From HIV to HPV, STDs are at all-time high
It was 1987, the AIDS crisis was in full swing, and Michael Therrien received news that changed his life forever. He was diagnosed with human immunodeficiency virus — better known as HIV — which he contracted while serving in the United States Navy.
“It took two weeks to find out if you were HIV-positive then — there were no instant tests,” Therrien, now 58 years old, said. “There was a period of time where I didn’t take any medications because the medications were killing people. I did not respond well to the diagnosis, not physically, not psychologically. I thought I was going to die. I watched people around me dying.
“I have buried more people than I’d care to count. I don’t go to funerals because I’ve been to too many. Nobody my age should’ve been through that many funerals.”
Approximately 1.1 million people in the U.S. are living with HIV, according to the Centers for Disease Control and Prevention. There are medications available now that reduce the viral load of HIV to undetectable, which led to the creation of the “U=U” slogan, which means “Undetectable = Untransmittable,” meaning that those who adhere to their medications and have an undetectable viral load can’t transmit the virus to someone else.
Therrien said that it is important for HIV-positive people to know U=U, but to continue to practice safe sex, even if they have an undetectable viral load, or are with HIV-negative partners who are taking the prophylactic PrEP, which prevents the sexual transmission of HIV.
“(PrEP) is also used as an HIV treatment drug, so if (HIV-positive people) run across somebody who has already punched through that drug, PrEP won’t work,” he said. “Then, what ends up happening is that they end up with a virus that is more virile, more difficult to control.”
Sex education is the key to preventing sexually transmitted diseases, Therrien said.
“There are people who have an anti-sex education view, they want to talk about abstinence,” he said. “Abstinence is a fool’s errand. People are going to engage in sex, we are sexual creatures. It’s in our DNA — it’s part of being human.”
Lois Morgan, a community health worker at UT Physicians in Beaumont, said that STDs have always been a problem in Southeast Texas, and that education is the way to remedy many misconceptions people may have about them.
“We live in the good ol’ South — the ‘Bible Belt,’” she said. “To talk about testing and protection, we have to talk about sex. But here, it’s, ‘We can have sex, but not talk about it.’ It is so sad that people have to suffer in silence when it comes to HIV.
“We need to teach our community that HIV is not a moral issue, it’s a health issue, just like diabetes, high blood pressure or high cholesterol.”
In 2017, the CDC reported that for the fourth year in a row, STDs had reached an all-time high in the U.S. Approximately 2.3 million cases of gonorrhea, chlamydia and syphilis were reported, even though they were close to extinct levels almost a decade ago.
Morgan said the rising cost of healthcare is another main contributor to the growing STD epidemic.
“Without the proper insurance or cash, healthcare is very difficult to access,” she said. “There are agencies that have programs for the under-insured or patients that have no insurance, but it’s still difficult.
“A friend of mine told me that they took their mother to the Jefferson County Indigent Clinic and were told that the mother’s monthly income had to be $200 or less for her to qualify for their services. You would almost have to be living under a bridge with that kind of income. There are a lot of stand-alone emergency rooms, but you have to have insurance or cash. Neighbors ER is closing a lot of their clinics because the competition is steep.”
Poverty leads to inaccessible healthcare and contributes to the lack of sex education, Morgan said.
“Poverty is a big issue facing Southeast Texas,” she said. “Even though we live in the land of the free, healthcare is not — and because it is not free, people do not go to the doctor. When they are very sick, it’s almost too late to address all the problems they have. Because of the poverty, families have to stay within a certain budget and they eat what they can afford and not necessarily what is good for them.”
Jarrett K. Jones, admissions worker at Legacy Community Health in Beaumont, said that everyone should have a vested interest in a strong foundation for the public health system, because all people deserve the ability to keep themselves and their loved ones healthy.
“We in public health must continue to keep the community aware of the issues that concern them,” he said. “More importantly, we must make sure that public officials are aware of these issues. Too often our elected officials tend to shy away from discussing more ‘controversial’ issues, when in reality, these are much more pressing to their individual constituents.”
People aged 15 to 24, gay and bisexual men, and pregnant women are the populations most affected by the recent rise in STDs, according to an article by Dr. Stacey Rizza, an infectious diseases specialist at The Mayo Clinic. The population of people ages 15 to 24 make up only a quarter of those who are sexually active in the U.S., but account for 50 percent of all reported sexually transmitted infections. STIs are sexually transmitted infections that have not developed into diseases (STDs).
Human papillomavirus, or HPV, is the most common STI in the U.S., according to the CDC. Approximately 79 million Americans, mostly in their late teens and early 20s, are infected. In most cases, HPV goes away on its own and does not cause any health problems, but when it does not go away, it can cause genital warts and cancer.
Someone with HPV may not have any signs or symptoms and may not know they have the virus. Like most STDs, HPV can be contracted through vaginal, anal or oral sex with someone who has the virus. However, unlike most STDs, HPV has a preventative vaccine.
“The HPV vaccine consists of two shots which can protect boys and girls from the most dangerous HPV strains, and the cancers they cause,” Dr. Tambetta Ojong, resident at SUNY Downstate medical Center, wrote in a 2018 article for ABC News. “Research by merck shows that 3,200 adult women showed the vaccine is about 88 percent effective in preventing infection, genital warts, vulvar and vaginal precancerous lesions and cervical cancer related to HPV 6, 11, 16 and 18.”
Between 2013 and 2017, cases of gonorrhea increased by 67 percent to 555,608 cases, syphilis increased by 76 percent to 30,644 cases and chlamydia increased 22 percent to 1.7 million cases, according to Mayo Clinic. All three of these STDs can be cured when caught at the right time.
