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Posted by pozlife on November 23, 2008

Well what to say on this cold day.  For some reason I can not get warm. The doctors say its is from muscle loss..talk about looking like Mr. Potato head !  I see that E harmony is being force to take on gay clients.  I am not sure the laws from above were right.  We have many HIV & Gay and lesbian chat rooms and some say no to straight people straight up front. So should it not be that they too, should  be posted gay personals ?  Why are movies so fucking cookie cuter….give me some strange and some unexpected ends ! I just hate watching yet another expeced planned ending.  The mist short from King is a great short story and movie. the story and the movie end diffrently and the movie was way more interesting.  Who would have thunk it and the way the media has fucked up every one of most of his books ( Carrie,Shawshank,Green Mile, Misery being the best of his movie adaptations )………..then we have lawnmoer man…the panish story was much beter than his taken  from “Flowers From Angernon” or is it “For Allgeron?  Eracer head fucks with your mind!!

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The South Shall Rise Again

Posted by pozlife on September 19, 2008

by Jimmie Briggs

In the two years since POZ last charted AIDS in its new U.S. epicenter—the South—infection rates have continued to rise in the region. In 2005, the South accounted for 41 percent of people with HIV in the nation; today, it’s home to 45 percent of new AIDS cases. The regional epidemic is further complicated by the lingering effects of Hurricane Katrina and an unnatural disaster: poor federal AIDS funding.

When POZ last toured the American South, in 2005, the region accounted for 41 percent of all HIV infections in the U.S. Dozens of prevention workers, educators and people living with AIDS in the 16-state region (which includes Washingon DC) told us then that they felt that federal health officials had given up on the area—even though it had emerged as the epicenter of the epidemic in the U.S. “We’ve got to figure out how to level the playing field [in the South], or we’re always going to be struggling,” Kathie Hiers, the head of AIDS Alabama, said at the time. “The status quo is going to kill Southerners.”

Two years later, Hiers’s words ring all the more true. According to the Centers for Disease Control (CDC), the South now accounts for 45 percent of all new U.S. HIV infections—and 50 percent of all American AIDS deaths. The causes for the region’s spike in new infections are as varied and contentious as they were in 2005: extreme poverty, wobbly AIDS-service infrastructure, comparatively low federal funding (northern and western metropolitan areas are still granted the vast majority of federal AIDS dollars), a high minority concentration (which has traditionally eluded HIV-prevention efforts) and a large rural population (which has difficulty accessing basic care and services).

Yet the mere act of labeling Southern AIDS a “regional problem” perpetuates the cultural stigma and interstate funding fights activists hope to prevent. The South, with its many economic and social constituencies, cannot be pigeonholed as one drawling, down-home backwater. Though the region, with its rich history and traditions, can seem more American than America itself, it has often been portrayed as a world apart, a secessionist image it has even strived to cultivate. And so the South can seem familiar and foreign—especially with an AIDS rate that rivals that of some African countries’.

How appropriate, then, that many Southern activists look at the exploding crisis and say, “How can this be America?” Activists like Hiers are still hard on the case, helping the nation understand why the Southern HIV rate continues to rise—and to keep it from emulating that of South Africa.

John Paul Womble, director of development of the Alliance of AIDS Services Carolina—who has himself been HIV positive for 15 years—says, “I beg of you, please, please, please don’t toss everyone down here together in one lump. Georgia is different from Florida; Atlanta is different from Miami. And please don’t describe our struggle down here as wanting to take federal money away from people who need it anywhere in this country. I am a child of the South, born in Kentucky, but when I fight for my people here, I also fight for people everywhere. Every sick person in this country deserves basic care. I am fighting for a bigger pie for everyone, not for someone else’s piece.”

In POZ’s July 2005 “Southern Discomfort,” by Kai Wright, activists said that they hoped something, anything, could clearly illustrate the South’s plight to federal officials, some sort of defining event or image to better plead their case. And then, just two months after we published our story, a nightmare illustration arrived: Hurricane Katrina. The slow, skittish federal response to that disaster echoed the slow, skittish federal response to AIDS in the South. As New Orleans began to drown, it was cordoned off and given up for lost, its citizens sequestered in a faceless mass. “And that’s how we feel down here fighting AIDS,” says Womble, whose father died of AIDS. “It’s like we’ve been roped away from the rest of the country and been abandoned. As if the government looks at us and says, ‘Tough noogies.’”

Today, Hiers says, the South’s post-Katrina frustration perfectly captures the divide between U.S. urban and rural areas, even within the South itself. “We found an HIV-positive man in New Orleans who was trapped on his roof for two days as the waters rose,” she says. “We got him out, relocated him to Alabama, got him an apartment, clothes, meds, new furniture. And yet he was still extremely upset because he was used to getting free hot delivered meals in New Orleans before the storm. And in Alabama, we have never had the money or programs to deliver that. And what am I supposed to say to him? That he has no right to be upset? That he should be grateful for what we did get him? That if he isn’t happy here, maybe he should make his way to San Francisco or Chicago, big cities with lots of fed money?”

Evelyn Scott is another frustrated person feeling the pinch of trying to survive with HIV in the South. She’s tired of waiting for help. Born in Ridgeland, South Carolina, she now lives 30 minutes away in Beaufort, after spending time in New York City and Delaware. Positive for 18 years, she lives alone and survives on her monthly Social Security check. She’d worked for a while as a hotel night auditor in the state’s Hilton Head island resort. When she can, Scott, 47, volunteers with ACCESS Network, a local HIV and AIDS advocacy group. She’s a client but also a sometime peer advocate.

“The big cities, they have all the AIDS services,” she complains. “They have support groups, transportation, activities. [But] down here, it’s still the same attitude as when the disease first came out. People don’t get the services they deserve, and a lot of people down here are scared that if they say anything [about having HIV], they’ll lose their job, or if they access help or care people won’t talk to them anymore. Beaufort is a little built up, but it’s still backwoods.”

Scott is not alone in her call for help. Scores of people with HIV, community-based organizations, foundations, public health officials and, slowly, faith-based groups are raising a louder call for greater awareness and support in the South. Even before AIDS arrived, in 1981, the region had long been home to the 10 American cities with the highest rates of sexually transmitted infections. But now, not only are seven of the 10 states with the highest AIDS rates in the South, but more survivors of the disease live in Southern states than anywhere else in the country. To tackle the disease in such diverse states as Mississippi, North Carolina or Louisiana means understanding the complex array of factors contributing to its spread and responding with cultural sensitivity and accuracy.

