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Michael Harney Writes
"The Rubber Man" on
AIDS and Living through the last 
4 Decades. 


DON'T BE IN THE DARK ABOUT HEPATITIS C, SYPHILIS AND HIV

Simple Free Tests Both Insure You Are Disease Free
or Alert You To Early Treatment and Cure

What the Rubberman Wrote by Michael Harney

Tax season has passed and whether you had to pay or not - all of us in Buncombe County can get something free of charge, tests for Hepatitis C, syphilis and HIV, at the Health Department or the Western North Carolina AIDS Project (WNCAP), guaranteed to pay individual and public health dividends whether the results are positive or negative, and thanks to a pot of tax dollars allocated by the North Carolina Department of Health and Human Services (NCDHHS).*

Need more convincing? The Optimal Management of HIV Disease & Hepatitis Clinical Conference (OPMAN XXV) held in Orlando Florida March 17-19, included sessions about the national effort to identify, test, and treat-to-cure the estimated 3.5 million or more people in this country living with the virus known as hepatitis C (HCV) – 75% of whom are thought to have been born between 1945-1965, many of them infected before mandatory blood screening for HCV began in 1992. Within the other 25% are additional people who have ever shared needles or related injecting equipment, and a smaller group who acquired the virus sexually. The recommendation for testing also goes for those of us who may have contracted syphilis – a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum – whether we have a recent infection, or have been living with it, sometimes without symptoms, for years.  

There is great concern about the upsurge in syphilis cases across the U.S. and in North Carolina, especially among men who have ever had sex with another man – but don’t count yourself out if that does not describe you. Syphilis masks itself in dermatological (skin) manifestations which may not stand out to a physician doing a basic health care screening. Has your doctor ever offered to test you for syphilis? Perhaps an unusual rash has appeared on your body; perhaps a small painless sore in your privates? Are you having visual changes or eye irritation causing you to visit an eye doctor or specialist? Read all about the many symptoms of syphilis by visiting www.cdc.gov, then clicking on “S” under the index at the top of the page. Scroll down to “Syphilis”. There, you’ll find the Fact Sheet in order to learn more.  

Syphilis is no joke, but can be treated and cured at all stages, even if one has had it for years. Self diagnosis is not enough. Testing is the only way to know for sure. And what would keep you from just getting tested anyway? If your doctor doesn’t seem interested, a simple call to the Buncombe County Department of Health and Human Services (local health department 250-5109) is the easiest way to set an appointment to get tested, and may be a good return on your tax dollars!

As for HCV, there are new, fairly simple treatments to cure it in 8-12 weeks for most people, with few side effects. This is unlike the old treatments for hepatitis C that someone you may know tried taking in the past, often with great misery and little to no success. There is some initial blood work to identify the genotype of hepatitis C in the body, which helps the provider know which medication to prescribe. Not all doctors may feel confident in treating patients with these medications, but it is not as hard as they may fear. The websites www.hcvguidelines.org and www.hep-druginteractions.org are quite helpful and comprehensive. Additionally, the manufacturers of these successful therapies have patient assistance programs to help pay for what insurance companies may not agree to cover https://www.nastad.org/sites/default/files/Hepatitis-and-PAPs-CAPs-Resource-Document_8.pdf 

There is also great information about HCV at the www.cdc.gov website, but this time click on the “V” for “Viral Hepatitis”, down the page a good way, where you’ll find the link to a list of risk factors which may increase your interest in being tested. Remember, it’s free and can be done at the same time you get tested for syphilis.  

So, what’s stopping you?  

Taxes may have been due by April 18th, but you are due the best health care possible all year long. Get your return today!  

Michael Harney is a prevention educator with WNCAP and helps operate NEPA@WNCAP – one of the local needle exchange programs in the region.
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*Just a note: Not all North Carolina counties have free hepatitis C testing. The Western North Carolina AIDS Project (WNCAP 252-7489) does HIV/HCV and syphilis tests for free too, but they are only for screening purposes, and not confirmatory and diagnostic, as would be the blood tests provided at the health department. 
Find out more about WNCAP HERE
Michael at 2018 World AIDS Conference

As this decade comes to a close, and the anniversary of almost 40 years of the HIV/AIDS epidemic is upon us, we cannot be deterred from the work still at hand, to teach next generations our history, the history of a complicated virus whose genetic mutations keep scientists on their toes as they seek ways to block its further transmission while also making it easier to live with. And thanks to newer treatments, people are living longer and healthier lives, as we note over half the people with HIV in the United States are now 50 years of age and older.

Still, the younger members of our communities are vulnerable when not provided enough understanding of how to avoid getting this easily preventable viral infection, so as not to become a continuous cycle of new generations with HIV in the decades to come.  

