Tim Barrus/ No one is going to arrive to save you


I have obfuscated the children in this collage. Can you tell.

Let me anticipate the grilling.


It is none of your fucking business why. I WAS the Shell Answer Man (you could ask him anything), but that was the past.

That lovely paradise, the past.

I don’t owe anyone an explanation.

How would you feel if as a child, you had been trafficked. You had been sold to people who kept you in a room for the specific purpose of fucking you in the ass.

And you have no idea what HIV is or what any of these people are saying.

You make the hungry sign. Jesus fuck.

You want to die.

You might.

Now, they’re pimping your ass in an abandoned construction site strewn with concrete pipes. A concrete pipe kinda keeps out of the wind.

But not the cold.

No one is going to arrive to save you.

You do not know this, but human trafficking in the United States alone is a 32 BILLION dollar business.

Each year.

Each year 32 BILLION dollars is spent by Americans to buy children and young adults so the Americans may fuck them in the ass.

Maybe we should just tax it. For every child you fuck in the ass, you must send the IRS a dollar. Republicans will want that busted down to fifty cents. Oh, all right, fifty cents.

The US Treasury would take in over a hundred billion dollars in one year.

I have a better idea.

People will not like my idea. Fuck’em.

New Rule: Anyone who fucks a child in the ass gets full-blown AIDS. No HIV numbers, Just right to AIDS.

I have news for you. Every trick I have ever known would pay that price.

Most of them are married men WITH children of their own. Yet you would fuck someone else’s child in the ass and not give the sweat from your balls for it.

The French had an even better idea.


We are a virtuous society.

And I am Sigmund Fucking Freud.

I reject Freud. Imagine that. I thought I had made it very clear. I reject Freud. Freud was a crock of coke. The only thing I could possibly have with this pompous fool is cocaine. Eat me. I am a student of Fritz. If you don’t know Fritz’ last name, that’s on you. It is not my job to teach adults. Especially the ones who think I embrace Freud. Please give me a fucking break, god. I do not sit down with anyone to explore their past. I am utterly focused on the here and now which was why after shooting photos all day, we stopped at the grocery store because the fridge was empty. Imagine that. Silly me. I should have called Freud up and had him fill it.

To mature means to take responsibility for your life, to be on your own. Psychoanalysis fosters the infantile state by considering that the past is responsible for the current condition.

I do my thing and you do your thing. 

I am not in this world to live up to your expectations, 

And you are not in this world to live up to mine. 

You are you, and I am I, and if by chance we find each other, it’s beautiful. 

If not, it can’t be helped.

(Fritz Perls, 1969)

Who the fuck wants to make any adult understand anything. Understand or not. I do not care what anyone understands. That is on them. People who need understanding from me have barked up the wrong fucking tree.

(Tim Barrus, 2012)

Tim Barrus/ Violence and HIV


Smoking More Lethal than HIV

By Michael Smith, North American Correspondent, MedPage Today

Published: December 19, 2012. Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Smoking kills. And among people with well-controlled HIV, that old slogan is even more true, researchers reported.

In a large case-control study, smokers with HIV had substantially higher rates of all-cause and non-AIDS mortality than HIV-positive nonsmokers, according to Marie Helleberg, MD, of Copenhagen University Hospital, and colleagues.

Also, HIV-infected smokers lost more life-years to smoking than to HIV-related causes, Helleberg and colleagues reported online in Clinical Infectious Diseases.

The study, carried out in Denmark, establishes the risks of smoking in a situation where HIV care is integrated and anti-retroviral therapy is available at no cost.

The bottom line, Helleberg said in a statement, is that “more than 60% of deaths among HIV patients are associated with smoking,” compared with slightly more than a quarter associated with HIV.

In the general population, Helleberg and colleagues noted, smoking is one of the major factors that reduce life expectancy.

Among those with HIV, the advent of highly active anti-retroviral therapy (HAART) has meant that lifestyle factors are increasingly affecting survival, while the mortality risk associated with the virus has diminished.

To pin down the effects of smoking on people whose HIV is well controlled, the researchers turned to the Danish HIV Cohort Study, a population-based nation-wide study that includes all HIV-infected individuals treated at Danish HIV centers after Jan. 1, 1995.

They analyzed outcomes for all members of the cohort who were older than 16 when they were diagnosed, were treated between Jan. 1, 1995 and Aug. 1 2010, and had smoking status at the time of diagnosis available. Injection drug users were excluded.

