WHAT ABOUT ALL THE CHILDREN TRAFFICKED TO THE USA AND WHEN DETECTED ARE THEN DETAINED IN US IMMIGRATION DETENTION CENTERS WITH NO TESTING AND TREATMENT.
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SMASH STREET BOYS BLOGMichele Sidebé. UNAIDS Humanitarian Disaster: Human Trafficking in an HIV pandemic.Human Immunodeficiency Virus (HIV) Acquired Immune Deficiency Syndrome (AIDS)
Michele Sidebé. Why are you not speaking about the HIV Humanitarian Disaster involving millions of men, women and children. Human Trafficking & HIV. Millions of people have not tested and have little hope of ever accessing ARVs created to reduce a person's infectiousness and in many cases also raise a person's quality of life and extend a person's life. WORLD AIDS DAY week end 2012: It is with profound sadness that we come together this week end from across continents and disciplines, generations and cultures to share our collective grief over the death of 30 men and women and children. Together we share the burden of witness as we watched and are still watching those we love dying slow and painful AIDS-related deaths. Knowing there are still 26 million people unable to access treatment (and this number does not include all the undocumented) has prompted many of us to stare in disbelief at the contemporary presentations offered by so many taking a leadership role in shaping the course of the HIV pandemic. Paragraphs, presentations, speeches stuffed full of statistics, currencies and carefully chosen words suggest the epidemic is under-control. We know this is simple not true. How can it be when there are still millions of children at risk for being infected with a virus that attacks their vulnerable immune systems. How can it be when there are still millions of children at risk for being violently infected with HIV in conflict zones, along human trafficking routes, in the shadows of our communities and behind our cultural net curtains in our homes. The cultural and social embarrassment experienced by adults at the thought of acknowledging the extent of sexualized violence directed at children, places hundreds of thousands more girls and boys at risk for being violently infected with HIV and for being left to die slow and painful and premature AIDS-related deaths. Here we must ask ourselves what is more embarrassing. For adults to sacrifice children, or for adults to acknowledge the inter-generational violence experienced by girls and boys. If we do not take urgent action to prevent sexualized violence directed at children in today's HIV/AIDS pandemic and if we continue to fail spectacularly to provide the child-survivors with appropriate and consistent testing and treatment for acutely compromised immune systems, our humanity will surely continue to die slowly of embarrassment. Thirty years after the HIV/AIDS epidemic began there were a SHOCKING 2.5 million new HIV infections and a STAGGERING 1.7 million AIDS-related deaths in 2011 (WHO estimated figures). 1.7 million deaths also speaks of the enormity of profound grief and stress experienced and borne by millions of people who yearned for those they loved to live as they were dying. Too many people who are infected have not been told they are infected. Too many people have not been tested and do not show in the estimated figures. There are not enough medications for the people who know they are living with compromised immune systems and would like to benefit from the antiretrovirals that have been created to reduce a person's level of infectiousness and in many cases raise a person's quality of life and increase his/her life expectancy. WORLD AIDS DAY 2012 IS A SERIOUS SUMMATION OF HUMAN SUFFERING AND FLAGS THE HUGE AMOUNT OF WORK THAT NEEDS TO BE DONE URGENTLY IF WE WANT TO PREVENT ANOTHER 2 million AIDS-related deaths in 2013. WORLD AIDS DAY 2012 IS A JOKE (Smash Street Boys/ Show Me Your Life/ Real Stories Gallery Foundation 501c3)Human Immunodeficiency Virus (HIV) Acquired Immune Deficiency Syndrome (AIDS)
They say that HIV is like a common cold. It is a big fat lie. Sometimes you can get the meds and sometimes there are no meds for you (Smash Street Boys, USA). President-elect Barack Obama made a strong statement backing a country's rights to buy affordable generics and promised to “break the stranglehold that a few big drug and insurance companies have on these life-saving drugs.” The pharmaceutical industry prefers to keep prices high. Even in developing countries, health concerns are underrepresented in negotiations. Trade agreements are not negotiated by health ministers, but by trade ministers advised by powerful commercial interests. Their goal is access to foreign markets. They are often quite content to trade away health considerations.
