World AIDS Day was first observed in 1988 and each year after that on December 1st. The objective of World AIDS Day is to increase HIV awareness and knowledge, speak out against HIV stigma, and ultimately move towards ending the HIV epidemic. For the 2020 observance of World AIDS Day, the theme is resilience and impact as we work towards ending the HIV/AIDS epidemic.
During this episode you will hear from:
https://www.allisterdean.com/
https://thejamarrogers.com/
https://www.unr.edu/public-health
World AIDS Day was first observed in 1988 and each year after that on December 1st. The objective of World AIDS Day is to increase HIV awareness and knowledge, speak out against HIV stigma, and ultimately move towards ending the HIV epidemic. For the 2020 observance of World AIDS Day, the theme is resilience and impact as we work towards ending the HIV/AIDS epidemic.
During this episode you will hear from:
https://www.allisterdean.com/
https://thejamarrogers.com/
https://www.unr.edu/public-health
WEBVTT
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Hannah Khan: We move towards ending the HIV epidemic for the 2020 observance. The theme we are encompassing is resilience and impact.
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Hannah Khan: Today we have a few special guests with us, one of which being Dean Trudy Larson Dean Larson is the Dean of the School of Community Health Sciences at you and our
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Hannah Khan: She obtained her bachelor's degree at the University of California Davis and her medical degree at the University of California, Irvine.
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Hannah Khan: Dean Larson is a pediatric infectious disease specialist and has focused her career on HIV and AIDS Dean Larson is also the founder and medical director of the hopes clinic in town, providing medical care to those with HIV and AIDS.
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Hannah Khan: We are honored to have Dean Larson here with us today to discuss the history of HIV and AIDS in northern Nevada.
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Hannah Khan: We also have here with us. Jennifer how Jennifer has been with the Washoe County Health District for a number of years, serving as a health educator
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Hannah Khan: Sexual Health Program Coordinator, as well as a number of other physicians Jennifer obtained her bachelor's degree and her master's of public health at you and our
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Hannah Khan: She was a certified Health Education Specialist for a number of years and has a variety of additional certifications in behavioral interventions.
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Hannah Khan: Jennifer has advocated immensely on sexual health issues, particularly HIV and AIDS and teen pregnancy prevention at the local, state, and national levels.
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Hannah Khan: Jennifer continues to bring awareness to sexual health issues through data driven approaches and will be informing us on prevention and how to become more involved within the community. Thank you for joining us. Jennifer
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Hannah Khan: We also have here with us allaster Dean asked her was born and raised right here in Nevada and as a memoir author
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Hannah Khan: His first love was photography but has now delved into the world of writing allaster has written a few books, namely it delicious Lee wicked and Bradley better Australia will be sharing his inspiring story with us. Thank you for joining us Allister
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Hannah Khan: And finally, we have two more Rogers with us tomorrow is a singer a songwriter and an advocate.
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Hannah Khan: Tomorrow has performed on the voice and finished as a semifinalist as music has proven to be a powerful unifier
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Hannah Khan: Tomorrow has been using his platform to spread awareness about HIV and AIDS and messages of love.
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Hannah Khan: He's been featured on many platforms, one of which being named in the group as one of their 100 most influential African Americans tomorrow will also be sharing his inspiring story with us. Thank you for joining us tomorrow.
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Melanie Flores: Great. I'll go ahead and
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Melanie Flores: get you started.
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Melanie Flores: The pleasure for us to have Dean Larson here. Not only is
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Melanie Flores: She leaving us at the university but we really wanted to honor her and her role in
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Melanie Flores: Combating the HIV epidemic here in Nevada. So I thought it'd be amazing if we could hear the history and her being one of those I'm you know I'm
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Melanie Flores: I'm wondering what is a steamroller but that's really
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Melanie Flores: Not the term. I think it up. I'm more speaking up
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Melanie Flores: Somebody who's really like brought the HIV movement into northern Nevada in
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Melanie Flores: Terms of prevention and treatment and really bringing awareness to the area. So without further ado, I would like to introduce Dr. Carson
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Trudy Larson: Well, thank you, Melanie. It's my pleasure. I have been at every single World AIDS Day celebration, since it started in 1988
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Trudy Larson: And sometimes I get to present and sometimes I just listened. But it's always an honor to be a part of this, because part of this is also a remembrance. So thank you for letting me remember back to the very beginning. So if we can start for slide please.
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Trudy Larson: So it was it in June of 1981 when the mmm WR which is put out by the CDC first reported on five cases of a very unusual.
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Trudy Larson: Pneumonia called New assistance which really until that time had only been seen in those with cancer who are had serious immune deficits and so it was very unusual to see five cases.
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Trudy Larson: All in Los Angeles, all in gay men who have this same pneumonia, but also were noted to have other opportunistic infections as well.
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Trudy Larson: I happen to be at UCLA in I started in July of 1981 and we had grand rounds.
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Trudy Larson: And learn from Dr. Gottlieb, who was really the reporter of these cases just a conversation about how unusual. This was and trying to figure out why these young otherwise healthy gay men.
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Trudy Larson: Had immune defects that were so severe that allowed them to get infected was an exposure. Was it a virus.
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Trudy Larson: Shortly after those first five cases reported another 26 additional cases were identified across the country, San Francisco, New York City.
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Trudy Larson: All in gay men, and by the end of that year, there were three papers in the New England Journal all case studies of gay men with these very unusual opportunistic infections and thoughts that maybe this truly was an infectious disease. Next slide.
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Trudy Larson: So, so I want to go through sort of the timeline here because I think it's impressive.
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Trudy Larson: So now we're now we're at six months after the the first cases and early in 1982 the CDC came up with a case definition based on these case studies.
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Trudy Larson: Of aids and so they turned to AIDS acquired immune deficiency syndrome because it really described what they were saying in these otherwise.
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Trudy Larson: Healthy gay men subsequently transfusion and infant cases reported and then people who use IV drugs were reported and then women were reported. So it's very clearly not just
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Trudy Larson: A GAY disease. However, in the New York Times, a term this grid gay related immune deficiency. They started this, which was really inopportune because it somehow said only game. Then we're going to be
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Trudy Larson: Susceptible to this and it really sort of slowed things down in terms of being able to move forward. Clearly, a number of different populations were being
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Trudy Larson: Identified in 1983 they came up the CDC came up with eight transmissions patterns very clearly, noting that but that this appeared very much like hepatitis B.
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Trudy Larson: It appeared to be an agent that was transmitted through sexual contact through the sharing of needles and syringes through IV drug use and through blood and blood exposure.
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Trudy Larson: And so a very detailed definition was created. It helped a lot of us clinicians to identify our patients because remember we still didn't have a diagnostic test. And it wasn't until the end of 1983 that Luke once a year in France, and then early in 1984
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Trudy Larson: Early 1984
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Trudy Larson: Sort of my my slide set totally went away.
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Melanie Flores: What I I must have shared my screen. Can you still see my screen.
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Trudy Larson: No, we see another screen.
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Okay.
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Trudy Larson: There we go.
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Trudy Larson: There you go. Perfect. So wasn't until early 1984 then the same retrovirus PREVIOUS SLIDE, PLEASE was identified in the US.
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Trudy Larson: By Gallo and they finally they debated this whether this was really good to be the cause of AIDS. And finally, it was decided that this retrovirus new retrovirus that they identify
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Trudy Larson: Was the cause of AIDS and they named it human immunodeficiency virus. It's now 1984 it's three years after the first cases were reported we finally identified a cos. Next slide.
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Trudy Larson: So dream all of the scientific advances and descriptors and the ability to recognize people with AIDS.
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Trudy Larson: There were a lot of things going on behind the scenes that are somewhat understandable, but that contribute to the sad story of AIDS these cases were being night diagnosed in in what we might be termed marginalized populations populations that didn't always have access to mainstream
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Trudy Larson: Medical care or or the ability to come out and say, Here I am. I'm a great person.
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Trudy Larson: Gaiman. I mean, people who use it, drugs, people of color, we're in. We're being increasingly noted to be diagnosed with AIDS and these were traditional populations.
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Trudy Larson: Did not have a big voice. They're also grouped in big cities like New York City San Francisco other big cities in low socio economic areas where, again, there were not a
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Trudy Larson: Good support systems either economically or medically and also in poor areas in the south again without access to a voice.
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Trudy Larson: And so stigma and discrimination really rapidly came along with a because of the discrimination and stigma that were already experienced by these populations.
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Trudy Larson: And it was horrifying. And the way it was manifest medical personnel were afraid that they were going to get infected and especially early on before we knew what it was a virus and where this virus was there was a lot of fear and so nurses that absolutely refused to take care of patients.
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Trudy Larson: They were, they were spacesuits.
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Trudy Larson: And and just were extremely fearful of transmission. Now I will tell you, I had a lot of experience I had moved. I moved to Reno in 1983 after taking care of a lot of patients with AIDS in at UCLA. So I was pretty familiar with it was very clear. This was transmitted like
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Trudy Larson: So now your slides went away again.
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Trudy Larson: It was very clear that this was transmitted by blood and body fluids and therefore, really, we already knew what we needed to take precautions with so the nurses were scared to death when I would walk into a patient room without a mask.
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Trudy Larson: Without again without anything and and to talk to my patients. And so to see what they were doing and to see what we needed to do.
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Trudy Larson: And I wanted to model for them. The fact that this was not a casually transmitted infection. It really required
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Trudy Larson: Exposure to infected body fluids in a substantial fashion and in so in 1983 finally CDC came out with their guidelines.
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Trudy Larson: That said really universal precautions. This is where Universal Precautions came from and said, you know, when you're going to touch blood and body fluids wear gloves.
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Trudy Larson: Or where, again, if you're gonna be splattered or a mascot Ruby splattered. But otherwise, you don't need these extraordinary efforts and this was really important to be able to provide that human contact and with with patients who who died, many of whom lost their jobs.
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Trudy Larson: Either because they were gay drug abusers and had AIDS. They were kicked out of homes they rejected by families. They were alone. It was a Friday and terrible time and in extraordinarily sad for for physicians like me to say goodbye to all of their patients. Next slide.
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Trudy Larson: And so I think it was really important even early on that this was all about fighting HIV not fighting people with HIV that this was a virus, and it really needed to be emphasized that that this was not an implication of people. Next slide.
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Trudy Larson: So what happened because of the social issues. Well, HIV AIDS spread and it was partially because prevention messages were highly censored.
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Trudy Larson: I was not supposed to say the C word in any of my educational programs. We didn't mention it in high school, for sure.
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Trudy Larson: And you didn't want to mention sexual intercourse particularly Lily not anal intercourse. So prevention messages out of CDC were also censored.
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Trudy Larson: The federal response was extremely slow and very blame based these people did things that made them at risk, they get what they deserve it could not tell you how many times I heard it was terrible.
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Trudy Larson: And so very, very slow response on the part of the federal government medical providers were very frustrated and demoralized because all of our patients died, we can only treat the opportunistic infections. We didn't have anything else to fight HIV.
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Trudy Larson: Because of the numbers of patients hospice care really evolved to include aids hospice hospitals and rewards to take care of these
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Trudy Larson: Folks with people who really wanted to care for them and give them a sense of belonging, even in their final hours these social issues are absolutely overwhelming for so many patients and for us as well. There was, it was a very difficult time to be to be part of. Next slide.
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Trudy Larson: In 85 we finally had the first commercial HIV antibody tests. This is the diagnostic tests that is still use although we're now in the fourth generation.
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Trudy Larson: But finally, we could do widespread testing President Reagan said as for the very first time in public in 1985 four years after the first cases.
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Trudy Larson: In 86 NIH to establish the clinical trials group to try to improve the the medications that were beginning to come out and in 87 the first medication AZT, also known as I do have your Dean was licensed by the FDA. However, he is you can see on the right side of this slide.
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Trudy Larson: It was pretty. It was a pretty difficult diagnosis in these early years.