All told, the researchers reported, the HIV-positive study population included 2,921 people, who were matched for sex and year of birth with up to 4 controls each – a total of 10,642 individuals — from the prospective Copenhagen General Population Study.

The two groups were followed for 14,281 and 45,122 person-years, respectively, yielding a median follow-up time of 4.2 years for patients and 4.1 years for controls.

As expected, the HIV-positive participants smoked more heavily than the controls — 47.4% were current smokers, 17.7% had previously smoked, and 34.9% were never smokers compared with 20.6%, 32.8%, and 46.6%, respectively among the controls.

Over the study period, there were 221 deaths in this HIV-positive cohort, including 58 (26%) related to the virus. There were also 142 deaths from non-AIDS related causes (64%). The remaining 21 deaths (10%) were attributed to violence.

Among the controls, there were 132 deaths from all causes.

When the researchers broke down the deaths by smoking status they found that all-cause mortality was substantially higher among smoking HIV patients compared with nonsmokers. The mortality rate ratio (MRR) was 4.4 (95% CI 3.0 to 6.7).

MRR for non-AIDS mortality was even higher at 5.3 (95% CI 3.2 to 8.8).

In contrast, among controls, the MRR was 3.5 (95% CI 2.2 to 5.5), when comparing current and never smokers.

The excess mortality rate per 1,000 person-years among current smokers versus non-smokers was 17.6 for HIV patients and 4.8 for controls.

A 35-year-old HIV-positive smoker had a median life expectancy of 62.6 years, compared with 69.1 years for previous smokers and 78.4 years for never-smokers.

Among never-smokers, having HIV led to 5.1 years of life lost, compared with the controls, Helleberg and colleagues found. That was greater than the 3.6 years lost when smoking controls were compared with nonsmokers.

But the greatest disparity was the 12.3 years of life expectancy lost when HIV-positive smokers were compared with HIV-positive never-smokers, they reported.

Helleberg and colleagues cautioned that it is possible that mortality among the controls was underestimated, which would tend to inflate mortality among the HIV-positive cohort.

Although the analysis accounted for a range of possible confounding factors, they added, residual confounding, and socioeconomic status in particular is likely.

The study had support from the University of Copenhagen. The journal said Helleberg reported no conflicts.

Tim Barrus (comments):

The conclusions regarding smoking and HIV can hardly be a surprise. In my little world, HIV and addiction go hand-in-hand. I see no light at the end of that tunnel. Often, people are just trading one addiction for another. There are yet other numbers in this study that also confirm what I have seen anecdotally. Violence. These numbers re: death by violence, at these high rates, should rock the boat of public health. These numbers mean that if you have HIV, you are at a much higher risk of dying by violence than the rest of the population. I will walk out on a limb here, and say that there is a correlation between addiction and violence. Would I go so far as to say that many young people with HIV are addicted to violence. I would. No one in the HIV community would agree with that. But I am dealing on a day to day (moment to moment) basis with young boys with HIV who do sex work. Many of them have a history of being trafficked. The added element of death by violence comes as no surprise. They are often murdered by pimps. Trafficking is a 32 billion dollar concern in the US alone. Many people feel boys are never trafficked. Ignorance is bliss. In the face of everything they are confronted with, they smoke. A lot. I have seen them climb into slowly passing cars and then simply disappear. I have seen them run away from abusive families and simply disappear. I have seen them arrested for soliciting, get put into juvenile detention where they kill themselves, usually by hanging. I have seen them beaten up by police and tricks. The violence angle is not a surprise only in that someone somewhere needs to take a hard look at that, too. If ten percent of the general population was dying from violence, someone somewhere would be stirred to action. 

Tim Barrus/ hiv boys who do sex work and use iv drugs

We will be out on a shoot all afternoon. It will be impossible to contact me until we have returned. Boys have been working on HIV Boys Suicide video: He Died With a Belt Around His Neck. I keep pressuring: FIND THE METAPHORS. And now I realize (I could not articulate it until we started this video) what it means and what it does not mean. This is where the boys are teaching me. We have some shots now of people living in sewers. Humans in sewer pipes. Clinical depression is an issue loaded for bear with other issues. Clinical depression and HIV are a combination that makes a kid-at-risk just closer to jumping or being pushed. Their metaphor re: depression is life in a sewer. This is what I mean by find the metaphors. What I do NOT NO WAY mean is find the comparisons. When you are telling these boys that what they have done is just like what so and so did somewhere in the past, even the recent past, what you are implying is NOT a critical analysis. It is a dig. A dig implies that what you are doing is not original. It is a negative implication in a context. That context is artistic expression by suicidal boys themselves. To compare their stuff to ANYTHING is not a situation where they are seeking to grasp their own metaphors. The implication is that they are stupid for not having known that someone somewhere has done it all before and maybe even better than you.

