kearns to LA city council: a 2-minute tour of my personal HIV/AIDS & aging-related frailties & multimorbidities (long play) (0076)



have video clips coming of this, and as part of my learning process will repost it later. but i wanted it and the next post to be in the mix.



[september 30, 2009, ryan white CARE act
sundown day]
good morning president garcetti,
distinguished council members. i have given the
clerk copies of my prepared remarks.

my name is richard kearns. i am a 58-year-old
gay man living with AIDS in los angeles for more
than 20 years. i am a long-term survivor & AIDS
activist, a medical cannabis advocate, a poet and
journalist. i’m here today to talk with you about
HAVVACC, the online HIV/AIDS Volunteer
Virtual Assisted Care Community
that began
publishing last week with the city’s proclamation
of National HIV/AIDS & Aging Awareness Day
. Our aim is to assemble a body of
both anecdotal & scientific knowledge to help
prepare the demographic surge of HIVers over
50 to enter & reform the assisted care system in
los angeles. in five years our 50+ segment will
represent 60% of the national HIV-infected

HAVVACC just published jules levin’s at
NATAP’s notes & links to recent abstracts from
studies on frailties & multimorbititiies in HIVers &
PWAs. it’s dry reading, but since i’ve got a good
number of them myself, i thought i would show
you how it works in a real-life person. (me.)

HIV infection is associated with, & is a predictor
of, diverse impairments that resemble frailty.
which is a state of decreased physiologic
reserves that increases patient risk of morbidity
and mortality.
frailty includes such conditions
myopathy (me), loss of muscle mass & weight
(me), fatigue & exhaustion (me), cognitive
dysfunctions (which includes AIDS-releated
dementia, which i have)
& motor abnormalities
(me again), & neuropathies (of course),
osteoporosis (me), physical shrinking (me) &
rheumatoid problems (not yet)

The estimated prevalence of frailty in 55-year
white, non-Hispanic, college-educated men
HIV-infected for 4 years or less is equivalent to
the estimate that in uninfected men of the same
ethnicity & education at age 65 years or older.
frailty risk increases 3 fold after having HIV for
10 years. (remember: i’ve been doing this for
more than 20)

The presence of multimorbidities, including
medical, psychiatric, and substance use
comorbidities, is
more common in HIV-infected
than in uninfected patients, but primary
care guidelines rarely account for comorbid
few HAART drug trials have involved
aging populations

protease inhibitors, while saving our lives,
triggered diabetes in many of us. (me too) insulin
4 times a day & all that. the diabetes makes it
difficult to stick to the 3,000 calories/day intake i
need to maintain to keep my weight steady.

Kidney function is low both in elderly patients and
in HIV-infected patients (mine’s waning),
affecting drug clearance, risk of drug toxicity, and
mortality associated with cardiovascular events.

& then the big C, cancer. after adjusting for age,
race and gender, the incidence of non-ADMs
(non AIDS-defining cancers) is significantly
higher among HIVers infected than HIV
uninfected patients in the HAART era. this
includes, from  the top of the list down, increased
incidence of


  • · anal cancer (15 times greater) (not me)
  • · hodgkins lymphoma (not me)
  • · prostate cancer (not me)
  • · skin cancer (me — i have this — they’re the
    red things you see on my face. they’re not
    karposi’s, not KS, though)


so this has been my little 2-minute tour of what
the whole comorbidity & frailty package looks
like. something to think about next time you run
across more statistics: “does richard have that
too?” probableeeeee. ask me.

and i wanted to remind you that the
ryan white CARE act sundowns today



—richard kearns


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