Aaron M. Laxton

Advocate | Writer | Social Commentator.

Actor Zachary Quinto

The Real Casualties in the PrEP-Battle

By Aaron Laxton
From TheBody.com

May 6, 2014

I sit waiting at a coffee shop in the Central West End at the Washington University in St. Louis Medical School. This meeting, like most these days, are spent working on strategic planning for implementing PrEP (Pre-Exposure Prophylaxis), a one-pill-a-day drug regimen that has been shown to be up to 99% effective in preventing HIV infection. People slowly trickle into the working group and we start to address the task at hand. Who could benefit the most from access? Believe it or not, it is not those who are waging a moralistic attack on whether or not it should be used. For the most part, it is not even the people who will read this article or who are on social media. That is because the people who could benefit the most from PrEP are limited on resources. The young, black male who has sex with men or the Latino ages 13-24; that is who are falling casualty of this absurd power struggle.

PrEP provides added protection when used within a sero-discordant relationship. Recently released data from the PARTNER study showed that within a sero-discordant relationship that ensuring viral suppression of the positive partner's viral load protects the negative partner. So then who would the ideal person be that would consider utilizing PrEP? It would be those who are engaging in high-risk sexual behavior; if you are sexually active and HIV-negative then PrEP is indicated for you.

The real casualties are not the ones who are voicing their opinions in this battle of public perception that is being waged in the media and across social media. Interestingly enough, I do not see these same talking heads delivering the diagnosis to an 18 year old African American male who tests positive for HIV. I do not see Michael Weinstein working in an STD clinic consoling a young Latina who now must adjust to life as an HIV-positive woman. Although I want gay men to have access to PrEP, this is not something that should be exclusive to privileged white gay men. Thankfully, as a result of the Gilead patient assistance program (PAP), those who cannot afford the medication will get it provided to them. There is also assistance to help pay for physician co-pays for office visits.

PrEP clinics are springing up across the United States and I am proud to be working to organize the first one in St. Louis. Physicians can cure sexually transmitted infections such as syphilis with a dose of penicillin, HIV however cannot at this time be cured. We can, however, do more than simply sending a person away from clinic with a bag of condoms that may or may not be used. PrEP is included in a total risk reduction strategy which includes reducing risky behavior, regular STI/HIV screening, and as well as monitoring adherence to the medication.

As I sit in the working group I realize that the talking heads who are railing against PrEP are irrelevant, holdovers of a bygone era. The work that we are doing to provide PrEP to those who will benefit the most is marching on. You say "Michael Weinstein" and I say, "Michael Weinstein" who? My clients do not know who he is and conversely they do not care. We will continue to treat the real casualties of this PrEP battle, interestingly enough these are the same people that many seem to forget or let fall through the cracks. I am guessing that young black men and Latinos aged 13-24 weren't invited to that party.

Let HIV-Negative People Decide Their Own Prevention!

By Aaron Laxton
From TheBody.com

April 17, 2014

PrEP (pre-exposure prophylaxis) is a proven concept. Regardless of whether opponents want to admit it or not, "bio-medical prevention" IS the key to reducing new-HIV infections in the highest-risk groups where previous risk-reductions methods have failed. Today, thanks to new research and science, we have a new method that can help those who are at the highest risk. We do not need more data; we do not need more trials to look at efficacy and safety ... PrEP is already a PROVEN concept. Anyone who says otherwise either doesn't know how to read data, is pushing their own agenda, or they are simply regurgitating the views of other people who have no clear understanding of the topic.

It is really interesting that those who are screaming the loudest in opposition of PrEP are people who could have benefitted the most from its use, had it been in existence. These same HIV-positive men say that condoms are easy to use and so effective. Then why are you HIV-positive dude? Immaculate infection?

I'm not laying blame, what I am saying is take a moment to step down off your moral-horse and contribute to an actual resolution rather than perpetuating a flawed strategy of "condoms-only." If condoms alone could end HIV then it would be over by now. Condom use, although it has been beat into our heads, seems to be an example of "Do as I say, not as I do." Since when does being an HIV-positive gay man give us authority over those who are negative and the things that can keep them healthy?