Tim Barrus (USA): I live in a town with a major hospital, hundreds of doctors, labs, a big health care foundation, and a significant university (UNC) affiliation. Not ONE physician will even see a patient with HIV. They sit there and simply shake their heads no. That leaves patients with one and only one option which for some people is over a hundred miles away at a county clinic that is overcrowded, mean-spirited, expensive, harassed, filthy, and the computers are typically crashed. They cannot access your latest labs so what is the point of the long drive. Their pharmacy on a good day can only fill half your meds, and there are waiting lists for antiretrovirals. The health care system is broken. To claim that it’s not disease discrimination is patently absurd. To advocate for repeated, unnecessary visits indicates a fundamental unawareness as to how the system works. It doesn’t work. Waiting lists alone for HIV medications in the United States is unconscionable. It is second-class medical care because HIV patients are seen within such a negative social context. STIGMA is REAL. Hospitalizations are an enormous strain on families who find the transportation issues a challenge. HIV education facilitating compliance is nonexistent. HIV care is better in many African cities. To advise for repeated exposure to a nightmare fails to recognize a system that has collapsed. If it was ever real in the first place. Maybe it looks good on paper, but it is not reality. People are still dying from AIDS even if the media wants to put a gloss on it. Imagine: early morning appointments for people who live far away, and there is no flexibility as to making appointments because they are issued, not negotiated. There is a fundamental ignorance as to how it works on the part of health care professionals. The responsibility to deal with a broken system is put on the patients — how many times can you make these trips even to a pharmacy that tells you to come back next week because they do not have the meds and then when you do, they still do not have the meds and they refuse to deal with patients on the phone because patients are seen as stupid — versus the health care community recognizing that the medical paradigm it functions in is an illusion. The structure represents a public health disaster, and cruel and unusual punishment.
An Humanitarian Disaster: Transmitting messages of hope in an HIV/AIDS pandemic is unkind. Hope is an emotional state, the opposite of which is despair. Hope promotes the belief in a positive outcome related to events and circumstances in one's life. HIV/AIDS Prevention and Awareness Campaigns have spent millions of dollars informing people throughout the world that Antiretrovirals (ARVs) dramatically reduce a person's infectiousness, thereby lowering the risk of transmission, and if taken appropriately and consistently ARVs will also extend the length and quality of a person's life. BEING AWARE of this magnificent knowledge whilst simultaneously reaching in vain for ARVs, due to lack of access or a lack of ability to pay for the medications, exacerbates the stress experienced by millions of people who are yearning to live and yearning for those they love to live as they are dying. It is cruel to transmit the message of hope to millions of people who could benefit from ARVs, when in reality there is no hope of them ever having access to an appropriate and consistence supply of the medications for themselves or for those they love. The ideas about hope vary from culture to culture. I do not know what is real to hope for. Some of the kids at-risk I deal with have hope. But not many. Ikeena is a very bright young man. If you were looking for hearts and flowers written by happy, smiling, Disney children, do me a favor, and don’t write to me. I’m glad you want to protect your children from the big, bad world. But some children live in it and to assume they’re stupid and backward is both a contempt for them, a paternalism, and it’s just wrong. It is mistaken. Their take on reality is as valid as your take on hope. I will bring you their poetry when I can. I have little hope we can attract much funding because the subject matter is just to grim for Americans to bear.
Hospitals and Graves: by Ikeena (Nigeria) (translation provided by Médecins Sans Frontières)
The official language of Nigeria is English You even own our language Do Americans speak Hausa No. The official language of America is not Chadic or Trade language The language of English is the language of power.
You in America have everything You have medicine for AIDS We have nothing.
You have school We only have schools here and there. I had to walk all day to get to school All day in the sun and dust.
America has shiny cars to drive in You have food We have nothing.
A cure does not mean us.
I am tired of God always behind me, where I cannot see him telling ME to have hope. He has hope I have nothing.
My father is dead My mother is dead My grandmother loaded down with a stone in her grave is sad. She weeps dead tears America pretends it cares it cares about America Do you think we do not know that!
Today the slave ship is not a ship at sea filled with my dead brothers and sisters Today the slave ship is a continent chained around our legs like the squalid air of harmatta that burns your lungs to breathe.
You have a Government We have Thieves.
You have Hospitals We have Graves.
You have Hope We have AIDS.
Our earth dissolves to dust Are roads are sand We have T.B.
We drift in boxes made from corrugated metal and plastic Our floors are made from dirt What are your floors made from?
I am supposed to be hopeful because you say so, You say I must.
We have no running water You have oceans of it It comes to you in pipes Mine comes to me in a bucket I carry from a hole of mud.
You have pills that makes the AIDS go away My brother was thin like a bird And crazy.
You have your God and Hope I have young siblings to feed.
