UequalsU Consensus Statement

uu-image
RISK OF SEXUAL TRANSMISSION OF HIV FROM A PERSON LIVING WITH HIV WHO HAS AN UNDETECTABLE VIRAL LOAD  

Messaging Primer & Consensus Statement 

There is now evidence-based confirmation that the risk of HIV transmission from a person living with HIV (PLHIV), who is on Antiretroviral Therapy (ART) and has achieved an undetectable viral load in their blood for at least 6 months is negligible to non-existent. While HIV is not always transmitted even with a detectable viral load, when the partner with HIV has an undetectable viral load this both protects their own health and prevents new HIV infections.[i]  

However, the majority of PLHIV, medical providers and those potentially at risk of acquiring HIV are not aware of the extent to which successful treatment prevents HIV transmission.[ii] Much of the messaging about HIV transmission risk is based on outdated research and is influenced by agency or funding restraints and politics which perpetuate sex-negativity, HIV-related stigma and discrimination.

The consensus statement below, addressing HIV transmission risk from PLHIV who have an undetectable viral load, is endorsed by principal investigators from each of the leading studies that examined this issue. It is important that PLHIV, their intimate partners and their healthcare providers have accurate information about risks of sexual transmission of HIV from those successfully on ART. 

 At the same time, it is important to recognize that many PLHIV may not be in a position to reach an undetectable status because of factors limiting treatment access (e.g., inadequate health systems, poverty, racism, denial, stigma, discrimination, and criminalization), pre-existing ART treatment resulting in resistance or ART toxicities. Some may choose not to be treated or may not be ready to start treatment.

 Understanding that successful ART prevents transmission can help reduce HIV-related stigma and encourage PLHIV to initiate and adhere to a successful treatment regimen.

 The following statement has been endorsed by:

  • Dr. Michael Brady – Medical Director of Terrence Higgins Trust and Consultant HIV Physician, London, UK

  • Dr. Myron Cohen – Principal Investigator, HPTN 052; Chief, Division of Infectious Diseases, UNC School of Medicine, North Carolina, USA

  • Dr. Demetre C. Daskalakis, MPH – Assistant Commissioner, Bureau of HIV/AIDS Prevention and Control New York City Department of Health and Mental Hygiene, New York, USA

  • Dr. Andrew Grulich – Principal Investigator, Opposites Attract; Head of HIV Epidemiology and Prevention Program, Kirby Institute, University of New South Wales, Australia

  • Dr. Jens Lundgren – Co-principal Investigator, PARTNER; Professor, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark

  • Dr. Julio Montaner – Director of the British Columbia Centre for Excellence in HIV/AIDS; Director of IDC and Physician Program Director for HIV/AIDS PHC, Vancouver BC, Canada

  • Dr. Pietro Vernazza – Executive Committee, PARTNER; Author, Swiss Statement 2008, Update 2016; Chief of the Infectious Disease Division, Cantonal Hospital in St. Gallen, Switzerland

Organizational endorsements include:

People living with HIV on ART with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV.  Depending on the drugs employed it may take as long as six months for the viral load to become undetectable. Continued and reliable HIV suppression requires selection of appropriate agents and excellent adherence to treatment. HIV viral suppression should be monitored to assure both personal health and public health benefits.

NOTE:   An undetectable HIV viral load only prevents HIV transmission to sexual partners. Condoms also help prevent HIV transmission as well as other STIs and pregnancy. The choice of HIV prevention method may be different depending upon a person’s sexual practices, circumstances and relationships. For instance, if someone is having sex with multiple partners or in a non-monogamous relationship, they might consider using condoms to prevent other STIs.

 “NEGLIGIBLE” = so small or unimportant as to be not worth considering; insignificant. 