“The spread of AIDS has transformed since the beginning of the epidemic,” explains Professor Charles van der Horst, MD, of the University of North Carolina, Chapel Hill. Having researched the transmission and impact of the disease since 1981, Van der Horst was part of the medical team that identified a cluster of infections among predominantly African-American colleges and universities in the late ’90s. “The fact that 50 percent of new AIDS cases are in the Southeast shouldn’t be a surprise to anyone, because that’s where the majority of STDs are found, as well as poverty.” Indeed, the average annual income of an HIV-positive person in Alabama is $7,900. “Crushing poverty and malnutrition make it hard to attack the epidemic in South Africa,” Van der Horst continues, “but those are also factors in our areas, too. We’re dealing with poor people who don’t perceive themselves at risk, people who are addicted to drugs that make them take chances, and a lack of comprehensive sex education.”

North Carolina has concentrated medical resources and personnel in larger cities, despite the fact that close to 40 percent of its population live in rural areas. That scenario is mirrored in South Carolina, Kentucky, West Virginia, Mississippi and many other Southern states.

Womble says that in 2007, many of the long-cited causes of the Southern HIV-infection disparity are often used merely as excuses to justify a federal monetary response that has not been tailored to the evolving epidemic. “This business that the South is just reeking with stigma and ignorance is  insulting,” he explains. “Look, I am a gay man, and when I was working in AIDS services on the South Side of Chicago, I myself was incredibly stigmatized because I am white and gay. There is stigma everywhere, not just the South. The truth is, with the Ryan White CARE Act money, the federal response correctly began with the areas that needed it most—large urban areas. But when the infrastructure that was built [no longer served the need of the people in the same way], the government didn’t want to change it, because they created it, and it worked. It’s easier to maintain the status quo than to change.” Womble says that just the other day, an HIV-positive woman from Connecticut called him and asked for advice on relocating to North Carolina so she could live closer to her son, who attends college there. “I said, ‘You really want my advice? Don’t come. You’ll get better services in Connecticut.’”

The regional crisis of HIV and AIDS in the South did not happen suddenly. Increases in infection rates and morbidity were recognized as early as the mid-’80s, and the large metropolitan areas where the disease originated drew media, federal attention and money. A turning point may have been a three-day event held in Charlotte, North Carolina, in November 2002.

Titled “A Southern States Summit on HIV/AIDS and STDs: A Call to Action,” the gathering was organized by the Kaiser Family Foundation, the Southern State AIDS/STD Directors Work Group and the National Alliance of State and Territorial AIDS Directors (NASTAD). It drew state public health
officials, legislators, directors of AIDS service organizations (ASOs) and advocacy groups. The occasion not only provided badly needed camaraderie and recognition for individuals battling deeply entrenched conservatism and denial, but also produced the “Southern States Manifesto.” In addition to outlining steps for moving forward in all response and advocacy areas, the manifesto noted the particular regional issues that public health authorities faced in the South.

“We’re somewhat behind the rest of the nation in coming to grips with the social aspects of HIV and AIDS, but the facts are well-known,” observes Craig W. Thompson, director of the STD/HIV Bureau in the Mississippi State Department of Health, a position he’s held for 18 years. “There have been gradual, productive efforts to increase the awareness of HIV/AIDS in the community, but it is somewhat difficult because of the religious climate. But the reality is less about North and South, and more accurately, urban versus rural. Access to care can be a problem for the underinsured and uninsured anyway, so when you add all the other baggage that comes with HIV disease, it becomes a task. We’re doing well in Mississippi just to get people into care and on medication.”

Last July, Thompson’s division pledged $200,000 annually for the next four years to support a pilot project funded by Housing Opportunities for Persons With AIDS [HOPWA]. It will create long-term, low-threshold supportive housing for HIV-positive Mississippians. The state has never before spent money on long-term housing for people with HIV/AIDS.

The Southern AIDS Coalition, meanwhile, to which Hiers and Womble belong, includes public and non-governmental health officials from 14 states in the South, plus Washington, DC. “We are making progress by finally uniting,” Hiers says. “But even from our own board [we see that], different states can have different agendas. The key is to resolve those so we can better demand what we need as a group.”

Debra Roth, director of communications and marketing strategy for the National AIDS Fund, says, “Leading private philanthropic organizations like the National AIDS Fund, in partnership with the Ford Foundation and the Elton John AIDS Foundation, have made the South a priority for their HIV/AIDS funding, with aspecific focus on building community capacity and leadership.” The national fund has been supported by the Ford Foundation to provide $1.8 million in “Southern REACH” grants to nine states in the South. Additionally, the group’s Gulf Coast HIV/AIDS Relief Fund will disburse $750,000 to alleviate the lingering impact of Hurricane Katrina on the organizations working to support those with HIV/AIDS in Southern states. “We are optimistic that by involving a broad cross section of sectors, including not just AIDS-specific organizations but other health and social service organizations, community groups, faith-based organizations, local philanthropy, business leaders and others, we can create the kind of comprehensive leadership and responses that are needed,” Roth says.

According to the Kaiser Foundation and CDC, more than 21,000 people with HIV and AIDS were directly affected by Hurricane Katrina in the hardest-hit states, Louisiana, Mississippi and Alabama. A larger metropolitan area with a high number of AIDS cases, New Orleans continues to struggle. Half the community-based prevention contractors went out of business, and a significant percentage of patients never returned after the storm, or returned months later to find their medical coverage was lost or in disarray.

“Right after the hurricane, [we] reached out to everyone in our network to try and raise whatever money we could to help affected organizations,” points out Michael Rhein, director of programs and resource development for the National AIDS Fund. “In trying to help those displaced by Katrina, the Ford Foundation wanted to invest in the South and Gulf coast area, so they gave us $500,000 last fall. By December we’d made that amount of money in grants.”

Michael Hickerson leads one of the agencies working on HIV/AIDS in New Orleans. Based in the Treme neighborhood, one of the oldest African-American enclaves in America, In This Together is an AIDS service organization and the first Title I group to work in the city. Hickerson and his partner, David Munroe, started In This Together after years of volunteer and professional work in the field. The problem was that they started it two months before Katrina hit the Gulf Coast on August 29, 2005. Evacuating to Baton Rouge and returning sporadically to their flooded house and neighborhood, they reopened the organization’s doors within a month after the storm.

The city of New Orleans ranks seventh for HIV/AIDS cases in the United States, and Hickerson’s neighborhood ranks first in case rates among all of the city’s neighborhoods.

“Personally, I continue to be pessimistic about the response to HIV and AIDS across the Southern states,” Hickerson notes. “Very little advocacy has been done among and within the community. Elected and religious leaders continue to dance around the issue. So as a result, more people are continuing to be infected. Look at New Orleans and the difficulty in getting resources onto the street. Is that any reason for optimism? ”

Jessica Mardis, 31, could use a few of the Ford Foundation’s $500,000. HIV positive for nearly half of her life, she’s an 11th-grade dropout—and now a single mother of Gabriel, 4. Her hometown, Gulfport, Mississippi, near the coast of the Gulf of Mexico, was ravaged by Katrina. While still struggling to rebuild her life, she works as a staffer for AIDS Action Mississippi, a division of Housing Works.