I no longer go to school You have school sports and computers
You tell me to have hope I have a shovel to bury the dead I will be among them.
You have your pills and hope Your sunlight is not our concern.
All I have are memories wrapped in bandages until they bleed. Your hope is the sound of an empty language All I have is hunger in a vacant space. There is no hope.
Your hope is just another slave ship and we are chained to it in the dark dragging our bones for the hyenas Who arrive to eat.
Tim Barrus (Creative Director, Show Me Your Life, Real Stories Gallery Foundation 501c3): An estimated 3.4 million children were living with HIV in 2012, 91% of them in sub-Saharan Africa. War and sex trafficking exacerbates the entire tragedy. Many children in Africa send Show Me Your Life a witnessing as to how they live their lives. Children who do so also risk their lives. Most of these children acquire HIV from their HIV-infected mothers during pregnancy, birth or breastfeeding. With efficacious interventions the risk of mother-to-child HIV transmission can be reduced to 2%. However, such interventions are still not widely accessible or available in most resource-limited countries where the burden of HIV is highest. Children with AIDS die every day. The number of children receiving ART increased from about 456,000 in 2010 to 562,000 in 2011, but this represents a coverage rate of only 28% among children in need of pediatric ART.
Antiretroviral Drugs (ARVs) Used in the Treatment of HIV InfectionClick on drug brand name for additional information. Multi-class Combination Products
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Protease Inhibitors (PIs)
Fusion Inhibitors
Entry Inhibitors - CCR5 co-receptor antagonist
HIV integrase strand transfer inhibitors
Generic drugs used in the Treatment of HIV Infection Tim Barrus: HIV/AIDS Medical Care of Adolescent Boys Who Are Survivors of Sexual Abuse
Scenario One: INT: As seen from Above. An ER where a kid has been admitted who has cracked up his car. People in white coats work feverishly. Scenario Two: INT: We see the kid waking up from surgery. He lifts a sheet and discovers a catheter. Scenario Three: A bathroom. We see the kid pulling out the catheter. Horrifying. Maybe to you. Maybe not to him. The medical team is both offended and confused. Why would anyone do that to themselves. Why would anyone drive their car into a tree. You mean, it wasn’t an accident. I mean, it wasn’t an accident. But let us go back to the “horrifying accident” and rethink all scenarios. I have seen a lot of blood. I have seen it in Africa. I have seen it in the emergency rooms of Los Angles. I have seen kids shot dead by cops. I have seen HIV blood splattered everywhere. I have seen kids who have carved up themselves like Great Uncle Henry carves a Christmas turkey. When you are exposed to something for thirty years, you see it, and you shrug. I shrug a lot. Of course, he pulled the catheter out. Of course, there was blood. He probably asked (we don’t know because it got edited out of the final cut) to have the catheter removed but his request was at first ignored (playing for time) and then, it was refused. Consider this: maybe he did what he had to do. Word that some kid pulled his catheter out (the one upmanship with this is that they know how to do it and you don’t, it’s called power) gets spread around the entire hospital pretty fast. I have seen versions of this a hundred times. People are just doing their jobs. If this is true, then those same people should be prepared to have the failure that can be inherent to making assumptions — in their face. You put a catheter in a kid who cannot handle it. Especially when he has failed to kill himself. Accidents are what kill most adolescent boys. I would argue that half of the figures here are not accidental. What to do. What the system does is adjudicate the boy for 90 days. Meds. Zombies do not remove catheters. They just piss through them. Oh, happy, happy health care workers. Who have just been following the rules. The 90 day hold will end. Then what. I am told that one in six boys is abused. I do not believe it. Anecdotal. I believe it is more like one in three. We need to build more realistic models as to who such kids really are. Maybe then, we would be more successful at keeping them alive. But this would mean a changing of the status quo. I wish you luck on that. Int: We see an idiot sitting in a hospital room and we see that said kid is in bed and tied there in a four point restraint the nurses screamed hell about. They would go for a ten point restraint if they could legally get it which they cannot. Patients have rights. So do people. Does he have the right to kill himself. Yes, he does. Whether we chemically restrain him or not. Whether we alter behavior with laws and rules and religions or not. It is self-evident that all humans who are created have the power to end their lives because their lives belong to them. I would bet the ranch this kid will be dead in three months. His call. In reality, he has already made his call. Psychoactive drugs or no psychoactive drugs. “It’s for his own good.” Sure it is. Usually, it’s for our own good. If we saw how many of our children actually want to kill themselves, it would be a game-changer. There are just some places culture does not dare to go. Our responsibility is to procreate. That we might be bringing children into a world where human life itself is shit, is not and never will be a sustainable world view. Life is shit and then you die. INT: We see a wrecking truck hauling a car away. Case closed. Problem solved. We see Shirley Temple in a wheelchair in the Swiss Alps. Such cute curls. Shirley stands up and takes a few halting steps. Look Grandpa, I can walk, I can walk. Cue orchestra. Run credits. Tim Barrus/ HIV/AIDS SEXUAL ABUSE SURVIVOR: AIDS CLINIC:
