The Alligator

So here we are just four days before Christmas and what’s up in the news?  Here are what I believe are the 12 stories of Christmas that are emblematic of where our country is at the finale of 2006.

1. A president who is delusional about the situation in Iraq and who is backing away from taking advice from military leaders because their view doesn’t jive with his.
2. A White House that is touting that the rank and file troops are telling Secretary of Defense Robert Gates that they want more troops there to achieve victory which differs from their leaders. 
3. A fight between “The Donald” and Rosie O’Donnell that is both ugly and a BIG “Who cares?”  But I have to admit that “The Donald” is just a nasty, nasty man!  The personal attacks were those of a 2 year old.  Geez Donald – Get over it- you are reacting to what a comedian said about you?  I think you are just looking for earned media just before the premier of your tired old show “The Apprentice”.  If someone would just fire Donald! At least Rosie is bringing ratings (for whatever reason) to “The View”.
4. American consumers are spending close to $1,000 per person during this holiday season.  Much of it due to irresistible bargains that are driving up personal debt.
5. The total retail number for the American holiday season is projected to be $457.4 billion.  Remember the  1947 movie- “Miracle on34^th Street”?  The theme was that too much commercialism was part of Christmas.  I guess we didn’t heed the warning.
6. Americans have given $260 billion to charity for the entire year of 2006 – compare that to the $457.4 billion that we’re spending on goodies for the holidays.   Makes you think doesn’t it?
7. The American Episcopal Church is on the verge of the biggest schism it has seen since Henry VIII founded the Anglican Church.  What a lovely Christmas message- if you don’t discriminate against gays, lesbians and women we want to pick up our marbles and your real estate and answer to some Ethiopian Bishop.  Talk about Christian Charity.
8. Although it is tragic that the hikers in Oregon have all been lost, it seems odd that so much money is spent on search and rescue for three white men who voluntarily went mountain climbing at a very precarious time (i.e., winter weather) and New Orleans is still in ruins.
9. The number of uninsured in the United States has reached an embarrassing high of 46 million Americans.
10. Teenage girls are the most likely candidates to begin smoking because it curbs their appetites!  Thank goodness we have so many positive role models for real life female body image!
11. In the  USA education funding shorts low-income children.   Alabama’s low-income students are not receiving as much federal money for education as those from higher-income areas, according to a report released by the nonprofit Education Trust that criticizes the U.S. government’s funding process. The report, which was released Wednesday, shows how the funding process benefits wealthier states and systems.  “In America, we say you can be anything you want to be if you work hard and stay in school,” Education Trust President Kati Haycock said. “But while we say that to kids, we are essentially sucker-punching them at the same time.” The U.S. government provides money for schools based on the number and concentration of low-income children in a state and on the state’s average per-student spending as outlined in Title I of the federal No Child Left Behind Act. The study shows that the state expenditure factor skews the distribution to benefit wealthier states.
12. The media replay OJ Simpson news and JonBet Ramsey news until we are ready to vomit.  And this is CNN not E!  What has happened to the television news media in this country?  I guess Edward R. Murrow and Fred Friendly are spinning in their respective graves.

Let’s hope we do better in 2007.  I pray that this country wakes up and get back on track.  I am not being cynical- just realistic and hopeful.  I’ll be posting again after the New Year begins.

I am a liberal and I enjoy some of the finer things in life.  Would the chattering class call me a Latte Liberal?  I am middle income, I am an openly gay man living in a comfortable San Francisco garden apartment with my partner of 18 years and our purebred beagle, I enjoy good food and wine, have traveled to Europe several times in the last five years, went to private school and have an Ivy League education- so I guess they would. Should I feel guilty about living comfortably while there are those that are less fortunate than I?

A while back a friend of my family’s made a remark about my Thanksgiving menu, which was somewhat a “foodie” delight, that got me to thinking about being a liberal and what that means in how I live my life.  Her comment was, “I always feel guilty anyway if we spend too much on a meal and then walk out on the street to see the homeless huddled over subway gratings or going through restaurant garbage cans for food”.   This hit particularly hard since I had just made a reservartion recently to have dinner at the famed “The French Laundry” where a bill for two is typically about $650.00

Should I feel badly about my occasional indulgences while there is suffering and poverty?  I truly do not think so if one’s liberal philosophy is more than just talk and there is action behind that talk.  But regardless the comment caused me to do a little stock taking of my own life.