Two years ago, Mardis’s fiancé, John, died of AIDS. Three years ago, her mother committed suicide. Until John’s death, she says, she hadn’t taken care of herself—using drugs and alcohol and unsuccessfully trying to live in denial about her physical condition.

“Until [my husband] passed, I was never comfortable with my status,” observes Mardis one late-summer evening after putting Gabriel to bed. “Before he died, I had a few friends that knew I was positive but not many people.

Afterwards, the word spread like wildfire. I was surprised at the helpful reaction. I look around down here, and people are being infected every day. Now we’re trying to put our faces out there to show people that not only is this disease real, but you need to stand up for yourself.”

Mardis says that includes standing up for funding and care. According to recent statistics, every AIDS case receives nearly $500 less in federal aid in the South than the rest of the country and $200 less in federal appropriation for HIV prevention per estimated AIDS case.

“Our funding tends to be historically based, and historically more money tends to go to the Northeast and the West,” notes Dr. Robert Janssen, MD, director of HIV/AIDS Prevention at the Centers for Disease Control. “Those are the areas where the epidemic started. [In 2007] we got $35 million in new money going to health departments. We haven’t looked yet at the distribution because final decisions haven’t been made, but based on state eligibility, a lot of that money is going to the South. As we look at the work we’re doing, we anticipate making our funding distribution across the states more equitable. The shift toward equitability is more recent than the shift of the disease.”

While there is certainly reason for pessimism and disappointment with state and federal responses to HIV/AIDS in the South, there have been notable successes and lessons learned, which could be applied throughout the country. Andrew Spieldenner, director of programs at the National Association of People With AIDS (NAPWA), notes that “many of the Southern states have taken creative steps in meeting the needs of people living with HIV in their jurisdictions, including those with health departments, elected officials, faith-based groups and other businesses servicing the same populations. Some of this has been necessary in order to maximize resources; some of it has come out of extensive relations already existing in the respective communities.”

Given the extraordinarily high percentage of churches, particularly black churches, in the South, it may be reasonable to expect more leadership and advocacy from the faith-based community. Still, the church as an institution is doing much to ramp up its response. At the forefront of the effort to recruit more faith-based support is The Balm In Gilead, a non-governmental organization led for the past 18 years by Pernessa Seele, a native South Carolinian who relocated the group from its New York headquarters to Richmond, Virginia, last year. As POZ went to press, The Balm In Gilead was planning to sponsor the National HIV/AIDS Conference for Black Churches in Hilton Head, South Carolina, in October 2007.

“There is a dire lack of information around the disease in the South, which so resembles Africa,” Seele observes. “Information does not come through the South. Most urban centers are the centers of information. Atlanta is the South, but it’s Atlanta. If you happen to live way across Georgia you might not get the right information. Now, we have churches who are on board, but far too many have their heads in the sand. We’re seeing a change in churches’ response to AIDS in urban centers but not rural areas. That’s why we moved The Balm to Richmond.”

Seele argues, “I can’t get people interested in doing something exciting around the disease—outreach, advocacy, testing, etc.—[in cities like] Richmond. Let’s not do Miami but rather organize in Plant City, Florida. We punish the people who don’t have all the information in the South, in rural areas, because they don’t know about the disease. Economics drives the conversations. We find people down here in rural areas who believe AIDS is from mosquitoes. You don’t have to go to Africa to find that thinking. Though we moved our organization down South, we’re still using the same methods for reaching churches and parishioners.”

One organization critical to fighting HIV has long been headquartered in the South: the CDC. Based in Atlanta, it may appear to have the advantage of proximity in trying to combat the area’s AIDS crisis. And Kevin Fenton, who directs its National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, has said that he intends to make the contributing social causes of HIV—poverty, lack of education, poor testing efforts, late diagnoses—a priority. But Hiers says that the “CDC and Ryan

White folks in Washington need to work together, to get their act together. Yes, the CDC is right there in Atlanta, but it’s really in an ivory tower, removed from the reality [of the South].” She adds that the Feds tend to point to all the wrong markers when explaining their response. “I get a bit frustrated when I hear that we should be encouraged because state ADAP [AIDS Drug Assistance Program] waiting lists are low. That’s misleading. Just because people aren’t on a waiting list for meds doesn’t mean they aren’t positive and don’t need meds desperately. They just haven’t applied for them, or they don’t know their status, or they have no way to access care because they don’t have a car or child care and they live far from a clinic so they think, ‘What’s the use?’”

Adds Womble: “With the medicalization of the Ryan White monies, focusing only on services and care that can be shown to reduce viral load and increase T cells, we lose out too—the supplementary services like transportation vanish. If you live in a city like Chicago, you can hop on the el to see your doctor. But if you live in rural North Carolina, and don’t own a car, like my people, you’re screwed.”

Hiers and Womble say that before progress can be made in their homelands, it is essential that the South not be punished or blamed for its own tragedy. “It’s not that we’re doing something wrong down here,” Womble says. “It’s not because we’re odd or socially retarded. We are who we are.” And until the Southern AIDS crisis is seen as an irreducible arm of the American AIDS crisis, he says, “it’s gonna be tough noogies for everyone.”

Correction: The National AIDS Fund has been supported by the Ford Foundation and the Elton John AIDS Foundation– with grants of $1.55 million from the Ford Foundation and $250,000 from the Elton John AIDS Foundation–to provide a total of $1.8 million in “Southern REACH” grants to nine states in the South.

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The South Rises Again

Posted by pozlife on September 19, 2008

by David Evans

The Southern AIDS Coalition (SAC) issued an update to its 2002 Southern States Manifesto, highlighting both the encouraging progress made against the HIV epidemic in the South and the daunting work that remains to be done. SAC co-chairperson Kathie Hiers shares with POZ her dream that activists will unite next year to help heal a part of the country most severely ravaged by the epidemic.

Hurricane Katrina, and its aftermath, has become a resounding metaphor for the deficiencies of the federal government in the American South. Just as the murky storm waters burst through a decrepit levee system soon after the hurricane had passed and the all clear had been sounded, HIV has broken through a neglected public health infrastructure in most Southern states.

The South, both urban and rural, has 177,613 people diagnosed and living with AIDS, more than any other part of the country. The epidemic also appears to be growing faster in the South than anywhere else. Just as Katrina hit African Americans harder, so too has HIV in the South. Despite the disproportionate impact of HIV, however, the South only recently began receiving the same level of funding for direct HIV care as the rest of the country, and still trails behind in terms of money for HIV prevention, housing and substance abuse treatment.