 ADDITIONAL EXPERT QUOTES, SOURCES, AND EXPLANATIONS [iii]

1. “If you are durably virologically suppressed you will not transmit to your partner… I’ll say this again, for somebody who is in a discordant couple, if the person [with HIV] is virologically suppressed, ‘durably’ –there is no virus in their system, hasn’t been for several months —  your chance of acquiring HIV from that person is ZERO. Let’s be clear about that: ZERO.  If that person the next day stops therapy for two weeks and rebounds, your chance goes up. That’s why we talk about ‘durable’ viral suppression…You’re as durably virologically suppressed as good as your adherence”.  Dr. Carl Dieffenbach, Director of the Division of AIDS, NIH.  NIH Video interview (November 11, 2016)

 2. “When an HIV positive person first starts on treatment, it takes a few months before viral growth is completely suppressed. During that short window of time, the couple should use condoms. Alternatively, the HIV negative partner might use antiretroviral agents as pre-exposure prophylaxis [PrEP].” Dr. Myron Cohen Chief, Division of Infectious Diseases, UNC School of Medicine, North Carolina, USA; Principal Investigator, HPTN 052. POZ magazine (September 26, 2016)

 3. Suppressing the viral load of a person living with HIV to undetectable levels “not only saves their lives but prevents them from infecting others.  So the higher percentage of people who are on treatment, in care and get their viral loads to undetectable, the closer you get to literally ending the epidemic.” Dr. Anthony Fauci, Director of NAID, NIH. NIH Video Interview  (August, 2016)

4. “..Once you begin therapy, you stay on therapy, with full virologic suppression you not only have protection from your own HIV….. but you also are not capable of transmitting HIV to a sexual partner. With successful antiretroviral treatment, that individual is no longer infectious.”  Dr. Carl Dieffenbach, Director of the Division of AIDS, National Institutes of Health. NIH Videointerview (August, 2016)

5. “We can now say with confidence that if you are taking HIV medication as prescribed, and have had an undetectable viral load for over six months, you cannot pass on HIV with or without a condom.” Dr. Michael Brady, Medical Director, Terrence Higgins Trust, London, England (July 2016)

6. “The force of evidence in both real world and clinical trial experience confirms that individuals with suppressed viral loads have a negligible risk of transmitting HIV. Treatment as prevention, pre-exposure prophylaxis, and traditional prevention measures, like condoms, make up an HIV prevention toolkit based in harm-reduction that allows individuals to make personalized and enlightened decisions to both maintain their health and prevent HIV and STI transmission.” Dr. Demetre C Daskalakis, MPH – Assistant Commissioner, Bureau of HIV/AIDS Prevention and Control New York City Department of Health and Mental Hygiene (July 2016)

 7. “Does this work over a long period of time for people who are anxious to be suppressed? The answer is absolutely yes, we now have 10,000 person years (of follow-up) with zero transmissions from people who are suppressed.” Dr. Myron Cohen. Medpage; NEJM. (July 2016)

8. “Among serodifferent heterosexual and MSM couples in which the HIV-positive partner was using suppressive ART and who reported condomless sex…there were no documented cases of within-couple HIV transmission” among 58,000 condomless sex acts.  Reporting on PARTNER study  Dr. Alison Rodger, et al. JAMA. (July 2016)

9. “These results are simple to understand – zero transmissions from over 58,000 individual times that people had sex without condoms…[PARTNER study] provides the strongest estimate of actual risk of HIV transmission when an HIV positive person has undetectable viral load – and that this risk is effectively zero.“ Simon Collins, Steering Committee, PARTNER, i-BASE (July 2016)

10. “The [Swiss] statement [was the first position statement that] addressed the infectiousness of an HIV-positive person once the virus was stably suppressed for at least 6 months with ART. [T]he [Swiss Federal Commission for AIDS-related Issues] felt, based on an expert evaluation of HIV transmission risk under therapy, that the risk of HIV transmission in such a situation was negligible.” Dr. Pietro Vernazza, chief of the Infectious Disease Division, Cantonal Hospital in St. Gallen, Switzerland; Executive Committee, PARTNER  Swiss Medical Weekly  (Jan. 2016, confirming the original 2008 Swiss statement)’

11. “[T]he HPTN 052 study saw only cases of transmission during ART that occurred shortly (days) after the initiation of therapy. If only transmissions after the first six months of ART are considered (as stipulated in the Swiss statement) the efficacy would have been 100% with a transmission risk of zero.”  Dr. Pietro VernazzaSwiss Medical Weekly  (Jan. 2016)