I spend some time and energy seeing that they are not exposed to this crushing weight. The message that says in the final analysis, you are stupid after all.

They are not saying that being suicidal is LIKE living in a sewer. They are saying something in the CONTEXT of a STORY. That context has a beginning, a middle, and an end. It is far, far more complex than announcing something is just like something else. It isn’t. One of the things they are saying is we are the ones who build the structures from which they can either jump and simply be aware of. Finding metaphors is about what are the options. Telling them that their options and metaphors have all been done before — the implication being that something is stale — leaves out the entire possibility that there are options, and that the human being will explore them and choose.

If what you have to say to me is the usual laundry list of this is just like this, please just keep it to yourself. We are busy making art. 

America is a culture that lashes out at anything or anyone who might happen to be pointing out that America produces young males, not just females, who feel that because they are marginalized, they have little choice, really, than to do sex work to survive. The Life. Some just grow into it. We make our art with one eye cast over our shoulders. It’s really, really bad for kids with HIV to live within that context, but the alternative is for them to live in a less supportive environment, where anxiety is the she-wolf who eats you inside out.

I have been in fighting mode. Issue: HIV boys and suicide. Prosecutors have been looking at increasing the number of prosecutions for HIV boy sex workers who threaten suicide. To threaten suicide can be illegal in many places. Boys who threaten to jump need peer-to-peer counseling (it is the only thing that works outside of medication) and to get off the street; to prosecute them is to drive them more underground than they already are. It is beyond stupid. It is mean-spirited and implies that the act of committing suicide is preferable to being jailed and prosecuted. I call this murder.

Tim Barrus: L.A. Thorazine Cages


i know this:

i am glad i left los angeles

but there is

a seduction of sorts

jim morrison’s motel room

got the spooks

denny’s with some chick at 4am


i worked in a college psychiatric hospital

with adolescents

in icu

kids the cops dragged in by the

hair and by the balls

kids they beat up

one kid they shot

high on pcp

angel dust

scraped off the pavement

of sunset boulevard

like seriously tattooed

so many cutters

cookies couldn’t hide

the curves carved in arms

and wrists

one night, all the icu kids

escaped through a window

they broke and they

camped out up at big bear

in a cabin they broke into

for three months

it was winter

and they were busted

breaking into other cabins

looking for food

the cops brought them

back sullen and hungry

it was winter and

not even sunset boulevard

could sustain them they

were right back on thorazine

highway exactly where

they started

Tim Barrus: A Conspiracy of Goodness: USAID (Dr Boothby)


A Conspiracy of Goodness: USAID

Posted by Neil Boothby, PhD, U.S. Government Special Advisor and Senior Coordinator to the USAID Administrator on Children in Adversity on Monday, December 17th 2012 

Neil Boothby is U.S. Government Special Advisor and Senior Coordinator to the Administrator on Children in Adversity. Photo Credit: Columbia University.

I’ve found there are some things on which everyone can agree.

  • Children need strong beginnings – health, nutrition and nurturing care – to live their most productive lives;
  • Children grow up best in the care of loving families;
  • Children have the right to live free of violence, exploitation, abuse and neglect.

These truths offer a simple moral imperative, but they are also backed by science. Neuroscientists, pediatricians and economists alike have demonstrated that a promising future belongs to those nations, communities and families that invest wisely in their children. I’ve studied the irrefutable links between the wellbeing of children and the economic and social progress of nations – they provide a compelling agenda for strengthening policies and investments to ensure that all children grow up within protective family care, and free from deprivation, exploitation and danger.

Following the genocide in Rwanda, over a million reed thin and weary refugees poured into the Goma refugee camp in what was then Zaire. In the midst of cholera, relief workers brought infants and children to make-shift orphanages in an effort to save lives. Little babies were lined up like loaves of bread on cots, given vaccines to stave off preventable illnesses and fed routinely through IVs. Yet they still died by the hundreds. It’s called “failure to thrive”—the lack of human contact and nurturance required to live.

