In the Life: Ep. 1803, "AIDS is Still a Big Deal"

[Host Michael Billy] Coming up on "In The Life"...Dr. Mathilde Krim and Phil Wilson on the state of AIDS. [Phil Wilson] Do you think we might see a cure at some point? [Dr. Mathilde Krim] There will be something. We're going to be able to block this virus. [Host] A victory against discrimination. [Bebe Anderson] The government is refusing to hire him based on outmoded assumptions about what it means to be HIV positive. [Host] And...HIV prevention on the World Wide Web. [Dr. Mary Ann Chiasson] If all these men are online, maybe we should be online too. [Host] All this and more on "In The Life." Documenting the people and the issues shaping the gay experience. "In The Life" is funded in part by the H. van Ameringen Foundation, Arcus Foundation, Newpol Foundation, The Estate of Richard W. Weiland and by the annual support of "In The Life" members...like you. [Uknown female voice speaking over loudspeaker]. Pat Lepore, Alan Berg, Ronnie Vines, Rick Schmidt, Paul Gunn, Michael... [Host] In 1981, a new virus that came to be known as AIDS changed the way society thought about health, sex, politics...nearly every aspect of our lives. "In The Life" began documenting the crisis in 1992 and with you we have witnessed the changes in attitude over the years as we reported on the anger... [Crowd protesting and man at podium]. "Fight back. Fight AIDS." [Host] the activism... [Crowds chanting] "Is a right, health care is a right." [Host] and the grief. [Elizabeth Taylor] Rock Hudson, Eddie Peterson, Cindy Gerando (?) [Host] But there is a surprising perception among many of today's young people that HIV is simply no longer a big deal. Tonight on "In The Life" the epidemic in 2008- the issues, the challenges, the battles and the people who are taking up the fight. ["In The Life" main title music playing]. During the 1990s HIV infection rates among men who have sex with men declined steadily. But since 1999 this number has been on the rise. In our lead story we look at a new approach to HIV/AIDS awareness in an era where more and more people meet sex partners online. We look at one effort that uses the web as an intervention tool to let people know that HIV is still a big deal. [Music playing]. [Dr. Mary Ann Chiasson] I started working in HIV in 1986 and looking at the data, it really felt like the '80s again. I mean, it was actually rather frightening. We did three large internet-based surveys looking at high-risk behavior in gay men and the relationship between that high-risk behavior and internet use. [Dr. Francine Shuchat Shaw] When Mary Ann and I decided to do this project together I do remember some of the alarming findings. People were reporting that they didn't disclose to each other their HIV status before having sex, well educated men believed that HIV was curable and that taking anti-retroviral therapy would prevent them from transmitting it. So they didn't need to use any safety measures. [Dr. Chiasson] It became very clear that to a lot of men and, and many men actually used these words, "That HIV isn't a big deal anymore." And when we heard that, we said, "Oh, we have to do something." [Sound of typing on a keyboard]. We thought, "Well, if all these men are online, maybe we should be online too." [Dr. Shaw] The HIV "Big Deal" project right now is comprised of three films- the first two are dramatic episodes. The first, "The Morning After" [Audio from "The Morning After." Fire engine sirens in the distance, man on bed waking up]. [Dr. Shaw] Every time we talked to a focus group or talked to men one-on-one, we heard a million stories but they all had one particular story in common and that was that they met someone, they had sex with this person, and then in the morning or the next day or the next week they found out this person was positive. [Audio from "The Morning After." Sound of man looking in medicine cabinet]. [Dr. Shaw] No disclosure, no conversation in advance about what's your HIV status. [Audio from "The Morning After"]. "It's this guy Eric that I met. We hooked up about a week ago. And he IM'd me last night. So I met him at Blink. We had a few drinks. [Unidentified Actor] I play Josh...uhm... he's kind of...uh... he's a bit of a party boy, I guess. [Music playing]. He's had some "at risk" or risky encounters. [Music playing]. And that's kind of the first time that it hits him, I guess. That, you know, that the reality of the lifestyle he's been leading. [Audio from "The Morning After"] "What happened?" "I don't know. All I know is that it was really intense and this morning I woke up and I found a bottle of multivir (?) in the bathroom with his