12. “We have…rigorous confirmation that treatment prevents the spread of HIV and improves the health of infected people.”  Dr. Thomas R. Frieden, Center for Disease Control Director, USA New England Journal of Medicine sourcing HPTN 052 & PARTNER studies (Dec. 2015)

13. “If people are taking their pills reliably and they’re taking them for some period of time, the probability of transmission in this study is actually zero.” Dr. Myron Cohen, Chief, Division of Infectious Diseases, UNC School of Medicine, North Carolina, USA; Principal Investigator, HPTN 052 Interview with plus (August, 2015)

 14. “[People with HIV] will not pass on the infection, if the virus is undetectable, to their partners…” Professor David Cooper – Director of the Kirby Institute for Infection and Immunity in Society. University of NSW, Australia; ABC AU interview (May 2015)

15. “When you treat a person who is HIV infected you render them no longer contagious. Over a period of years that benefit is further realized… Sexual relationships can be much safer because [treatment] suppresses transmission. There is a societal benefit, a public health benefit, an altruistic benefit. ” Dr. Myron Cohen, Chief, Division of Infectious Diseases, UNC School of Medicine, North Carolina, USA; Principal Investigator, HPTN 052 At IAS Meeting,  (2015)

16. When asked what the study tells us about the chance of someone with an undetectable viral load transmitting HIV, presenter Alison Rodger said: “Our best estimate is it’s zero.” Reporting on PARTNER study interim results. Dr. Alison Rodger, University College London, United Kingdom; Lead Author PARTNER,  NAM -AIDSMap (March, 2014)

17. People living with HIV “are leading lives that are normal in quality and length. With effective treatment, they are not infectious.”  Health care workers on effective HIV treatment are “totally safe.” Professor Dame Sally Davies, Chief Medical Officer, England. The Telegraph (Aug. 2013)

 18.“In reality, if you give the treatment the opportunity to get on with its work, you will have zero transmission”. Dr. Julio Montaner,  Director of the British Columbia Centre for Excellence in HIV/AIDS; Director of IDC and Physician Program Director for HIV/AIDS PHC:  TED Talk referring to HPTN 052 (Nov. 2011).

[i] Much of the current prevention messaging refers to this as Treatment as Prevention or TasP.  As of the writing of this primer, there have been no confirmed cases of HIV transmission from a person with an undetectable viral load in any studies. The official cut-off point for an undetectable viral load as defined by the WHO ranges from <50 copies/ml in high income countries to <1,000 copies/ml in low to middle-income countries. For the purposes of this statement, an undetectable viral load is defined as under <200 copies/ml.

[ii] Only a small proportion of HIV-positive people in a large US treatment study regarded themselves as non-infectious after up to three years on antiretroviral therapy (ART), and a third of participants regarded their chance of infecting a partner as still ‘high’, even though only 10% of participants actually had a detectable viral load.” NAM- AIDSMap (2016)

[iii] Acknowledgements: In addition to PAC’s Founding Task Force, Professor Carrie Foote (Indiana University-Indianapolis) and Edwin Bernard (HIV Justice Network), reviewed and provided valuable input on the Primer.

President-Elect Donald J. Trump: An HIV-Positive Born-Again Christian’s Perspective

trump-bible

It’s now well known across the world that the United States recently elected Donald J. Trump to be its 45th president. Emotions are running high, not only within the HIV community, but also within communities across the globe, as we grapple what the future holds for our country. His presidency came as a surprise to many, especially in light of polls that overwhelmingly favored his opponent, democratic nominee Hillary Clinton, as the projected winner.

I’ll be the first to say that Trump was not my preferred choice for president from either the stance of a born-again Christian or someone living with HIV. This, however, was not the consensus of the Electoral College or of many white evangelical Christians. In fact, white evangelicals make up 25% of the United States population and over 80% voted in favor of the Republican ticket.

It seems that many Christians have forgotten words spoken by Paul in Titus 1:7-8, “Since an overseer manages God’s household, he must be blameless — not overbearing, not quick tempered, not given to drunkenness, not violent, not pursuing dishonest gain. Rather, he must be hospitable, one who loves what is good, who is self-controlled, upright, holy and disciplined.”