HIV, while more manageable since the 1980s, still has no cure.
“When you have HIV, your self-worth goes into the toilet,” Therrien said. “It’s not humiliating, it’s mortifying. There are people who get right on their medications, stay healthy, get good jobs or go to school and become productive people, but they’re still going to have to deal with HIV.
“There is no cure, and there’s likely not going to be a cure. Even if there is a cure, the damage that the virus has done is still going to be there.”
Therrien said that a lot has changed since he was first diagnosed — but the stigma of HIV remains.
“I think HIV, unfortunately, was probably the best thing that ever happened to the gay community, in that people started looking at gay people as human beings as opposed to something they didn’t understand,” he said. “I come from a place where being gay got you hurt, it got you beat up, it got you killed. Then HIV came in and people backed off.”
People don’t discuss HIV because it’s a scary disease, Therrien said. He said that people don’t talk about HIV before it’s contracted, or after, which is one of the reasons he’s so vocal about his positive status.
“People today are not nearly as afraid as they used to be — they’re not afraid enough,” he said. “People take a laissez-faire attitude towards it. People still die from HIV, and there are other STDs out there that are nasty, too.”
Jones said that the stigma around health issues are the biggest problems facing Southeast Texas in terms of public health.
“The lack of availability regarding behavioral health sciences in this area is a serious issue,” he said. “Unfortunately, the stigma associated with therapy and counseling still makes us hesitant to explore the available avenues when we do need these services, but even worse, the need for these services has become political fodder.”
The National Institute on Drug Abuse reports that abuse is a common avenue of HIV transmission.
“In the gay community, the big culprit (of HIV transmission) is crystal meth,” Therrien said. “I know when I see somebody using that, all of their sexual inhibitions go away. They’re trying to get to a climax that’s not going to happen — and they don’t really know who they’re sleeping with.”
Where there’s poverty, there’s drug abuse — and there’s infection transmission, he said.
“A lot of people think that drug abuse causes poverty, and it’s actually probably the other way around,” he said. “That addiction will kill you long before anything else does.
“(Southeast Texas) is vulnerable. And one of the reasons it’s vulnerable is because of economics, because people don’t have access to the education, because of their economic status or lack of education, and that makes them more vulnerable.”
Jones said he’s optimistic about the future of the public health system.
“I think as our society continues to open its doors for all people, public health will continually evolve in an effort to meet the needs of all people,” he said. “If continued on its current course, however, we run the risk of allowing our medical needs to run along partisan lines.”
Therrien said people whose families abandoned them because of their HIV diagnosis have come to him for guidance, and that he views those people as his babies because he takes care of them.
“I met this guy in Houston, his name was Victor, on Christmas Day, 2001,” Therrien said. “He was dead within six months of that meeting. He was full of tall tales, he was just not dealing with reality well. He was telling people this story about how he contracted HIV in prison and how he was suing the state and was going to be very wealthy. Other people believed him — I was doing a lot of work with a local lawyer at the time and checked it out, and there was no lawsuit. I went ahead and let him tell his story — it wasn’t costing me anything.
“Eventually, he came down with pneumonia, and it took him out. It was me, another friend of mine, and a couple of other people in the hospital around his bed. They were taking him off of the respirator — he was on the respirator for three days and the prognosis was that he wasn’t going to make it and that there was no point in keeping him on the respirator. I ended up holding his hand when they took him off the respirator and the rest of the people in the room were just standing back, they didn’t know what to do.
“I took him by the hand and said, ‘OK, Victor, just go towards your light, buddy,’ and I was with him right there in that moment and then he was gone. The first thing these other people wanted to talk about was how they were going to get access to this money, and I looked at them and said, ‘You don’t get it. There is no money.’ And they go, ‘What do you mean?’
“Victor told that story because he wanted people to stay around him. He didn’t think anyone would ever value him as a human being.”
Morgan said that sex education is the first step to battling STDs and the stigmas surrounding them. She said that people who are sexually active — or use drugs like meth or heroin — need to get routinely tested, just to be safe. The cost of healthcare is a barrier that separates people from a curable infection to a fatal disease.
“If the rising cost of healthcare continues, the stigma from STDs and HIV, the people will suffer, our community will suffer,” she said. “If people don’t know they have STDs, they will have sex with others and spread it, and so on and so on. It will become extremely difficult for people without healthcare and people will die from preventable and treatable illnesses.”
Therrien, who serves as a freelance counselor to those newly-diagnosed HIV-positive and those dealing with other life-threatening issues, said that people often ask him how he makes it through each day.
“People come up to me and look at me like a candle in the darkness,” he said. “They’ll come to me and say, ‘How do you do it?’ I don’t do anything. And then they go, ‘Well, it’s really a miracle you’re still alive.’ Perhaps that’s so, but here’s the truth of it — and this is what I’ll tell somebody that’s really upset because they found out they had leukemia or something else and they may die. I tell them, ‘Here is what you do — you go in your house and you put on music that you feel really good about, you put your headphones on, and you shut out the rest of the world. Then, take a piece of chocolate — the best piece of chocolate you can find if you like chocolate — and you put that in your mouth and you just sit quiet and enjoy every single second of that chocolate melting in your mouth. And when it’s done, I want you to open your eyes and I want you to treat every minute that you’ve got like that moment with the music and the chocolate.’
“That’s the secret. I don’t know whether I’m going to get hit by a bus tomorrow — you’ve got today, live today. That’s all you’ve got. Tomorrow’s not a promise — it’s a hope. I make plans for next week, but I may not be able to get there.”
Story package by Olivia Malick