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Trudy Larson: On this graph. What it shows is a months after an opportunistic infection diagnosis of survival. And you can see by 10 months I'm only 40% of the folks were still alive and it was
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Trudy Larson: You know sir routinely dreadful after years, suggesting that in this six years that are covered by this graph, we really did not have anything of substance to offer. Next slide.
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Trudy Larson: So with AZT, that was a start.
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Trudy Larson: In in 9293 as case definition expanded
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Trudy Larson: To include CD four counts because they now had a way to measure them so that gave us a sense of how immune suppressed our patients actually were and gave us opportunity to actually give medications that could stop.
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Trudy Larson: Them from getting some of the opportunistic infections. So that was very important. We also identified other cancers infections that were associated with HIV and its immune suppression.
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Trudy Larson: New drugs were developed DDI DDC D 40 was another one. Those are all early nuclear side reverse transcript died crumbs crumbs days inhibitors which is the only class of drugs we had at that time.
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Trudy Larson: Very importantly during this period of time, the Ryan White Care Act was passed, and you see this picture that young man is Ryan White Ryan White was a hemophiliac, and he acquired
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Trudy Larson: HIV from his transfusions that were required to give you this clotting factors and that's his mom and they actually went to Congress and testified to try to bring attention to the issues of care for HIV and AIDS and the Care Act has been has been
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Trudy Larson: Has been reauthorized every single year since it was first pass to provide care medications education.
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Trudy Larson: And in particularly important for all of my patients as drug assistance program because these these drugs have always been expensive. They were expensive then and the AIDS drugs Assistance Program is
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Trudy Larson: As a needs based program that really pays for medication was huge, huge in an OG getting medications out to a lot more people who are infected with HIV.
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Trudy Larson: Early Intervention clinics expanded because of the Ryan White Care Act. It was one of the happy things that happened in 91 and 92 and 93 this
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Trudy Larson: One of the big world eight conferences that I went to the Concord study which was a study to say what if we started treating as soon as we found out somebody had HIV.
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Trudy Larson: When and it was compared with differing and tell people got a little sicker. Like they started having symptoms and what they discovered was there was no difference in any death rates over three years with either early or deferred single drug therapy. It was so sad. Next slide.
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Trudy Larson: And one of the ways that that people express their sadness during this time was with quilts. And so this is just a small portion of the AIDS Quilt.
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Trudy Larson: And every section is dedicated to a person who died of AIDS made by their friends and their families all very different all representing them and their personalities.
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Trudy Larson: As I think the last time this was displayed in its entirety it covered the entire mall in Washington, where the Washington. Washington Monument is a very, very powerful expression of the toll that this virus chick. Next slide.
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Trudy Larson: In 94 we got some good news.
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Trudy Larson: AZT was given to pregnant women. This took three years of work in the NIH to try to get a medication to pregnant women before that it was not allowed, but because of the clear transmission of HIV from a pregnant woman to her baby.
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Trudy Larson: They said, let's go ahead and try it and it was remarkably effective at reducing transmission. So mothers given AZT during pregnancy their babies given AZT at birth and and for another two months.
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Trudy Larson: Reduced transmission by two thirds, just with AZT alone. This was the first prevention trial with a drug that prevented acquisition of infection.
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Trudy Larson: A happy note. And just so you know, since 1994 there have been no birth of HIV infected children in Washoe County, which is an amazing statistic for us. Next slide.
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Trudy Larson: 1995 and six finally
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Trudy Larson: Viral load testing became available PCR was actually discovered created and this allowed us to understand how much virus was circulating in our patients and to understand if the medications we were giving them were actually effective or not.
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Trudy Larson: And this really cool graph here. This shows that when you have a high viral load you progress to AIDS quite rapidly and when you have a low low viral load, you don't
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Trudy Larson: And so the goal became with all medications to try to reduce the viral load, so that it was very, very low to stop the progression to AIDS in 9596 the first protease inhibitor was approved by FDA. The first major, major breakthrough in terms of fighting HIV. Next slide.
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Trudy Larson: So you can see here what the introduction of of protease is did
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Trudy Larson: Along with the combinations. So it's very clear that three drugs were going to be needed to really treat this appropriately because of its rapid replication and mutation rate of the virus. And so you can see here that deaths.
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Trudy Larson: From aids peaked. And then as soon as we started getting really good antiretroviral therapy that
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Trudy Larson: We had a substantial decline in the death rate a huge decline in the death rate when people used antiretroviral therapy. Next slide.
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Trudy Larson: This was, I was at the at the world's AIDS Conference when this was announced, and this was, it was a joyous time we finally had a medication that had a chance of giving, giving to our patients.
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Trudy Larson: This was so powerful that it appeared this triple drug combination can suppress a HIV replication.
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Trudy Larson: Down to 50 and allow the immune system to recover. So the CD for sale started coming back. So that's what we identified as being the goal. So very aggressive treatment hit hard hit early, that's what we did. We started people immediately on these
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Trudy Larson: This is where we came up with a cocktail.
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Trudy Larson: The three drug cocktail, and the mathematical models looked at how fast.
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Trudy Larson: That the HIV became undetectable thought that if we can keep that viral suppression for three years, maybe we can totally eradicate the virus. It was it was a very exciting year of potential and then reality hit Next slide.
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Trudy Larson: The next year, they found these resting to memory cells, a sort of a CD for cell precursor team memory Linda sites that have HIV DNA in the cells.
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Trudy Larson: That were just resting and as soon as you activate it that sell it began to produce HIV.
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Trudy Larson: And so we had no way to get rid of these T memory lymphocytes, they reside in lymph nodes all over the body. And so the virus was there and we identified that we could never get rid of it.
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Trudy Larson: And so it was identified, even with complete viral suppression, we could not get rid of this virus. And so the model changed from eradication.
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Trudy Larson: To chronic disease and chronic disease management, but at least it offered an opportunity for rebuilding of the immune system.
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Trudy Larson: And the notion that folks would need to take medication their entire life to keep this under control.
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Trudy Larson: This also we started seeing long term toxicities occur from medications and from disease with fat redistribution metabolic abnormalities
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Trudy Larson: Medications were significantly hard to take next slide just to show you like this is one day's worth of pills.
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Trudy Larson: For three drugs, some of them had to be taken twice a day. Some three times a day. They had to be taken with or without medication.
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Trudy Larson: In the morning before they went to bed. It was a nightmare. So being adherence trying to take these medications. When you were supposed to some of them required refrigeration.
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Trudy Larson: I learned that my patients didn't have refrigerators. I didn't know that. So these social determinants of health.
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Trudy Larson: Became huge factors in the ability of people that actually do that. We asked about their digest food. So could you take your medications with food is directed
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Trudy Larson: Because that was really important to get enough, high enough levels. So this was a such a such a difficult time to help patients. Learn how to take their medications, but when they did.
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Trudy Larson: their immune systems recovered.
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Trudy Larson: And they were really given a huge hope of life. Next slide.
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Trudy Larson: You can see this is just one pipeline started with AZT continue with the multitude of protease inhibitors and it just keeps going.
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Trudy Larson: And so there was a lot of effort to try to say, can we make these medications better and can we make them safer. And so let's look at where we are today. Next slide.
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Trudy Larson: So today we have combination pills. The three dread meant regimens come in one pill that needs to be taken once a day so that huge pill burden has been taken away and made much, much simpler, it still requires that you take that pill every single day.
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Trudy Larson: Now we're starting to see long acting medications. Some of the newer ones. They're not quite licensed yet but they will be soon.
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Trudy Larson: injectables that you take every 330 days you come in, just like birth control, you get your
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Trudy Larson: Shot every 30 days and that takes care of it. They also have some that are looking at once every two months. In other words, making it easier and easier and easier.
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Trudy Larson: To be adherent to these regimens that provide these medications that keep the virus under control. However, there are also expensive so are a death.
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Trudy Larson: Becomes an incredibly important resource, they're safe much much safer than the early medications and very easy to take
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Trudy Larson: So now our current prognosis is a normal lifespan by controlling HIV giving routine follow up and making sure that you get your blood pressure taken care of and all the other tasks that
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Trudy Larson: I didn't think I would ever see my patients have and we used to joke that we were getting old together and starting to Creek when we got up and complaining have our backs aching and and we had rejoiced that we got to do that because of these amazing accomplishments. Next slide.
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Trudy Larson: However, the AIDS crisis is still not over, even with these amazing advances. Next slide.
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Trudy Larson: In 2010 during the Obama administration that actually came up with a plan.
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Trudy Larson: Reduce the number of people in becoming infected increase access to care, reduce health disparities.
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Trudy Larson: Ds and have organizations work together. Next slide. Was the first time we've ever had a national strategy and this is how we were going to measure it. We were going to look at this care continuum, where the first bars. How many people are diagnosed
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Trudy Larson: This is from 2016 so a little bit better now. But essentially at this time 14 people 40% of people were not yet diagnose. They didn't know they had HIV and clearly there those folks are the ones that have
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Trudy Larson: More opportunities to infect other people. So really fueling continue transmission of those who are diagnosed only 64% actually got into care.
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Trudy Larson: And 49% were retaining care and 53% actually had viral suppression, so you can still see even with all of our medical innovations, there are still some major, major problems with being able to really control this virus. Next slide please.
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Trudy Larson: And it's changed white gay men were the first advocates and those who really pushed for so many things to happen.
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Trudy Larson: Federal government, local governments, they were a huge advocates, but the
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Trudy Larson: Epidemic has changed in its nature, and particularly for those who don't have access to things like testing.
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Trudy Larson: And so, people of color. Now comprise far more of those who are getting infected and are infected and so we need to do more to really be able to come to what we really need to look at now. Next slide.
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Trudy Larson: If we look at men who have sex with men, these statistics are sobering African American men who have sex with men have a one into chance
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Trudy Larson: Of getting infected by HIV over their lifetime. One in four for Hispanic men who have sex with men, one in 11 for white men who have sex with men. These are very unacceptable statistics. We can do a lot better. Next slide.
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Trudy Larson: So is one of the answers to try to really prevent infection and reduce transmission through prep or through task treatment as prevention.
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Trudy Larson: I'm hoping that john Jen is going to talk a bit more about PrEP, but the the first study that was done was a study with pregnant women. And when you gave their infants AZT, they didn't get infected that's prevention. Next slide.
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Trudy Larson: So I don't know if you've ever seen this you equal to you. Well, that's our current model.
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Trudy Larson: Undetectable virus equals untranslatable virus. And so for all those folks who are in care on medications, who are undetectable. They do not transmit HIV.
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Trudy Larson: And that's critically important. If we really want to look at reducing our number of new infections PrEP is the other side of that to try to prevent infection in the first place. Next slide.
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Trudy Larson: So you may have seen this. Getting to Zero. This is an initiative and I never thought in my lifetime that we'd actually have a chance of doing this next slide that. Next, click. So our goal is no HIV. Next, click
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Trudy Larson: And to do that we have to find everybody who has HIV now. Next, click
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Trudy Larson: We need to cure those that are infected or make them undetectable. Next slide.
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Trudy Larson: And then we need to stop transmission
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Trudy Larson: Can't. Can we do all these things. Well, yeah, we can because look at all this stuff we've already done.
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Trudy Larson: We've already found the virus that took four years and a lot of sophisticated scientific work. Big Pharma companies independent researchers have found safe and effective medications.
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Trudy Larson: Global research involving the thousands of people have shown that you equals you the ADA act within that
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Trudy Larson: Noted that HIV is a disability allowed for support and disability payments for those people who have HIV, who really need that assistance ACTA that huge federal program brought a lot of men into Medicaid, so that they could get care. And so those were really big financial and discrimination.
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Trudy Larson: federal efforts, we have team based care is a new norm. So all of the social determinants get asked about now and HIV tests are fast and easy.
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Trudy Larson: And so these achievements have made a shady a chronic disease normal lifespan reduce infections for adults and children.