I have spent the better part of the last decade working on public health issues that impact those without health coverage.  True most of my work revolves around HIV/AIDS and I am a person living with AIDS- but I am fortunate- I have always had decent health coverage.  My work has focused on those who have no coverage and who often fall through the cracks.  I have worked hard to ensure that people with HIV/AIDS in California have access to life saving drugs and that IV drug users have access to clean syringes.  None of those things have affected me personally- but knowing what life is like for someone living with HIV/AIDS- I have harnessed that energy to work on better public policy.  I’ve also worked in San Francisco on issues affecting including the direction of resources to those living with HIV/AIDS that are homeless or very at risk for homelessness.  I have also opened my own wallet for many of these causes.

Politically I have actively supported candidates who have platforms that include services for those that are poor.  But for me the most important issue is to look at candidates’ stands on health care and if they are willing to address the fact that 46 million Americans are without any health coverage.

I put my money, my time where my mouth is… I feel that I walk the walk.  Does that mean I have to live like a monk?  I really do not think so.

The New York Times magazine section on Sunday looked at American philanthropy and how much folks should give.  There was a comment that Bill Gates who is the richest person on the planet- while giving away tens of billions of dollars still has the money to buy a Leonardo codex and live in a house estimated to be worth $100 million.  Is he not entitled to enjoy his fortune while being an exemplar philanthropist?  What about George Soros and Warren Buffett?  Even though they are great philanthropists should they feel guilty about living well?

My answer is no.   In my mind living well and caring for those less fortunate are not mutually exclusive.  I might be accused of being an advocate of noblesse oblige- and I plead guilty.  I do think that those who are well off have a social responsibility.  If someone dedicates their life, their passions and a good portion of their resources to issues that is a good citizen in my mind.  What is a good portion of their resources?  I cannot answer that question- but for millennia tithing (giving 10% of one’s income) has been considered appropriate- maybe it should still be considered the minimum standard.

Regardless of my own contributions to the causes and issues that I believe in, I still have that liberal guilt about enjoying the better things in life and the privileges that I have been afforded.  If I didn’t have that guilt- the comment about Thanksgiving dinner would not have resonated at all.  I do not think I should have that guilt but when you care about issues and you cannot completely fix them with what you have done and with what you have given, you cannot help but wonder if these problems would be eradicated if you had just skipped that one extravagant dinner or forgone that last latte.  Sadly giving those things up will not fix it, but good public policy mixed with philanthropy from all people of means and corporate responsibility might give these causes a fighting chance.  Good public policy is the key.  Without good policy no amount of private funds will ever be enough to fix the problems that face humanity.

This past Sunday, Reverend Paul Barnes, the leader of a Denver evangelical megachurch confessed to having sex with men.  He said that he had often cried himself to sleep- begging God to remove his attraction to men.  It was only a few weeks ago that Reverend Ted Haggard, then president of the National Association of Evangelicals and the pastor of a Colorado Springs megachurch stepped down after a three year relationship with a male prostitute was revealed; a relationship that seemed to also involve methamphetamine use.   In his letter of contrition to his congregation, Haggard wrote that he had struggled all his life with impulses he called “repulsive and dark.”

Unlike some in both the faith and the gay communities, I am not disgusted by these men’s hypocrisy.  Instead I have nothing but pity for these men who, because of their faith, have been forced into self loathing and a deep self-hatred.  The true ugliness here is not the hypocrisy of these men, but the dangerous arrogant moral superiority of “moral leaders” who judge and deem that being homosexual is abhorrent, un-natural and against God’s nature.

Barnes and Haggard are men obviously tormented by the natural inclination in their soul to be gay and the moralizing of Pat Robertson, James Dobson and Jerry Falwell telling them that their core is evil.  Living a double life is toxic.  Ignoring and hating your very essence is toxic.  Just look at Governor James McGreevey of New Jersey.  The Governor destroyed his life and those around him by denying who he was.  Much of why he denied his true nature was also rooted in religion- in his case Catholicism.

I don’t condone the lies and deceit that these men committed.  Their deceit hurt many of the people around them.  I also get more than a little miffed at McGreevey’s mea culpa for profit,  But the hell that all of these men have gone through because they bought into the idea that innately they were damaged and bad is sad and unnecessary.

What does that do to a person’s soul?  How is one to find God when their soul is sick?  Their sick souls come from being hard wired by their faiths to believe that who they are at their very essence is bad; is wrong. 