We can discuss comprehensive sex education as one tool in the toolbox of prevention, but that is not always an easy subject to cover when the stigma of human bodies outweighs the rationale of how biology works; and almost nobody receives an age-appropriate human anatomy book for a birthday or holiday gift.  Maybe this year will be different...When was the last time we ourselves took a class about the human body and its functions?  When is the last time we took ourselves to the health department or to a medical provider and got tested for HIV, and organisms that cause other sexually transmitted diseases like chlamydia, gonorrhea, or syphilis?   

Now that the liver disease hepatitis C has become more and more prevalent in our society, North Carolina's 85 county health departments also make available free testing for HCV, the virus that causes it, and which is easily spread through contact with blood when needles are shared, or by sharing other drug using equipment, or via sex.  On the other hand, it’s important to note that because of intensive screening, HIV and HCV are almost never transmitted anymore by blood transfusions.

And more great news about hepatitis C; it is now easily cured for most people who don't have severe cirrhosis, within 8-12 weeks, using much more human-friendly therapies with few reported side effects, unlike those we may remember an older family member or friend experienced years ago before pharmaceutical science advanced to this level.  We even have local clinics in Asheville and the Western NC region where successful clearance and cure of Hep C happens each month.  
Getting tested for HIV and HCV is as near as that phone call to make an appointment, particularly important if you were born between 1945 and 1965, the age range where HCV is most prevalent; or if you ever once shared a needle/syringe behind someone;received tattoos in prison; have taken blood products or had an organ transplant or transfusion years ago; or are currently using needles/syringes for non-medical recreational purposes, where exposure within your social group from blood or sex may be a risk factor.

HIV is also treatable, and the medications are increasingly life sustaining.  There is a scientific update to know about called U=U which stands for Undetectable =Untransmittable.  It is all the talk in POZ or Plus magazines, and means effectively that a person being treated for HIV, whose blood has fewer than 200 virus copies per milliliter, and who maintains that viral load suppression for more than six months while still taking antiretroviral therapy, will not transmit HIV. 
Further, when lab tests show that treatment is maintaining viral suppression, condoms don't have to be used - though they are still recommended to avoid sexual exposures to other bacteria and viruses.

If the criteria of the HIV control measures are met, one does not in North Carolina have to disclose his or her HIV positive status to a sexual partner.  Yes, you may be shocked to learn this, so take a look at the literature for yourself, and discuss the matter further with your healthcare provider.  Visit www.cdc.gov to read more about it., and www.projectaccess.org to learn about the Partners II clinical trial results that along with revised North Carolina HIV Control Measures, have validated U=U.

Yet the science is not enough if that knowledge is not being transmitted to the next generations. There are options in the HIV prevention toolbox that offer additional barriers to the transmission of HIV.  Ever heard of PrEP?  It stands for Pre-Exposure Prophylaxis - and means taking a pill once a day during a time in life when the risk of acquiring HIV might be heightened due to social connections we make No discrimination or stigma.  
Let's be real...we make social connections that may include a variety of sexual expressions, and substances used.  Not gonna talk real?  Really? Nowadays?  Up to you.

Recently, just this year, added to Truvada - the decade old PrEP pill - is its slightly altered drug named Descovy.  And in the near future, injectable PrEP administered every month or two for prevention may become available.  It is currently known as Cabotegravir and is still in clinical trials, but showing good signs of effectiveness in preventing HIV transmission.

There is so much to know, but how do the details ever get to the many people who need to know them?  Are you willing to share this conversation over the holidays as we near the end of this decade?  

 If so, and you need more information, please be in contact with The Rubberman at the local office of the WNC AIDS Project. 









 You probably recognize his face.  He'll be glad to help you gather the information and resources to help you become the educator to the community you serve.  He always says he can't do it alone.  

Lastly, remember those who've passed from HIV and AIDS-related causes on December 1st, which is known across the planet as World AIDS Day. The theme this year is
“Ending the HIV/AIDS Epidemic: Community by Community”, reflecting the need to achieve the national and worldwide goal to End the Epidemic by 2030 by redoubling our efforts together here at home.   Say the names of those we remember.
Make a quilt panel if you haven't already.  We cannot forget them...we shouldn't forget them, but we can look forward to a better day when this is all archived in the library and researchers look back to get an understanding of something we lived through for decades. 
 It is not over yet, but getting there. Be well.
What The Rubberman Wrote 
by Michael Harney 
                            November 2019 
Michael Harney is an Educator with the Western North Carolina AIDS Project Office and AIDS prevention advocator for over 30 yrs. Reverently
referred to as "The Rubberman" from
his activism in handing out condoms all over Asheville.