name on it." [Dr. Chiasson] We wanted to make something that was very gay positive, respectful of people who have HIV and...but really exploring the, the difficulty it is in negotiating safer sex, in talking about your own status. [Audio from "The Morning After"] "Why'd you run off like that? We had a great time last night?" "Why don't you tell me?" "Tell you what? What are you talking about?" "The pills Eric?" [Unidentified Actor] Eric is an architect who's HIV positive. [Audio from "The Morning After"] "I thought you already knew." [Unidentified Actor] Eric really falls for him and he's afraid to tell him that he's HIV positive because he's afraid that he might chase him away. And, he thinks, "Well, if Josh didn't ask then I don't have to say anything." [Audio from "The Morning After"] "If you've been so concerned, why the hell didn't you ask me? "If anything, I should be worried about catching something from you." [Unidentified Actor] It is a difficult thing to talk about. Especially if you don't really know each other. Especially if you just met in and it's a potential hookup situation. [Dr. Shaw] We have our characters say, you know, the one who's positive says to the other one, "How do you know that you're not positive?" "Have you been tested?" And of course this fellow has not been tested. [Audio from "The Morning After"] "Safe sex is two-way street. It's not all up to me, you know." "Uhm... I'm perfectly fine. And me, ask you?" [Unidentified Actor] You don't want to jeopardize the potential, you know, a possibly good relationship and you're, you're afraid that, you know, by bringing that up that it's all of a sudden... it's gonna, it's gonna suck the... that initial magic out of the situation, you know. It's gonna make it too serious, too fast. [Dr. Shaw] Mary Anne, to my knowledge, didn't find that men assume that a partner, a prospective partner, is positive. [Audio from "The Morning After"] "You get wasted like that. How do you know whether or not you've already got HIV? [Music playing]. [Dr. Shaw] In fact they probably assumed just the opposite and that's how they get into trouble. [Music playing]. [Dr. Shaw] We found a lot of different learning theories concur- that a change in attitudes is a precursor to change in behavior. And to influence attitudes you must have an emotional appeal and storytelling is a very good way to make that appeal. [Audio from "The Morning After"] "Look can we...uh...can we talk? You want to get something to eat or something?" "You sure you have time? I hear you've been a very busy guy." "Yeah...uhm.. look, I got an HIV test today." [Dr. Chiasson] We found that men, actually after watching the video...in the three months after watching the video, were three and a half times more likely to disclose their status to their partners. [Dr. Shaw] The future of "HIV is Still a Big Deal" could be more webisodes, uhm...uh...taking on different parts of this population- women, different avenues, different situations. [Dr. Chiasson] One of our big goals is to get men tested, to get people tested who are at risk. 120 men were tested in the three months after they watched the video and 17 of them told us that they tested HIV positive for the first time. So that's fourteen percent which is really a lot. [Dr. Shaw] Having watched this epidemic, having friends who have suffered from the epidemic, friends who've had friends who've suffered from the epidemic, having a good relationship with my husband and my son and their friends uhm... it's...I just feel maybe kind of motherly about it. [Music playing]. [Dr. Chiasson] Many people are very private about their behavior and they, they don't want to talk about it with others. They may have trouble even admitting their behavior to themselves and so the privacy of the internet, I think, is a wonderful way to reach people who may not be reached in other ways. [Music playing]. [Host] In September of 2007 "In The Life" introduced you to Lorenzo Taylor who was denied entry into the foreign service because of his HIV status. With the help of Lambda Legal, Taylor filed a lawsuit against the Department of State and Condoleezza Rice. Tonight, we look back at the case and update you on this fight against discrimination. Lorenzo Taylor sued Secretary of State Condoleezza Rice under the rehabilitation act of 1973 which states that "No otherwise qualified individuals with handicaps shall be subjected to discrimination." [Bebe Anderson] Here you have the government, our own government, that's supposed to be a model employer. It's supposed to do a better job than the private employment sector under the law when it comes to accommodating people with