I looked into the eyes of many of these Rwandan babies who “failed to thrive”. It was an experience that continues to haunt me to this day. In a brief moment, I witnessed the flicker of God-given potential dim – a desperate fight at first, then resignation and a ghost-like stare until death. It’s the opposite of when I looked into my own son’s eyes and, for the first time, he recognized me and responded with delight!

Last year 6.9 million children died from preventable causes. We have the science to explain what happens within the bodies and brains of children who face deprivation, exploitation and danger. We have the evidence that demonstrates how early intervention break cycles of poverty, inequality and violence. We have empirical data that shows investments made early in the lives of children yield greater returns than at any other point in the life cycle. We have other champions and partner organizations on the ground prepared to roll up their sleeves and scale up what is proven to work. We work with governments all over the world that are prepared to partner to do more and better on behalf of their children in need.

In June, the Governments of Ethiopia, India and the United States, in collaboration with UNICEF, hosted the Child Survival Call to Action. As an important follow on to this global effort, this week the first-ever U.S. Government Action Plan on Children in Adversity (PDF) will be released. It is a testament to the fact that the U.S. government takes the science – and the investment – seriously. With significant investments in international development, the technical expertise and research capabilities embedded within key agencies, and diplomatic outreach, the U.S. government is well positioned to lead and mobilize around this sensible and strategic global agenda for children in adversity – children who face poverty, live on the streets or in institutions, are exploited for their labor or sex, recruited into armed groups, affected by HIV/AIDS, or separated from their families as a result of conflict or disaster.

The Action Plan I have helped to develop outlines objectives that will deliver ambitious and positive results for children. It also identifies programs that work and that can be taken to scale. It demonstrates that we can measure impact and affect change.

Yet, this work is about more than science, or sound economic investments. It is about the miracle and potential of each child, and our profound duty to care for our children, and in so doing, protect our future.

I have spent 40 years working to create a world in which all children grow up within protective family care and free from deprivation, exploitation and danger. The U.S. Government Action Plan moves us closer towards this vision. I invite you to join this global conspiracy of goodness.

Dr. Boothby has taken a leave of absence from Columbia University, where he is the Allan Rosenfield Professor of Clinical Forced Migration and Health at Columbia University’s Mailman School of Public Health. As Director of the Program on Forced Migration and Health, he has lead several research initiatives, including the Child Protection in Crisis (CPC) Learning Network—a constellation of over 150 agencies working in 32 countries on the development of an evidence base for efficacious child health and protection programming. Through the CPC Network, Dr. Boothby established university based research centers and graduate training programs in Africa, Asian and the Middle East.


Tim Barrus: I admire but I do not share this optimism. It does not reflect reality. Children are exploited in American culture. Nurturing seems to be an accident. We are the ultimate culture of indifference. We mean well. But our behavior is not evidence of a conspiracy of goodness. I deal with HIV+ young boys, many runaways, who are out there doing sex work. It is a landscape of sheer and brutal survival.

Many adolescents in this at-risk group end up killing themselves. The system’s response is usually to arrest them, and incarcerate them. The HIV rate, the death rate, the tuberculosis rate, and just plain and simple rapes in child detention facilities is a national nightmare. It is a disgrace. The estimate that there are a million homeless children in this culture is bogus; the real number is much higher.

If we actually cared about kids in this culture, why are so many of them on waiting lists for HIV drugs.

They are lectured to that their HIV rates (going higher) are unacceptable. But then they are denied the medication they need. We push HIV testing.

How many American juvenile detention facilities test. None.

How many provide HIV medical support. None.

Wake up and smell the media for what it is. Sound bites and rhetoric. It does not REFLECT the reality too many children live.

The kids I deal with eat pizza out of dumpsters. They don’t have big dreams. They’re marginalized because that is what poverty does. They understand that the focus has to be to just make it through the day.

Drugs are an escape. For kids who can’t get antiretrovirals, they have no problem finding heroin.

We mouth lots of words. But the evidence of our indifference toward how we perceive and nurture our children is everywhere. The men who pick up the boys I deal so that they might have sex with them (oral sex is five bucks and anal sex is twenty), are almost always married.

How do I know this.

I go to the source every day. They understand what they are up against. They also understand there is not much hope to be found out there. Hope does not mean them, and they are not alone.

Fully half the children in this culture live in poverty.

I would love to believe in a conspiracy of goodness. But I am compelled to live in the real world.