People Wonder by Damyon People wonder why I hate my life I hate my life because I am now always forced to be around doctors I hate them and I hate what they do 2 me and i hate nurses most of all because they humiliate me and I hate them and I do not want none of them touching me again
HIV/AIDS SEXUAL ABUSE SURVIVOR: AIDS CLINIC: Damyon, Dude, No one wants to see it. You are supposed to neatly fit into the health care structure the animal has created so it might limp along. You hate it. I believe you. I hate it, too. But i have worked hard to change it around for myself, and for other people so the survivors of sexual trauma do not avoid the health care that every person infected with HIV is subject to. I contend that health care providers have a responsibility to treat us as if the trauma, too, was and is part and parcel of who we are as people, and if the system cannot do this there are going to be people out there acting out and sexually acting out a repertoire of rage and defeat, and we are not exactly recognizing that our own sexual behaviors are not exempt from a process that can eat anyone alive. They started to listen but it took a lot of assertiveness, and it did not happen overnight. And they started to change. Also, I was not alone doing this. People they are obliged to respect were supporting me with their voices. First, the clinic people didn’t want to hear it. Mainly, they’re tired, and exhausted. And this is just one more thing coming at them. I think one of the keys here to getting through to them was in recognizing that they are so obviously exhausted. “What I hear you saying is that handling one more special need is going to make your job harder than it is.” This happens to be the truth, and it is also a simple acknowledgement. I need this, too, from people and rarely get it — a reflection that simply says: what i hear you saying even with your body language is… I am in no need of being psychoanalyzed by friends. But people validating the experiences of other people is important. We both know that the status quo of the hospital gown and the invasiveness can set us back years and years. They have no idea that we do hate them for humiliating us and it feels as if the violence is happening all over again. I had to remain very firm and they did everything they could do to get me to change my demands, but they lost, and it works for me if i have to go there and I do. That does not make it easy. But here’s my gig with it. They cannot touch me unless I permit it, and i do not. There is no hospital gown. I do not remove anything. They do not like to admit this because they cling to their old, outdated medical paradigms. But the reality is that they can get what they have to know from blood tests. I go. He reads off the blood testing results. I sign off. And he writes me six months of prescriptions. I do it every six months and i never ever complain about anything because i do not want them touching me and i do not want to fly off in a rage. That is why the police are there. People get hurt in these places. People lose it. I myself have punched overly zealous nurses. But there is no need to go there because they recognize my very real need to not be touched. To bring the cops into it is a complete fucking drag.
I would support you in this. Just let me know. Fight back. They will take you on. But the more they lose this battle, the better off we will be. But you have to fight for it because it will never be given willingly. They will have a lot of check lists gone blank. For them, that means federal funding. They do not want to see our reality because it is not their reality. You might have to push. Pushing is okay. It is not monstrous to stand up to the way things have always been. It is only perceived as monstrous. It comes from a fear that what worked in the past might not work in the future. Learning to ignore things is important in this. It is a process, not a single event. You, too, I am sure have people who invade your skin — like at the clinic. Walk in there and hold tight. I am with you all the way. We can and we will inform them that this trauma and these triggers are relevant and valid. Kicking this back to life helps nothing and no one. It is destructive. And if i fuck up with you in any manner that triggers any of the trauma, dude, just yell. Keep pushing. Kiril/ A Man Arrived
This is the first time Kiril has ever worked with video. Kiril does not speak English. This is a short called A Man Arrived. It is dedicated to Kiril’s mother who sold him. Kiril has written many poems. He wrote this one especially for his video. Поэзия Кирилла Для мамы Однажды человек пришел. Мама плакала. Она продала мне. У нас не было денег. Мне пришлось бежать. Я бежал. Человек поймал меня. Этот человек был означать, и пили водку. Я ненавидел его дыхание. они делать плохие вещи для меня, мама. Вы продали мне. Я побежал трудно. дети бегут от мужчин прибывающих. Выполнить, дети, бежать. Это было зимой моя мать продала меня. Сейчас я хочу спать замороженными в снегу. До последнего времени это лед. CDC: Youth HIV Rate Sky High in USA. SHOW ME YOUR LIFE, WORLD AIDS DAY.