disabilities and hiring people with disabilities and yet here we have this exceptionally qualified person, Lorenzo Taylor, and the government is refusing to hire him based on outmoded assumptions about what it means to be HIV positive. The State Department was enforcing a 1986 ban on hiring HIV positive applicants to the Foreign Service. [Lorenzo Taylor] It was a rational and humane policy at that point, but it certainly doesn't make any sense now. Colin Powell came in as Secretary of State back in the year 2000. Powell had been running around the world talking about stigma and discrimination against people with AIDS. [Colin Powell] No stigmatization, they are just like anyone else. This is one of those lessons we have to get to all employers and nations around the world. [Taylor] We started to think that maybe uhm... this might be a good time to push for uhm... opening the Foreign Service to people that are HIV positive. [Music playing]. [Host] Along with 15,000 applicants to the Foreign Service, Lorenzo took the written and oral parts of the exam. Only 15-20% passed. Lorenzo was one of them. [Taylor] Just to make it through that whole process was really exciting. It really felt like I had a lot of people who uhm... had known that this was something I wanted, who were there for me. It's really wonderful. [Host] Then came the medical screening. [Taylor] In one of the pieces they gave me was a form that said, "HIV testing at the top." And the third paragraph down it said, "That if you're HIV positive, you will be no longer considered eligible for employment." [Louise Crane] Being HIV positive is one of several medical conditions that require medical monitoring and medication. You are simply not eligible to go to the most difficult post, the greatest hardship posts. Therefore, you're not worldwide available. [Taylor] To have it put so succinctly and clearly was jarring. It was really, really surprising and I thought how many people would just have walked out who are HIV positive, would have just walked out at that point. Something inside me just pushed me forward and said, "I'm gonna go through this, I'm gonna get through this." [Dr. Douglas Ward] I've been taking care of Lorenzo for over 10 years. Uhm...he's one of the successful HIV patients and his viral load is consistently suppressed to an undetectable level. [Taylor] The fact that I can manage my own health condition and that I am, according to my own doctors and according to their examination, except for HIV incredibly healthy. I think makes it difficult to me to understand the arguments. [J. Anthony Holmes] We're very sympathetic to Mr. Taylor but at the same time we, we...just this principle of world wide availability cannot be compromised. Leading a normal life in New York or Washington isn't t all the same thing of leading a normal life in Ouagadougou or in Harare or in many other places in the world. [Taylor] I was certainly willing to travel anywhere and be posted anywhere in the world that the State Department would have put me. [Dr. Ward] My suspicion is that the blanket ban on new employees who are HIV positive doesn't come from the doctors, it comes from policymakers who have absolutely no concept of what the status of HIV is in this day and age. [Holmes] You have essentially two choices: one, is to maintain a uniform policy that applies to everyone; or, the other choice is you have a case-by-case approach and when you're dealing with 14,000 existing employees and 20,000 who annually every single year take the foreign service exam is that second choice really an option? [Anderson] They're trying to justify their policy by saying that if we let Lorenzo Taylor serve as a foreign service officer, we're going to have to let everyone else serve. That isn't what the law requires and they know that. The law requires you look at the individual. And, in fact, when you look at the individual and you look at Lorenzo Taylor he can serve. [Taylor] It's a real 1985 mentality in the 2000s that uh... doesn't recognize the whole evolution in HIV healthcare that's taken place. [Anderson] So victory in this case is going to be very important. Not just for making the federal government do what it needs to do but also letting everyone know that discrimination is still happening today and that is illegal. [Taylor] Opening a door of opportunity to people that are HIV positive is so important and sends such a strong message to people that are living with HIV around the world- that everyone is treated fairly and given the opportunity to serve. [Music playing]. [Host] On February 15th, 2008 less than two weeks before Taylor vs. Rice was scheduled to go to trial, the