Monthly Archives: February 2014

Valuable HIV Lessons for HCV

By: Marcus Hopkins, HEAL blogger

I’ve had three major relationships over the course of my life, so far, two of which took place after I received my HIV+ diagnosis in 2005.  These two relationships have each helped to craft and mold my ever-evolving views about the “Safe Sex” movement.  It’s actually more appropriate to say that they have augmented my views on “Safe Sex,” as I have long been of the opinion that having sex comes with a bevy of responsibilities, the onus of which falls upon all parties involved to ensure the safety and wellbeing of themselves and others.

Lessons LearnedAs I’m sure has happened with many others in my circumstances, one of my first responses after testing positive for HIV was to put a moratorium on having sex with others.  My thinking was, “If I can prevent the infection of anyone else as a result of sexual contact with me, I will be okay.”  Not only was this view unfair to me, it was unfair to others, as it put me in a position of unwillingness to cultivate meaningful relationships.

My first Post-HIV relationship reshaped the way I approached the topic of sex.  A complicated man whose views on sex and politics were as varied and radical as could be, but whose intelligence far outweighed many of his likely partners, challenged my views on sexuality and “Safe Sex.”  He practiced what many refer to as “Sero-Sorting” – the practice of having sex only with others who share your particular virus/illness in order to prevent the further spread amongst the uninfected.

Though it wasn’t the first time I’d heard of this practice, it was the first time I’d seen it used outside of the HIV- community.  While my boyfriend took HIV into account, it was, perhaps, the only virus he considered in his sorting – other nuisances like Hepatitis and Syphilis be damned, he was going to enjoy bareback sex with other HIV+ men, come hell or high water.

To be fair, at the time I was young enough to buy into his mindset without considering the ramifications of these other illnesses.  I hadn’t yet truly begun my in depth research on STDs/STIs outside of HIV, and so I merrily followed his advice, throwing caution to the wind.

It wasn’t until my first doctor’s appointment after my relationship with him ended that I began to take other diseases into account.  I had recently begun my coursework in the field of Health Communication, and my advisor suggested that I look beyond the scope of HIV/AIDS to address other sexual and reproductive health concerns.  It was then that I expanded my educational outreach to include other diseases, as well, not the least of which was HCV.

After this revelation, I entered into my second post-HIV relationship with a man whose sexuality was (and still is) both simplistic and confounding.  My third partner was a man who had come to age in the late 1980s, and had seen firsthand the ravages of the HIV virus in the Los Angeles gay community.  He was (and still is) the only person of his generation whom I’ve met who has never had unprotected sex.  Ever.

Having reached majority at the turn of the millennium, this is an amazing anomaly, to me.  I can’t even begin to account for the number of unprotected sexual encounters I’ve had, and this man can’t even count to “one.”

It is fair to say that he is likely a statistical outlier; there are likely so few people in his age demographic who can say the same.  He had a longstanding anecdotal joke that, whenever he goes to get tested, the person administering the test asks him, “Why do you even need to be tested?” likely as confused as the rest of the world that he has never slipped up, even during one of his infrequent drunken trysts.

This sort of sexual surety is something that I will likely never be able to claim, but it certainly helped to mold my evolving views on “Safe Sex.”  That someone can actually exemplify such steadfast sexual self-control is both an inspiration and a wonder.  It did, however, allow me to reconsider taking certain risks, and helped to develop my own guidelines for establishing a mutually beneficial sexual risk assessment that helps me determine whether or not a potential sex partner will turn into an actual one.

The more I write for HEAL Blog, the more research I do into HCV and the havoc it wreaks on the HIV community.  The statistics I research in order to inform my writing often astonish even me, and I’m about as jaded and realistic as someone who’s worked in the healthcare field for a decade can be.  Beyond just the bodily ramification of HCV, the sheer cost of treating/curing the disease is astounding on its own, much less in combination with the cost of treating HIV/AIDS.

Writing about HCV has afforded me the opportunity to reevaluate and reaffirm my approach to “Safe Sex” – we need to do away with the term, altogether.

I know that this is political heresy within the sex education community, but hear me out:

We need to reinvigorate sexuality with the concept of “Smart Sex” – taking responsibility for actions that place both you and others in sexually risky situations.