We’ve heard over and over this election season that this was bigger than any one candidate but rather about the values we stand for as Americans. As a Christian, I must ask myself, does Donald Trump represent the above-stated values? Many Christians simply vote on one core issue: abortion. While I myself do not agree with abortion except in unique and rare circumstances, I feel that there are many more issues that one must take into account.

The old saying “WWJD” or “what would Jesus do” leaves me shaking my head anytime I hear Trump talk about anything from immigration to poverty. Christians have put nation before kingdom, and that is a big reason why Trump will be our 45th president. I will follow the bible verse in Matthew 22:21 that says, “Render to Caesar the things that are Caesar’s and to God the things that are God’s,” however, I will also hold Trump accountable for his actions.

From another perspective, as someone living with HIV, it’s frightening this man will be leading our country. It’s really like a blind coin toss with the outcome unknown, as he has not elaborated his views on the subject. With the recent passing of 2016 World AIDS Day, I was hoping to get a glimmer of hope, some shimmer of light that would tell me, “OK Josh, things are going to be all right.” But that didn’t happen.

Instead, we got more of the same response surrounding an issue that personally affects my life: silence. We my as well have heard crickets from the president-elect as, instead of recognizing such an important date, he spent it touring the country on a “thank you” tour that only served to boost his ego. I wasn’t expecting huge recognition. Heck, I would have settled for a simple two-to-three-minute message. The fact is, over 1.2 million in the United States are living with HIV, and your telling me in the last year he couldn’t find the time to mention us even once? Instead of thanking the voters who elected him, how about thanking the long-term survivors who in many cases gave their lives so that I and others living with the virus have the opportunity to live.

Unlike other issues, HIV has lives at stake if he doesn’t get it right. This isn’t a plan that he is simply going to be able to “wing” or piggyback off current strategy. We need a leader who has a clear and concise plan that will address all aspects of the pandemic, both nationally and globally.

We’ve fought too hard to increase funding for prevention and awareness to turn back the wheels of time. While we can’t be certain what the future holds, the silence from the Trump administration and past conservative stances on the issue are unsettling at best. This may not be the nation’s top priority, but it’s my top priority, and I will make sure that the Trump administration, Congress and the Senate know it. These are our lives and we will continue to speak up to ensure the progress we’ve made is not undone.

I urge all Americans to remain vigilant during this presidency. We must not grow complacent or allow yesterday’s news to detour us from our mission for today. While I’m willing to follow the advice of Hillary Clinton and give him a chance, that does not go without limits. It’s going to be a long road ahead of us; however, we must remember the words of Frederick Douglass, who said:

If there is no struggle, there is no progress. Those who profess to favor freedom and yet depreciate agitation are men who want crops without plowing up the ground. They want rain without thunder and lightning. They want the ocean without the awful roar of its many waters. This struggle may be a moral one, or it may be a physical one, and it may be both moral and physical, but it must be a struggle. Power concedes nothing without a demand. It never did and it never will.

God Bless America and may he give us all the wisdom and strength to move forward in the years that follow.

National Heterosexual Men’s HIV/AIDS Awareness Day Petition

Help support heterosexual men living with HIV by signing the petition, click here

There are approximately 36.7 million people in the world living with HIV and 1.2 million people in the United States alone. A significant percentage of those living with the virus are heterosexuals including many straight men who struggle to find their voice within this pandemic. Straight positive men, like myself, are living with a condition that is highly stigmatized and believed by the general public to only happen to already marginalized groups within society; namely gay men/msm, sex workers, and IV drug users. This has greatly contributed to many of them living in silence, shame, and fear. Therefore, contributing to a decline in treatment adherence, negative lasting impacts on mental health, and disclosure challenges.

The creation, recognition, and implementation of August 16th as, National Heterosexual Men’s HIV/AIDS Awareness Day, will help break the barriers of stigma and give a sense of community to a group of people living with HIV/AIDS that is all too often left out of the conversation. Will you help the cause today by signing your name and urging the CDC to take this step in support of heterosexual men across the country living with HIV?

 

Si Se Puede: Speaking Up as Allies to Latinx Communities

“Si se puede” or “yes, one can,” a term coined by Dolores Huerta, could be heard in speeches by Cesar Chavez and the United Farm Workers in the early 1970s. It’s a slogan that not only served to unify Latinx people, namely Mexican Americans, but also raised awareness around the plight of farm workers. It is still used almost 40 years later for various causes. Little did we know that a decade after the saying became popular, the world would face a health epidemic — HIV/AIDS — it had never seen before, and Hispanics would become a disproportionately affected group.