In 2002, the Southern AIDS Coalition (SAC)—an alliance of public health officials, AIDS service organizations and activists—sounded the alarm, publishing its Southern States Manifesto. “The original manifesto was…an attempt to focus the media, policy makers and funders on the massive problems that the South has with HIV disease,” says Kathie Hiers, the chief executive officer of AIDS Alabama and the current co-chair of SAC.

The SAC issued an update to the manifesto last week, documenting lessons learned and progress made since 2002. According to Hiers, SAC “also wanted to highlight that the work is far from done and that the numbers, as far as the epidemic goes, are just getting worse in the South.”

While Hiers concedes that SAC is not yet ready to make specific recommendations for the remaining funding inequities, the timing of the update is not a coincidence. The Ryan White CARE Act, the largest funder of HIV care in the United States after Medicaid, is up for renegotiation next year. Significant changes could also occur in the administration and Congress, which could in turn open the possibility for increases in prevention, housing and substance abuse funding. “I’m not going to shut up until everybody in America who is HIV positive and low income can get [the same] standard of care services,” Hiers says.

Hiers and SAC will be fighting to reverse funding inequities between the South and the rest of the country, but they also want to reverse inequities that exist within the South, often between the largest cities and more rural areas. Hiers says Katrina made that kind of inequity “painfully clear.”

“Where a person who’d been living in New Orleans before Katrina could get assistance with their medication co-pays up to $15,000 a year, when they moved 20 minutes down the road to Baton Rouge after Katrina, they could only get $1,500 a year,” Hiers says.

Last time the Ryan White programs were up for reauthorization by Congress, much was made of the fact that people with HIV in cities like New York and San Francisco could get massages and acupuncture, while people in South Carolina were literally dying because they were on waiting lists for the AIDS Drug Assistance Program (ADAP) in that state. Ryan White contributes to the state ADAP programs, which traditionally cover the cost of HIV medications for people who don’t have private or government insurance and can’t afford them. Individual states decide how much to chip in, who will qualify for the program and what drugs are covered.

Hiers doesn’t like how divisive discussions like this became in 2006, both among lawmakers and activists. “It is true that some cities could afford massage therapy and acupuncture and those kinds of things, and those aren’t bad things. They’re good things for HIV-positive people. But until we have some level of fairness across the board where at least everybody can get medicines and viral load testing and things they need to stay alive and stay healthy, then that is problematic for me,” she says.

Hiers favors a proposal that was floated and shot down in 2006 that would have taken ADAP from the states and made it a national program. Such a program, she says, would ensure that when people with HIV move from one state to another they could keep their benefits and receive the same standard of care.

The politics around that proposal in 2006 were complex and intense, but so too were the disagreements between the North and the South about how to split up a pot of money that wasn’t big enough for everyone to get exactly what they wanted. One of the biggest problems is that many Southern states have Medicaid programs that are far less generous than other areas of the country. This means that people with HIV in the South receive their care through Ryan White and ADAP when they would have qualified for Medicaid in other states; a fact that leaves AIDS activists in states like Mississippi and Oklahoma—which regularly score the worst of any states on health care in general—in a bind.

Hiers says, “My dream would be that the AIDS community can come together this time around rather than being so divided. I’m hoping that there are more coalition-building opportunities, because quite frankly Congress is sick of us, and they’re sick of our fighting, and they want us to come in there with a more cohesive position, and that’s not going to be easy.”

The update to the Manifesto also acknowledges that money isn’t the only solution to the problems the South faces with HIV. Two overwhelming complications are stigma and distrust of the health care sytem. Intense stigma around HIV pervades the South, particularly rural areas. The report says this is especially true for men who have sex with men (MSM) and African Americans, the two groups most brutally impacted by HIV in the South.

Aside from stigma, however, the long shadow of the Tuskegee syphilis study still looms large in the minds of the African-American community. The study ran from 1932 to 1972 in Tuskegee, Alabama, where 399 poor—and mostly illiterate—African-American sharecroppers were studied to observe the natural progression of syphilis if left untreated. The study ran, and the men remained untreated, for 25 years after it became standard of care to treat and cure syphilis with penicillin in 1947.

“There’s still a good bit of distrust among African Americans for the medical community, and I don’t blame them,” Hiers says. “Some horrific stuff has happened in the South in the past. But we’ve got to find a way to get past that and reach folks so that they can learn to take care of themselves.”

“We have one of the best clinics in the world in Birmingham, [Alabama],” continues Hiers, who adds, “And do you know that the [average] CD4 count upon initial diagnosis there is still under 200? The average CD4 count is around 160. We’re just getting people into care too late. We’ve got a lot of work to do down here in terms of education and outreach.”

Birmingham is also the city where Martin Luther King Jr. wrote his famous letter, a civil rights manifesto, while in jail for civil disobedience. The sentiments he expressed in that letter are echoed in Hiers’s and SAC’s dream of equal care for Southerners with HIV. King wrote: “Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”

Hiers hopes that the update to the Southern States Manifesto will inspire people to think like King, especially people living with HIV. She says, “No person’s voice is more important to me than the person living with HIV. And [SAC is] going to make sure that HIV-positive people have a voice in what we do, whether it’s policy making, or on our board, that’s a key principle for us. So if anyone is interested in joining, we’d love to have them.”

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Oh’ To Be Stone Free!

Posted by pozlife on August 14, 2008

kidney stones, urinary tract, bladder, kidney stones treatments, calcium stones, oxalate, kidney stones symptoms

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Kidney stones, one of the most painful of the urologic disorders, are not a product of modern life. Scientists have found evidence of kidney stones in a 7,000-year-old Egyptian mummy. Unfortunately, kidney stones are one of the most common disorders of the urinary tract; more than 1 million cases were diagnosed in 1996. An estimated 10 percent of people in the United States will have a kidney stone at some point in their lives. Men tend to be affected more frequently than women.

Most kidney stones pass out of the body without any intervention by a physician. Stones that cause lasting symptoms or other complications may be treated by various techniques, most of which do not involve major surgery. Also, research advances have led to a better understanding of the many factors that promote stone formation.

Introduction to the Urinary Tract

The Urinary Tract.

The urinary tract, or system, consists of the kidneys, ureters, bladder, and urethra. The kidneys are two bean-shaped organs located below the ribs toward the middle of the back. The kidneys remove extra water and wastes from the blood, converting it to urine. They also keep a stable balance of salts and other substances in the blood. The kidneys produce hormones that help build strong bones and help form red blood cells.