Department of State set new guidelines. Foreign service applicants will no longer be automatically disqualified due to their HIV status and they now must be evaluated on a case-by-case basis. Taylor now works for a federal public health program in San Francisco. [Music playing]. [Host] For more than 20 years, Dr. Mathilde Krim and Phil Wilson have been leaders in the fight against AIDS. In 1985, Dr. Krim founded the American Foundation for AIDS Research and in 2000 she received the Presidential Medal of Freedom. Phil Wilson is the Founder and CEO of the Black AIDS Institute. Let's hear what they have to say about the state of the AIDS epidemic. [Phil Wilson] Hello, Dr. Krim. [Dr. Mathilde Krim] Hi, Phil. [Wilson] It's good to see you again. It seems like we have to stop meeting this way. [Dr. Krim and Wilson laugh]. [Dr. Krim] We should not! [Wilson] That's right. We should not stop meeting this way, exactly. [Dr. Krim] It's always interesting and constructive. [Wilson] You have literally dedicated your life to fighting HIV and AIDS and at what point did you realize that's what it was going to be? In the beginning did you think that this is going to be it or? [Dr. Krim] Really in '83 when we became incorporated as a not-for-profit research organization we had a pretty good idea that we were far from seeing the global impact but it really could be expected. You could tell that it was going to be something big. The potential for really global epidemics is there with HIV. [Wilson] As you know, because I've said this before, that you're certainly one of my heroes and and you're, quite frankly, an unlikely AIDS hero. [Dr. Krim] I was very lucky not only to have been an biologist too good... you know, understand or see [unintelligible] so certain things in the rational way, okay? Secondly, that there was a woman. I was not the gay men and I would, nevertheless, totally dedicated to this. And thirdly that there was not a young girl. I was obviously a lady whose it was not talking it herself personal interest and the fact that I had a husband who was prominent in the entertainment industry- where he was respected, had many friends. And I could go from one to the other and as well and of course being able to put people on the air. I want screens with famous names and the most famous of all those has been Elizabeth Taylor who helped enormously just by being there. I would like to ask you a question about your work? [Wilson] Okay. What brought you to create the Black AIDS Institute? It's all a journey, you know. I got involved in HIV and AIDS in the very beginning in 1982. Uhm...and I found out that I was HIV positive around 1985, '84 or '85. And uhm...turns out that I'd been infected in 1980 and so by 1996 I actually had gotten very, very sick and my doctors thought that I was going to die and so I stopped working. In fact, my doctor had given me less than two days to live. [Dr. Krim] Oh my god. [Wilson] It was really that bad. I was in intensive care unit at Kaiser Permanente Hospital and my mother came out. So I stop working just as the time that protease inhibitors and the new known regimen were kind of coming on the market. So I started on, you know, those regimens, you know, and, you know, I came out of that and by 1999, I felt like well, "I should go back to work." And so we decided that we really had to get black communities engaged. So we started the Black AIDS Institute in an effort to mobilize, you know, traditional black leaders and black media and black civil rights organizations to kind of confront HIV. We've trained hundreds of people in the science of HIV. One of the things that is really, really problematic in Black communities is the low HIV science literacy. [Dr. Krim] That's right. [Wilson] And that's an important part of what... [Dr. Krim] There you go, back to education. [Wilson] And the thing is that when people don't understand the science of HIV, they're less likely to protect themselves against the virus... [Dr. Krim] Of course. [Wilson] ...you know. They're less likely to, you know, access treatment. It's difficult for them to adhere to treatments, you know. Their in no position to impact policy. Knowledge is so important. [Dr. Krim] Yes, people... acquire self motivation by knowing, you know, then...then education for safer sex makes sense. [Wilson] That's right, that's right. [Dr. Krim] And I think one of the big mistakes our society has made is to be...to make moralistic judgments about natural events. [Wilson] Right. [Dr. Krim] Natural events should be looked with what we know about nature and a rational system to analyze the events. [Wilson] Do you think that a national AIDS