Tim Barrus/ Why has PEPFAR ignored boys who are doing sexwork.


I am writing an article about how PEPFAR has no outreach to a very relevant group/population young boys who are HIV and still doing survival sex. It’s like they don’t exist. They do exist, and some of them are undocumented boys doing sexwork who are subsequently detained — HIV goes untreated — on military bases in unacceptable conditions for children with both HIV and tuberculosis. They are then returned where they are again trafficked back to the US. PEPFAR totally ignores this group, and there seems to be the STIGMA of sex and children and HIV and exactly who is having sex with these children. They are disposable. But only to a certain extent. That extent ends when they cross over into the US for a second time. Again, they remain untreated. There is a bare bones hospice for them in Tijuana. It’s a cycle of violence against children perpetrated by an indifference that is unacceptable.

I am wondering if PEPFAR has any kind of response.

PEPFAR’s own list of agencies it has private-public-partnerships with does not seem to have a single listing that includes any organization whatsoever who deals with child trafficking and prostitution. My article will begin with boys living on Sunset Boulevard and doing sexwork. They receive no health care at all. There seems to be only one small organization managed by one man who even responds to suicides, many of these kids kill themselves, and although he has a relationship with Children’s Hospital (same exact neighborhood), there, too, seems to be no awareness of these kids on an institutional basis. My own research indicates that by the time a kid has been trafficked three times, the HIV kicks in and the kid dies. There doesn’t seem to be any waiting period while the virus attacks an immune system. There seems to be no immune system to attack. Infectious disease specialists I have talked to about this postulate that this population is also at high risk for TB and Hepatitis and combined with environmental variables, at risk turns into AIDS very quickly.

Why are these children out there having sex with American men. Most of whom appear to be married with families.

Why are there no supportive structures built around safe places where kids who are doing sexwork can be tested and treated. Why has PEPFAR ignored this very significant piece of the HIV/AIDS puzzle.

Thank you.

Tim Barrus

Tim Barrus/ it is always the owners fault


Kirk [transcribed]:  Before I came here, a bunch of us guys were going to rob this fag we knew who hung out on the street looking for boys like us. He never wanted to have sex with us. He was a fucking drag queen, and they’re always looking for ways to sell pussy. Every drag queens gotta hole. She liked men not boys, but she hung out with us cuz we had so many tricks. Tricks is where the money is. One trick took me to his home. He had kids, and liked fucking my hole in his son’s bed. Fucking sick perv, but most of my tricks are fucking sick pervs. I hate them. We were going to rob the drag queen and kill him. But then I realized I was a faggot myself. I suck cock and I like it. I talked them other dudes out of killing that drag queen faggot but we did rob him. It was messed up. But if you wanna fuck me in my hole you gotta pay more. That is how I think I got HIV. Being fucked in the hole. When I first started selling hole, I was in junior high school. They never did teach us about sex or condoms so how was I supposed to know, you know, so I could make twenty bucks getting fucked. You can’t say like some kids do that there is no blood when you get fucked in the hole cuz I bleed like crazy every time my hole is someone’s cunt. I would give up whoring, but am I supposed to do? The world I live in is all about how much you got in your pocket. No one I know goes to no bank. My parents hate me cuz in my house hole was always free, and now if he wanted to fuck me in the hole, I would charge him twenty bucks. He kicked me out of the house and said to never come back. I did go back. I set that house on fire. Turned it into an abandominium and now I have no idea where my parents are. I doubt they are still together cuz when he was fucking my hole she didn’t like it. Like that motherfucker used to tell me, drugs cost money, boy. I hope HIV kills me, you know. Will save me the trouble of doing it myself. I think I might hang myself. I want to. But I might not have the balls. When men are done fucking my hole, I just wanna die. Drugs hide the pain and then they fade and then you need more to keep the pain away. It costs a lot of money, drugs. Anyone can fuck me. I am a hole. A big hole of shit, you know. I have a belt. I seen a guy once who did it. I don’t think it would take too long to choke. Kids jack off doing it. I might. There is more blood in fucking a hole than when you hang. I think about hanging all the time. I can’t get it out of my head. Maybe my parents would read about it in the paper but not really cuz they don’t read. But if they could read maybe then they would be sorry. Right now, I’m high on kangaroo I guess it shows, huh.