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Trudy Larson: Next slide. So, so where are we at, how do we get to zero. We have all the tools, all the tools to stop HIV AIDS, we have testing. We have treatment. We have a safe and effective medication. So what's stopping us
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Trudy Larson: The things that have stopped us all along cost stigma and discrimination social inequality. I can't. That is not something that any one person could attempt
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Trudy Larson: By themselves, however, to honor and remember those because that's what World AIDS Day is about 200 remember those who are no longer with us due to HIV AIDS, we should commit to overcoming these obstacles to eradicate HIV from our world, because it is possible
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Trudy Larson: Thanks.
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Hannah Khan: Thank you Dean Larson for sharing the history of HIV and AIDS, your knowledge and experiences with us. It's now my pleasure to introduce Jennifer Howell, who will discuss prevention of HIV and AIDS and how to become more involved within the Community.
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Jen Howell: All right, thank you so much. And thank you so much. Trudy you've been an inspiration to me for so many years, and
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Jen Howell: I'm so sad. I'm so glad that I would have the opportunity to work with you and so sad to see you go, but you've left quite a legacy for us to all work from. So thank you so much.
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Jen Howell: All right.
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Jen Howell: Let me share this
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Jen Howell: So can we all see that
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Jen Howell: All right. Um,
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Jen Howell: I'm truly touched on a lot of things that I was going to discuss so
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Jen Howell: I'll kind of cruise through there as they come up. But or
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Jen Howell: kind of reiterate important points, but we really are at up
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Jen Howell: A wonderful opportunity today and the epidemic. And even with the current administration putting forth resources to do that in the end of the epidemic plans.
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Jen Howell: We really there's been a recognition that we have the tools we just need to work to bring everything together to stop new HIV infections, which will in effect in the epidemic.
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Jen Howell: However, stigma drives this stigma social term determinants of health, health inequities those drive this disease. And we're seeing that. And the covert epidemic as well.
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Jen Howell: But we really, there's a lot to be learned from HIV and a still a lot more to go.
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Jen Howell: So let's just have an idea for the impact
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Jen Howell: Globally, we've had 38 million infections and
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Jen Howell: Interestingly, almost 2 million of those occurred in 2019 but that's a decline since 2010 so that's exciting news that global infections are decreasing
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Jen Howell: It's still an estimated 21% of people globally, do not know their status, and that is something that needs to be corrected through more testing, but there's a lot of barriers in place for people to get tested.
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Jen Howell: And this is still a leading HIV is still leading cause of death worldwide. But those deaths have reduced binary just 60% since since they peaked in 2004 which is great news. So most of the cases still are in eastern southern Africa and then dispersed.
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Jen Howell: Throughout the rest of the world. As you can see here
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Jen Howell: In the United States about an estimated one in seven people are living with HIV and don't know their status and Trudy spoke about that. And I have a slide that
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Jen Howell: That presents that in a different way. So you can see more of the impact we have over a million people living with HIV in the US and we have been steadily are stable infections.
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Jen Howell: new infections have been stable at about 38,000 a year since 2014 which is excellent news.
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Jen Howell: When I started 20 years ago it was over 100,000 new infections and then it dropped down to 80,000 50,000 54,000 I remember that number. And now we're at 38,000 so that is amazing.
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Jen Howell: But that's one infection is too many. And so we really need to look at the populations that are disproportionately impacted and that includes communities of color, African American females are
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Jen Howell: highly impacted and geographically. We'll look at that the transgender community has a high burden of disease. And there's a lot of risk associated in that in that community that needs to be addressed.
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Jen Howell: And then most of our cases still occur among men who have sex with men, and we say men who have sex with men because we're identifying a behavior and
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Jen Howell: There's a lot of men who have sex with men who don't identify as being gay or bisexual and so we need to identify and look at the behavior and how we can reach men who are engaging in sex with other men, and not just target the gay and bisexual community and and pigeonhole that community.
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Jen Howell: So looking at
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Jen Howell: disease transmission categories of men who have sex with men comprise most of our new infections, followed by heterosexuals and then people who inject drugs. And then there are the group of men who have sex with men who also inject drugs and so
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Jen Howell: These are these bring up important points of what we need to address. We need to address the social determinants of health is Trudy said, and we we have an opioid epidemic. The we can all work together to address these multiple concerns if we just bring our resources and our minds together.
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Jen Howell: Looking at it by in communities of color and transmission categories. Black or African American men who have sex with men comprise 25% of new infections and it's true, said
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Jen Howell: We can do better with this we know where transmissions are occurring and we we need to work with the communities bring dries the communities up, bring them up support them and and give them the tools to address HIV in their communities and address other health issues as well.
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Jen Howell: And then if you look for heterosexual contact African American Black women comprise 10% of infections that that's disproportionate to the representation in the community or in the population.
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Jen Howell: Geographically, the South, or what's known as the Bible belt has most of new infections with almost 20,000 and 2018 followed by the West Coast and a lot of those do occur in the urban areas, but we do have representation and suburban and rural areas and so it's not
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Jen Howell: Just relegated to a sit big cities HIV occurs everywhere.
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Jen Howell: Here's kind of representation of where the states are at Nevada is
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Jen Howell: When we do represent a good amount of infections. And luckily, we're not in the darker colors, but we are on our way there.
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Jen Howell: And then looking at why it's important for people to know their status and this goes into some more topics that I'll get into in a few minutes, but
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Jen Howell: For the people that don't know that their status, they don't know, they have HIV and for those that know they have HIV and are not in care. They're responsible for 81% of new infections.
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Jen Howell: 81% so if we can get more people tested more people into care and that HIV care continuum, really, you know,
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Jen Howell: measure our progress with that, then we can help reduce new infections. Now you see down at the bottom. The 51% of people who are taking their medications that are virally suppressed.
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Jen Howell: They are responsible for zero new infections, and that's what Trudy was talking about with you, equals you undetectable equals on transmittable unequivocably the data is solid, you cannot argue with it. People who are virally suppressed will not transmit HIV.
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Jen Howell: So where's Nevada with this be ranked fifth in the US for new HIV infections with the rate of 16.8 per 100,005th
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Jen Howell: Where
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Jen Howell: We people say, you know, it's not a big deal and about it is we ranked eighth for Stage three infections, which stage three.
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Jen Howell: HIV infections is the new term we're facing the word aids out because of all the stigma associated with that. And a lot of people who are
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Jen Howell: diagnosed with HIV. Now, if they get on their medications quickly hit hard hit it early.
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Jen Howell: They will never progress to stage three infection or advanced HIV disease and so that term is becoming more and more antiquated. There's still a lot of people who identify as being an aid survivor or living with AIDS, but for the most part.
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Jen Howell: To help reduce the stigma and help help tell a better story about HIV. The word AIDS is is, like I said, being discontinued.
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Jen Howell: In Nevada total between HIV stage one and two and stage three infections. We have about 11,000 or almost 12,000 people living with HIV in our state.
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Jen Howell: It's really interesting because
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Jen Howell: Our cases are kind of half and half of people who have progressed to stage three infection and
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Jen Howell: People who have it. And I think that's really interesting. We have a people, a lot of long term survivors here and our state and we need to
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Jen Howell: address the needs of long term survivors, because people who have fought since the 80s, the 90s and have lived with this disease. They bring a whole kind of set of baggage if, for lack of a better term, or experiences with them and some survivor guilt.
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Jen Howell: You know, they thought they were told they were going to die within a couple of years, we saw the graphs that tree presented that said you know it didn't look good people were were dying very quickly.
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Jen Howell: And so they're people had to move past that and realize that they were living and then how did they decide how are they going to live.
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Jen Howell: Are they going to live powerfully or are they going to live kind of fly by the seat of your pants and not plan for the future.
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Jen Howell: And so those are things that we need to continue to address because it goes into prevention and treatment and people being able to be to retain themselves in care.
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Jen Howell: Looking at in Nevada by diagnosis among males and ethnicity, excuse me, race, ethnicity,
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Jen Howell: Black males and Latinx still are disproportionately impacted by rate and this is unacceptable health disparities in our state. We are small enough state where we can really make an impact on health disparities.
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Jen Howell: And we need to do so because we, we have the opportunity, even though you know
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Jen Howell: We have a lower number of cases, we have the opportunity to make a big impact with those lower number of cases compared to other states. And I said in Washington County, particularly as well among females by ethnicity black females are way disproportionately impacted in our state and
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Jen Howell: We need to address the health concerns of our African American black communities and our Latin next communities and Asians are increasing cases among agents.
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Jen Howell: Have been increasing, and so we need to look at all these and say, Do we have the right people at the table to tell their stories to give us their experiences and then for us to provide the resources for those communities to build up their prevention efforts.
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Jen Howell: I'm wearing a t shirt. Actually, this has this on it is. This is from Keith Haring he was a wonderful artist in the 80s and he
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Jen Howell: Died from HIV related causes and this became a mantra of the prevention and actually the whole HIV movement, the ignorance equals fear and silence equals death.
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Jen Howell: And this continues today. I tell people in my HIV class.
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Jen Howell: You if you talk about if you stop talking about something that doesn't go away. It rears its ugly head in some way, shape, or form and
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Jen Howell: You need to use knowledge and power to combat that. And so we need to keep talking about HIV. We can't stop the conversation we cannot let there be ignorance, especially when we have so many resources and education and information available.
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Jen Howell: So we measure our progress now by the HIV care continuum that Trudy spoke of. And really this is
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Jen Howell: Looking at getting people tested having them know their status, the CDC recommends that everyone between the ages of 13 to 64 and have at least one HIV testing in their lifetime and more depending on their risk. Um, so
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Jen Howell: So testing is key. However, we have providers that are not taking sexual risk histories, they're not offering HIV tests and I'll talk in a minute or so about
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Jen Howell: What we're doing to address that. So we need everyone to step up to get people diagnosed, and if they're positive we link them into care, get them retaining care.
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Jen Howell: Get them on medications and then help them stay on their medications and achieve viral suppression, so they will not transmit the virus and we will have new infections from people that are in care.
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Jen Howell: And then if they're negative we link them to prep services or prevention services, get them engaged and retained in those services provide the medication and then they will not acquire HIV if they're on these medications.
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Jen Howell: But to do this kind of the theme of the day is to address those social determinants of health and health and apologies.
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Jen Howell: And stigma, which drives all of this. So before we can get people tested before we can get them linked into care and have them achieve viral suppression, we need to look at racism poverty homophobia.
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Jen Howell: Homelessness misogyny classism, we need to look at all of these issues.
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Jen Howell: Because people won't come in the door. Unless we're addressing these things, they won't even come in the door to get tested because they're dealing with other bigger issues.
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Jen Howell: And so our programs have to address these things we have to have a safe place for people to go. And then when they're in care or on PrEP. They need a safe place to maintain that. And this is absolutely crucial if we're going to end the epidemic. It's not just providing people medications.
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Jen Howell: The plan to end the epidemic is fourfold for evidence based strategies of diagnosis, treatment, prevention and then response.
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Jen Howell: And spoke about these already, but diagnosing people as early as possible, get them on medications as quickly as we can.
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Jen Howell: Like in Southern Nevada. They're doing a rapid art so rapid start rough with art so
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Jen Howell: They're getting people on medications and this is happening across the country, but they're getting people on medications, the day that they're diagnosed the data they get their test results.
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Jen Howell: And there's just so many more wonderful health outcomes that come from that because HIV then doesn't have the opportunity to break down the body and cause damage.
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Jen Howell: As much so we want people to get tested early. Another issue that we're seeing in Washoe County where we want people to get tested early
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Jen Howell: Is we're seeing a lot of late testers. What we mean by that are people who are getting diagnosed when they're in the hospital it with advanced HIV disease or stage three infection which which has been known as AIDS and we're actually putting out
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Jen Howell: An epi news article about this in the next month to really discuss the characteristics of people in that category. And we looked at data over 10 years we had 83 of our cases and Washoe County were late testers and Hispanics were
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Jen Howell: More represented in that group and then people under the age of 40 over 60% or 6% of those cases were under the age of 40 so that means it's a good 10 years
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Jen Howell: That they were likely infected before they ended up in the hospital and sick or more. The average time for a person to develop stage three or AIDS diagnosis.