For the past twelve years, my life has largely centered on this very group, even though I myself am not Hispanic. At 14 years old, I began to take food and clothes down to a local orphanage in Tijuana, Mexico, through missionary work with my church. Almost immediately, it was apparent that I needed to learn the language if I wanted to be effective. I learned formal Spanish including reading and writing in school, while I learned what we call “street” Spanish from monthly visits to Mexico.

Later on, Tijuana would grow to become like a second home. It’s where I met my now ex-girlfriend and possibly the very place I contracted HIV. It was in this border town, a melting pot of both U.S. and Mexican culture, that I learned about life. The people, ways of life, and spirit of helping fellow humans I’ve seen in Tijuana has always inspired me. It’s also opened my eyes, educated me with real-life experiences on the plight of undocumented workers and given me a bird’s eye view on the rippling effects of poverty.

mexican-cultural-institute
Josh at the Mexican Cultural Institute in Washington D.C. September 2016

Although I am Caucasian, I have continually immersed myself in Mexican culture. Whether it is television, food or music, I am “Tijuanense” — Spanish slang for someone from TJ. I was given the Spanish nickname of “Juanito Perez” (a name I got after working as a painter in my early teens) among others such as “Miklo Velka” and “Güerro.” I may not be Mexican by blood but I often say I am at heart.
My love for the Spanish language and knowledge of the culture has served especially useful in my HIV advocacy. I help moderate the largest Spanish-speaking international support group on Facebook, Grupo Internacional para Personas con VIH/SIDA y las Personas Afectadas, founded by fellow HIV advocate Maria Mejia. With over 18,000 members from across Latinx America, the group has given me a unique perspective not only of HIV here in the United States, but also on the challenges faced by the Latinx community across the world. Whether it is antiretroviral shortages due to the political situation in Venezuela or a lack of one-pill-a-day treatment options in countries such as Mexico, change is necessary.

Culturally, this virus remains a highly stigmatized and hush-hush subject within the community. Far too often, the voices of Hispanics go unheard, in some cases due to fear of social rejection due to the simple act of being open about one’s status. As discussed in the group on Facebook and elsewhere, various factors that can contribute to the stigma, including male machismo, lack of education/awareness, religious beliefs, language barriers, immigration status and poverty. I have great regard for the power of these issues, informed by my personal experiences and my efforts to appreciate the diverse cultures the Latinx community. I am committed to being a strong ally.

To those of use who are not Latinx, I urge you to put the term “si se puede” to use by uniting with our Hispanic brothers and sisters to look beyond our differences and break the stigma. At a time when Hispanics make up almost one-third of new HIV infections and the alarming news that one in 36 Latinx men (and one-quarter of gay Latinx men) will become HIV positive if current trends continue, it’s more important to speak up now than ever. We must support the work of Latinx leaders to get information about treatment as prevention and pre-exposure prophylaxis (PrEP) out to the Hispanic community. By doing so, we are not only chipping away at the stigma, but also saving lives along the way.

A battle isn’t won with a single soldier but rather with an army, a team in which each person’s role contributes to the overall group goal. It’s my hope that as an ally I can continue to lend a voice to the voiceless and a helping hand to a community that often lives in silence, alienated from the HIV/AIDS conversation.

If you are a Latinx person living with HIV or know someone who is, I would encourage you to visit the HIV/AIDS Resource Center for Latinos at TheBody.com by clicking here. If you are in search of a Spanish support group online check out Grupo Internacional by clicking here.

**This article was originally written by Joshua Middleton for http://www.thebody.com. Permission to share published content should be obtained through the original author and or Thebody.com**

Original Article Link can be found by clicking here

My 10 Step to Do List for Enduring Depression

This blog was published for The Body and original weblink for article can be found by clicking here.

My 10-Step to-Do List for Enduring Depression A plan of action to combat depression is necessary. While we may never be cured of this condition, we can take steps to suppress it. Some of these things may make us feel uncomfortable or at times seem down right pointless; however, I promise the more you do to actively combat your depression, the better you are going to feel in the long run.

