Streaming Media in Cleveland Memory:
The Gay 90's with Buck Harris

Transcript

0:00:00.9 Advertisement: 

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Announcer: 

Get ready America for an out of closet experience. It's the Gay 90's with Buck Harris. Sometimes serious, sometimes humorous, but never. Straight Talk.

[0:00:29.4] Buck Harris: 

(singing with theme music) "I don't want praise, I don't want pity. I bang my own drum... Well good evening Cleveland on this February 25th. Welcome to the Gay 90s, the voice of northeast Ohio's gay and lesbian community. It is the intent of this show to provide programming, that represents the diversity of the gay and lesbian community and reveal the deep culture and historical contributions that for two long have gone unrecognized. The opinions expressed by the host and guests are not necessarily those of 

the management as a matter of fact. Probably not, those are not those of WERE and its management. If you are a member of our community or just a friend or just a curious listener, give us a tune in, give us a call tonight here at 578-1300. If you're not a friend, don't tune in, don't call in, find some of the way to torture yourself, and they're worried about our advertisers, unless otherwise stated, you can assume their sexual orientation, be either gay by host... Well, good evening, Sherry Morabito my co-host.

[0:01:19.5] Sherry Morabito: 

Hi, Buck, how are you doing? 

[0:01:21.6] Buck Harris: 

I'm good, I'm good. Who wouldn't be bad? On a day like today.

[0:01:23.3] Sherry Morabito: 

It's beautiful today...

[0:01:24.2] Buck Harris: 

Now, you're a lesbian. Did you go golfing today?

[0:01:25.9] Sherry Morabito: 

Oh, I wish I could've. No, I didn't. 

[0:01:28 - 

0:01:30]

Buck Harris:

And you call yourself a lesbian? I mean, you must've been itching though, were you like polishing your clubs?

[0:01:32.9] Sherry Morabito: 

I've been pitching and chipping in my living room. 

Buck Harris:

Pitching and chipping, 

Sherry Morabito: 

Tearing up the carpet on...

Buck Harris:

Does it have something to do with golf?

Sherry Morabito: 

I think that's personal. 

[0:01:42.9] Buck Harris: 

I was out in the yard today doing a little bit of... I wanted to put my geraniums in and stuff, but I have to use some restraint. But even now, the bulbs are sort of inching their way out of the ground and I can hardly wait.

[0:01:55.3] Sherry Morabito: 

It's light when we're driving down to the station, now it's staying... lighter later. I love it.

[0:02:00.7] Buck Harris: 

It's come and Spring is on the way in the way. The time of love. Yeah, yes. I've had a very... I'm speechless. I've had a really, very nice weekend, as a matter of fact, I was at a...

John interjects:

MARK YOUR CALENDARS: BUCK IS SPEECHLESS!

Buck Harris: 

I was out of town all week and I got back Friday, and then yesterday I spent a good bit of my time at the Cleveland Clinic, and part of that performing AIDS thing that they did, they brought in a bunch of nationally known talents among them, Michael Kearns, who was a guest on the show a couple weeks ago, he did a thing called "Intimacy." It's a video that he made of or nine different characters living with AIDS, and he plays each of those characters. That was a remarkable experience. And then last night I went to the Cleveland Public Theater and saw Tim Miller, and he did a performing arts piece called "My Queer Body," and I really enjoyed myself. Oh yeah, I didn't have stick around for Frank Green's piece. I had seen it done, had it, been there, once was enough for me, but the house was full, it was standing room only for Tim Miller's program. 

Sherry Morabito: 

Great.

[0:03:09.0] Buck Harris:

So otherwise, I also, I went to moonlight bowling last night. Hey, John, you went to moonlight bowling didn't you...?

Sherry Morabito:

I fell asleep, I couldn't get to. 

John Farina:

I did, yeah. 

Buck Harris:

How did you do?

[0:03:14.5] John Farina: 

I bowled about a 148 the first game, and then I did really bad in the last two games... 

Buck Harris:

Well, I'm sorry to hear that, but then our motto is, it's not whether you win or look, win or lose, but how you look... 

[0:03:24.7] John Farina:

I looked fine, I looked pretty good, yeah.

[0:03:25.3] Buck Harris: 

Your shoes didn't go with your outfit.

John Farina:

Oh the horrendous bowling shoes.

[0:03:28.7] Sherry Morabito: 

Red and green. 

John Farina:

Yeah. Terrible.

[0:03:30.7] Buck Harris: 

For those who don't know, it's moonlight bowling, it's sponsored by GIFT, Gay Invitational somethingorother... Or something rather.

Sherry Morabito:

Lots and lots of fun.

[0:03:36.4] John Farina:

It's their tournament that they have here in Cleveland, and they bring a bunch of bowlers here.

0:03:39.5 Buck Harris:

There were about 150 gay men and lesbians, and actually some of the Paradise Club were there as well. 

John

Yes, gay men and lesbians and other.

[0:03:44.9]: Sherry Morabito:

it's a great time. It's a great one. It was a lot of fun. 