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Jen Howell: Is about 10 years. And so, I mean, it's different for different people. But that's the average. And so you think back to if they're in their 40s. They were infected in their 20s, if they're in their 20s. They were infected in their teens.
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Jen Howell: And what did. Where did we miss the boat we missed the boat with sex providing good sex education.
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Jen Howell: We missed the boat with providing testing opportunities we missed the boat with this disease being highly stigmatized where people are scared to know their status and that's what we need to address.
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Jen Howell: Then we get people in for treatment.
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Jen Howell: We need to address the mental health, behavioral health issues, substance abuse or substance use of people that are newly diagnosed. So they really feel supported and engaging in care and staining care.
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Jen Howell: And then offering PrEP to people who test negative PrEP is an amazing advancement, the studies have shown over 94% effectiveness of preventing HIV acquisition. Now it's considered to be 100%
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Jen Howell: For for sexual contact and over 74% for
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Jen Howell: Risk of sharing needles for our injection drug use and so I'm with PrEP, though it's a system, it's a it's a process. And so we need more providers that are able to are willing to offer prep. We only have a handful of providers in our community that
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Jen Howell: That offer it to enough people or not. I mean, to a substantial number of people.
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Jen Howell: It's really a missed opportunity in our community. And I asked people what side of history. Do you want to be on
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Jen Howell: If you offer prep. You're on the right side of history because that's part of history where we're going to end the epidemic.
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Jen Howell: We and we offer testing throughout that process of offering PrEP. So we know if someone test positive, we can get them into care right away if they test negative, we can keep tabs on what's going on with them and help them.
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Jen Howell: Prevent acquiring for HIV and also address other STDs that our state has a huge issue with and I'll talk about that in a second. And then we respond to quickly to our outbreaks and
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Jen Howell: There is a advancements in surveillance, which
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Jen Howell: Are controversial, but we we have different tools available to identify clusters and outbreaks and then respond to those
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Jen Howell: So the big part of this is testing.
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Jen Howell: And we need to wrap that up the target for to for people who are test negative to get on PrEP is 50% were only about 18% of those people that are eligible have are prescription
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Jen Howell: That is unacceptable.
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Jen Howell: That means people don't have the access they don't know about it and it's just not readily available to people and we need to change that.
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Jen Howell: Because we we don't put the onus of this of any of the epidemic just on the backs of people living with HIV anymore. It's everybody
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Jen Howell: And then offering treatment we need 95% of people that are HIV positive people living with HIV. We need them to be in care and we only are about an virally suppressed and we're only at about 63% right now.
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Jen Howell: In Nevada Southern Nevada has a higher burden of disease. They have about 85% of the cases in Nevada and it's been designated as an ending the epidemic site federally
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Jen Howell: For the phase one implementation, which means the bigger cities and counties that contribute to the most infections. They've also been excuse me identified as a fast track city and the fast track city initiative is global. And it's really pushing resources towards
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Jen Howell: Towards cities that have a high burden of disease and trying to get people to the 90 9090 goals which is 90 people 90% of people will know their status 90% of the people who know their status will be engaged in care and 90% of the people engaged in care will be virally suppressed.
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Jen Howell: We have guiding documents that help us in these efforts. And this is all evidence based. This is all data driven and the largest document that helps us with this is from a
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Jen Howell: long standing community planning process where we develop an integrated care and prevention plan and that plan takes information from the community.
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Jen Howell: Takes what resources are available. What we know is evidence based interventions and then really tells our community is our community telling itself. What we need to do to do to address HIV.
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Jen Howell: We have prevention planning groups in northern Nevada and Southern Nevada, which we have a few Members on here right now that are members of those groups.
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Jen Howell: And then we there in Southern Nevada. They have planning councils, which
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Jen Howell: Are focused on HIV care or a planning council focused on HIV care. So we really
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Jen Howell: Have to have the voice of the community. So we can address the community concerns with that. It's just us telling community, what to do and that never works. So it's a very collaborative process and it has been since the early 90s.
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Jen Howell: Nevada has developed a statewide into the epidemic plan and it's in the final stages and and southern about his plan is already been completed.
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Jen Howell: But we will have a statewide plan that really mirrors the efforts of what's an integrated plan and the Southern Nevada plan and
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Jen Howell: It comes from community forums focus groups keen format interviews date epi data that really takes this and puts it into
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Jen Howell: How, how are we addressing those four strategies of ending the epidemic. A lot of the information is available at in HIV Nevada dot work, which is our state website that houses information on prevention and care.
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Jen Howell: What else are we doing so advocacy is a huge part of HIV. It's the history of HIV. It's the foundation of how we address HIV in our communities and it doesn't. It hasn't stopped when the marches and those things stopped.
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Jen Howell: What we're doing for this next legislative session is looking at modernizing HIV laws, the laws are very archaic
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Jen Howell: They, they hamper the ability of us to reach out to the community for people to get tested and really
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Jen Howell: Kind of make people scared that if they find out that they have HIV that they could be penalized for that with felony charges and go to prison for 10 plus years with a huge fines.
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Jen Howell: When the reality is not a lot of people in our have Mal intent and transmit HIV.
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Jen Howell: With that Mal intent. And so we need the science to match the last match the science. We need to modernize our laws to protect the community. However, we need to also
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Jen Howell: Identify the fact that if somebody is on their medications and they're not going to transmit HIV, then they really don't need to disclose their status to anyone.
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Jen Howell: They're taking care of their health. They're doing what they need to do. They're not putting anyone at risk because they are taking those efforts. And so the laws need to be changed accordingly.
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Jen Howell: And we need to, again, take that responsibility and onus off of the backs of people living with HIV because there's enough going on. We don't need to add more to it.
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Jen Howell: We also need to encourage healthcare providers to offer testing to patients. And what we're doing is
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Jen Howell: Senator Dallas Harris from Southern Nevada. She's carrying forward two bills one to modernize the HIV laws that come
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Jen Howell: From suggestions from a governor's task force and the other is requiring all healthcare providers, we're focusing on primary care providers are in urgent cares to offer HIV testing to their patients.
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Jen Howell: And we're also looking at expanding that to STD testing because Nevada does have the highest rate of infectious syphilis in the in the United States, and we are second and congenital syphilis so babies born with syphilis and United States.
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Jen Howell: So we want people to have the opportunities for testing and not wait for their health care providers to offer it and healthcare providers not waiting for their patients to ask for it.
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Jen Howell: And so those are two bills that are going to be going forth in the next legislative session that we need people like you that are on here. They care about these issues. So step forward and help support these efforts going through our legislative process.
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Jen Howell: And if you want information on that. My, my information and will be at the end my contact information we need the community to step up and say we need these things need to happen. We need these laws changed or addressed or passed in Nevada.
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Jen Howell: We also need to have more testing the community because that's really how we're going to end the epidemic is people knowing their status.
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Jen Howell: And that includes testing at health districts community or organizations substance use treatment programs, wherever we can get testing out into the community into those
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Jen Howell: Those pockets of the community that are hardest hit. We need to get it there so people know their status and have the ability
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Jen Howell: To have better health outcomes about higher quality of living, because they have the support services and the medication. They need to have those those things happen.
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Jen Howell: How are we doing in Nevada. Well, our continuum of care, it's improving
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Jen Howell: In 2019 it was estimated about 72% of our people living with HIV were linked into care and then retained into care.
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Jen Howell: A 20 about 29% of those and then viral suppression and about 26% so we have a long ways to go. But we are measuring our efforts and that means that we know where we need to improve and this is great information. It's not bad news. It's just news and information that we use to go forward.
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Jen Howell: It's estimated about 1200 people in Nevada our prep users and this is based on prescriptions. However, this data is
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Jen Howell: This may be very low estimates of prep users in Nevada. There is 100 clinic in Southern Nevada, where they probably have a lion's share of these prescriptions Northern Nevada hopes has
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Jen Howell: A good number of people who are in prep as well. But this is nowhere close to what we need to make a dent in
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Jen Howell: In preventing people from acquiring HIV.
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Jen Howell: Our surveillance continues of new cases. And then people who are out of care, trying to get them back into care and then identifying outbreaks in
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Jen Howell: Responding to them molecular surveillance is one of the ending the epidemic strategies and this is a controversial topic, but I think we're going forth in Nevada with some prudence and looking at this kind of
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Jen Howell: In implementing it in a methodical way because it really can
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Jen Howell: What it can make people living with HIV very nervous. And what this molecular surveillance is is that it looks at people's
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Jen Howell: The genetic makeup of their HIV, if you will, and compares it to see if it's the same stream of the virus that's being transmitted in the community. And then if you
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Jen Howell: See people with the same strain, then the same genetic makeup, then that you can address clusters of infection that way. And again, there's a lot of work to be done on this and again controversial, but it is one of the tools, that's available to identify clusters and outbreaks.
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Jen Howell: So what can you do. I've talked about it throughout know people know your status encourage other people to another status. Ask your provider if they offer routine testing, put them on the spot.
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Jen Howell: Tell them you want to get tested. And if they say you're not at risk. Tell them how did they know that you don't ask me about my risk.
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Jen Howell: My providers. I think they shake their head. Every time I come into
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Jen Howell: The office because I'm like, What are you doing about your HIV testing, are you doing extra genital testing for STDs what's going on and they are just like roll their eyes and I'm like, okay, roll your eyes, but you need to do it.
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Jen Howell: And let me give you some information on how to do it.
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Jen Howell: So put your providers on the spot get tested for other STDs. If a person has an STD, they're three to five times more likely to acquire HIV and or transmit
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Jen Howell: HIV. So we need other STDs to be addressed as well, promoting condom use there's tons of different condoms all shapes, sizes, textures colors flavors out there. So finding one that works for you.
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Jen Howell: And if condoms don't work then PrEP is an option. We need to promote support services that help people living with HIV linking to care and staying care participate in advocacy and keep talking about this, the conversations can't stop.
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Jen Howell: So there's the HIV risk tool that is available at CDC, so you can go in and put in different risk attributes and it'll tell you what your risk is. And then, then it also offers
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Jen Howell: Prep locating services condom locating services and testing locating services within this tool. It's a really great tool that needs to be more widespread. So people have an opportunity to use it.
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Jen Howell: Here's some resources, my contact information and
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Jen Howell: I just thank you for the opportunity and
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Jen Howell: I'm not going to say happy World AIDS Day, but I'm glad you're all here to help us remember help us bring forth more awareness and address HIV in Nevada, because we can't end it.
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Hannah Khan: Thank you, Jen, for putting the HIV epidemic into perspective and providing strategies we can implement to build up prevention efforts now please join me in welcoming ouster Dean to share his story.
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Allister Dean: I don't know if I am
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Allister Dean: Live or not.
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Melanie Flores: Yes, you are.
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Allister Dean: Okay, great.
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Allister Dean: Hello everyone.
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Allister Dean: Happy World AIDS Day actually be happy, but like the previous speaker, you know, it is what it is I'm. My name is Alice 13 and I am
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Allister Dean: 31 years old and I was diagnosed with HIV. Two years ago and it was in the hospital. I thought I was having known yet first and it was a it was not. It was just, you know, my body trying to tell me, hey, there's something else going on. And so I remember the day as clear as possible.
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Allister Dean: It was back in April two years ago and and at eight o'clock in the morning like clockwork my
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Allister Dean: doctor came in as I'm you know stuffing my mouth full of pancakes and all that wonderful, you know, hospital food was really looking forward to the brownie at lunch there brownies are amazing and
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Allister Dean: The doctor came in and basically told me I don't think that he didn't mean to say it like or come across as as he did, but he basically said, oh, you have it.
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Allister Dean: And I was like, I have what pneumonia. Yes, they do. And he's like, No, you have HIV. And so, you know, we now can go ahead and proceed forward with treatment and so on and so forth.