I cannot imagine that a spiritual life could ever be based on a sick soul.  But Robertson, Dobson and Falwell are culpable in the development of many sick souls.  These men are pastors- they are to tend to the health of their flocks’ souls, not to cause their souls to get sick, dry up and die.  Maybe it is time for conservative Christians to stop judging and to follow the teachings of Christ from the Sermon on the Mount.  Judging is easy.  Living a life of love, understanding and acceptance is hard.  Living a Christian life isn’t easy.  Contrary to some beliefs, it should not be just about saying “I accept Christ” and sending a tithing check to the local megachurch.  It is about giving to the poor, understanding those that are different, loving ones enemy without reservation and is never about judging.  Many of today’s conservative Christians are the modern day Pharisees.

If one believes in God the Creator than it seems likely that God created gay people too and that we deserve the love and acceptance of God, our fellow man and our Christian brothers and sisters.  Judging gays and lesbians by religious leaders begets sick souls.  These leaders should be healing those souls not causing them to die.

Ever since the Iraq Study Group came out with its 79 recommendations for a shift in US policy in Iraq, the Republicans have been bickering with one another! I guess they took lessons from the Democrats on public bickering.

Personally- I hope that the President follows the recommendations of the Baker Hamilton group.  They are logical and seem to lead to a scenario that is not necessarily complete disaster.  But many of the neo-conservatives and hawks like Senator John McCain say that this will not lead to victory in Iraq.  The tasteless New York Post created a tacky front page with Secretary Baker’s and Congressman Hamilton’s heads superimposed on monkey bodies and captioning the two chairmen of the Iraq Study Group as “Surrender Monkeys”. 

So here’s the question to the neo-cons and the hawks- What does victory mean?

Iraq is a disaster.  It is a Civil War slipping to chaos.  What is their to salvage?  At the very least we can leave with a little grace and dignity and attempt to give some support to the Iraqis without a never-ending commitment that will continue to allow the Iraqis to shirk responsibility for developing their own security.

Of course we are to blame for their lack of security.  We completely obliterated their security infrastructure rather than re-tooling it.  We invaded the country without any sense of what would happen afterwards.  Does the US bear guilt here – yes.  But there needs to be a point where we say we cannot do anymore.  But let’s go back to the question:  What is victory?  I do not think that there is any such thing as victory in this situation and that using the term is political bluster at best and dull headed arrogance at worst.  McCain says we need to add troops.  I ask: From where?  Our military is stretched to the limit.  But even if we did have the necessary resources to add more troops- it doesn’t seem that it would work.  We have increased troop levels in the past- and guess what folk?- we are where we are so it didn’t work!

Of course the neo-cons nearly had collective heart failure at the idea of “talking” to Iran and Syria! It seems to me that I remember that diplomacy means talking to your foes- not just your friends.  There are ways to have conversations with those that we do not trust and with whom we have some deep seated problems on areas where we might all agree on a mutually productive end.  Iran and Syria have little interest in seeing Iraq completely disintegrate.  Without engaging the whole region the region could easily slip into a regional conflict.  Hey Neo-Cons – a regional conflict would have a devastating effect on OIL! 

The pipedream that there is still a hope of a democracy in Iraq makes want to cry and laugh alternatively.  If I hear one more time that because there were purple fingers wagging in the Baghdad breeze that there is still hope for a democracy I think I’ll scream.

As much as it warms the cockles of my heart to see the Republicans squabbling, this should be a no brainer.  Adopt the principles of the Iraq Study Group and let’s get the hell out of there.  There is no victory to be had in this unmitigated disaster.

Today is World AIDS Day.  I was rather disheartened to see barely a blip on the news this morning’s “Today Show”.  If it had not been for someone in the crowd outside the Today Show’s studio giving a red ribbon the Meredith Viera there would have been nothing mentioned at all.   

This morning’s New York Times had a pullout section which was a World AIDS Day “community education” advertisement by Glaxo Smith Kline. 

Of course the AIDS community- those that provide services, advocates for issues that affect HIV/AIDS care and prevention and people living with the disease are aware of this day of remembrance and awareness.  But for the general pubic the day seems to go by with faint and fleeting interest if any at all.

Why is that?  According to UNAIDS approximately 47 million people worldwide are living with HIV/AIDS.  There are approximately 3 million children living with the virus throughout the world.  And 25 million people have died from HIV/AIDS leaving some 12 million AIDS orphans throughout Africa.