1.) Be Prepared – Arm yourself with knowledge about yourself, your sex partners, and sexual health; be willing to ask potential partners about their sexual history, health, statuses, and practices; don’t rely on any one person to provide protection – bring your own damn condoms; don’t assume that your potential partners are being truthful – people lie; get tested often and be truthful about the results

2.) Ask Smart Questions – Engage in an open and honest dialogue with any and every sex partner about their sexual health; gauge whether or not they’re being honest with you; find out whether or not they are under the influence of drugs or alcohol, and if they are, can you trust their word; determine whether or not drugs or alcohol will play a role in your sexual activities

3.) Engage in Full Disclosure – Be open and honest about your own sexual health practices; if you know you’re infected, disclose this information to any potential partners; ask if your partner is infected; don’t be afraid to say “No” if you’re uncomfortable with a potential sex partner’s answers

4.) Accept Responsibility – You are ultimately responsible for your own actions, as well as the repercussions; know your risks and make informed decisions – are you comfortable having sex with an infected partner?; think with your head, and not your genitals, making decisions based on reason and logic; know your risk factors – do you or your partner have any open sores or are you currently fighting an infection?

It’s my belief that following this approach to sexual encounters can help to stem the tide of HIV and HCV infection rates, not only within the HIV community, but in the sexually active community, at large.  We need to stop thinking in terms of “low risk”/”high risk”/”at risk” groups, and start operating from the perspective that everyone is “at risk.”

Viruses are some of the few things in life that affect everyone, regardless of age, race, sex, or station – we are all vulnerable to their ravages, and it is up to all of us to assume responsibility for ensuring that both we and those around us are kept informed and safe.

Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates.


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HB 465

By: Marcus Hopkins, HEAL blogger

Rep. Mia L. Jones

Rep. Mia L. Jones

We here at HEAL Blog have consistently hammered home our belief that testing for Hepatitis C become common practice in the course of medical examinations. This January, Florida State Representative Mia Jones (D – Jacksonville) filed legislation requiring doctors to offer patients an HCV test during check-ups.

This is an important step forward in the fight against HCV, particularly in a state like Florida, where the highest afflicted demographic (Baby Boomers born between 1945-1965) make up a significant portion of the population (18.2%).

What is important to note about this piece of legislation, HB 465 is that it requires only that doctors offer the test, not that the test be conducted. There are exemptions built into the bill for those who are facing a life-threatening emergency, are unable to consent, or have already been offered the test.

In addition to the obvious risk posed to Baby Boomers, another demographic should be considered, as well – people between the ages of 13-25, particularly Men who have Sex with Men (MSM).

While HCV’s most common manner of transmission remains injection drug use, the increase in popularity of injectable drugs within the MSM community increases the likelihood that HCV will be spread via sexual contact. Combined with an increased incidence of unprotected sex practices within this age demographic, there is little indication that the trend of sexual transmission will abate.

This demographic is one of the least served groups in America. People in this age range are less likely than their older peers to visit the doctor outside of an emergency, largely due to the perception that healthcare is out of their price range. As a result, they are also less likely to be made aware of any conditions for which they might not normally be screened.

Requiring that doctors at the very least offer testing to every patient is a small step, and means little more work for practitioners than simply asking the question. Whether or not the opportunity is taken advantage of is up to the patient.

This sort of common sense legislation is the type of advocacy we need to see in our state and Federal houses, but there are concerns on the part of Republican representatives and the Florida Association of Health Plans that the bill would “mandate” additional coverage.

In the wake of contentious battles over the Affordable Care Act, it would appear that insurers and the representatives who represent their interests in state and Federal governments have little appetite for legislation that requires coverage be offered for any additional medical conditions.

Both patients and insurers have consistently seen costs for HCV treatments as being “untenable,” both in terms of financial costs and in terms of reactions to treatment. The side effects of many of the traditional HCV therapies have kept many patients from seeing the regimen through to conclusion.

New treatment options are becoming available, two of which we’ve covered assiduously in previous posts, OLYSIO and Sovaldi. The costs of these two medications are, however, prohibitively high without Patient Assistance Programs. Both manufacturers for these drugs offer PAPs for their products, which greatly reduce the burden shouldered by individuals with lower incomes or little/no insurance coverage.

Insurers believe that mandating coverage for HCV treatment would require that they shoulder a greater financial burden, negatively impacting their bottom lines. This, of course, would result in patients being forced to ask for assistance when they mistakenly believe their insurance should cover the cost of treatment.

It is the opinion of this author that the crisis we face in terms of HCV far outweighs the financial interests of health insurance companies and their shareholders. The long-term costs of care associated with liver degradation and failure far outpace those of simply treating the illness when it’s first detected.

When insurance companies and legislators focus on near-term expenditures without taking into account the increased costs associated with failure to treat illnesses when they’re first detected, the primary victims of their shortsighted approach are patients.

HB 465 is an important first step to combating the spread and long-term consequences of HCV, and it is important our readers in Florida contact their local representatives to tell them to vote in favor of its passage. I feel it is incumbent upon our readers in other states to contact their representatives about crafting similar pieces of legislation.

Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

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