strategy is important? And what do you think it will take for us to develop a national AIDS strategy in this country? [Dr. Krim] We used to have a federal council, like an advisory Council to the president on AIDS. And the first...they were called czar's, remember? There were the AIDS czar's. Well one after the other kind of disappeared and I understand the council disappeared also recently. So there goes...the... unit that was in charge of developing or maintaining a strategy in this country. We don't have it anymore. [Wilson] We have no excuse for not being able to develop one. Other than, you know it requires political leadership. [Dr. Krim] It...it requires political leadership. It also it requires a grassroots movement. [Wilson] Mm-hmm. I did a lot of lobbying in the early years of the epidemic going from one office to the other Capitol Hill and also in the certain states. Everything with the state governments and... what amazed me is that the people high placed in government knew not more and sometimes less than the people the bottom. Important new strategies must start at the varsity level and and trickle up. Now, I think, give us what your vision or your sense of where the epidemic is today. [Wilson] Recently the CDC released studies showing that the AIDS epidemic in the United States is forty percent worse than previously believed, you know. Previously we thought that we were having about 40,000 new cases a year. [Dr. Krim] It's 50, yeah. [Wilson] It's 56,000 new disease. So that's a huge increase, you know. 25% of HIV positive people in our country don't know that they're HIV positive. That means a conservative estimate would say 600,000 people are living with HIV and they don't know that they're infected. 40% of the new cases among men are black. We see 70% of the new cases among adolescents and youth are black, you know. [Dr. Krim] See any very important aspect of the disease, its control, is to know where it is, who catches it, how is it...is...is transmitted, etc. And this we can know only if everybody gets tested and it is very important even people who are unlikely to come back positive they never know unless they are tested because there are no clinical symptoms to reveal infection. [Wilson] You've been at this for a long time and, and do you think we might see a cure at some point? And, and what might that look like? [Dr. Krim] Well because I have a fundamental belief in science I think, you know, it's only a matter of time. But we are going to get to understand this darn virus and know what it wants and what it needs and deprive it of it. And uhm... and, you know, there will be a vaccine. It's not going to be a vaccine based on knowledge of the immuno... immune system as in the past. But there will be something. We're going to be able to block this virus. And this is what makes me very hopeful. And in addition people like you, you know, who...work hard and are smart and knows what goes on and do the right things. We tend also to speak about data, about information on the epidemiology, you know, the spread of the disease and who gets it and who doesn't always counting the bad situations. We count the people who are sick or this or that. We don't count because we can't count all the lives we have saved already and the public should know that. There have been millions of people who have not become infected or have not died of, of AIDS because of what we have done in terms of prevention or treatment. [Wilson] That's right. [Dr. Krim] And that should be it is in fact very encouraging [Wilson] Well, thank you very, very much Mathilde. [Dr. Krim] Thank you for being here. [Music playing]. [Host] Thank you for watching "In The Life." To sign up for monthly air date alerts or to download past episodes 24-7, please go to our website at InthelifeTV.org or call 1-800-627-onTV. We'd love to hear from you. I'm Michael Billy. Thanks for tuning in and please join us next month. [Uknown male voice speaking over loudspeaker]. Joseph Anthony Azar, Lawrence Williams, Gary Smithback. [Uknown female voice speaking over loudspeaker]. Ron Keil Marty Story, Dale Taylor, Elaine Voucher. [Uknown male voice speaking over loudspeaker]. W.L McCormick, Ed Carter, Daniel Davila, Jr., [Uknown female voice speaking over loudspeaker]. David Hudson, Patrick McGuire and a very special young man, Damon Embree (?) "In The Life" is funded in part by The H. van Ameringen Foundation, Arcus Foundation, Newpol Foundation, the Estate of Richard W. Weiland and by the annual support of "In The Life" members...like you. [WNET Thirteen New York station identification music]. [American Public Television station identification music].