What about at home?  If one looks at all of the attention that the epidemic abroad has from celebrities, foundations and even the Bush administration, one would think that it really isn’t a problem here anymore.  It has been relegated to the status of a chronic illness that affects the most disenfranchised members of our society.  But there are more than 415,913 Americans currently living with AIDS.  This does not include people who are HIV + but have not progressed to an AIDS diagnosis (HIV case data started to be collected in some states a number of years ago- but only within the last year has HIV case reporting been collected by all states and territories).  The total number of people living in the USA with HIV/AIDS is thought to be between 1,039,000 and 1,185,000.

In June 1981, the first cases of what is now known as AIDS were reported in the USA. During the 1980s, there were rapid increases in the number of AIDS cases and deaths of people with AIDS. Cases peaked with the 1993 expansion of the case definition, and then declined. The most dramatic drops in both cases and deaths began in 1996, with the widespread use of combination antiretroviral therapy (ARV). The rate of decrease in AIDS diagnoses slowed in the late 1990s. After reaching a plateau, the number of diagnoses increased slightly each year from 2001 to 2004. There were an estimated 42,514 diagnoses in 2004. In total, an estimated 944,306 people have been diagnosed with AIDS. The number of deaths among people with AIDS remained relatively stable in the period 1999-2003, before dropping slightly to an estimated 15,798 deaths in 2004. Since the beginning of the epidemic, an estimated 529,113 people with AIDS have died in the USA.

During the 1990s, the epidemic shifted steadily toward a growing proportion of AIDS cases among black people and Hispanics and in women, and toward a decreasing proportion in gay men, although this group remains the largest single exposure group. Black people and Hispanics have been disproportionately affected since the early years of the epidemic. In absolute numbers, blacks have outnumbered whites in new AIDS diagnoses and deaths since 1996, and in the number of people living with AIDS since 1998.  From 2000 to 2004, the estimated number of new AIDS cases increased in all racial/ethnic groups. Over the same period, the estimated number of new AIDS diagnoses increased by 10% among women and by 7% among men. The number of new cases probably due to heterosexual contact grew by 20%, and the number probably due to sex between men grew by 15%, but the number among injecting drug users fell by 12%.  

What about my own city? As of December 31, 2005, a cumulative total of 26,609 San Francisco residents were diagnosed with AIDS. This comprises 19% of California AIDS cases and three percent of cases reported nationally. As of December 2004, San Francisco was ranked third in the cumulative number of AIDS cases and ranked seventh in the AIDS incidence rate in 2004 among metropolitan areas nationwide.  I am one of those men.  I have been part of that statistic since 1997.   Approximately 25% of gay men in San Francisco are living with HIV.  That is one in four – a staggering statistic.

But – Most folks wouldn’t know that World AIDS Day is today if they were asked.  The attention has shifted. There are some understandable reasons for the shift of attention, but it is deeply disturbing that the attention to the epidemic domestically has lost momentum and the public isn’t all that interested anymore. 

Yes- there have been remarkable advances in treatment that have given those of us living with HIV/AIDS the prospect of a much longer life.  However these drugs are expensive.  Mine cost approximately $24,000 a year.  Thankfully I am covered by my insurance and the California AIDS Drug Assistance Program (ADAP).  But the access to treatments is not consistent throughout the country.  Many states have poorly funded ADAPs due to lack of state resources committed to this state / federal program.  Oh yeah- and don’t forget the 46 million Americans who have no form of coverage for their healthcare; undoubtedly there are many people living with HIV/AID that are among them. 

My fellow AIDS advocates and I (I have played a minor role in this work and have worked with some amazing and dedicated people) have done the best possible job to cobble together a patchwork of programs to assist people living with AIDS so they can access health care, retain their healthcare, adhere to complex treatments and manage the vast number of social and economic issues that most of them encounter.  However, there is never enough funding; there is never enough flexibility with those insufficient dollars to create innovative programs of care and prevention.

We are saddled with the conception that prevention messages are easy- “use a condom” or better yet – “abstinence until marriage”.  Prevention is complex.  AIDS is complex.  People make choices about their sexual practices through the prism of deeply personal emotional and psychological experiences.  Intimacy, self esteem, are obvious issues- but what about the very real issue that all animals have the natural instinct to procreate and with a chronic life threatening illness walking hand in hand with the natural instinct to reproduce there is a perversion of reality.  These are big issues. 