Narrow tubes called ureters carry urine from the kidneys to the bladder, a triangle-shaped chamber in the lower abdomen. Like a balloon, the bladder’s elastic walls stretch and expand to store urine. They flatten together when urine is emptied through the urethra to outside the body.

What Is a Kidney Stone?

A kidney stone is a hard mass developed from crystals that separate from the urine and build up on the inner surfaces of the kidney. Normally, urine contains chemicals that prevent the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine without being noticed.

Kidney stones may contain various combinations of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person’s normal diet and make up important parts of the body, such as bones and muscles.

A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Much less common are the uric acid stone and the rare cystine stone.

Kidney stones in kidney, ureter, and bladder.

Urolithiasis is the medical term used to describe stones occurring in the urinary tract. Other frequently used terms are urinary tract stone disease and nephrolithiasis. Doctors also use terms that describe the location of the stone in the urinary tract. For example, a ureteral stone (or ureterolithiasis) is a kidney stone found in the ureter. To keep things simple, however, the term “kidney stones” is used throughout this fact sheet.

Gallstones and kidney stones are not related. They form in different areas of the body. If you have a gallstone, you are not necessarily more likely to develop kidney stones.

Who Gets Kidney Stones?

For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 20 years. White Americans are more prone to develop kidney stones than African Americans. Although stones occur more frequently in men, the number of women who get them has been increasing over the past 10 years, causing the ratio to change. Kidney stones strike most typically between the ages of 20 and 40. Once a person gets more than one stone, others are likely to develop.

What Causes Kidney Stones?

Doctors do not always know what causes a stone to form. While certain foods may promote stone formation in people who are susceptible, scientists do not believe that eating any specific food causes stones to form in people who are not susceptible.

A person with a family history of kidney stones may be more likely to develop stones. Urinary tract infections, kidney disorders such as cystic kidney diseases, and metabolic disorders such as hyperparathyroidism are also linked to stone formation.

In addition, more than 70 percent of people with a rare hereditary disease called renal tubular acidosis develop kidney stones.

Cystinuria and hyperoxaluria are two other rare, inherited metabolic disorders that often cause kidney stones. In cystinuria, too much of the amino acid cystine, which does not dissolve in urine, is voided. This can lead to the formation of stones made of cystine. In patients with hyperoxaluria, the body produces too much of the salt oxalate. When there is more oxalate than can be dissolved in the urine, the crystals settle out and form stones.

Shapes of various stones. Sizes are usually smaller than shown here.

Absorptive hypercalciuria occurs when the body absorbs too much calcium from food and empties the extra calcium into the urine. This high level of calcium in the urine causes crystals of calcium oxalate or calcium phosphate to form in the kidneys or urinary tract.

Other causes of kidney stones are hyperuricosuria (a disorder of uric acid metabolism), gout, excess intake of vitamin D, and blockage of the urinary tract. Certain diuretics (water pills) or calcium-based antacids may increase the risk of forming kidney stones by increasing the amount of calcium in the urine.

Calcium oxalate stones may also form in people who have a chronic inflammation of the bowel or who have had an intestinal bypass operation, or ostomy surgery. As mentioned above, struvite stones can form in people who have had a urinary tract infection. People who take the protease inhibitor indinavir, a drug used to treat HIV infection and AIDS, are at risk of developing kidney stones.

What Are the Symptoms?

Usually, the first symptom of a kidney stone is extreme pain. The pain often begins suddenly when a stone moves in the urinary tract, causing irritation or blockage. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin.

If the stone is too large to pass easily, pain continues as the muscles in the wall of the tiny ureter try to squeeze the stone along into the bladder. As a stone grows or moves, blood may appear in the urine. As the stone moves down the ureter closer to the bladder, you may feel the need to urinate more often or feel a burning sensation during urination.

If fever and chills accompany any of these symptoms, an infection may be present. In this case, you should contact a doctor immediately.

How Are Kidney Stones Diagnosed?

Sometimes “silent” stones–those that do not cause symptoms–are found on x-rays taken during a general health exam. These stones would likely pass unnoticed.

More often, kidney stones are found on an x-ray or sonogram taken on someone who complains of blood in the urine or sudden pain. These diagnostic images give the doctor valuable information about the stone’s size and location. Blood and urine tests help detect any abnormal substance that might promote stone formation.

The doctor may decide to scan the urinary system using a special x-ray test called an IVP (intravenous pyelogram). The results of all these tests help determine the proper treatment.

How Are Kidney Stones Treated?

Fortunately, surgery is not usually necessary. Most kidney stones can pass through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. Often, you can stay home during this process, drinking fluids and taking pain medication as needed. The doctor usually asks you to save the passed stone(s) for testing. (You can catch it in a cup or tea strainer used only for this purpose.)

The First Step: Prevention

If you’ve had more than one kidney stone, you are likely to form another; so prevention is very important. To prevent stones from forming, your doctor must determine their cause. He or she will order laboratory tests, including urine and blood tests. Your doctor will also ask about your medical history, occupation, and eating habits. If a stone has been removed, or if you’ve passed a stone and saved it, the laboratory can analyze it to determine its composition.

You may be asked to collect your urine for 24 hours after a stone has passed or been removed. The sample is used to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate, and creatinine (a product of muscle metabolism). Your doctor will use this information to determine the cause of the stone. A second 24-hour urine collection may be needed to determine whether the prescribed treatment is working.

Lifestyle Changes

A simple and most important lifestyle change to prevent stones is to drink more liquids–water is best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, including dairy foods, help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones.

You may be told to avoid food with added vitamin D and certain types of antacids that have a calcium base. If you have very acidic urine, you may need to eat less meat, fish, and poultry. These foods increase the amount of acid in the urine.

To prevent cystine stones, you should drink enough water each day to dilute the concentration of cystine that escapes into the urine, which may be difficult. More than a gallon of water may be needed every 24 hours, and a third of that must be drunk during the night.

Medical Therapy

The doctor may prescribe certain medications to prevent calcium and uric acid stones. These drugs control the amount of acid or alkali in the urine, key factors in crystal formation. The drug allopurinol may also be useful in some cases of hypercalciuria and hyperuricosuria.

Another way a doctor may try to control hypercalciuria, and thus prevent calcium stones, is by prescribing certain diuretics, such as hydrochlorothiazide. These drugs decrease the amount of calcium released by the kidneys into the urine.

Some patients with absorptive hypercalciuria may be given the drug sodium cellulose phosphate, which binds calcium in the intestines and prevents it from leaking into the urine.

If cystine stones cannot be controlled by drinking more fluids, your doctor may prescribe the drug Thiola, which helps reduce the amount of cystine in the urine.

For struvite stones that have been totally removed, the first line of prevention is to keep the urine free of bacteria that can cause infection. Your urine will be tested regularly to be sure that no bacteria are present.