As someone who has lived with depression for many years, I have learned there is no magical one-size-fits-all solution, but it’s my hope that implementing even one of these steps can help you on your own journey.
Credit: PixelEmbargo for iStock via Thinkstock.

Physical Activity and Diet

Physical Activity and Diet

Study after study has shown that exercise can help fight depression. It increases the endorphins or “feel good” chemicals flowing throughout our systems.

 I started out slow and am still not where I need to be, but have taken a step in the right direction. As the old saying goes: “The only bad workout is the one you didn’t do.” I push myself to go to the gym every other day, approximately three to four times a week, and do thirty minutes of cardio along with thirty minutes of weight training. Over time, I will increase the amount I work out, but for now, it’s just right for me. It energizes and motivates me to keep pushing forward.

Eating healthy is also important. I won’t sit here and say that I am a health nut; however, especially lately I have been trying to incorporate a more balanced diet into my health plan. I still fall prey to an occasional temptation for a sweet now and then, but overall, I feel better when I eat more healthfully. Cutting out soft drinks and junk food while increasing your intake of fruits and veggies are simple things you can do to set your diet back on track.

Credit: artpaseka for iStock via Thinkstock.

Music

Music

Music is said to be the pathway to the soul, and I agree. Nothing gets my blood pumping more than uplifting music. As someone who has an hour commute to work every day, I have to find a way to keep myself occupied. Music invokes emotion, and while that can be counterproductive at times, it’s often helped me push through the depression. Soothing and relaxing music triggers good feelings and puts me in a peaceful state. As someone who has a love for the Mexican culture and the Spanish language, this incorporates the majority of what I listen to. Listen to whatever you enjoy because it will get you out of your mind’s thinking trap and take you to a state of being where your emotions have a voice.

Credit: Katerina_Andronchik for iStock via Thinkstock.

Build and Maintain a Support Network

Build and Maintain a Support Network

Building a support network is a big step that everyone living with depression should have in place. Whether it is a close friend, significant other, beloved family member or therapist, we all need someone we can trust and talk to. For me, a combination of all of these networks helps. At any given time, if I start to feel depressed, I know I have someone I can call and speak with or even visit to express my feelings. Make it clear with your networks what you want in return when you express how you are feeling. Most of the time, I just want someone to listen. And I am fortunate to have a great support network that will do just that.

Credit: aelitta for iStock via Thinkstock.

Get Creative

Get Creative

Whether it is writing, painting, drawing or singing, do something you love that can let your feelings flow. For me as a blogger and writer, that come’s in the form of written words and poetry. Putting my thoughts on paper is a way for me to fully work through my emotions and express what I am feeling inside. It’s not always the finished product but instead the process of writing that helps. Whatever might work for you, take up a creative hobby, and if you don’t know what yours is, begin the process of exploring one. You won’t regret it!

Credit: print10 for iStock via Thinkstock.

Connect With Nature

Connect With Nature

The beauty of the outdoors brings a sense of mindfulness that I’ve found effective in my journey. Whether it is relaxing at our family cabin in Big Bear, swimming in the Pacific Ocean or exploring the beauty of Alaska aboard the annual HIV Poz Cruise, nature is important to me. I forget about the depression and for that moment focus solely on the beauty that surrounds me. It’s a very therapeutic exercise and fun at the same time.

Credit: Purestock via Thinkstock.

Spirituality

Spirituality

Whether you are a born-again Christian like me or hold no religious views, spirituality is something that can be beneficial to anyone living with depression. Spirituality is simply connecting with something bigger than us — connecting with our surroundings in a search for the meaning of life. Religion aside, it’s something that all humans experience on one level or another. It helps us to look at the big picture because, when we do, our problems do not seem so overwhelming. It helps us discover our purpose in life, which in turn inspires hope within us that, although we may be going through a tough time, things can change for the better just as quickly as they did for the worse. I personally practice praying, reading bible scriptures and focusing on improving my relationship with Jesus Christ.

Credit: cihanterlan for iStock via Thinkstock.