Youth HIV Rate High, Testing Low, CDC SaysBy Michael Smith, North American Correspondent, MedPage Today. Published: November 27, 2012 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston Action PointsYouths ages 13 through 24 accounted for more than a quarter of new HIV infections in 2010 in the U.S. – about 12,000 cases -- but only a third of that age group had ever been tested for the virus, the CDC reported. "This is our future generation, and the bottom line is that every month, 1,000 youth are becoming infected with HIV," said Thomas Frieden, MD, director of the agency. The "shocking" data, reported in a Vital Signs article from Morbidity and Mortality Weekly Report, detail the prevalence, incidence, and risk factors of HIV among youths, Frieden said in a teleconference with reporters. One implication of the new incidence data is a growing future healthcare burden, Frieden said. Noting that the lifetime cost of care for a person with HIV is about $400,000, he said: "Every month we are accruing about $400 million of healthcare costs -- and every year $5 billion -- from preventable infections in youth." "It is just unacceptable that young people are becoming infected at such high rates," Frieden said. CDC researchers used surveillance data to analyze 2009 prevalence rates of diagnosed HIV among youths and the number of new infections in the 13 to 24 age group in 2010. They also assessed the prevalence of risk factors and HIV testing among youths, both those still in high school and those 18 through 24. They found that in 2009, the prevalence of HIV among youth was 69.5 per 100,000 population, with a state-by-state range from 2.3 to 562.8 per 100,000. The rates were higher in southern and northeastern states compared with the West and Midwest. Also, of the estimated 47,500 new HIV infections in 2010, 12,200 (25.7%) were among youths. More than four-fifths of the new infections in 2010 (82.8%) were acquired by males. Among newly infected youth, 57.4% were African American, 19.6% were Hispanics, and 19.5% were white. Male-to-male sexual contact accounted for 72.1% of infections, while 19.8% were because of heterosexual contact. Injection drug use accounted for 4%, and 3.7% of infections were due to a combination of male-to-male sex and injection drug use. Among males, 87.1% of infections were attributed to male/male sex, while among females, 85.7% were attributed to heterosexual contact. Overall, youths with HIV made up 6.7% of the 1.1 million HIV-positive people in the U.S., the agency reported, and 59.5% of those did not know they were infected. "That's a much higher proportion than the less than the 20% we estimate overall don't know they are HIV-infected," Frieden said. The agency used data from 12 states and nine large urban school districts, collected in 2009 and 2011, to analyze risk behaviors among male and female students in grades 9 through 12. Males who reported sexual contact with other males, the CDC found, reported more risky behavior than other youths. For instance, they were more likely to report sexual intercourse with four or more persons during their lifetime (39.4% versus 26.9%) and to have ever injected any illegal drug (20.4% versus 2.9%). Importantly, they were also significantly less likely to have used a condom during last their sexual intercourse (44.3% versus 70.2%), the agency reported. They were less likely to report having ever been taught in school about AIDS or HIV infection (74.6% versus 86.3%), the CDC found. Overall, in 2011, 12.9% of all students in grades 9 through 12 reported that they had ever been tested for HIV, but the proportion reached 22.2% among those who reported being sexually active (49.2% of males and 45.6% of females). In the older group – those 18 through 24 -- 34.5% reported ever having been tested for HIV. The CDC has recommended for several years that HIV testing should be part of routine medical care, but Frieden said many doctors still haven't bought into the idea. "You have a very, very small proportion of who refuse testing," he said, "but unfortunately a relatively large proportion of doctors who don't make it routine." The analysis was supported by the CDC. Authors are employees of the agency.