If struvite stones cannot be removed, your doctor may prescribe a drug called acetohydroxamic acid (AHA). AHA is used with long-term antibiotic drugs to prevent the infection that leads to stone growth.

People with hyperparathyroidism sometimes develop calcium stones. Treatment in these cases is usually surgery to remove the parathyroid glands (located in the neck). In most cases, only one of the glands is enlarged. Removing the glands cures the patient’s problem with hyperparathyroidism and with kidney stones as well.

Surgical Treatment

Surgery should be reserved as an option for cases where other approaches have failed or shouldn’t be tried. Surgery may be needed to remove a kidney stone if it

  • Does not pass after a reasonable period of time and causes constant pain
  • Is too large to pass on its own or is caught in a difficult place
  • Blocks the flow of urine
  • Causes ongoing urinary tract infection
  • Damages kidney tissue or causes constant bleeding
  • Has grown larger (as seen on followup x-ray studies).

Until recently, surgery to remove a stone was very painful and required a lengthy recovery time (4 to 6 weeks). Today, treatment for these stones is greatly improved, and many options do not require major surgery.

Extracorporeal Shockwave Lithotripsy

Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside of the body travel through the skin and body tissues until they hit the dense stones. The stones break down into sand-like particles and are easily passed through the urinary tract in the urine.

Extracorporeal shockwave lithotripsy.

There are several types of ESWL devices. In one device, the patient reclines in a water bath while the shock waves are transmitted. Other devices have a soft cushion on which the patient lies. Most devices use either x-rays or ultrasound to help the surgeon pinpoint the stone during treatment. For most types of ESWL procedures, anesthesia is needed.

In some cases, ESWL may be done on an outpatient basis. Recovery time is short, and most people can resume normal activities in a few days.

Complications may occur with ESWL. Most patients have blood in their urine for a few days after treatment. Bruising and minor discomfort of the back or abdomen from the shock waves are also common. To reduce the risk of complications, doctors usually tell patients to avoid taking cfmirin and other drugs that affect blood clotting for several weeks before treatment.

Another complication may occur if the shattered stone particles cause discomfort as they pass through the urinary tract. In some cases, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone is not completely shattered with one treatment, and additional treatments may be needed.

Percutaneous Nephrolithotomy

Sometimes a procedure called percutaneous nephrolithotomy is recommended to remove a stone. This treatment is often used when the stone is quite large or in a location that does not allow effective use of ESWL.

Percutaneous nephrolithotomy.

In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. Using an instrument called a nephroscope, the surgeon locates and removes the stone. For large stones, some type of energy probe (ultrasonic or electrohydraulic) may be needed to break the stone into small pieces. Generally, patients stay in the hospital for several days and may have a small tube called a nephrostomy tube left in the kidney during the healing process.

One advantage of percutaneous nephrolithotomy over ESWL is that the surgeon removes the stone fragments instead of relying on their natural passage from the kidney.

Ureteroscopic Stone Removal

Ureteroscopic stone removal.

Although some kidney stones in the ureters can be treated with ESWL, ureteroscopy may be needed for mid- and lower-ureter stones. No incision is made in this procedure. Instead, the surgeon passes a small fiberoptic instrument called a ureteroscope through the urethra and bladder into the ureter. The surgeon then locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a form of shock wave. A small tube or stent may be left in the ureter for a few days to help the lining of the ureter heal. Before fiber optics made ureteroscopy possible, physicians used a similar “blind basket” extraction method. But this outdated technique should not be used because it may damage the ureters.

Is Any Research Being Done on Kidney Stones?

The Division of Kidney, Urologic, and Hematologic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funds research on the causes, treatments, and prevention of kidney stones. NIDDK is part of the Federal Government’s National Institutes of Health in Bethesda, Maryland.

New drugs and the growing field of lithotripsy have greatly improved the treatment of kidney stones. Still, NIDDK researchers and grantees seek to answer questions such as

  • Why do some people continue to have painful stones?
  • How can doctors predict, or screen, those at risk for getting stones?
  • What are the long-term effects of lithotripsy?
  • Do genes play a role in stone formation?
  • What is the natural substance(s) found in urine that blocks stone formation?

Researchers are also working on new drugs with fewer side effects.

Additional Reading

Coe, F. L., Parks, J. H., & cfmlin, J. R. (1992). The pathogenesis and treatment of kidney stones. New England Journal of Medicine, 327(16), 1141-1152.

Curhan, G. C., Willet, W. C., Rimm, E. B., & Stampfer, M. J. (1993). A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. New England Journal of Medicine, 328(12), 833-838.

Curhan, G. C., Willet, W. C., Speizer, F. E., Spiegelman, D., & Stampfer, M. J. (1997). Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Annals of Internal Medicine, 126(7), 497-504.

Savitz, G., & Leslie, S. W. (1999). Kidney stones handbook: A patient’s guide to hope, cure, and prevention (2nd ed.). Roseville, CA: Four Geez Press. (800) 2-KIDNEYS.

Understanding kidney stones . . . Management for a lifetime. (1995). San Bruno, CA: Krames Communication. (800) 333-3032.

Prevention Points To Remember

  • If you have a family history of stones or have had more than one stone, you are likely to develop more stones.
  • A good first step to prevent the formation of any type of stone is to drink plenty of liquids–water is best.
  • If you are at risk for developing stones, your doctor may perform certain blood and urine tests to determine which factors can best be altered to reduce that risk.
  • Some people will need medicines to prevent stones from forming.
  • People with chronic urinary tract infections and stones will often need the stone removed if the doctor determines that the infection results from the stone’s presence. Patients must receive careful followup to be sure that the infection has cleared.

Foods and Drinks Containing Oxalate

People prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods on this list:

  • Beets
  • Chocolate
  • Coffee
  • Cola
  • Nuts
  • Rhubarb
  • Spinach
  • Strawberries
  • Tea
  • Wheat bran

People should not give up or avoid eating these foods without talking to their doctor first. In most cases, these foods can be eaten in limited amounts.

Other Resources

American Foundation for Urologic Disease
1126 North Charles Street
Baltimore, MD 21201
(410) 468-1800

National Kidney Foundation
30 East 33rd Street
New York, NY 10016
(800) 622-9010; (212) 889-2210

Oxalosis and Hyperoxaluria Foundation
12 Pleasant Street
Maynard, MA 01754
(888) 712-2432, PIN# 5392; (508) 461-0614

For information about hyperparathyroidism:

National Institute of Diabetes and Digestive and Kidney Diseases
Building 31, Room 9A04
31 Center Drive MSC-2560
Bethesda, MD 20892
(301) 496-3583

For information about gout:

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
Phone: (301) 495-4484
TTY: (301) 565-2966
Fax: (301) 718-6366
E-mail: namsic@mail.nih.gov
Web site: www.nih.gov/niams/

The U.S. Government does not endorse or favor any specific commercial product or company. Brand names appearing in this publication are used only because they are considered essential in the context of the information provided herein.

