November 29, 2011

UI Ph.D Student Struggles With HIV’s Stigma

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David Harvey

Harvey talks about HIV with his students. Photo by MacKenzie Elmer

Sitting in an examination room at the University of Iowa Hospitals and Clinics, David Oscar Harvey gives the magazine rack on the wall an amused glance: It holds Ducks Unlimited, Pheasants Forever and POZ, a monthly for the HIV positive community.

Harvey, who tested positive for HIV shortly after moving to Iowa for graduate school in 2007, makes a routine visit to the virology clinic every six months. So far, doctors have not put him on a drug regimen, because his viral levels remain low. Today, the news once again is good: Reviewing his charts, UIHC fellow Dr. Jeremy Storm pronounces him “one of the lucky ones.”

Checking Harvey’s armpits and ankles, Storm asks whether he’s experienced any swelling or rashes. He hasn’t.

“So, since last time we saw you, there was maybe a new partner, is that still the same, or…?”

Harvey looks at the ground, smiles slightly. No, not recently, he says.

“So, nothing going on right now?” This time, Harvey just nods, no.

The session is over quickly, clearing the way for some researchers to enter to seek Harvey’s cooperation in the pursuit of medical knowledge. They want his blood. They are especially eager for him to participate in studies because of his curiously low viral load, and as one tells Harvey, they hate the thought of specimens going down the drain after testing. “To a researcher that bit of blood is like liquid gold,” she says, extending release papers for him to sign.

Harvey exits the room holding eight empty test tubes sealed in a biohazard bag. Next stop: the lab, where a technician would fill ten tubes by the final count.

Being HIV positive hasn’t posed any major health issues for Harvey, he says, although he’s made important lifestyle changes: He cut down on drinking soda, works out almost every day and takes milk thistle and calcium supplements to strengthen his kidneys.

To him, the psychological aspects of being HIV positive have been more challenging than the virus itself.

“It’s not uncommon for people living HIV end up experiencing depression or an adjustment disorder that goes along with the baggage of being positive,” says Dr. Jeff Meier, associate professor of internal medicine at the University of Iowa. It is routine for the virology clinic to screen newly diagnosed patients for depression. A nurse practitioner licensed in psychiatry is involved early in the process.

“There’s often a lot of emotion that goes with discovering you’re positive, and dealing with the stigma,” Meir said. “There is a certain amount of discrimination that goes along with it. You’re perception of yourself and your worth may be damaged by that discovery.”

And Iowa’s criminal HIV transmission law is one of the psychic pressures that trouble him most. Harvey found out he was HIV positive in May of 2007, just after relocating to Iowa City from New York City, where he’d completed undergraduate and master degrees surrounding cinema at New York University. Now, he’s a doctoral candidate in cinema studies at the University of Iowa.

State health authorities are required to contact newly diagnosed HIV positive persons and inform them of available services as well as their rights, and Harvey’s test results prompted a phone call from Johnson County Public Health asking him to come into the office. “The girl who called me told me their office was across the street from the porn store,” he recalled. The next day, the department followed up with an unsealed note taped to the door of his apartment complex, reminding him to drop by.

Harvey found the reception no more reassuring than the methods of notification. When he went in, “They handed me a manila folder full of papers and condoms,” he said. “Then they read me the law.” The office also referred him to a group for HIV positive gay men. But Harvey was reluctant to get involved in any activity where he could be identified as positive in Iowa’s small gay community.

“What if I slip up?” he thought. “The law really inhibited my own personal journey to accept that I was HIV positive, because I was hysterically concerned about prosecution.”

Until recently, Harvey was involved with another man who knew of his HIV positive status before they began dating. “We had a good relationship. We didn’t fight or anything,” Harvey said. But his boyfriend’s concerns about HIV heightened his own anxieties and ultimately led to their breakup, he said.

Harvey, now 31, already had struggled with self-acceptance since the age of 16, when he recognized his sexual orientation. “Shit, I’m gay,” he remembers thinking. Foremost in his mind were his childhood neighbors, Eddie and John, a gay couple who had died from HIV/AIDS in 1990, before the advent of anti-retroviral medication that now enables thousands of HIV positive people to lead fairly normal lives.

Harvey

David Harvey. Photo by MacKenzie Elmer.

Harvey grew up in Nanticoke, a town nestled along the Susquehanna River in eastern Pennsylvania—the sort of place that, as he describes it, had “one black kid in my high school.” Feeling stuck in a community lacking diversity, he turned to Internet chat rooms, where he met other gay men. He also got to know gay students at a nearby college.

He describes himself then as a “film dork” obsessed with Woody Allen and Ingmar Bergman, who wrote to film stars at their home addresses and still has autographed photos some sent back to him. He graduated at the top of his class at Greater Nanticoke Area High School. It was a high school counselor who directed him to the cinema studies program at New York University.

Although Harvey’s interests focus on film analysis rather than production, his experiences in Iowa inspired him to make his first film, an experimental short titled “Red Red Red” that expresses his reactions to living with HIV.  “I’m not a techy guy, so I took production classes gearing up to this film,” he said.

The original impulse, he said, was his shock at finding out about the criminal transmission law. When he arrived in Iowa City, he expected to find activists fighting a law that he finds to be so “epically” irrational.

While working on his doctorate, Harvey has been teaching a film survey course to undergraduates, and he is open with his students about being an HIV positive gay man. But the law and the feeling of being “toxic” still weigh heavily on his mind and deter him from developing close relationships.

“Hypothetically, if you don’t disclose your status before you have sex with someone, you can’t go back, even if you want to fix the mistake,” he said. “The law doesn’t influence my own ethics about disclosure; it influences my practices, because I divorce myself from tentative sexual situations.”

The county offers services to help HIV positive people cope with psychological and medical stress, but Harvey is dismissive of such programs. “Oh, you’re teaching me how to disclose because of your stupid law,” he said. “I’m wary of any state organization like that. Are they helping me or are they just looking for more criminals?”

Harvey’s mother died in 2009 and his father, a civil engineer, has come to terms with the fact that he is gay. Harvey has told his sister about being HIV positive, but doesn’t want to worry his dad with that information.

Meanwhile, the tests from his last clinic appointment confirm that he is doing well and can keep deferring anti-retroviral treatment.

(Mackenzie Elmer is a senior majoring in journalism at the University of Iowa)

 

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