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Allister Dean: And, you know, like I said, that was at eight o'clock in the morning and not something that I was not really, you know, it was just like, I hit a brick wall on
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Allister Dean: And I didn't know what to do. You know, my, my mind went blank. My body with none, I lost my appetite. Um, and I just didn't know how to process it and so
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Allister Dean: You know, my first as soon as a, you know, starting regaining, you know, you know, thinking process and all that. My first thought was, Oh God, what is my mother gonna think
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Allister Dean: Because at the time I was 29, you know, but my mother and I have a wonderful relationship.
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Allister Dean: And so, you know, my biggest thought is what my, what is my mother gonna think of me because he coming out as you know, gay to her years ago I thought was going to be like the biggest you know
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Allister Dean: I guess the biggest thing for me to overcome. And it was actually that moment. And so, you know, I basically said better late than never. So I called my mom and I told her that
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Allister Dean: That she needed to come down the hospital and that I was going to tell her you know face to face in person right then and there. Not over the phone. And so, so she you know was there along with my step dad.
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Allister Dean: And you know basically told told him, I said, well, the pneumonia was caused by HIV. And so, and my mom basically told me she's like, I kind of had an inkling that it was going to be that
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Allister Dean: And so
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Allister Dean: I was kind of relieved that at that moment of when my mom told me that. And so my mom was very educated and became even more educated with with HIV and how to treat it and
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Allister Dean: So on and so forth. So
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Allister Dean: You know the hospital was too. So we, you know, started calling the hopes Nevada getting an appointment in getting everything situated so I can start getting on treatments and become that untouchable status.
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Allister Dean: And so there was that I had such support from my family. I had the support of Nevada hopes.
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Allister Dean: You know they they really show shown that they were really involved and that they that this was not like it wasn't so then it wasn't an issue, but it was something that needed to be handled and so
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Allister Dean: So with that I
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Allister Dean: You know, I started doing the treatments. I started to, you know, start to look like myself again because I did lose about I want to say 20 to 30 pounds. I went in 170
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Allister Dean: Because I'm a very odd gym person, you know, I work out all the time. And then I left the hospital at like 140 so I was literally a stick. It was very, it was not very pleasant to see in the mirror so
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Allister Dean: Um, so moving forward. Fast forward. I was on the medication. I started gaining the weight back my doctor, you know, over a course of a year.
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Allister Dean: Basically told me he's like he you know your your treatment to the medication is phenomenal. It's your body's reacting to it.
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Allister Dean: Amazingly, and so he's like, how do you know how do you remember take out one
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Allister Dean: pill every day and I was like, well, you know, just like everybody you know the first thing that they reach for their phone in the morning and check their messages. So I usually have my medication right next to my
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Allister Dean: To my phone. So that way, remember to take it every single day. And so my, you know, like clockwork every six months in July and December I I see my doctor and get my blood work done, just for him to tell me, Oh, you got another gold star, you know,
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Allister Dean: Um, so after coming over that whole
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Allister Dean: You know process.
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Allister Dean: You know, I really didn't know how to tell people, and I told one person, you know, it was a good friend of mine. And she's like, You didn't even need to tell me like it's actually none of my business.
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Allister Dean: But I felt like that you know it was you know now, this was a part of my life and that I needed to, you know,
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Allister Dean: start telling you know close friends, you know, obviously family as well. And so it was kind of, you know, starting to open up a little bit, but I still had that stigma and you know people who found out that would treat me very differently that would
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Allister Dean: You know, think of me of, you know, like I'm, you know, a diseased person. Don't go near them or anything of that sort. I actually came across one person that actually did that to me. And that was over. It was on a date it was
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Allister Dean: You know, like the second or third date and things are going very well. And you know, I felt that it was time to tell him, and so I
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Allister Dean: Went ahead and I told him, I said, you know, if we're going to continue, you know, seeing each other. There's something that I do need to tell you. And so I told them and
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Allister Dean: He was like, okay, and then at the end of the date I never heard from him ever again. And then when I did. He said, I can't deal with that. That's messy so
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Allister Dean: It was not
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Allister Dean: Not, not very, I wouldn't say comforting. But it was just, I didn't feel very good. And so after that I kind of isolated myself. I am you know I was
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Allister Dean: I was, you know, wrapped up in my third book. Actually, I have three books that are actually published my third one actually came out back in March, which is Never have I ever, which is a bucket list book and so
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Allister Dean: I focus more on that on accomplishing you know things on my bucket list versus, you know, going out on dates and being, you know, trying to find love and relationships and all that stuff. And when I got to the end of the book, I realized that
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Allister Dean: That just because I have this is that that I'm undetectable that I have this disease that it does. It doesn't control my life.
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Allister Dean: I have, you know, the resources I have, you know, the family to to, you know, back me up and so on and so forth. And that kind of really opened up for me. So I started telling a little bit more
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Allister Dean: About myself to people and you know I have another really good friend Alex she works in the medical field. And she's like, You know what, I don't even really care, like you're taking care of yourself. You're doing good. You're doing good.
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Allister Dean: Um, so, you know, there was that my mother, you know, did have me watch Dallas Buyers Club. If you have not watched that film that is a film that you do need to watch. It's that in the 80s and it talks about a lot about what Trudy was talking about how
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Allister Dean: Men were starting to attain you know this disease and not and we really didn't have the resources to, you know, take care of it. And suddenly we were having gay men.
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Allister Dean: You know, suddenly you know die off. And so it really it really touches you and it really tells you that you know
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Allister Dean: Just because you don't have it doesn't mean that you should, you know, not really worry about it, you should worry about it, you know, pretty much just make it a you know a daily routine, you know, to be considerate and so on and so forth.
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Allister Dean: So that there's that and then
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Allister Dean: And so
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Allister Dean: You know i for the longest time, you know, I've gotten comfortable with it. I have acknowledged that I have, you know, I'm doing my part, I'm taking a medication every day. I'm getting checked and I, you know, and I'm staying, you know, in that undetectable status.
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Allister Dean: And so one of the biggest things is that I had
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Allister Dean: Started repeating to myself is, like, who's gonna who's ever going to be with me. You know, like after that whole date instant who's ever going to be with me and for the longest time I really didn't do, do any of that. But now I'm engaged to a man who also is HIV positive, and we both are
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Allister Dean: Very happy. We, we, and we are very educated in that in that area and we support each other you know we remind each other. Oh, don't forget, you have a doctor's appointment on this day go get testing and all that stuff, but
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Allister Dean: Um, you know, and my, my mother absolutely love them so like the biggest thing that I can, you know, provide for you is
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Allister Dean: You know, take the time to really educate yourself and HIV and and you know the whole world in and not so we may have that friend died on that one day well
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Allister Dean: You know test positive and they're going to freak out and I'm going to tell you, I'm going to be, you know, real honest with you, they're
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Allister Dean: Either going to freak out, or they're not going to do anything at all because they don't know what to do or they don't have the resources if you are that one person that is educated and that is
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Allister Dean: You know well versed in the HIV, you know, world and all that stuff and you become not friends. You know, you're definitely supporting
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Allister Dean: You know, HIV AIDS, all that stuff and you're making the bed, making this world a better place. So that's something that I can definitely on, you know, I tell all my friends thought it's like you know be versus not take a couple classes, you know that we you know what to do so.
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Allister Dean: So that's pretty much my story.
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Allister Dean: And one of my friends good friends actually told me about this, about this. You, and are You know
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Allister Dean: Presentation and so on and so forth. And he's like, I think you're a good fit for it and i hope i was but i'm i'm glad to see all you guys here that you guys are, you know, taking an interest in this and really
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Allister Dean: You know, getting you know well versed in this world. So
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Allister Dean: That's pretty much it. That's all I have.
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Hannah Khan: Thank you so much, asked her for sharing your inspiring story with us. We really appreciate your openness, your honesty and your incredible string.
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Hannah Khan: And now please join me in welcoming Mr. Rogers to share his story.
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Melanie Flores: And actually learn here.
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Jen Howell: He's here yet.
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Jen Howell: He has another event that he was finishing up
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Jen Howell: So, um, he was planning on being here, like right after 430 so
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Melanie Flores: Okay, well, how about we open it up to questions from any of our three speakers. And first, I want to say Alister. Thank you so much for doing this and and thank you to Robert Harding.
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Melanie Flores: For connecting us with you. I think your story is very powerful and we really appreciate you sharing it with us.
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Allister Dean: Maybe guns. I think you for having me. I appreciate it.
430
01:21:33.150 --> 01:21:35.580
Melanie Flores: It sounds like you have a good support system so
431
01:21:36.420 --> 01:21:37.740
Allister Dean: I really, I really do.
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01:21:37.920 --> 01:21:40.500
Allister Dean: Yeah. Very much so. Sorry, I don't mean to keep cutting you off.
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01:21:40.800 --> 01:21:48.510
Allister Dean: I'm terrible. I'm really I haven't really done do meetings before. So this is like, I'm all like, all right, I'm just gonna be quiet until you know she's done
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Melanie Flores: All right, well, I'll go ahead and open it up to the crowd. If you want to unmute yourself to ask a question or you can put your question in the chat box for any of our speakers and
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Melanie Flores: While we're kind of waiting for those to happen. I had a question for you, Alister in terms of those initial moments you said a freaking out when you got your diagnosis and what kind of
436
01:22:21.510 --> 01:22:28.080
Melanie Flores: words of advice would you give to somebody who might be going through that same moment in time.
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01:22:29.760 --> 01:22:44.580
Allister Dean: And I actually, to be honest, I had someone who was 19 actually reached out to me out of the blue. It was just, you know, is over Instagram messages. And he was just like, you know, I don't know who else to talk to you. I can't talk to my parents about this.
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01:22:45.720 --> 01:22:54.870
Allister Dean: You know, what if I do have HIV, you know, you know, what do I need to do. And so basically, the first thing to do is take a deep breath and we saw
439
01:22:57.000 --> 01:23:05.310
Allister Dean: You know, it's not it's not the end of the world. You know, you know, you were very careful. You know, you, you, you know,
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01:23:05.880 --> 01:23:13.440
Allister Dean: It just, it just happens. And so the best way to handle it is that you just sit down, take a deep breath and you figure out your next step.
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Allister Dean: That we have plenty of resources and your doctor who you know will tell you you know you are positive will provide you those resources as well. And, you know, just you know it's it's not a. It's not a
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Allister Dean: In your ways, I would say wasting more time freaking out. But you are you know it's it's not as bad as it was as it as it was in the 80s. So just take a deep breath, you know, take a minute. Find your center and then get a game plan that's all I can say.
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Melanie Flores: Great, thank you.
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01:23:50.580 --> 01:23:51.090
Jen Howell: I'll start.
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Allister Dean: Yeah.
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01:23:55.050 --> 01:23:55.380
Jen Howell: Um,
447
01:23:56.550 --> 01:24:11.460
Jen Howell: Since there's, I think a lot of students on here and future providers, what would you have liked to have a provider do for you. That wasn't done to help support you, or in any part of your journey.
448
01:24:12.510 --> 01:24:13.110
Allister Dean: Um,
449
01:24:15.120 --> 01:24:27.480
Allister Dean: Honestly, like what I would have had my provider or my doctor done differently is not say it so so bluntly, you know, especially at eight o'clock in the morning.
450
01:24:28.440 --> 01:24:33.210
Allister Dean: And my even my mother would excuse my language. She was pretty pissed off.
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01:24:34.140 --> 01:24:42.480
Allister Dean: And she literally went up to provider and said, so you could not wait 20 minutes for me to come down, be in that room with them.
452
01:24:42.840 --> 01:24:52.740
Allister Dean: So that we can go and explain to him. You know what's going on. You could not wait 20 minutes. And so she you know I could hear her out in the hall, giving the doctor like
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01:24:53.340 --> 01:25:10.020
Allister Dean: Like a mouthful, but I'm that's something that I would like providers to keep in mind is I, you know, this is this is a big deal. This is life changing. This is, this isn't like, you know, oh, you have a hemorrhoid, you know, sit on a donut for taught you know two weeks or whatever.