National Kidney and Urologic Diseases Information Clearinghouse

3 Information Way
Bethesda, MD 20892-3580
E-mail: National Kidney and Urologic Diseases Information Clearinghouse

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1987, the clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, health care professionals, and the public. NKUDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and Government agencies to coordinate resources about kidney and urologic diseases.

Publications produced by the clearinghouse are carefully reviewed for scientific accuracy, content, and readability.

This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.

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Anti-Gay Former North Carolina Sen. Jesse Helms Dead at 86

Posted by pozlife on July 5, 2008

By Ross von Metzke | Article Date: 7/04/2008 11:44 AM

Former North Carolina Sen. Jesse Helms, often portrayed as a racist and a sexist in the media, died this morning on the Fourth of July. He was 86.

“It’s just incredible that he would die on July 4, the same day of the Declaration of Independence and the same day that Thomas Jefferson and John Adams died, and he certainly is a patriot in the mold of those great men,” former North Carolina GOP Rep. Bill Cobey, the chairman of The Jesse Helms Center at Wingate University, told The Associated Press.

But that image of patriot wasn’t always what followed Helms’ career. A die hard conservative, the right-minded Republican was known for his often controversial views and conversation-stirring tactics.

Perhaps his most controversial stand was his argument against recognizing Martin Luther King with a holiday. “The legacy of Dr. King was really division, not love,” he said at the time, labeling King an “action-oriented Marxist,” according to Time Magazine.

Later, in 1993, Helms took then President Bill Clinton to task for attempting to appoint an openly gay assistant secretary at the Department of Housing and Urban Development.

“I’m not going to put a lesbian in a position like that,” he said in a newspaper interview at the time, according to the Associated Press. “If you want to call me a bigot, fine.”

Helms was often known for pushing AIDS funding to Africa, arguing it would better serve people there than Americans dying of the disease.

Helms had been plagued by health problems in later years. In 2006, his family announced he had been moved into a convalescent home.

* Now I can say ” I like Callin’ North Carolina Home”

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"Sexual Silence" Contributes to Spread of HIV in Southern United States, Opinion Piece Says

Posted by pozlife on June 18, 2008

 

July 25, 2003

“The South’s inclination to avoid speaking about uncomfortable subjects” has helped make the Southern United States the new HIV/AIDS “epicenter” by encouraging “sexual silence,” Michael Alvear, a syndicated sex advice columnist, writes in an Atlanta Journal-Constitution opinion piece. The South has the highest concentration of the two groups most likely to be infected with HIV — African Americans and low-income individuals — and silence surrounding sex has “amplifie[d]” these demographic factors, Alvear says (Alvear, Atlanta Journal-Constitution, 7/25). According to CDC figures cited in the “Southern States Manifesto,” written by HIV/AIDS directors from various states and presented at a two-day conference in Tampa, Fla., in December 2002, more than 130,000 people in the South have AIDS, compared with about 100,000 people in the Northeast, 36,000 in the Midwest and 62,000 in the West. In addition, the officials said that the South has a bigger HIV/AIDS problem than elsewhere in the United States because of its racial and economic demographics and “a cultural conservatism that interferes with attempts to arrest the disease” (Kaiser Daily HIV/AIDS Report, 1/14). One of the most effective ways to prevent HIV transmission is for sexual partners to be aware of each others’ HIV status and “the only way to know is ask,” according to Alvear. However, many Southerners would consider such a question “too rude for words,” Alvear says, adding, “There’s a tradition here — if you can’t be kind, be vague. Problem is, you can’t be vague with a plague.” Alvear concludes, “The South, ever mindful of its manners, is killing itself with its own kindness” (Atlanta Journal-Constitution, 7/25).

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HIV/AIDS in the Southeastern U.S.

Posted by pozlife on June 18, 2008

 

The southern United States is a region both famous for fried chicken, sweet tea, and a slow pace of life, yet notorious for its religious conservatism and a history of slavery and segregation. The South has gained another reputation in the past few years, however, that is not so widely known: it is quickly becoming the center of the HIV/AIDS epidemic in the United States.
One reason why AIDS prevalence in the south has gone unnoticed for so long is that the average southerner doesn’t think the epidemic can affect them. Most associate HIV with large urban cities, like New York City, San Francisco, and Los Angeles, places that don’t have much in common with small southern towns. They also still see AIDS as a “gay disease” and are generally uneducated about HIV and what it means to be HIV+.
The southern region of the United States, as defined by the US Census Bureau, includes 16 states and the District of Columbia. The Deep South represents a group of six southern states (Alabama, Georgia, Louisiana, Mississippi, South Carolina, and North Carolina) that are disproportionately affected by the AIDS epidemic. From 2000-2003, CDC estimates show a 35% increase in new reported AIDS cases in the Deep South, but only a 5.2% increase nationally. The Deep South also has some of the highest AIDS death rates in the country.
Other health indicators, such as measures of diabetes prevalence, stroke rate, heart disease deaths, infant mortality and preterm births also show high mortality rates in the Deep South. Furthermore, the Deep South also has very high levels of STD infection. The Kaiser Family Foundation reported that in 2002, the five states with the highest rates of gonorrhea were all in the Deep South; these states also had high rates of chlamydia and syphilis. STD prevalence is of particular importance because the presence of an STD facilitates HIV transmission.
Since its discovery, HIV has disproportionately attacked socially marginalized groups, starting with the gay community and spreading to the poor and disenfranchised. Deep South states generally have higher poverty rates than other regions. Poverty contributes HIV/AIDS rates because individuals do not have access to health education or preventative services and cannot afford treatment. Poverty has also been associated with drug use, which can lead to HIV transmission through the sharing of needles.
The south also experiences a large number of rural HIV/AIDS cases. The 1995 US Census estimated that 43% of people living in the south live in rural areas. In rural areas it is often hard to find nearby healthcare, and many patients won’t or can’t get to services. This leads to late diagnosis and unintentional infection of others.
Nearly 80% of new AIDS cases in the South are among African Americans. The HIV/AIDS epidemic is concentrated in poor communities, where African Americans are disproportionately represented. This is particularly true in the Deep South, where populations are approximately 30% Black, compared to the 18.5% in other southern states. Overall, 25% of African Americans live in poverty and are 1.5 times more likely than Whites to lack health insurance. Medical and social service barriers for African Americans are not uncommon in the rural South, and access to HIV medication and care is no exception. Many African Americans feel distrust and anger towards the healthcare system due to historical oppression and enduring medical inequalities. This has led to conspiracy theories that are believed by even the most educated and has created barriers for HIV prevention.
HIV prevalence in the Deep South cannot be studied without a look at historical and cultural factors as well. Many people often blame the lack of medical professionals and poor access to healthcare for the South’s high HIV rates, yet the South is just as rural as the Midwest and does not have fewer health providers than other rural areas. The southern “culture of politeness” prevents discussion of topics that are deemed offensive, such as sex and homosexuality. Religious conservatism also contributes to the spread of HIV by affecting education. Many schools teach abstinence-only curriculums and don’t provide information about other forms of protection, putting youth at risk for infection. Religious conservatism is also associated with close-mindedness, which increases the perceived HIV stigma.
In the end it is important to consider all possible causes of AIDS prevalence in the Deep South states in order to provide more effective preventative and treatment services to everyone who is afflicted by HIV.
Sources:
Adams B. Polite to a Fault? HIV Plus.com May 2003; http://www.hivplusmag.com/column.asp?id=49&categoryid=1.
Adams B. The South Has Risen. HIV Plus.com May 2003; http://www.hivplusmag.com/column.asp?id=48&categoryid=1.
CDC. Fact Sheet: HIV/AIDS Among African Americans. Feb 2006. http://www.cdc.gov/hiv/topics/aa/resources/factsheets/aa.htm.
Reif S, Geonnotti KL, Whetten K. HIV Infection and AIDS in the Deep South. Am J Public Health 2006; 96: 970-973.
Whetten, K, Nguyen, T. You’re the first one I’ve told: new faces of HIV in the South. New Brunswick: Rutgers University Press.