Tim Barrus Responds: I work with undocumented adolescent boys with HIV/AIDS. I shrug. Who is surprised that young people are neither educated or free from HIV infection. Mainstream culture perks up its ears. The ironies of the culture are too extreme. You want kids to be educated. You want kids to be responsible. You want kids to be healthy. Yet you make huge cultural distinctions. What kids are we talking about. How is it that one is worthy, and the boy standing next to him is not. Children are expendable. It’s not that they fail us. We fail them. We continue to see sexual behavior itself as worthy of a 1952 gym class filmstrip. What we want does not fit into the space where adolescents really live. AIDS funding, even at the CDC, gets showered everywhere you can shake a study at infectious disease. But not one dime for the kids I see every day. They can be migrants. They do not count. I am here to tell you that when it comes to HIV/AIDS, everyone counts. A virus does not recognize a wall built in San Diego. Children with HIV are returned to their country of origin every day. Only to return two weeks later. Untreated. Unrecognized. And under the radar. We do not so much as give kids incarcerated in the detention systems we design simple physicals. They just get detained. Especially if they are marginal in the first place. There are now over a million children detained, jailed, and imprisoned in America. How many of them are tested and treated. Zero. Not one. How does it arrive as a surprise to the mainstream culture that children are inherently connected to a disease where stigma and denial are real forces that rule the day. Adolescents with HIV are very, very likely to kill themselves. The numbers and the trends all are there. Yet you pick and choose who it is you might see. I am not convinced that they are wrong. That killing yourself is not one way out because it is. You do not see them. You do not know them. You deny that they exist. There are reasons young people are not getting the message. The refusal to admit that they matter, too, would be one of them. Why are boys detained in US immigration detention facilities not being tested for HIV or being treated for HIV. Why are these children not being spoken to in appropriate environments where it feels safe for a boy to disclose his story. It is not a secret there is a connection between human trafficking, rape, sex work, HIV and repeat exposure to new strains of HIV. It is not a secret that early diagnosis and early intervention with appropriate nutrition, medical care and therapies profoundly affects the quality of a child's life and his life expectancy; and reduces a child's levels of infectiousness. Why are these boys being warehoused and sent to countries of origin such as Honduras, Guatemala or Nicaragua, where the child will not receive any HIV treatment whatsoever. These children have a high chance of being back in the US in under two weeks. It would be more cost effective to treat a child like this before his symptoms required surgical intervention. The current policy of returning children who are ill, but who re-enter the country anyway, seems self-defeating when paying for outpatient treatment versus entire hospitalizations also makes sense financially in today's financial crisis. Why are there no statistics that can be applied to determine what boys in this group are at risk after deportation for returning to the US and for continuing to be exposed to the medical and psychological vagaries of HIV that lead easily to death. No one seems to know things like the CD4 counts of the boys in this group, when in all probability full-blown AIDS is almost endemic among them. How is it that the world of the adolescent sex worker is so difficult to reach? Why aren’t we using other young men, who have done sex work and who understand the issues these boys face, to do direct outreach to this community in terms of raising awareness as to what the issues are: addiction, medical care, nutrition, and homelessness. SHOW ME YOUR LIFE is today launching a survivor led initiative to research and design a safe house initiative for boys whose lives are changed forever in the sex trades. If we really want to impact these shockingly high rates of HIV infection among male youth in the USA, it is imperative that we build safe places for acutely at risk boys and begin to learn from survivors what the real number of male youth infected with HIV is and more significantly how the boys became infected and reinfected with new strains of HIV so we can begin to design ways to tackle the source of the infection. http://www.globalgiving.org/projects/safehouse-boys-sex-trade-survivors/ Tim Barrus/ The health care system is broken
There are no studies being done by the CDC or anyone else that follow HIV Poz adolescents who have left the system. They are on their own. I live in a town with a major hospital, hundreds of doctors, labs, a big health care foundation, and a significant university (UNC) affiliation. Not ONE physician will even see a patient with HIV. They sit there and simply shake their heads no. That leaves patients with one and only one option which for some people is over a hundred miles away at a county clinic that is overcrowded, mean-spirited, expensive, harassed, filthy, and the computers are typically crashed. They cannot access your latest labs so what is the point of the long drive. Their pharmacy on a good day can only fill half your meds, and there are waiting lists for antiretrovirals. The health care system is broken. To claim that it’s not disease discrimination is patently absurd. To advocate for repeated, unnecessary visits indicates a fundamental unawareness as to how the system works. It doesn’t work. Waiting lists alone for HIV medications in the United States is unconscionable. It is second-class