HIV prevention and education

1. HIV
Tony Lane, CPH
Positive Life

2.  Who is Tony? What is Positive Life?
 Fresno County HIV Statistics
 What is HIV and AIDS?
 Nerdy tangents about HIV pathology
 What should I do if I tested positive?
 What does it mean if I am living with HIV?
 Disclosing HIV status
 Dating
 Ways to protect my partner

3.  Started as a trained facilitator for the PLUS (Positive
Living for Us) Program of Stop AIDS Project in 2006
 Joined the California Statewide Training and
Education Program (CSTEP) Treatment Advisory
Board
 Joined the HIV Advisory Board at Community
Regional Medical Center
 Testified before the Presidential Committee on
HIV/AIDS
 The creation of Positive Life

4. POSITIVE LIFE
 Empower people living with HIV through-
 Education
 Fostering linkage to care
 Creating a safe space and community for
all people who are affected by HIV
 Our website:
http://www.poslife.org

5. HIV
What can you tell from this
bar chart?
Hint:
Who do you think are at
risk of HIV the most?
The proportion of new HIV cases by race in
Fresno County, 2014

6. White, not
hispanic, 30.9,
31%
Black or
African
American , 5.9,
6%
Asian, 10.7,
11%
hispanic or
latino, 51.9,
52%
Other, 0.6, 0%
Population break down of Fresno County, California, by
race 2014
White, not hispanic
Black or African
American
Asian
hispanic or latino
Other
Census, 2014
Now, did you change your
mind?
Hint:
Compare the HIV incidence
rate with the demographic
breakdown of Fresno County

7.  What can you tell from
this bar chart?

8. HIV AIDS
 What does HIV stand for?
 What does AIDS stand for?
 Is HIV and AIDS the same?
 A person living with HIV does NOT necessarily have AIDS
 HIV is a virus
 AIDS is syndrome caused by virus, if left untreated
 Therefore…
 A person living with HIV can be very healthy, as long as they adhere to the treatment!

9. ANATOMY
 SKIN!
 Mucous membrane
 Epithelial layers
 Vagina (40)
 Rectum (1)
 Head of penis

10. HIV
 Blood
 Transfusion
 Sharing Needles
 Semen
 Unprotected anal or vaginal Sex
 Pre-ejaculate
 Vaginal fluid
 Unprotected vaginal sex
 Breast Milk Breast Feeding
 Oral sex
 Minimal risk, why?

11.  Life course development of Virus
titer, CD4 cell number and anti-
gp120 titer during the HIV
infection
 Can skip this section if you do
not want to go in depth

13. POSITIVE
 Linkage to care
 Find a doctor, and get treatment
 Get vaccinated for other diseases (e.g.
pneumonia)
 Positive Life will assist you with the process, if
help is needed.
 Staying in care
 Taking your medication everyday and not missing a
dose.
 Keeping your doctor appointments.
 Create a support network.
Then Now

14.  The market price of a one year supply of
Atripla will cost $31,200, that’s $2600/mo.
 You can afford it through…
 Private Insurance
 A basic plan with Aetna would cost you a copay
about $30/mo.
 Covered California
 Medical
 AIDS Drug Assistance Program
 Co-Pay Cards (by the pharmaceutical
company)

15. HIV
 What does Stigma mean? (Goffman, 1963)
 What does it mean when I am HIV positive…
 Structural Stigma
 The law mandates self disclosure
 Interpersonal Stigma
 Ignorance and fear among others might lead to cruel
and unjust rejection and discrimination against you

16. HIV
 You are always more powerful than you
realize!
 HIV is not a punishment for immorality
 Take your time and space to find answers
you are looking for
 Educate and take good care of yourself
 We cannot change the past, but we can
choose our future by forgiving ourselves
"Forgiveness is something we choose;
it only happens when someone
chooses it.”