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My True Colors

Posted by pozlife on April 18, 2006

SweatyIn the last few weeks a lot of talk has been going on about immigrant workers, it has made me think about race, gender and sexuality in the south. I first started to school in 1966 , rode the bus with black kids and thought nothing about it. I had no idea that the vacant school we passed on the way to and from school was the old "Colored " school. It was just at the edge of what we called " colored" or "The N Word" town. Back then every small town had its own black section. I had no idea what freedom rides were , at the time I would have guessed free rides at the fair . My state of North Carolina is on the rim of that boiling pot of the clan, Alabama. As a matter of fact, some of my neighbors now, were very active clansmen.To the point that in the 80's ,when my homosexuality became well known . My parents got the clan paper in their yard , complete with highlighted passages about them damn queers. Back in the golden years of my youth, I had no idea that black and white people were never allowed the same privileges. I knew that the " N" word was wrong , even if my big hearted grandma did use it , colored was what I was taught to call black people. That is until a day in the second grade when I called a girl colored and she turned and said " Oh, well what color am I ?" She then explained to me that black was the preferred term. I was even so far removed from the separatist world , that when I saw a sign in our local dry cleaners that said " Whites Only ", I thought that they only did white clothes. The only time I used the "N" word that I can remember, has to this day filled me with shame. I was on the bus talking with two friends , one just happened to be black and for some damn reason I called someone a "N". I know my friend was hurt, even after I said I was sorry. The hurt was so plain in his brown eyes, it was born out expectance, I saw that he knew this was not the first nor the last time he would hear that nasty word. I could also hear another word in my heart, one that I would hear many times in the years to come "Faggot" and then an there I knew that we were the same. Outcasts, one because of skin color , one because of a secret . A secert that made me hang my head in shame after many a "fag" roll call. There were only black, white and few native Americans in my graduating class and as far as I knew one queer.  As close as I got to exotic even back in 1979, was when my second cousin and her husband adopted an Asian baby. No one had any idea what changes were to come. Now they call Siler City " Little Mexico" in an article for National Geographic.

"A case in point: Siler City, North Carolina, close to the Raleigh-Durham hub that has seen a phenomenal 1,180 percent rise in its Latino population since 1980. At Siler City's new adobe-style church, St. Julia's, where flowers share garden space with jalapeño peppers, Friar Michael Lorentsen ministers to a thousand parishioners, most Spanish speaking. A dozen years ago a 125-seat Catholic church was big enough for this small southern town, whose population was then about 70 percent white, 30 percent black. Today 40 percent are Latinos, lured here by jobs, especially in poultry processing.

"Siler City would be a dry place in the middle of a mud puddle if it weren't for them," says Bob Hall. His produce store serves a mostly Latino clientele, many of whom are living in and revitalizing a neighborhood of former textile factories. "We came here for our children, to give them a better life, a better future," says a customer originally from Mexico. "There weren't the same opportunities for them back home, or work for me." Most Siler City Latinos earn low wages, and many hold two jobs, but they're making their version of the American dream come true as they buy cars, homes, and other middle-class comforts"

Bobby I love exotic looks and European accents arouse the "Dirty Boy" in me, so I am very happy to see the colors of my state expanding. Bill Maher has said illegals should " Stop and sign the guest book when they enter. " , I do agree on that , but we in the USA think we are the all knowing, great ender of all evils, we never think of how young a country we are.Our ideals are changing every day, only the true Native Americans can say " I belong here". Our country was founded by "illegals" looking for a better life and our very founding fathers said " give us your tired, hungry and poor." I work hard not to be a prejudicial person , but in the south that can be very hard. I remember about a year and a half after my lover died, I went out to the local bar and this very nice looking black leather man proceeded to pick me up. He was smart , sexy, fuckin built ,over 6 foot, shaved head , eyes the color of faded leather. He had a deep Barton voice, that rolled over you when he talked, like a vibrating caress. We went back to my place , talked and smoked a joint. That channeled our passion into some of the best sex I have ever had in my life, the very smell and taste of him was like nectar. I became all heady with need when he begged me to fuck him, as he was returning the favor, back in his chaps and harness . I came., out of nowhere, hands free. As he dove deeper impelling me , causing moans of desire. We spent the entire weekend talking, connecting and fucking. Come Sunday afternoon he had to leave, I gave him my number and we "WERE GOING" to do this again. After a week I received the call on Friday night ….I screened it and did not answer it. I told myself it was just to damn soon after my lover died, but I knew. It was because he was black and what would people say. Hell, what would my mom and dad say, wasn't my being a queer enough. In my mind I knew that both my parents and I had a big circle of black friends and that he was the kind of person they would like. I saw him again about 3 years later in Atlanta at the Eagle, I said "Hi." He acted as if he had no idea who I was, just what I deserved. I think he may have been one of the good ones , and I still ,at that time had to much old South in me to see it. Now I have grown enough to see that it is not what others think , but the kind of man I want to be and the kind of man I want in my life.

One last though, Why are the telephone sales people, never people who speak English well, It would be of great benefit to the employers to get people who can verbalize and be understood

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