The disease has receded from the spotlight, but the HIV infection continues to spread -- and invade the lives of Philadelphians.
Four months after “bottoming”— assuming the passive role during anal sex—for the first and only time for his Center City “fuck buddy” one evening two years ago, R. Vincent Johns developed a painful testicular infection. It prompted him to undergo a series of STD screenings including an HIV test.
The openly gay, Abington-born South Philly resident was accustomed to being tested for HIV because he bed-hopped some. But he always practiced safe sex with everyone except his fuck buddy, a healthy-looking pre-med student Johns fancied too smart to have HIV.
But as Johns showered on the morning of March 30, 2008, in preparation for his trip to the Mazzoni Center clinic at 12th and Chestnut, a premonition chilled his slender bones.
“I didn’t think the infection had anything to do with HIV,” he says. “I was thinking I’d get tested ... just to rule it out. But I suddenly had this thought, ‘Today’s the day I’m gonna test positive.’”
Twenty months later, Johns, a catering waiter who graduated last June from the Art Institute of Philadelphia with a degree in industrial design, has AIDS. You wouldn’t know he had the virus if you passed him in the supermarket: His skin’s unblemished, his gait is steady and he doesn’t cough much, even though he sometimes chain-smokes.
In fact, dressed in his trademark shades, khaki jacket and trousers and gray leather sneakers, he looks much like any other street-chic under-30.
That’s good, of course. Johns is a far cry from the AIDS-inflicted character Tom Hanks played in the 1993 film Philadelphia , who started to resemble a lesion- ridden cadaver by the middle of the movie.
Still, more than a few voices in the AIDS services community caution that in the decade-plus since effective antiretroviral meds have transformed HIV infection from a disfiguring, uncompromising death sentence into a chronic but manageable infection, too many people have lost their fear of getting the virus.
“I’ve absolutely had people tell me they let their guards down, maybe took chances because AIDS is now a treatable disease,” says Kevin Burns, executive director of 12th and Arch-based ActionAIDS, the largest AIDS service organization in Pennsylvania. “Some people kind of have the attitude that, you know, ‘If I get it, I’ll just have to take a pill.’”
Ron Powers, director of programs for the Mazzoni Center, which characterizes itself as the city’s LGBT (lesbian, gay, bisexual, transgendered) health center, adds, “I don’t think most people actually say it that clearly, but it’s more in terms of they didn’t think of it as such a big deal anymore. I think there’s some complacency in terms of people looking at it like all you need to do is take a couple of pills a day and you’ll be fine.”
The problem with that outlook—even as quarter-century-old images of deathly sick gay men covered in purplish Kaposi’s sarcoma (KS) lesions tottering into big-city emergency rooms fade—is that HIV/AIDS is still an epidemic to be feared.
Most people develop a brief flulike illness, called acute retroviral syndrome, shortly after the virus invades them but then remain apparently healthy for five years or more. But Johns’ early HIV trip has been atypically difficult. Only two years after becoming infected, he undergoes chemo treatments for the KS flare-ups that swell his lymph nodes and cause the sporadic appearance of what he describes as “a little red guy” in his left eye. He suffers from headaches and fatigue. Every night he takes Atripla, a three-med cocktail tablet that often wipes him out for part of the next day.
Johns’ lymph nodes became alarmingly swollen a year after he became infected. It was his first bout with KS, although he didn’t know it then.
“You have lymph nodes throughout your body, and they run down your neck,” he says. “And so when it first started happening I literally looked like I was becoming a dinosaur or something because I had like bump after bump after bump all over my body. It was freaky as fuck.”
Dr. Robert Winn, who’s Johns’ doctor as well as the Mazzoni Center’s medical director, isn’t sure why his patient has encountered serious complications so early.
“He’d only recently been infected, so it was really surprising that he had KS,” says Winn. “It’s really not clear why he’s having a tougher time than most. He’s doing OK now because he’s on meds, and he’s going to be fine, but most people who are newly diagnosed don’t have to deal with this.”
It’s a lot to handle, even for an irrepressible 28-year-old who takes great pride in his resiliency, laughs easily, smokes weed daily, apologizes for talking too much and almost always sports an oversized birdie charm around his neck.
The African-American woman in the photo looks about 60, maybe 65. Her graying hair in a tidy bun, she wears a neat blue and white silk dress with a bow at the neckline. She tilts her head and gives a melancholy half-smile for the camera. Above her head are the words "I Never Asked. I Wish I Did." Inside the brochure this sweet-looking lady tells her story. She'd been widowed. She began dating a longtime friend. They never discussed sexual history, and because of her age, birth control wasn't an issue. Now she has HIV. It seems strange, even freakish, but it's all too common. HIV/AIDS is the No. 1 killer of black American women between 25 and 34. But the fastest growing segment of HIV incidence is among black women in their 50s and 60s. Grandma has AIDS. Women get together to discuss many different things. We talk about family, we talk about politics, we gossip endlessly. But when it comes to talking about HIV/AIDS and the simple things we can do to prevent it, our mouths are shut. Philadelphia-specific HIV statistics are grave. Averages here are higher than the rest of the nation, especially among women. Philadelphia's response is appropriately targeted, with some of the...
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