17. RESILIENCE
 Seek out for support!
 Emotional support is essential to your survival!
 Reach out to support group
 Positive Life offers a support group every 3rd Tuesday
of the month from 6:30pm~7:30pm for HIV+ people
and people who are affected by HIV
 You don’t have to tell everyone.
 Don’t let HIV define who you are, take control and
empower yourself with absolute acceptance and
forgiveness.

18.  There is no way of knowing how people will react…
 So ask yourself before disclosing to someone:
 Whom do I want to tell and why do I want them to know?
 How much am I ready to share? How much are they ready to
hear?
 How will disclosing my HIV status affect me and how will it
affect the people I tell?
 Choose a place where it is comfortable for you to disclose
your status.

19.  Disclosing your HIV status can be
stressful.
 It can be challenging to find support
 People will react differently.
 When people react negatively…
 Give them time and information to educate
them before
 Do NOT take it personally
 Keep yourself physically and mentally safe!
 If threatened, call the National Domestic
Violence hotline at 800-799-SAFE

20.  Your medical provider
 It is recommended that you screen for other STD/STI as
well
 Your current and past sexual partners
 More information on the next slide…
 If you use injection drugs…
 Inform peers whom you shared needles with
 Once again, you do NOT need to disclose with
everyone.

21. SEXUAL
If you are in a serious relationship…
 Disclosing your HIV status can put a
strain on relationships
 Keeping the news to yourself for too long is
not a good idea!
 It is normal to feel nervous and scared.
 Tell your partner to get tested
 Practice safe sex!
 Couple counseling might be beneficial

22. VIOLENTLY
 Disclose in a semi-public place like a public park with
many people around
 Consider disclosing with a third person present
 Meet only in public with that person until you feel safe
 Avoid exposing others to HIV without warning them
ahead of time.

23. DATING
 You could be found guilty of a felony for not telling a
sexual partner you are HIV+ before having intimate
contact.
 Stigma and fear against HIV is real!
 Your HIV status will prevent some from wanting to see
you.
But again…
A person living with HIV can be very healthy and deserving
of many long and fulfilling relationships, as long as they
adhere to the treatment!

24. NOT
 Your employer
 People living with HIV are protected from job
discrimination
 The law demands your employer to reasonably
accommodate your illnesses after disclosure.

25. STORY
MATTERS
 Some people share their stories to…
 Advocate for others
 Educate neighbors, communities and churches
 Some women find a purpose and self-esteem by
sharing their stories
Story telling can be empowering, but…
 Consider how much of your story you are ready to
tell.
 When facing a question that you are not ready to
answer, simply say “does it really matter?”

26. HIV
 Before telling your children, ask yourself:
 Will they be angry if you keep a secret?
 Do they suspect something?
 Are you sick?
 Children might react differently, depending
on their age
 Children need support too!
 Give them a name, whom they can trust, to
talk to
www.kidstalkaids.org/program/index.html. Also see our
info sheet on Talking with Your Children about Your HIV
Status.

27. It is important to…
 Get support from family and friends
 Foster stronger bonds with loved ones
 Adhering to your medication
 Follow up with your doctor regularly
 Concealment of stigma (e.g. living with HIV)
will lead to poorer health outcomes,
 Empower yourself by disclosing your status
when you are ready.
No one will love you, if you stopped loving
yourself.

29.  Always use condoms!
 So far, the most effective method in HIV
prevention
 Always check the expiration date
 Do NOT open the package with your
teeth

30.  Use water based lube instead of silicon based
lube
 Less odds of allergic reaction
 Less odds of irritating the skin
 Less likely to cause superficial bleeding

31.  Less alcohol and substance use
 Needle exchange programs
 Get free and clean needles from your local
needle exchange programs.
 Avoid needle sharing with others.

32.  A way for people who do not have HIV to help
prevent HIV infection by taking a pill every day
 It reduces the risk of HIV infection significantly,
when taken consistently.
 Caution: PrEP does NOT adequately prevent other
STD/STIs!

33. Questions?
 Feel free to contact Positive Life at:
support@poslife.org
info@poslife.org
By Tony Lane, CHP