medical care because HIV patients are seen within such a negative social context. STIGMA is REAL. Hospitalizations are an enormous strain on families who find the transportation issues a challenge. HIV education facilitating compliance is nonexistent. HIV care is better in many African cities. To advise for repeated exposure to a nightmare fails to recognize a system that has collapsed. If it was ever real in the first place. Maybe it looks good on paper, but it is not reality. People are still dying from AIDS even if the media wants to put a gloss on it. Imagine: early morning appointments for people who live far away, and there is no flexibility as to making appointments because they are issued, not negotiated. There is a fundamental ignorance as to how it works on the part of health care professionals. The responsibility to deal with a broken system is put on the patients — how many times can you make these trips even to a pharmacy that tells you to come back next week because they do not have the meds and then when you do, they still do not have the meds and they refuse to deal with patients on the phone because patients are seen as stupid — versus the health care community recognizing that the medical paradigm it functions in is an illusion. The structure represents a public health disaster, and cruel and unusual punishment. Poor HIV patients improve with care beyond drugs: studySeptember 27, 2012|By Susan Heavey | Reuters WASHINGTON (Reuters) - Patients stepping into Johns Hopkins University's HIV clinic in east Baltimore do not just see a doctor or get prescriptions for their antiretroviral drugs. Many also get help finding a place to live or bus fare to make it to their next appointment. Such care that goes beyond the examination table and into patients' often challenging lives has been key to helping poorer HIV patients - particularly blacks and women - live long, healthier lives, according to a 15-year study published on Thursday in the journal Clinical Infectious Diseases. From 1995 to 2010, doctors at Hopkins joined with social workers and other experts to treat HIV, the human immunodeficiency virus that causes AIDS, and address other aspects of care that can often derail patients, such as being able to fill prescriptions or access health insurance programs for the needy. They found that with additional assistance, patients at the clinic could expect to live to about age 73 despite their background. Researchers found no difference in patients' health over time despite their gender, race, risk group, or socioeconomic status - a finding they said showed comprehensive care could eliminate disparities that arise among at-risk groups. "Just like over time we have developed medications that are easier to take, have fewer toxicities and are more effective, I think we've done exactly the same things in our ability to deliver quality care to this particular population," Dr. Richard Moore, the study's lead author, said in an interview. Moore, a professor of infectious diseases and director of the university's clinic, said the program showed it was possible to counter the impact of economic disparities on healthcare. Even though HIV medications have significantly improved since the virus emerged in the United States decades ago, accessing those medications, receiving consistent care and follow-up appointments for the chronic condition are key, he said. HIV still hits certain populations harder than others, and rising infection rates among gay black men, for example, remain a major worry among public health experts. IMPROVING OUTCOMES "Our results emphasize that advances in HIV treatment have had a positive impact on all affected demographic and behavioral risk groups in an HIV clinical setting," Moore and his colleagues wrote. Previous studies have shown that certain groups of HIV patients - the poor, minorities, women and drug users - tended to have worse outcomes and die earlier. Moore found that more comprehensive care that addresses problems such as homelessness and a lack of reliable transportation could help an average 28-year-old with HIV live roughly 45 more years with no significantly higher risk of various infections or other complications, a result that "did not differ by demographic or behavioral risk group." Tim Barrus: Key Chain
He was selling stuff on the beach. Key chains he had stolen. Gum. Paco was seven. In 2004, I was in Mazatlan shooting commercial beach scenes Cinematheque was selling to European travel accounts. Everyone is selling something. I list myself as WHORE (all caps) on Twitter. It still has some symbolism for me. Paco is fifteen. He uses the word Puta. His english is only slightly better than it was in 2004. I am slightly tempted to publish the photographs that were taken of him in what he calls California USA. Never just California. The Smash Street Boys have shown Paco his photographs in a sort of awe that they would give to any porn celebrity. Paco remembers the photos being taken. But they shame him. He will turn away. He was paid in meth. This is the story of a key chain. He still has the one he was attempting to sell me in Mazatlan. He keeps the safe house key on it. The reason I (I will spare you) want to show you the dirty pictures is not sexual. I do not find them erotic. I find them sad. The Smash Street Boys know all the signs. In one of the photographs, Paco is about to slip his finger into his rectum. His fingernail is caked in dirt. Why. It means he was homeless and probably in Los Angeles. California USA. I have kept track of Paco all these years. Sometimes I lose him for months. Then, he’ll call. I send him money. Money is what people need when they are homeless. I wrote a story once that was published in an anthology by a New York book publisher. The story was about a mother who sold her son. You almost