Among young people living with HIV, having a detectable viral load is associated with a slight increase in the risk of cardiovascular disease.
Sitaji Gurung, MD, PhD, MPH, of Hunter College at the City University of New York, presented findings from a study of HIV-positive youth 14 to 26 years old at the 2020 Conference on Retroviruses and Opportunistic Infections in Boston last month.
The study relied on electronic health records from the Adolescent Medicine Trials Network 154 Cascade Monitoring, which derives its data from clinics across the United States that care for adolescents with HIV.
Researchers at the National Institutes of Health (NIH) have found that the antiretroviral drugs, dolutegravir and emtricitabine/ tenofovir alafenamide fumurate (DTG+FTC/TAF), may comprise the safest and most effective HIV treatment regimen currently available during pregnancy. The findings come from a multinational study of more than 640 pregnant women with HIV across 4 continents.
Previous research has demonstrated that antiretroviral therapy (ART) to suppress HIV prevents perinatal transmission of the virus and benefits the health of both mother and child. In the current study, 3 ART regimens were compared, showing that the regimens containing DTG were more effective in suppressing HIV than a commonly used regimen containing efavirenz (EFV).
We all know that HIV is no longer a death sentence, but to deny that some people still experience it that way — due to fear, stigma, history, and lack of access — is to miss what happens to young Black men today. The ability to get and stay on treatment, to get to undetectable within weeks, to never transmit the virus and live a normal, healthy life isn’t something you can take for granted if you are a working class person of color in the U.S., much less in a different country (read our feature on HIV-positive asylum seekers from Africa on page 32). If you’re a working class, Black or brown woman with HIV, you know this well too: you may dream of affording the “self-care” everyone recommends for you (massages, acupuncture, vacation) but struggle to pay the rent and buy the kids’ school lunches, much less fork over $50 to feel good for an afternoon.
I’m relieved that my friends who lived are now healthy long-term survivors. I’m thrilled that PrEP uptake has risen almost 500 percent, scientists now universally agree that treatment can make you undetectable (and unable to transmit the virus), and that new research has us closer than ever to a vaccine and a functional cure.
But let’s not forget that while most people today won’t ever see their diagnosis devolve into stage three HIV (formerly known as AIDS), some untreated folks will. Without treatment, AIDS can progress quickly, much like it did in those early years.
I remember the time when I was little, before I had a degree or the knowledge to verbalize that something was wrong: All I knew was the feeling of suffocating. Continually fighting to breathe, fighting to get through, fighting to wake up each morning.
I am not sure whether I was angry at nature or nurture. Whether I was angry at my inability to never fit in, to never seem to know how to shut up or just fold. My inability to accept a “yes” and just swim along the tides. Would HIV have been more bearable if I simply knew how to assimilate? I get a house with a white picket fence, monogamous sex, church three times a week, stay at home? Would it have been more bearable if I had known my mother, black HIV-positive woman, before she gave me up?
Why is that? Well, I think it’s because I didn’t grow up in a black household. My adoptive mother was a Boriqua queen who ran the house and the heart of my father (both were born and raised in Puerto Rico). I was black and, back then in 2000s when everyone my age thought being “Spanish” was looking like JLo or Pitbull, I wasn’t allowed to claim what my Afro-Latina stepmother did. (She often told me she was black, and once, that my white-passing father’s family did not want my caramel-toned stepmother in the family.) While I value her experiences, I needed to see other little black girls with Latinx last names and who loved merengue just as much as I did. There was no “Afro-Latina” then in the South Florida where I grew up. I had no right to be as proud of my parents’ culture as they were, although I was raised as stereotypically as you can get: loud bilingual momma, yuca and yellow rice on the stove, a mechanic father with plenty of machismo. There was no one to help me navigate the world as a black woman. Maybe my anger came because I understood things I couldn’t yet speak.
Stories of my biological mother are few and far between, pieced together and passed to me by the nursing staff of my former hospital in Broward County, where I was born in 1991. I know she was a woman living with HIV when there was inadequate treatment. I know she was black, a mother of at least nine children, dealing with drug addiction and HIV, and she never got to know me. I assume she used drugs because I was born with drugs in my system. I read my hospital report, which says that this beautiful black woman had more demons than I could ever come to understand. Before black spaces, I would have assumed she was doing drugs, running around sleeping with folks to fuel her life. Before black spaces, I would have read my chart and hated her more for passing so much onto me with little support — for making me deal with the so-much before I even learned how to walk. Truth is, black spaces helped me realize that she could only do as much as her chains would let her: I lived. I’m here writing and excelling. A black momma did that, not only did she, but with the weight of oppression on her shoulders. Mission complete. I think she did exactly as she was supposed to do with all against her.
The story was that she named me and that was it. Did she plan a name in the midst of her heightened addiction? Did she pray for forgiveness? To die? To separate from her blackness as I did? Was it her blackness that aided in her losing me to another momma? For a black women with HIV and children in the midst of drug addiction, police and jails and judgmental doctors and child protective services in the 1990s demonstrated a lot of disdain for her, her choices, and the children she birthed.
Coming to terms with an HIV diagnosis is rarely as easy as “just dealing with it.”
Depending on where you’re diagnosed, when you’re diagnosed, who you are, and where your life is, it can be a huge challenge to figure out how to make sense of living with HIV. It’s a process that can easily take years, and involves a ton of factors: your emotional health, your physical well-being, your support network — not to mention potential issues with family life, access to health care, housing, substance use, and so many other concerns.
We asked Latinx people living with HIV in the U.S.: How did you come to terms with your HIV diagnosis and develop the confidence to stay healthy? Here are the stories they shared.
Everyone deals with a certain amount of stress every day. But if you are a woman living with HIV (HIV+), stress can become overwhelming. Long periods of high stress can damage your immune system and cause physical and emotional illnesses. Research has shown that stress can speed up the progression of HIV.
In the U.S., recent studies have shown that women living with HIV are five times more likely to have post-traumatic stress disorder (PTSD) and two times more likely to have survived domestic violence than women in the general population who are not living with HIV. In addition, women living with HIV who experienced recent trauma were four times more likely to stop adhering to their HIV drug regimens and to have higher viral loads than women living with HIV who did not experience trauma.
No one living with HIV/AIDS is immune from the impact of isolation. Numerous studies find that social isolation is a problem among the aging population in general, and especially among the elderly living with HIV. Younger persons are also affected. One study found that younger people living with HIV/AIDS experience more disconnectedness from family and friends than their older peers do. Researchers believe this is due to a combination of factors, including stigma, feeling blamed by others for their illness and younger people not identifying with the need to battle a chronic illness. It should also be noted that persons affected by HIV/AIDS, especially those who went through the 1980s and 1990s, can experience the same symptoms of trauma and isolation as people who are HIV-positive.