really make sense to neglect to protect children from disease because it’s uncomfortable, inconvenient or contrary to our preferred reality to admit that 14-year-olds have sex?
Well, admit it. Even “wholesome,” “good,” “high-achieving” 14-year-olds have sex. They may not be old enough to drive a car without an adult in the passenger seat, but they’re old enough to get HIV. In fact, the Guttmacher Institute reports that in 2011-’13, 13 percent of females and 18 percent of males had sex before the age of 15.
But good luck finding a condom in school. Last week, WJCT reported that Duval County can educate kids about condoms, but it can’t provide them, which makes about as much sense as your dentist talking to you about flossing but letting you leave her office without 60 yards of minty waxed thread when she knows full well that you’re too embarrassed to buy it at the pharmacy. And you can argue until you’re blue in the face that a person who isn’t mature enough to buy condoms isn’t mature enough to have sex: They’re still going to have sex.
Would we rather have an epidemic of teen STDs, including HIV, and pregnancies than make condoms available in the one place the vast majority of teens are guaranteed to spend time?
Lessons in morality certainly have their place in our homes, schools and churches, but so too does science and facts and reality. And the reality is that kids are getting laid and kids are getting AIDS.
People are dying in Northeast Florida because we’re not taking HIV prevention and treatment seriously enough. But it’s not too late to change.
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