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Allister Dean: This is, this is going to impact someone's life and you need not necessarily coddle someone but you know be
455
01:25:19.350 --> 01:25:37.140
Allister Dean: You know that provider that that person, you're in care for reason you know you are there to help people get better. You're there to provide you know some kind of resolution with some sort of empathy and feeling not, you know, like, Oh, you've got HIV. Good luck.
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Allister Dean: So,
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Melanie Flores: Thank you. I have a question for you, allaster
458
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Melanie Flores: From Jessica and
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01:25:48.360 --> 01:26:00.360
Melanie Flores: I'm so she's kind of just wondering, you know, what was your risk perception prior to your diagnosis and you know where you offered testing at any point before
460
01:26:01.290 --> 01:26:13.890
Allister Dean: I actually, to be honest, I showed no symptoms. What's the weather like I my doctor actually not my hospital doctor but my doctor at
461
01:26:15.240 --> 01:26:18.420
Allister Dean: The health clinic. He told me he goes, how long
462
01:26:20.400 --> 01:26:36.540
Allister Dean: Have you you know how that I said well I just found out that I had it for, you know, about two weeks, he's all like, Well, you've had it for a lot longer because you're on that virgin like stage two and so because my my white blood cell count was way down.
463
01:26:38.520 --> 01:26:47.790
Allister Dean: And so he because you did not have any weight loss, you did not have any of these symptoms, the flu symptoms or anything of that sort, and said, no, I lived on
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01:26:48.360 --> 01:27:01.590
Allister Dean: You know my life, you know, as normal I maintained a one Sunday. Wait, I, you know, ate healthy I you know all that stuff that had no symptoms until you know something. My body was just like, dude, you got pneumonia.
465
01:27:02.880 --> 01:27:08.520
Allister Dean: I don't know what's going on. I didn't know if my body was like, okay, you need to have pneumonia. Pneumonia back when I was
466
01:27:09.120 --> 01:27:22.140
Allister Dean: In fifth grade. So it's like, let's have a reunion. But, and that's, I don't know. I don't remember. You know my statistics, but I remember that I was, you know, in that almost Stage two area so
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Melanie Flores: Thank you. And then I have a question for men and for you, Dr. Larson or Jen, what is a good way to get involved in the community and HIV. I've got zero research, especially now with coven hindering some abilities to volunteer or intern.
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01:27:46.020 --> 01:27:58.590
Jen Howell: Oh well, they're still, we still have internships available and volunteer opportunities where we actually have established because of code, the opportunity to accept volunteers at the health district which we hadn't had before.
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01:27:59.880 --> 01:28:15.660
Jen Howell: And we can navigate that. So it depends if you're a student or not. If we are a medical provider. We have our medical Reserve Corps that we can utilize as volunteer opportunities as well they'll try to drag you into code, but we can try to pull you right back out.
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01:28:17.250 --> 01:28:19.710
Jen Howell: So code. Code everywhere. Um,
471
01:28:20.790 --> 01:28:28.200
Jen Howell: But really the thing is to keep talking about it, um, you know, help promote active like give
472
01:28:29.310 --> 01:28:37.620
Jen Howell: Things that are going on like this, talking to your family, friends, your social circles, your provider getting involved in advocacy.
473
01:28:38.820 --> 01:28:57.060
Jen Howell: We have to do a lot of, you know, email, writing and that kind of thing. Social media outreach when we get into this legislative session, we have a Community Coalition for the HIV modernization efforts. And so that's an opportunity to get him involved if you're interested in the the
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01:28:58.410 --> 01:29:08.940
Jen Howell: Legislative process and that going about it that route. So there's some different things you can reach out to me. I'll put my email in the chat box.
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01:29:10.560 --> 01:29:21.120
Jen Howell: But the best way is to keep the conversation going and asking people, Hey, you know, I, I had the opportunity to listen to this today.
476
01:29:21.600 --> 01:29:27.510
Jen Howell: when was last time you got tested for HIV. Have you ever been offered an HIV test. What was your sex education in school like
477
01:29:27.930 --> 01:29:41.010
Jen Howell: You know having those conversations. So we can start opening it up. So people realize that they really don't have all the information that they need or marwat and that they need more Trudy, do you have anything
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01:29:41.040 --> 01:29:54.420
Trudy Larson: I do have another thing, because I think, I think it's really important for people to understand sort of this process, everybody who's listening should have had an HIV test. And if you haven't, you should
479
01:29:56.010 --> 01:30:02.760
Trudy Larson: Not that I expected it would be positive, but to go through the process is really important because it makes you pause
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01:30:03.240 --> 01:30:15.870
Trudy Larson: It makes you sink. It makes you say what if. And so going through it, then you can explain it to somebody else. If you have a friend, for example, hold their hand and take them and get tested.
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Trudy Larson: I i've advocated for routine HIV testing for well over 20 years
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01:30:22.860 --> 01:30:28.740
Trudy Larson: And I'm really happy to see that is at least starting to get more common.
483
01:30:29.430 --> 01:30:42.300
Trudy Larson: Because that's really the key. It's like any other diagnostic tests that we do. So if you've never had an HIV test, you should go get one. So you know what that process looks like. And then, and then you can speak really
484
01:30:42.660 --> 01:30:46.470
Trudy Larson: Well, you can speak with some authority. If you think somebody else has to get tested.
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01:30:46.950 --> 01:30:58.200
Trudy Larson: The other thing is writing your legislators, when we get into those sessions. Be sure you know what bills are going to go up and that you can talk to the person in your, from your district.
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01:30:58.650 --> 01:31:09.300
Trudy Larson: And say I really agree with this. I hope you vote for it, or even do more research about it. So I think there's two ways to really get more involved.
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01:31:11.580 --> 01:31:20.850
Jen Howell: We also have an HIV prevention planning group. And if you contact me, I'll let you know when the meetings are and that that group is responsible for
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01:31:21.180 --> 01:31:26.730
Jen Howell: Getting the integrated plan together and to really discuss prevention issues in our community.
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01:31:27.540 --> 01:31:44.280
Jen Howell: There's some it's the membership is based off of risk of like risk populations but anyone's welcome to join and enjoying the conversation. So, contact me. I put my information in the box there and I can get you information on those meetings.
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Melanie Flores: So I have a question for both probably Dr. Larson and you, Jen, as well. And so I know while back, there was kind of a push to see if you could get
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01:31:59.490 --> 01:32:08.730
Melanie Flores: HIV testing as part of the regular standard of care for primary care providers. You know how like it right now. And they do a mental health screening
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Melanie Flores: And I know one of the things, especially when I teach the HIV class.
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01:32:14.130 --> 01:32:30.210
Melanie Flores: Students don't know they think they go in, they get their Pap smear or whatever, and they get STD tests they don't realize that, you know, HIV is not or syphilis is not in that battery of tests. And so you know what what is going on there. I mean, why, why can't we get as
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01:32:30.810 --> 01:32:33.030
Melanie Flores: Part of the regular standard of care.
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01:32:33.450 --> 01:32:42.300
Trudy Larson: So, so for 15 years the CDC has suggested routine testing it all primary care offices every year.
496
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Trudy Larson: 16 years
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Trudy Larson: It has not been adopted by. There's a lot of reasons. I mean, there's legislation that went through that said, hey, listen.
498
01:32:51.300 --> 01:32:59.070
Trudy Larson: You don't have to do a full education and get consent or any of that kind of stuff that went through to make it easier for providers to do this.
499
01:32:59.730 --> 01:33:15.210
Trudy Larson: But it should have been adopted a long, long time ago. All the evidence points to this being a very effective screening tool like other screens. So all the all the big agency level.
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01:33:15.720 --> 01:33:18.360
Trudy Larson: Groups are talking about screening endorse.
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01:33:18.900 --> 01:33:30.960
Trudy Larson: Routine HIV testing. There's some years. Obviously if you're in a routine committed relationship, you never have sex with other people you don't your nails. You don't have to do it annually, but everybody needs a test what's
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01:33:31.530 --> 01:33:42.960
Trudy Larson: And then from there, the decision decisions are about annually. If you have sex or you do drugs, where you're where you're using injections at all or sharing needles, so it's
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Trudy Larson: I can't even tell you, I don't even know why it hasn't been incorporated this is AZT, see I see them Victoria young here and then Jennifer. Jennifer Bennett's also here and we have we have been talking about this, like you said, For 15 years. Please, please, please do this.
504
01:34:02.790 --> 01:34:03.180
Trudy Larson: Great.
505
01:34:03.270 --> 01:34:04.620
Melanie Flores: Thank you and
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01:34:04.680 --> 01:34:11.550
Melanie Flores: I also want to just throw it out in terms of a call to action for our students because we have lots of our students on the on
507
01:34:12.840 --> 01:34:21.720
Melanie Flores: The presentation that maybe that's something that you can incorporate into your master's degree, maybe I want to do assessment of offices that
508
01:34:22.020 --> 01:34:36.630
Melanie Flores: Have you know put that into a regular standard of care. So we have something to work off of. And then maybe do some academic detailing later. But I think tomorrow is online. So I'm going to go ahead and throw it to you, Hannah and to go ahead and introduce
509
01:34:38.730 --> 01:34:44.550
Hannah Khan: Alright guys, and please join me in welcoming Mr. Rogers to share his inspiring story as well.
510
01:34:45.690 --> 01:34:46.680
Hannah Khan: Tomorrow, take it away.
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Jamar Rogers: Hello, are you guys doing
512
01:34:50.640 --> 01:34:52.290
Jamar Rogers: Can you hear me. Can you see me. We're good.
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01:34:52.800 --> 01:34:53.940
Melanie Flores: Yeah, we're good.
514
01:34:54.330 --> 01:35:08.580
Jamar Rogers: I don't have that really nifty background that you guys have. What the heck I'm thank you so much for having me. Um, I guess do. Am I just telling my story is, is anybody asked me questions of how are we proceeding here.
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01:35:08.670 --> 01:35:12.720
Melanie Flores: You go ahead and do do, how you feel. And then we could do questions afterwards if you're
516
01:35:12.840 --> 01:35:23.520
Jamar Rogers: I like do how we feel. I like to how I feel. All right. I mean, it was Mr. Rogers I'm based in Los Angeles, California. I was a contestant on the voice and on American Idol.
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01:35:24.240 --> 01:35:31.170
Jamar Rogers: I've done some really cool other stuff in film and TV and commercials. I am a musician, a full time musician, so
518
01:35:31.890 --> 01:35:44.460
Jamar Rogers: This year has been crazy for everyone. And I'm really glad to be here. I was diagnosed with HIV back in 2005 I have been living with the virus for 15 years almost all of my adult life.
519
01:35:45.540 --> 01:35:58.050
Jamar Rogers: And I call it the gift of HIV because through this virus. I learned how to accept myself. I learned how to love myself and I also learned how to have more compassion and love for others. So
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01:35:58.740 --> 01:36:08.490
Jamar Rogers: I was raised in a very religious household. I didn't meet my father, my biological father until a few years ago. So I spent the first 35 years of my life, not knowing my father.
521
01:36:09.990 --> 01:36:15.660
Jamar Rogers: Because my mom was young when she had me, you know, she did the very best that she could, but she was really hard on me.
522
01:36:16.290 --> 01:36:27.510
Jamar Rogers: And I felt unloved. I felt unwanted I felt ugly. I never felt like I was enough. I remember being suicidal at the age of seven, so I definitely had some mental health issues at a very young age.
523
01:36:28.170 --> 01:36:44.130
Jamar Rogers: My mom remarried and and so he we were like the the typical super evangelical Christian family and I knew I was gay at a young age. So I felt like I was going to hell. And so as a teenager I struggled with fitting in. I struggled with making friends.
524
01:36:45.210 --> 01:36:56.070
Jamar Rogers: And so I ended up running away at the age of 17 it's by the grace of God that even graduated high school, but my senior of high school, I was definitely a drunk. I was an alcoholic. I had a fake ID.