At a certain point, HIV-positive men who feel it necessary to dictate the availability of PrEP as a tool to those who are negative need to simply stop. If you are an HIV-positive man railing against PrEP, you are no different than men attempting to dictate the sexual and reproductive health of women. What is even more disturbing is that some opponents of PrEP pervert a once-authentic argument regarding efficacy and safety. And when presented with data to address this they choose to dismiss it.

Our community fought in the streets, stormed the FDA and forever changed how drugs are studied and made available to those that need them. Is the message now going to be, we will only advocate when the medications save our lives, however we won't fight on behalf of prevention? HIV-negative individuals have a right to have access to medications that can assist them with staying negative. If you are HIV-positive and an opponent of PrEP, consider how you would react if someone was attempting to block/impede/stop/derail a drug that could keep you healthy. Now realize that in your opposition you have become that person. Congratulations!

Meth, PrEP and What Could Have Been

By Aaron Laxton
From TheBody.com

March 25, 2014

Let me take a second to debunk a commonly held myth: "Meth is not fun or pleasurable." That simply is not true, in the beginning. The fact is that there is something about the experience of using meth that seemed attractive to me. The truth is that there came a point where it became far too much work to achieve the same high that you had the first time I used. This is commonly referred to as "chasing the high" not to mention the toll that my body paid in the process of that futile mission. This mission could best be described as "my love affair with meth."

My drug of choice is crystal meth. As soon as you hear "crystal meth," you instantly think of a meth lab in southern Missouri. I can assure you, however, that meth can be seen in every walk of life across all socio-economic groups. While it is true that many gay men use crystal to enhance sex, that is certainly not the only group that utilizes it.

Even before a person actually uses meth, their brain is already anticipating the chemicals that are about to be released. Most people will start out by snorting meth that is finely ground up into a powder. I equate this to snorting table salt. As a person's addiction grows they will usually progress to smoking and many times eventually by shooting, more commonly referred to as slamming. I am getting ahead of myself. Many are starting down this journey with a prescription in hand; that prescription is for Adderall. When you have a prescription for something, then the stigma is removed. Meth, manufactured using household cleaning products, rat poisons, and liquid drain-o and let us not forget, the ever-important pseudoephedrine becomes more accessible and socially acceptable when acquired from your local pharmacy, albeit under the name of amphetamine-salts.

In the beginning a person isn't an addict, they are simply a person who is using meth. Addiction occurs when the person longs for the physical attributes that meth affords them. Increased energy, increased libido, hunger suppression, increased focus (initially), the ability to be more social (initially) -- however, all of these traits are short-lived. For some, this addiction may develop with the first use and for others it is something that takes time. My own addiction was something that formed over a period of time, somewhere between 6 months and a year and a half. Seemingly, one day, I woke up and realized that I had become a person that I never wanted to become. I was addicted to methamphetamines.

It started as something that I did socially; it soon became something that I did by myself. When I was social with people, it was either with other people who were using or I if was out and most likely detoxing. Soon however I got to where I wasn't even social with other users since I did not want to share my own stash.

Meth did not make me a "sex-crazed monster"; it only served to make me less-inhibited. Meth helped to increase sexual libido and decreased pain-receptors. Many times this served to create a scenario where I would place myself into situations while I was using that I never would have placed myself if I was sober. For me, HIV infection did not come as a result of using meth directly, such as with a dirty needle. It came instead as a result of high doses of methamphetamines which caused my body to have an allergic reaction. As a result, I was placed on prednisone, which knocked out my immune system. I like to say that I helped to create the ideal situation to become infected with HIV. Another interesting point is that had I been prescribed and actively taking PrEP (Pre-Exposure Prophylaxis) my HIV infection could have been completely preventable. Studies have shown that PrEP has been up to 99 percent effective in reducing HIV infection. Condoms were used, however, not as much as they could have been. PrEP however would have offered another level of effective protection.

My life as an addict had one purpose: to acquire and use as much meth as I could in order to achieve a high. The monster grew and got bigger the more that I used. The more my addiction grew, the more that I would have to use. With extremely high doses of meth, a phenomenon known as "amphetamine psychosis" became normal: hallucinations, hearing voices, inability to sit still or concentrate or to even perform basic functions or tasks. Most people just refer to this as "tweaking." One day would quickly morph into 3-4 days awake without having anything to eat or any sleep. My only desire, my only need was to use more.