[*kangaroo is drug slang for crack]

I am told by professionals that there is no hope for this kid or boys like him. It would be easy to believe it. I just don’t believe it. There’s something in me that says this kid can change. He can turn it around. I do not know why I think that. It’s not based on evidence. It’s not based on psychology. It’s not based on any sort of theory. It’s just something I believe like I believe that when there is something wrong with a dog, it isn’t behaving appropriately, it is my experience that it is always the owners fault. The dog is just trying to stay alive. The owner, more often than not, just wants to keep the cycle of violence intact. It’s easy to give up on the dog. It’s easy to say it’s just a vicious animal. We do it all the time. — Tim Barrus

Tim Barrus/ HIV and Smoking

I have been on a kick to get the HIV+ boys I deal with to quit smoking. When you do this, you seem to bump up against all the other addictions; especially an addiction to a self-image as being cool. It’s not simple. It’s more than just making rules. One success has been teaching photography. You can’t really smoke and deal with the more complex cameras. The kid can find a lot of reinforcement in the photography versus the cigarette. If we go on a photo shoot, the boys are leaving cigarettes behind as a choice by them and not a directive by me. My biggest challenge is in confronting the jaded attitude that “something is going to get me anyway, in fact, it already has.” It’s hard to find activities like making art that have the ability to substitute a social reinforcement from a hit of nicotine with any kind of rush from success when these HIV drugs cost so much, and art materials (and everything else in life) take a back seat to buying ARVs. Even co-pays constitute literal fortunes. I do not see how those of us on the ground can expect to be effective in a confrontation with nicotine when we only have facsimiles of tools to employ in battle with addictive behaviors when the biggest focus in life is to keep the gravy train of ARVs coming. I have observed doctors saying to the boys: “You have to stop smoking.” And I keep wondering: does this doctor really think that simply telling a kid he has to stop smoking means he really will. Compliance is more than a one-way conversation. I can fight many HIV battles with the boys, and I hate seeing a 14-year-old smoke. But I can’t fight HIV and the economic consequences of having very little left over once the monthly meds have been purchased when I am only left with my own one-way conversation about heart disease. At some point the kid just turns you off. These other conflicts like heart disease cannot be addressed when your most basic, fundamental conflict is keeping the child medicated. The high cost of the meds is the problem. Heart disease is an afterthought. It’s one thing to say: it better not be an afterthought. I know that. But I am left with no tools to facilitate the attention of the kid when at the end of every month, we have been drained dry. I am told it is not Big Pharma’s fault. I can understand that. But when I look around at corporate involvement (even a company as removed as Chevron gets involved) in World AIDS Day, I do not see a single corporate entity from Big Pharma at the table. The medical community hates it when I am critical of Big Pharma, and I don’t speak their language. But Big Pharma is entirely indifferent to problems where just throwing pills at kids is such a candidate for failure in the face of nicotine addiction. Economics is a wall you hit on a consistent basis. And now I am supposed to address heart disease. It just doesn’t work that way because the system does not allow it. The boys are right: something is going to get them. How many battles can I fight. The only other weapon I have is peer to peer mentoring. Anectodal: It’s a paradigm that has a history of success but it’s never supported. Kids listen to other kids. I have seen kids quit smoking and take another peer with them. But this is not a paradigm supported by any institution, any funding, and it’s not recognized let alone incorporated into any programmatic context on the ground. I can get boys to take up sports. Then, what you run up against HARD is stigma from the community which we gloss over with the word stigma when, in fact, it’s hate. If I took their blood pressures right now, every last one of them would be on the high end. A few would be alarming. They’re time bombs waiting to go off. Diet. Nutrition. Education. Behavior. Economics. Medication. The list gets longer, and this IS the stuff of heart disease. Trips to the clinic are a hundred miles away because the medical community itself has compartmentalized and marginalized HIV/AIDS to the point that on the way to the clinic we pass dozens of doctor’s offices, hospitals, and a university, all of which treat heart disease as an ordinary treatment modality. But we are left out of that equation, and I would strongly suggest that if any community wants to see us treat heart disease, then that community is going to have to come up with community-based support mechanisms that are real and not limited to telling an addicted kid with HIV that he needs to quit smoking. He knows. But he isn’t and he can’t do it by himself because if he did, half these boys would not have HIV. Maybe all of them. If you were to conduct studies like this with adolescents who do sex work, you are going to find some very, very sick children.


HIV-infected children and adolescents receiving antiretroviral treatment have more than twice the odds for having a specific marker of heart disease than children without HIV, researchers found.