had to be there. Paco is from a family of eight children. That makes ten people who live on less than five thousand American dollars a year. I go back to Mazatlan when I can. The year they were selling blankets was a good year. The year they were selling their children was not a good year. You sell what you have to stay alive. “No, no voy a comprar a su hijo. Los niños no están en venta. No es correcto.” They sold the girls first. It is not hard to find traffickers at any of the late night beach bars of Mazatlan. Then, they sold the boys. Sometimes, I wish I had bought him. Maybe then he would not have HIV. Maybe is a morally very vague word. Sometimes Paco talks so fast, I do not catch all of it. How he got to Los Angeles — en un camión — flashes lightspeed by me. Children’s Hospital in Los Angeles participates with other support groups (Youth Supportive Services is one of the best) to try and get kids off Santa Monica Boulevard. They do more than I can write about here. Kids in LA suicidal crisis mode: eight-seven-seven-nine-eight-five-zero-one-zero-zero. Paco was sick. One of my cards that Rachel had made up was in his wallet. Where do you draw the line with these kids. Do you say: we will only help American children. It would be a slightly stupid thing to say if you thought you would make any dent in sex work or trafficking on Santa Monica Boulevard. Latino boys on Santa Monica Boulevard are everywhere. We only help American children. Then fuck you. The first time I saw his dirty pictures, I vomited on the floor. Vomit and eroticism just do not go hand in hand for me. Paco is in a safe house. The men he was pimping for, the men who took those photos, cannot find him. Not that they haven’t tried. There are challenges. I will not go into all of them. This is not about that. We do not go around looking for trouble. We keep a low profile. This is not that. This is to let the latino kids who contact us know that people are out there who care. Eight-seven-seven-four-three-three-five-one-one-one. I include this photograph of Paco because you looked like that once, too. The bruises around Paco’s neck have healed. Suicide will get you before AIDS will. And then AIDS will get you. It makes me sick that there is a World AIDS day. I see no progress being made. With the exception of maybe one kid at a time. I have banned ropes and unnecessary cords from the house. Even computers have gone wireless. You cannot hang yourself with an iPad. I am not kidding. I never kid. Apparently, some of the places Paco was rented out were clubs. He has a favorite song. You can’t escape songs and drugs and clubs (I can’t). I could lose myself in that hypnotic mixture. They are just a part of the life. The Smash Street Boys got Paco to dance. All smiles. Hips grinding. You can hear waves in the background. Mazatlan is a long stretch from where Paco is living now. Pound the alarm. Jeans so tight I can see the outline of the key chain in his pocket.
Oh, oh, oh, come fill my glass up a little more Tim Barrus/ VisionsRupture
Over 64 million adolescents ages 10 to 24 live in the United States, representing roughly 21% of Americans. In the past ten years, the adolescent population has grown by more than 7%, with the largest gains seen among sexually active young adults ages 20 to 24 . Young people in the United States reflect the increasing diversity of American society, as racial and ethnic minority groups continue to expand. Latinos and African Americans account for 20% and 16% of adolescents aged 10 to 19, compared to 18% and 15% of young adults ages 20 to 24. Conversely, while White youth represent 61% of young adults, they account for 58% of adolescents.This growth of minority communities is expected to continue in the coming decades, with estimates projecting that white youth will account for 48% of adolescents by 2040. Other trends seen among adolescent populations in the United States include a rising number of young people living in immigrant families (19% in 1990 to 24% in 2008), increasing school enrollment, and declining high school dropout rates. Further, 10.2 million young people lived in poverty in 2006, accounting for 23% of all Americans living in poverty. The poor sexual health outcomes experienced by Latinos and African American communities calls for a critical perspective examining national and local data on adolescent sexual risk behavior and outcomes. These shared, diminished sexual health outcomes for American youth present a pressing public health concern that greatly impact adolescents’ health and future well-being. In addition to racial and ethnic health disparities, social and economic inequalities — particularly in the undocumented immigrant population that is primarily male and primarily consisting of 14-21 year-olds — are glaringly apparent. High rates of poverty, inadequate access to health care, HIV education, and suboptimal access to HIV medications shape the environment and exacerbate adolescent health outcomes; particularly Latino and African American youth. These challenges situate immigrant teens in an ecological context of heightened vulnerability, where inequalities impact not only individual success but the overall well-being of the entire community. Undocumented immigrant teenage males should have access to a safe house structure where HIV treatment and confidentiality are the preeminent focus. The alternative is an entire population of sexually active adolescent males with HIV intransigently stuck in the cycle of infection and reinfection. You are either going to pay for this, or you are going to pay for prolonged and expensive AIDS medications and services when HIV infections turn into full-blown AIDS. |
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| (William Cleveland, Founder & Director, Center for the Study of Art and Community) | ||