I knew that my life had reached a new low when I was on the verge of getting evicted from my house, my new VW Jetta SUV was on the brink of getting repossessed and all I could think about was getting high. I quit going to work, a job that I had for close to seven years. All that I wanted to do was to be left alone and get high. The only time that I would venture out of the house was to make a trip to the corner liquor store for a case of beer. I decided to cash out my 401K and soon the only person that I would see or talk to was my dealer. Life had reached that new low when it is 4AM and I am sitting in the living room of my house watching television with a dealer that ordinarily I would never have associated with. Now, however, he was my lifeline.

All of these stories I had heard before. I had seen other people who had lost everything and I swore that would never become me. I will not sit here and tell you not to do meth. I will only tell you that meth can be found among you and your friend groups. You might be dealing with addiction, or you might think that you have it under control. I use my life as an example of the potential of life on meth and also the potential of life off of meth.

If you think that you might have a problem with methamphetamines I encourage you to talk to someone.

HIV Prevention and "Click It or Ticket": Are New Devices Safe?

By Aaron Laxton
From TheBody.com

January 27, 2014

After doing research on new safety devices being proposed to protect drivers and passengers of automobiles, I have come to a conclusion: There is no need for an increase in new safety devices.

There are several reasons why we don't need more safety devices and quite honestly it angers me when people suggest that we do. It is all about choices. If people follow laws, traffic signs and speed recommendations then we would see a huge reduction in traffic accidents and mortality rates.

Additionally, as drivers embrace new safety devices such as airbags, anti-lock brakes and seat belts it will obviously promote and ultimately facilitate an increase in reckless and careless driving. Not to mention that these new (and unproven) "safety" measures will also mean that people are driving more. This will inherently increase the statistical odds of more accidents.

Am I saying that accidents never happen? No! For the most part however, people who follow the rules rarely get into accidents. There is also the issue of compliance. If people truly want to avoid auto accidents, then all they have to do is follow the rules of the road. These new "safety devices" that are being proposed by certain groups have only proved to be effective when used.

These same groups should also talk about the risk of injury posed to drivers and passengers of the vehicle should an airbag be deployed or anti-lock brakes lock up during a skid. There have been reports of side effects such as bruises, contusions, whiplash and even death as a result of the deployment of these new safety devices. More research needs to be conducted concerning how we can reduce these risks and increase driver/passenger safety-device utilization.

Next there is the cost of implementing use of these new "safety devices." How will it be paid for? Will insurance companies and auto-manufacturers be receptive to these new costs? To some extent this simply looks like an effort by the auto industry to bolster market share and to pad the pockets of shareholders. What data we have showing the efficacy of safety devices in automobiles has all been driven by the auto industry, so is there an issue of biased data sets?

In my opinion, we should not be pouring more money into safety measures that might work but instead use that money for increased education. Drivers simply need to use better choices when they get behind the wheel of a vehicle.

Now re-read this entire article and consider if this entire piece were about HIV pre-exposure prophylaxis (PrEP).The above stated arguments are the same ones that I hear each and every day regarding the use of PrEP. Many in the community feel as if we simply do not need anything other than condoms to fight and end new HIV infections. The "condom-only" message is falling on deaf ears and if we are serious about addressing those who are at greatest risk of becoming infected with HIV then we must embrace new technologies such as PrEP. We must consider PrEP even if there are those in the community who rail against anything other than condoms.

These are the same people who believe that the risk of harm/side effects exceeds the potential benefits. They seemingly fail to inform people that when taken consistently PrEP has been proven to reduce HIV infection by up to 99 percent. Just as risk-reduction (following traffic laws/speed limits) lowers the risk of having an auto accident, we must also adopt safety measures for those who will not embrace traditional risk-reduction strategies (condoms). By continuing to perpetuate the ill-conceived notion that "condoms alone" are going to end new HIV infections, you sound just as ridiculous as the statements presented at the start of this article.