There was a significant difference in carotid intima-media thickness between children with and without HIV (0.434 versus 0.424 mm, P=0.018), according to Talia Sainz Costa, MD, of University General Hospital Gregorio Maranon in Madrid, and colleagues.

Having HIV was independently associated with a thicker carotid intima-media wall after researchers adjusted for age, sex, body mass index, and smoking (OR 2.68, 95% CI 1.34 to 5.35, P=0.005), Sainz Costa reported at the 2012 EuroEcho and Other Imaging Modalities meeting in Athens, Greece.

Sainz Costa and colleagues noted that antiretroviral treatment does not cure HIV and since the virus remains in the body, the immune system is constantly activated, creating a chronic state of inflammation.

They also noted that research is ongoing into ways to control the inflammation and immune activation with agents such as probiotics, aspirin, and steroids.

Another problem, however, is that antiretroviral drugs often affect cholesterol, specifically by increasing low-density lipoprotein cholesterol and lowering high-density lipoprotein cholesterol, they said.

And since these children and young adults are living longer with the virus, this one-two punch of chronic inflammation and dyslipidemia puts them at greater risk for developing cardiovascular disease much earlier than the general population.

Patients with HIV die 10 years prematurely from non-AIDS diseases, which include cancer and cardiovascular, liver, and renal diseases, researchers noted.

“This is especially important for children because they have been living with HIV since birth or even before,” Sainz Costa said in a statement.

“By the time they are 50 years old, they will have accumulated more toxicity from the treatment and more secondary effects from the infection, and will be at an even greater risk of heart attacks and other complications,” she added.

The investigators concluded that education about healthy lifestyles, as well as aggressive lipid-lowering measures, is needed to prevent early cardiovascular death in children with HIV.

For the study, Sainz Costa and colleagues enlisted 150 HIV-infected children and adolescents and 150 age- and sex-matched healthy controls. The mean age was 14.6 and 63% were female. In the HIV group, 17% were smokers compared with 11% of controls.

Nearly all (96.7%) of the HIV-infected group had an undetectable viral load, and all but four patients were on highly active antiretroviral therapy (HAART).

All participants had their carotid intima-media thickness measured by ultrasound, a measurement often used as a surrogate for the risk of cardiovascular disease. Those with HIV had significantly thicker carotid intima-media.

Sainz Costa commented that this population has “arteries that are more rigid and less elastic, which means that the process of atherosclerosis has begun.”

The investigators also found higher frequencies of activated T CD4+ cells in 34 HIV-infected patients compared with 11 controls (P=0.002), which indicates an activated immune system.

The frequency of activated CD8+ cells was borderline statistically significant in HIV-infected children and adolescents.

“Cardiovascular disease has already put down roots in children and adolescents with HIV, and we need to take preventive measures at this early stage. We should be more aggressive in treating their high cholesterol with medication – this practice is common in adults but rare in children,” Sainz Costa said.

"i believe you" SHOW ME YOUR LIFE: Rough Whore Blues

They do what they do, because they can. They do not have to hurt one more boy. Not one. We can stand up to these people. They are not courageous individuals. They are always poised to run.

rough whore blues


we were the only mother and son team in our building

i would fuck her and men would watch

jacking off

and we would

have to swear we were really related

and we would speedball

mama and i and i would do some tricks on the side

but no holding out on mama she knew where i lived

in her pussy and her twat so then i started getting

public hair so she shaved me cuz shaved was what

those tricks wanted

and i do not think of myself as no

whore but i thoughta her one and she owed money

to a dealer fuckingshit so he paid me to beat the cunt

off that bitch

i hated her and her fucking needles and

her crispy creams was all we ever had you go live

in them projects you think it’s so funny boy i knock

your motherfucking teeth out your head

i hated that bitch

but men would pay us to watch me beat her up and

i beat her until that rough fucking whore turned

blue and if they paid me skank i’ll beat on you

so that is why i am a loser punk cutter dope bitch

who wants to die

with this disease please god i am so tired no

speedball can do me right

i have been sober a week and i hate it soaking

this chill in a thousand blankets

no one can get to me or hurt me

wrapped up in a thousand blankets

HUMANITARIAN DISASTER: Human Trafficking in an HIV/AIDS pandemic.

HUMANITARIAN DISASTER: Human Trafficking in an HIV/AIDS pandemic.


Latest Gallery Updates

Visit Art Gallery
Back to Top