525
01:36:56.730 --> 01:37:04.980
Jamar Rogers: So I was getting drunk all the time and then by the age of 18 I was addicted to Crystal Meth was addicted to Crystal Meth between the ages of 18 and 23
526
01:37:05.430 --> 01:37:14.700
Jamar Rogers: And what got me off of meth and what got me away from homelessness and all of it was finding out my HIV status, the day that I found out. I'll never forget I had been sick.
527
01:37:15.720 --> 01:37:21.780
Jamar Rogers: For a few few weeks more than a few weeks about a month. I had a horrible fever. I have thrush.
528
01:37:22.710 --> 01:37:30.450
Jamar Rogers: Yeast growing inside my throat and in my mouth. I looked, I was so skeletal I was so skinny and went to the emergency room.
529
01:37:31.020 --> 01:37:40.020
Jamar Rogers: And I remember opening my mouth to tell them what was going on with me and I threw up everywhere. And it was definitely a low point definitely rock bottom in my life.
530
01:37:41.040 --> 01:37:51.210
Jamar Rogers: And so when the doctor came in to tell me that it was a it wasn't just an HIV diagnosis. I had AIDS. I had five T cells. I should have died probably
531
01:37:51.630 --> 01:37:59.160
Jamar Rogers: Um, but in that moment that I that I found out that I was living with HIV. I felt so empowered, because now I have the knowledge
532
01:37:59.790 --> 01:38:12.000
Jamar Rogers: Before that I was guessing I was in, I was anxious I was fearful, but once I knew that I was HIV positive, I was able to then take action. And so within a year and a half. I was actually undetectable.
533
01:38:13.290 --> 01:38:17.190
Jamar Rogers: A triple A like I owe to a triple A triple it really helped me out a lot.
534
01:38:18.360 --> 01:38:23.190
Jamar Rogers: And now 15 years later, I am still undetectable. I would also like to give a word of caution.
535
01:38:23.760 --> 01:38:28.320
Jamar Rogers: throughout that time I was feeling really great. So I thought that I could take myself off of my meds.
536
01:38:28.860 --> 01:38:37.200
Jamar Rogers: Because I had been undetectable for a while and I would just say, don't do that. It was not a good time for me. I ended up back up back in the hospital.
537
01:38:37.890 --> 01:38:43.650
Jamar Rogers: With pneumonia and it just was not good. So, I will say that this is a chronic illness.
538
01:38:44.190 --> 01:38:53.310
Jamar Rogers: You're not dying from it anymore. You can really, you don't have to survive. You can you can thrive. I'm having the life of my dreams. I have a, I have a partner who is
539
01:38:53.880 --> 01:38:59.940
Jamar Rogers: Not positive, who is HIV negative, and and we have a relationship that is thriving and doing well so
540
01:39:00.450 --> 01:39:07.560
Jamar Rogers: The myth. There is a myth, there's a stigma. There's a lie out there that if you are positive, that you may be you feel unlovable.
541
01:39:08.160 --> 01:39:13.830
Jamar Rogers: Maybe you feel the toxic. Maybe you feel like no one will ever want to be around you and that's just not true.
542
01:39:14.070 --> 01:39:19.530
Jamar Rogers: That's not a lie that you have to believe anymore. What I would like to do is tell you the truth, and the truth is,
543
01:39:19.740 --> 01:39:30.510
Jamar Rogers: That you are on this planet with the purpose and you're not leaving this planet and to fulfill your purpose. And so my messages of love and self love and understanding that yes, you might have made some mistakes.
544
01:39:31.050 --> 01:39:34.800
Jamar Rogers: Yes, you might have been, you might have trusted the wrong person that that infected you
545
01:39:35.310 --> 01:39:42.570
Jamar Rogers: But you don't have to stay where you are. And you can start to forgive yourself and forgive others, but it is a journey, it is a it is a path.
546
01:39:43.140 --> 01:39:57.060
Jamar Rogers: But I do encourage you that you do not do not have to believe the lie anymore that you are not built for more that you weren't made for more and that you can't have a life that is worthy of you. So that's my story and I'm sticking to it.
547
01:39:59.940 --> 01:40:17.250
Melanie Flores: Thank you so much Mr. Um, so I guess I'll open it up to questions. Sure. And so either you can put your questions in the chat box, or you can unmute your mic. I'm going to kick it off. So can you tell me how you got on the voice.
548
01:40:18.090 --> 01:40:18.600
Yes.
549
01:40:21.540 --> 01:40:30.570
Jamar Rogers: Yeah, it was crazy. I had just had done American Idol, a few years before that and I had such a horrible experience that I swore I would never do reality TV ever again.
550
01:40:30.930 --> 01:40:37.530
Jamar Rogers: But then there came like this cool new show that came out and I was a really big fan of Cee Lo Green at the time. And he was a judge.
551
01:40:38.310 --> 01:40:46.950
Jamar Rogers: And so for the second season right before it came on, I all of my friends started hitting me up. They're like, yo, I had a dream. You're on the show. You should audition, you should audition.
552
01:40:47.520 --> 01:41:03.060
Jamar Rogers: But what I also knew from doing American Idol was that you have to have a story. Whenever you do these reality shows the only way they keep you on the show is if you have a compelling story and I wasn't sure I was ready to talk about having HIV on such a large scale, but I also
553
01:41:03.060 --> 01:41:14.550
Jamar Rogers: Knew that I couldn't hide who I was, I had to stand in my truth and my power and little did I know that taking that leap. The net appeared. I stood on that stage, I told 14 million people that I was living with HIV.
554
01:41:14.910 --> 01:41:26.910
Jamar Rogers: And I ended up almost winning the show. So I'm I just, I'm living proof that if you are willing to just love yourself and believe in yourself, you can really make some amazing things happen. And all I did was audition.
555
01:41:27.960 --> 01:41:36.720
Jamar Rogers: And I wasn't invited to audition. I stood in the cattle call i i i but i believe in myself and I knew that I was good enough to do it. And so, yeah, yeah, here I am.
556
01:41:39.690 --> 01:41:42.000
Melanie Flores: Doing anything. Oh, yeah. Trudy. Go ahead.
557
01:41:42.480 --> 01:41:45.870
Trudy Larson: Okay, thank you so much for being here. It's wonderful.
558
01:41:46.140 --> 01:41:48.690
Trudy Larson: To see you looking so well. So
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Trudy Larson: So so so I did. I took care of HIV AIDS patients. My entire career. I just retired. A couple of years ago. And one question I have for you because 2005 that's a bit of a time ago. Did you have difficulty finding care. I know a lot of support systems, but I still think it's hard to navigate
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Jamar Rogers: So, okay, when I found
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Jamar Rogers: Out I actually was leaving Atlanta, Georgia. At the time where I got sick. And I found out in Charlotte, North Carolina. I wasn't even supposed to stay in Charlotte,
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Jamar Rogers: But that moment I actually called my mom in Wisconsin. And I said, Mom, they're saying I have this horrible thing and I need to heal. Can I come move in with you.
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Jamar Rogers: And so she that was actually the first step of healing our relationship. Actually, I moved back in with her and the care at the time. I'm not going to say it was the best. I had a nurse practitioner who did not really love her job.
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Jamar Rogers: I remember making it a point that I was going to be, Mr positivity because because it was such a sadness in that place no one there was such a despondency there. And I said, this will not be me. I'm alive. I
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Jamar Rogers: Actually have this gift of life. So I'm going to bring that presence with me every time I go there. And so I will say the best care that I received was in New York City.
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Jamar Rogers: And and now that I'm in LA. There's. There's just, there's just too many resources available now in 2020
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Jamar Rogers: For people to be afraid to get tested or to be afraid that they're not going to find good care. There is good care everywhere I went, I went to South Africa, there's great HIV care going on there now so
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Jamar Rogers: I'm in Mexico. There we have come a long way. We have come a long way where we still need to do a little more work is just like demystifying HIV and dismantling stigma.
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Jamar Rogers: But my my message is actually for people living with HIV and letting them know you are lovable. There's nothing broken with you. There's nothing wrong with you. You're not toxic, you just
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Jamar Rogers: You encounter something really crappy, but you're going to be okay. And you're still beautiful and you're still here. So, like, don't give up yet. We still got a whole lot of life left to live like what the heck
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Melanie Flores: Go ahead, Jen.
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Jen Howell: So tomorrow. I know the answer to this, but I think people need to hear because you did experience a lot of stigma.
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Jen Howell: And you you push through it but um when you were on that other show
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Jen Howell: Um,
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Jen Howell: Talk about what they did to you because I think people need to hear that that stuff still happens
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Jamar Rogers: Oh yeah, well, this one was actually when I was on the voice. I remember
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Jamar Rogers: I remember they were they, they brought in a doctor before they even started the auditions and they they had a general announcement for all 300 contestants, which was do not hook up with each other.
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Jamar Rogers: You never know what someone will never know what another contestant has
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Jamar Rogers: And I remember just feeling really I knew they were talking about me. I
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Jamar Rogers: When I was on idol. They did not bring in a doctor to give this speech about not hooking up with each other because they didn't know I was HIV positive.
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Jamar Rogers: Here I am. I had told the producers on the voice. I was living with HIV. And they brought in a doc, like, first of all, I'm not that big of a hoe. I wasn't gonna just start like
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Jamar Rogers: Sleeping with everyone.
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Jamar Rogers: That was on the show.
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Jamar Rogers: But I, you know, they were covering their tail and I get it, but that still just shows the
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Jamar Rogers: Ignorance that a lot of people still carry or or or the stigma that they think that HIV positive people are super promiscuous, or that we're just out here, just like a little aids for you a little aids for you, nobody's doing that, you know, so
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Jamar Rogers: I am grateful, though, that if that were to happen to me now. I wouldn't be so hard on myself.
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Jamar Rogers: As when that did happen, eight years ago when that happened, man. I, I started taking my pills each night in the hotel bathroom so that my roommate wouldn't see that it was me. In fact,
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Jamar Rogers: Though the producers knew I was HIV positive. I didn't tell any of the other contestants, you know, initially because I didn't want to be judged by them. So they found out when they watched it on TV, like everybody else did.
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Melanie Flores: Any other questions. Oh, I have one from one of our students.
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Melanie Flores: Okay, and says, Hi, Mr. Thank you for sharing your amazing story. What do you wish. Other people understood about HIV that they currently seem to be getting wrong.
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Jamar Rogers: Hmm.
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Jamar Rogers: Oh wow, that's a really good question. Um,
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Jamar Rogers: I think that
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Jamar Rogers: A lot of people are still, they still think that once you catch this, you're going to die.
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Jamar Rogers: And I think another misconception is that if you are HIV negative, you can't be in a healthy sexual relationship with someone that is positive.
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Jamar Rogers: And you definitely can I have a great sex life. And I love my partner and like I said he's negative and we're great we're doing great. And he's also on PrEP, so I am an advocate for PrEP.
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Jamar Rogers: There are there are many ways out there for you to find love
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Jamar Rogers: So that is the misconception that I would like to get, get rid of is that people living with HIV for some reason we're supposed to just, I don't know, go in a corner and be like,
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Jamar Rogers: alone for the rest of our lives and they'll decrepit, I mean that's how its portrayed in the media, you know, I've never seen a story, a love story in positively for someone living with HIV.
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Jamar Rogers: I love pose, but it's like so sad. So I want to tell my, my brothers and sisters living with HIV, that this is, again, this is not the end for you.
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Jamar Rogers: And that there is someone who will love you. There is someone who will see through
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Jamar Rogers: What you think is ugly, but first you have to see it for yourself. You have to believe that you are worthy of love, you have to know without a shadow of a doubt that you
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Jamar Rogers: Are enough, just as you are. And that is my message. I can't, I can't stress that enough to someone that's living with HIV.
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Jamar Rogers: You are enough just the way you are. You're not broken, so it's quit trying to fix yourself. All you got to do is love yourself, and as you love yourself you invite more loving experiences into your life. And the only reason I'm saying this so adamantly is because I'm living proof.
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That's it.