Pets

Pets

It is well known that there is a close correlation between those living with depression and our pets. I always had animals growing up; however, I never experienced a stronger bond than in the years of enduring depression. I have two dogs named Lobo and Lacy; they both play a vital role in my health care and have been there for me through my worst. They simply want to love and to be loved, the most basic principles of life itself. When I feel down and drained of energy, seeing the smiles on their faces is an amazing feeling. They define what it means to live in the moment, and simply by being with them that energy transfers to me. Nothing like a good fluffy hug to lift my spirits.

I love the story of six-year-old child who asks his parent why dogs die at such a young age. The boy says, “People are born so that they can learn how to live a good life — like loving everybody all the time and being nice, right?” The child continues, “Well, dogs already know how to do that, so they don’t have to stay as long.”

Credit: Shedevrator for iStock via Thinkstock.

The Power of Positive Thinking

The Power of Positive Thinking

I know this step seems cliché, and I agree that it is not enough to shake the depression at times. However, I have realized that surrounding myself with positive people and filtering out the negativity and toxicity changes how my mind thinks. Sometimes it may seem as if there is nothing positive in our lives, but I guarantee you there is if you would only look for it. I suggest writing down three things you are grateful for. Regardless of how big or small, over time this will change the way you see the world. This is more of a mindset than an individual practice, but when implemented, you will notice the change.

Credit: Jeremy Webster for Hemera via Thinkstock.

Stepping Outside My Comfort Zone

Stepping Outside My Comfort Zone

Depression and isolation often go hand and hand. It’s actually something that I’ve practiced in the past because I don’t want others to suffer. I’d rather block them out, ignore them and fall into a state of nothingness. It’s easier to do that than to accept that, to fully get ahold of my depression, I have to interact with society. As a social media advocate, this also means taking a break from the digital world. Although inside I may not be feeling it, the benefits of physically interacting with others are enormous. It could be as simple as hanging out with friends or giving to someone who is less fortunate. Doing these things serves as a distraction, as the focus and attention shifts from my own thoughts to the lives of others.

Credit: dalebor for iStock via Thinkstock.

Recognition and Acceptance

Recognition and Acceptance

Awareness and recognition of what triggers my depression is important. This not only helps me better understand my condition, but also helps me formulate a better response the next time it happens. For many, recognizing when depression is sinking in can be a hard task. For me, I now know almost automatically. It’s been a learning process to get to this point; however, I can now accept when it is hitting and implement the steps above to suppress it to the best of my ability.

Credit: EgudinKa for iStock via Thinkstock.

General Disclaimer: TheBody.com is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through TheBody.com should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.

Cada 40 Segundos (Version en Español)

Cada cuarenta segundos

“Necesitamos crear conciencia de la otra epidemia-depresión”

Por Joshua Middleton

Este es una translacion literal de un articulo que fue escrito y que es propiedad de  A&U:America’s AIDS Magazine : El enlace original del articulo se puede encontrar aqui. Translacion cortesía de Kraus en fivver.com 


Soy VIH-Positivo y, si, también vivo con depresión. Es correcto, lo he dicho. La gran palabra con “D” que nadie quiere decir. Permíteme compartir contigo mi perspectiva sobre una epidemia posiblemente mucho más grande que cualquiera que hayamos visto antes.

joshua-gg-big
Joshua pedaleando a través del Golden Gate en un viaje reciente a San Francisco. Foto cortesía de J. Middleton

 

En un viaje reciente, mientras pedaleaba sobre el puente del Golden Gate, la realidad de lo que se ha vuelto un tema tan tabú realmente cobró sentido. La obra maestra arquitectónica que es visitada por enjambres de turistas anualmente también se ubica arriba de un cementerio donde miles han sucumbido a la aparentemente interminable batalla contra los problemas mentales, en específico la depresión.

Mientras el lecho marino empieza a levantarse, me asomé a mi derecha hacia otro icónico pedazo de historia en el Área de la Bahía, la infame prisión de alcatraz. Imagina estar encarcelado en tal lugar. Cuatro paredes confinándote de la libertad con solo un vistazo del mundo exterior. Un lugar que tiene entradas y salidas, pero, a pesar de saber cómo salir de él, no pareces ser capaz de lograrlo. La felicidad y alegría son tomadas de ti y la realidad es la extensión de tiempo que esta frente a ti. Parece que solo estas siguiendo la corriente. La peor parte de ello es que, nadie habla acerca de lo que estás pasando; como si no existieras. Se te deja con un sentimiento de aislamiento, rechazado por la sociedad. Ahora sabes cómo es para alguien que vive con depresión.