And that is just the problem around the sexual transmission.  What about IV drug use?  Our society is wildly contemptuous of drug users and in essence considers them as expendable and a burden on “good people”.  There is great resistance to meaningful prevention for this population.  The most obvious intervention is syringe exchange or syringe access programs.  But the federal government believes that this would encourage drug use and many communities throughout the country have similar beliefs.  Of course harm reduction protocols like syringe exchange are only a band aid— they lessen HIV infection- but they don’t really do anything about the root cause of drug use.  Poverty, hopelessness, fear, mental illness are the areas that need to be addressed in order to deal with the drug problem in this country.  Warehousing non violent drug users in prison with no meaningful recovery programs available to most prisoners is an absurd and head – in – the – sand policy.  It does not lead to addicts being able to lick their addition and it is horribly cost INEFFECTIVE. 

So AIDS in this country deals with sex and drugs- topics that Americans are not at all eager to discuss and confront with compassion and honesty.  These two areas are among the least comfortable areas for policy makers and elected officials to discuss candidly and effectively.  After all we live in a country where many believe that there is some sort of national morality that is sex phobic and sees drugs as the problem and not the societal forces that lead to drug use as the core problem. 

Well it was fine for AIDS to be the disease “du jour” when we were all dying.  That made us victims.  It made us pitied.  But now- we have the opportunity for a longer life and the public would like the core groups of people affected by HIV/AIDS to just go away- gay men, IV drug users and people of color (many within all of these groups are also living in poverty).  We don’t like to see these people in our pristine world- the world that we convince ourselves exists – but isn’t the real world at all. 

So- as we have begun to live longer the focus has moved abroad.  Of course the epidemic in
Africa is beyond horrific and deserves resources and time and focus.  But I personally feel that it has become “easier” to focus attention on AIDS in Africa than it is to confront the ongoing problem of AIDS in the USA.  In Africa AIDS predominantly affects heterosexuals, children are left orphaned and the poverty is overwhelming.  Additionally it isn’t here- it is safely “somewhere else”.   

There needs to be a recommitment from our citizenry to address HIV/AIDS in the USA.  We should not diminish our support of those with HIV/AIDS in Africa or other parts of the world- but we should not compromise our attention locally either.

One simple solution is to address HIV/AIDS in the USA is fairly simple and would be beneficial for all Americans.  Universal Health Care!  We are the only industrialized nation that does not offer some sort of health care for all of its citizens.  Health care policy has too long been under the influence of pharmaceutical companies, insurance companies and for profit health care leading to a a system of care that works for them but not for the patients.  Our system of care that is not equitable, not accessible by a substantial number of our people and incredibly cost ineffective (administrative costs are much higher in the private sector than in a program such as Medicare).

The second solution is to get over our fear about sex and drugs.  We must have candid conversations about these topics and confront them with the sensitivity, rigor and intelligence that might allow us to create STD and HIV prevention programs that actually work and allow us to cut off drug use by addressing its root causes.

 My personal journey with AIDS has been my own journey- there is no one way to have AIDS.  The disease manifests itself differently in each one of us.  Some of us have less tolerance for some treatments, some of us have resistant strains of HIV.  We also live the life of a person with HIV/AIDS through the lens of our life experience.  I use my disease as a catalyst to help create a better life for me and my peers. 

The anger and the fear have motivated me to focus much of my life on HIV/AIDS advocacy and planning. Other people handle their disease in other ways.  I tend to intellectualize and avoid the feelings associated with my disease.  It is easier for me to be angry and harness that anger for a positive purpose (ideally) than to deal with my fears and my grief associated with HIV.   Some develop a very strong spiritual life- I haven’t done that very successfully.  I guess I am still pissed at the Universe that this disease exists.  That anger has made it difficult for me to approach spirituality and God with the faith necessary to dispel my rage. A rage that cannot comprehend that God has allowed so many to die and suffer from HIV/AIDS and that so many unspeakable horrors exist on this planet. 

Someday I may be able to approach God without so much anger.  But right now that anger motivates me to do what I can to make life just a little better for me and my brothers and sisters living with HIV/AIDS. 

But today I ask for your prayers for all people living with HIV/AIDS and those that are affected by the disease.  I ask that we all commit ourselves to re-focusing some time, money and attention to the epidemic in this country while increasing our commitment to the needs of those affected in Africa, Asia and other areas of the world.  We must begin to look at all people on this earth with compassion, respect and dignity.  That would be a REMARKABLE step to addressing HIV/AIDS and many other problems that exist in our world.