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Melanie Flores: I have another question from Michelle. Hi, Mr. How can we begin to address the stigma associated with HIV and prep.
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Jamar Rogers: I wish I think that we should just talk about it like talking about it online casually doesn't have a wired. We only talked about him on World AIDS Day. If you want to be an ally for people living with HIV and AIDS.
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Jamar Rogers: Let's, let's talk about let's let's talk about some amazing people that have died from this disease like our author Arthur Ashe
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Jamar Rogers: And Rock Hudson, there's some of these amazing artists that live with this so that that people know that we have icons and and forebears that live before us and we need to honor their memories. So I think it's just conversation talking about it, everyone in my life knows I have HIV.
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Jamar Rogers: They know that I'm an activist. There's no secret about it. So I think that once we stop being ashamed of it ourselves, then we can talk about it more openly.
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Jamar Rogers: But I don't know what comes first, the chicken or the egg. Right. So do we talk about it. To remove the shame or do we remove the shame to talk about it. I think that that is a question that each person has to ask for themselves.
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Thank you.
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Melanie Flores: It looks like nobody's talking
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Melanie Flores: Let me unmute your mic maybe
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Melanie Flores: You might have to unmute your mic.
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Christer123: Yeah.
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Hey,
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Christer123: Everybody
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Christer123: And for everybody. I know it's not, it should be like have a special world say day, especially with everything that we have been dealing with
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Christer123: Trudy we're gonna miss you, but you're gonna be here with us all the time. Danny ferry wonderful Melanie, all of you are doing a wonderful, wonderful job and so important.
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Christer123: Like we truly we've been, I've been doing this for 20 some years as an advocate and activist and is important and remind you to count Mike Carroll, as with a beautiful song that we will always ask to have it in video
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Christer123: And if you are so beautiful to remember that and because of who you are and everybody up Allister everybody that's doing this, we gotta keep on fighting, we can be doing this because it's so important. And yes, by
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Christer123: Erasing trying to erase this thing my we were trying for this long I everybody that is here.
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Christer123: Talk about and I'm be honest about it and be respectful, because he's so important when they know that we are respectful and we are honest about that we truly, truly, truly.
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Christer123: truly care is when we know that they know that they can confide in us and trust us and work with us and deal with us in so many ways because it's not easy and sometimes
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Christer123: Especially now with the coffee. I have had people from people that I have HIV that are dealing with the loss of their parents, their friends and their
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Christer123: Somebody that they partners to so they're dealing with the situation that they're living with and that's important thing, leaving. That's a very important word and
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Christer123: And also with the current their pandemic and I'm so grateful that all of you are there for us. Thank you. Thank you. Thank you. Thank you. And we gotta keep on fighting and many, many blessings to all of you.
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Melanie Flores: Thank you.
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Melanie Flores: And man. Well, I saw you pop down your video. Did you have a question.
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MANUEL MEDEROS: No, I don't have a question, but I know this lady who just spoke, and she's amazing. She does amazing work in the community. And I think we adore her. And she has spent
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MANUEL MEDEROS: Many years dedicated to the efforts that she does. And she has changed lives like crazy in our community. So I just wanted to say thank you to her for doing the work she's doing. Thank you.
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Melanie Flores: Jim, I didn't have a question, because you kind of mentioned you had this big moment in terms of, you know, am I going to out myself to the entire world on the voice. Um, can you talk a little bit about that process and then what has happened since you kind of really spoke your truth.
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Jamar Rogers: Oh, man. Well, I feel like before I did that I had no career in music like it gave me a career.
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Jamar Rogers: And so there's a there's a beautiful lesson there that when you one take the leap. The net will appear and to
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Jamar Rogers: When you live in your power and your truth. No one can take that away from you. Right.
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Jamar Rogers: But I had to fall in love with the man that I was first and I had to forgive myself first. So since that since I decided to
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Jamar Rogers: And here's the thing I just want to clear something up when I initially audition for the voice. I didn't tell them right away.
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Jamar Rogers: I told them that I had struggled with drug addiction and that I had gotten clean and I thought that that was a great enough story to use
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Jamar Rogers: It was after I'd gotten home and I and I kept thinking about it and I said you know what is now is the time. I can't continue to live in fear. I can't continue to live in shame because my biggest fear was okay I'm gonna go on the show.
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Jamar Rogers: And they get big and then somehow somebody's going to find out. And they're going to blab it and
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Jamar Rogers: I said I wanted to narrate I wanted to tell my story on my terms and and take the power back from fear, basically. And since then, man. I've gotten to do so many cool. I got to do. The Ellen Show like I was invited to South Africa by the shell Corporation to give talks and speeches.
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Jamar Rogers: World AIDS Conference. Um, I've done commercials. I was in a movie. I had, I was doing. None of this, you have to understand. I was a bartender.
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Jamar Rogers: Before I audition for the voice. So there is such a power that comes with just saying, I mean, I look at Ellen's career and how
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Jamar Rogers: It really, really took off for her after she was able to just be honest and just be
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Jamar Rogers: Authentic. So there's this real beautiful thing about you being you and only you can tell your story the way that you can tell it and we're waiting to hear it. So, however, you need to share it.
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Jamar Rogers: Whether it's through art, whether it's through writing, whether I don't know what it is. You know what it is, though, and I, and this is your sign if you are waiting for a sign. This is your sign that there's a whole wide world out there that's waiting to hear your unique perspective.
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Melanie Flores: Thank you. You are there any other questions.
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Trudy Larson: Just, just a comment because this is something since I since I've been doing this since 8681
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Trudy Larson: I think the other really important. The other really important thing is to touch. And I remember so early on when people were so scared that
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Trudy Larson: When I would walk into a room of without the mass without the gown, you know, first of all, the nurses freaked out. But I wouldn't touch.
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Trudy Larson: My patients, and I would touch them. And that meant and tons of them. Because this is about connection. And so, you know, Nettie noses. I'm a hugger. I mean, CO is killing me.
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Trudy Larson: And so I think that touches critically important. It's very much like people well cancer, you know, that's the same thing. People are afraid to touch them.
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Trudy Larson: And that touches so human. It is such a connecting kind of thing. And so, as if you don't know what to say. Sometimes all you have to do is touch. And I think that really conveys that
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Trudy Larson: That feeling of, you know, like I'm with you. And so I just wanted to add that, because it's an it's an added in so much my life to do that.
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Melanie Flores: I do have a question for you, Dr. Larson.
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Melanie Flores: That said, a month ago, Timothy. Ray brown died as you're aware of. He was the Berlin patient
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Melanie Flores: Are you aware of any studies that can cure.
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Melanie Flores: HIV instead of just maintaining it as a chronic disease. I'm sure you get this a lot of us.
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Trudy Larson: Do. And so, I mean, so like my little talk when I talked about those resting cells as lymphocytes that have the HIV in them. That's the problem is getting rid of them.
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Trudy Larson: Because they're they're even when the viral load is undetectable. And so they use bone marrow transplantation, try to do that. So he the Berlin patient actually have leukemia.
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Trudy Larson: And one of them cures for leukemia is a bone marrow transplant. And so they were able to find a donor that has the lymphocytes. The don't that don't have a
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Trudy Larson: Protein on them that attaches to the HIV. So you can't get a decent the cells don't get infected with HIV.
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Trudy Larson: So it's a genetic mutation. Basically, it's fairly rare. It's called a delta. And so their donor of the bone marrow had that mutation. And so they use that bone marrow and infused it into the Berlin patient and
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Trudy Larson: And that repopulated is bone marrow with normal healthy cells and and conditioning for that you kill off all of yourself so you kill off all of your
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Trudy Larson: Lymphocytes that you have. So it's a dangerous very dangerous procedure, basically. And you survived and they, they, he
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Trudy Larson: He did well with that he had a second transplant. Same kind of thing he did well with that because I think he has another recurrence of his leukemia.
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Trudy Larson: And so that's been investigated as a potential here. The problem is bone marrow transplantation carries with it about a 20%
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Trudy Larson: Mortality rate. So it's a very difficult procedure to do
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Trudy Larson: And and there. This has been done in a studies and it's not always 100% because the conditioning.
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Trudy Larson: Chemotherapy they used to try to get rid of all of your lymphocytes don't always work. So you have some residuals left and that's sufficient to be able to see everything with HIV again so so that's the closest to the income and, you know, so is that out of reach. No, but I think
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Trudy Larson: You know, much like things in science, there needs to be like one of those miraculous kind of things that happened, somebody thinks outside the box and discovers a way to get rid of these resting cells that have HIV and
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Trudy Larson: Sort of have them out. And so I am still. I mean, I didn't think I'd get to this point in my career where I could see we have medications that work but i think i think it will happen.
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Trudy Larson: The new scientists really do think outside the box. It's really exciting and
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Trudy Larson: And I am they have so many new techniques and tools and and everything. So I'm still hopeful that we'll find a way to cure, but in the meantime are medications are safe.
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Trudy Larson: Very, very safe and so effective that we have a good interim measure, it's not it's not a cure yet but I'm still really helpful. I'd be like much happier if we can do this end, the agent HIV.
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Trudy Larson: Kind of thing and in the stigma and discrimination and, you know, we're on that because I think that's even that's more of a realistic.
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Trudy Larson: That's something we can do something about now, but we can still really hope for the future.
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Melanie Flores: Thank you, Dr. Miller some
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Melanie Flores: Layer about time. But before I kind of let you go and Jamal, can you tell us about what you're working on, that's new, like anything you want to plug
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Jamar Rogers: Yes I do, actually. I have a song I'm editing the music video right now. I'm really proud of this song because I swam at the bottom of a lagoon, and Mexico wearing a suit.
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Jamar Rogers: I was very dapper and I faced some fears doing it, but the song comes out in January. It's called flow and you you can follow me on Instagram. I'm Jamal Rogers official or on Twitter where I'm Jay squid word like sponge Bob's friend squid.
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Melanie Flores: Thank you so much, and I, I was looking up your music on Spotify and you have a lot of good music there as well and YouTube
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Jamar Rogers: Link, you want to see do live so thank you so much. Thank you, Jen, how
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Melanie Flores: For connecting us with Jim are again and we really value you and your inspiration and your
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Melanie Flores: Inspiration, you know, just not as somebody who has HIV, but somebody who can preach like just goodwill and and being a good person and I think those lessons that you teach are something that we all can take with us as we move forward. So
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Jamar Rogers: Thank you so much. Thank you for having me. Seriously. Thank you.
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Melanie Flores: And have have happy holidays. Thank you so much.
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Jamar Rogers: Thank you.
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Melanie Flores: And Alister. I didn't want to let you go yet because I know you working on
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Melanie Flores: Some things as well. So how do people
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Melanie Flores: You know purchase your books.
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Allister Dean: I'm a pretty much everywhere. Barnes and Nobles Amazon just, you know, plug in my name, and boom, you'll have a bunch of different sites to purchase from
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Allister Dean: So yeah, that's where you can purchase it even on Apple books and you know all the digital version, you know all that so that I will be releasing another book in January. It called stories. I never tell without wine. These are epic stories before my first book.
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Allister Dean: And, you know, for my college days.
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Allister Dean: Leading up to, you know, in my 20s. And then a few additional stories, including my HIV story so
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Melanie Flores: Great. Thank you so much. And I want to thank you Dr. Larson, as always, sharing your wisdom and
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Melanie Flores: All the things he bring to the table and Jen, you know, you've been fighting the good fight for so long and I appreciate you always being there with me, hand in hand, when we're trying to get the word out.
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Melanie Flores: And thank you to the masters society for public health and the public health coalition
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Melanie Flores: AND ALL OF OUR PARTNERS IN HEALTH Nettie you know you've always been out there, Northern Nevada hopes wash KIND OF HEALTH DISTRICT Northern Nevada outreach team. And of course,
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Melanie Flores: The School of Community Health Sciences. So thank you to everyone and go forth and do good and please spread the message to reduce stigma and
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Melanie Flores: Discrimination and get tested. Thank you. Have a good day, everybody.