Irónicamente, ambas están localizadas en San Francisco, una ciudad que ha estado afectada mayormente por el virus desde el inicio de la epidemia de SIDA. Aunque algunas estadísticas muestran que el sesenta por ciento de los individuos que están viviendo con VIH también están viviendo con depresión y que somos tres veces más probable que nos deprimamos, la sociedad como un todo no le importa hablar de ello. Es incomodo, extraño y lejano a ellos que no lo han experimentado.

Sus efectos en alguien viviendo con VIH van desde casos extremos de suicidio a otros problemas como una disminución al apego al tratamiento, abuso de sustancias, y una reducción en general de la calidad de vida.

¿Sabías que el suicidio es una causa principal de muerte? Tan solo en 2014 hubo poco más de un millón de muertes al año, lo que se reduce a una muerte por suicidio aproximadamente cada cuarenta segundos. En dos-tercios de los casos, la depresión fue un factor subyacente al momento que terminaron con sus vidas. Por el momento que termines de leer este artículo en teoría cinco más se habrán ido porque no pudieron aguantar más. Fueron fuertes por demasiado tiempo.

Así es, fuertes. No leíste mal ni hay errores. Soportar la depresión requiere fuerza. No es un signo de debilidad y es el mismo estigma que nos dice esas cosas y que está manteniendo a tantos en las sombras del silencio. Necesitamos un nuevo enfoque sobre como miramos esta condición. Necesitamos animar a la gente a hablar y buscar ayuda cuando sea posible.

¿Cómo podemos esperar que la gente se adhiera al tratamiento cuando tomar una pastilla parece tan difícil como subir una montaña? ¿Por qué no estaría al alta el abuso de sustancias cuando la gente se siente tan mal en sus vidas que encuentran un modo de estar temporalmente bien y enmascarar su dolor? ¿Cómo podemos decirle a la gente a que vea lo positivo de la vida cuando el mundo parece estarse desmoronando tras ellos?

Entendiblemente, el VIH es un diagnóstico que cambia la vida. Es un virus que ha sido estigmatizado desde el principio y por varias razones puede activar depresión. Un cuidado integral tanto de la salud física como mental desde el inicio del diagnóstico es vital. Hay ayuda ahí afuera, pero la gente solo la busca cuando están listos, pero son frecuentemente retenidos por el estigma.

¿Qué puedes hacer tu para ayudar a alguien con depresión? Escuchar. Sí, es así de simple. Date cuenta que un oído imparcial y que no juzgue es crucial. Una que no esté ahí para ofrecer opiniones no solicitadas o consejos pero que solo ofrezca una línea simple de comunicación y dar un abrazo cuando sea necesario. Con este paso sencillo. Habrás validado los sentimientos de ese alguien en saber que no hay vergüenza en decir, “tengo depresión y está bien hablar de ello”.

¡Si vamos enserio acerca de alcanzar nuestra meta cero entonces debemos empezar por hablar de depresión!

El cambio inicia con una conversación y reconocer el problema – ¡Eso empieza aquí!

¿Estás buscando servicios por salud mental/abuso de sustancias? Llama la línea directa nacional SAMHSA gratuita al 1 (800) 662-HELP. ¿Estas experimentando una crisis de salud mental justo ahora o te sientes suicida? ¿Necesitas a alguien con quien hablar? Por favor, llama gratuitamente al 1 (800) 273-8255.

Joshua es un blogger de redes sociales, educador y orador público que aboga por crear conciencia del VIH y salud mental. Como alguien viviendo con VIH y depresión el mismo, él sabe lo difícil que puede ser, pero también cree firmemente en el impacto de relatar y apoyarse entre sí por medio de compartir su propio viaje personal con el mundo. El ayuda a inspirar esperanza en otros a través de este blog, www.pozitivehope.com, al mostrar consistentemente a la gente que “el cielo es el límite: hay vida más allá del VIH”.