[0:03:48.9] John Farina: 

Yeah, and when they do this crazy bowling where you know you spread your legs and push the ball down the alley and bend over and throw the ball between your partner's legs and all that kind of stuff. That's a lot of fun. 

Buck Harris:

I didn't do that. 

Sherry Morabito:

John, where were you bowling?

[0:03:58.8] John Farina:

OH Buck. Oh yes, all that spreading and bending and I thought I was home. Nevermind.

Sherry Morabito:

Where were you, John?

[0:04:05.6] Buck Harris: 

I suppose I ought to tell our listeners what the show's about tonight, by the way, in a short while we'll be joined by Dr. William Ruby. 

John Farina: 

The amazing Dr. William Ruby.

[0:04:15-0:05:14.] Buck Harris:

Amazing Dr. William Ruby. Bill is a physician who works with people living with HIV and AIDS... And so this next show was gonna be... This next hour is gonna be a medical update and some of the advancements made in therapies and drug treatments for people living with HIV and that show the show by the way, the entirety of it will be sponsored by Blacks Are Welcome. So I like to certainly thank them for lending us their support. And so it'll be a call in segment too so our number here is 578-1300, please call. After that, we're gonna talk with Claudia Brenner, she's coming to town next Sunday, and she has authored a book called "Eight Bullets," and it really chronicles her life and how it was impacted by gay violence. She, her lover, and she were hiking in the Appalachian Trail in 1988, when they were both brutally stalked by a man simply because they were a lesbian couple, and he, eight bullets were shot out and her lover was killed, and she was left to die, suffered a number of bullet wounds, so we're gonna hear her compelling story and...yeah, and look at the larger problem of gay violence, and so that'll be in the second hour. So, Republican primaries. Have you been following the yes.

[0:05:24.6] Sherry Morabito:

What happened?

Buck Harris:

Who knows?  Good old Pat Buchanan.

Sherry Morabito:

How did 26% of those people think that his was the right message?

John Farina: 

27% 

Buck Harris: It's scary.

Sherry Morabito:: It's scary either way. 

[0:05:37.9-0:05:48.9]
Buck Harris:

It is amazing though. Still, you got Dole and Buchanan, they're running a tight race, and I still have all these gay Log Cabin people like John Farina, a... What are you gonna do, John?

[0:05:50.3] John Farina: 

Well, Pat Buchanan will not be the nominee, he can't make it all the way, his spark will die out, his wave will crest, he can't make it all the way to California.

Buck Harris: 

But they said that about him in the primaries, that he would never go as far as he's gone.

[0:06:03.4] Sherry Morabito: 

27% of the people thought his message was good - 

[0:06:05 - 0:06:13.8]

John Farina: 

27% of the people thought his message of keeping jobs on the shores and things like that, that's what they were listening to, the, the 27% of the people didn't necessarily vote for Pat Buchanan because of his social causes, that's an aside for him, and it's a scary aside, but it is a true fact. But he's becoming more and more extreme, he's being associated with more and more people who are on the fringe

  Klansmen and...

[0:06:28.9] Buck Harris: 

People working on his campaign who are white
[sic] supremists. 

[0:06:33 - 0:06:43.7]

John Farina:

Exactly, and the more that starts to come out and the more...

 you know, when Steve Forbes was Mr. January, most of it was positive. Pat Buchanan was Mr. February and the really hammered it and is continuing to hammer him. He can't make it.

 He's too extreme for the country, let alone for the party, 

[6:47-

0:06:56.8] Buck Harris:

So we can all take a sigh of relief when... Because it'll be Bob Dole, whoa that really makes me feel comfortable... Do you know Sherry, the new theme song now for the Log Cabin club - the Gay Republicans. What is that? It's my party and I'll cry if I want to. Cry if I want to, cry If I want to.

[0:07:04.1] Buck & Sherry Morabito:

You would cry too... 

Buck Harris:

If it happened to you. 

John Farina:

Oh you guys.

Buck Harris:

Oh the gay Republicans, a strange lot of people

[0:07:12.6] Sherry Morabito: 

Pat Buchanan is the best thing that would be able to happen to us actually...

[0:07:17.6] Buck Harris: 

Other controversy in the news...

John Farina:

And Bill Clinton is a fine, fine, ringing supporter of our community.

[0:07:23.8] Buck Harris: 

Absolutely positively is.

John Farina:

Well, he may be friendly, but he certainly, I have still yet to see solid demonstration of what he can do for us 'cause he hasn't done it.

[0:07:32.8] Buck Harris: 

Oh, well, we'll talk, as I'm gonna move on the... I wanna talk about Utah outlet where the Mormons live. Yes, you notice that they had the young students trying to start up again, Gay and Lesbian and Straight Alliance, and the school said, No way in hell.

[0:07:48.7] Sherry Morabito: 

Yeah, we're gonna report that.

[0:07:49.6] Buck Harris: We're gonna ban them from the school... Well, instead, what happened once they found out that it was unconstitutional to the ban just one group, 

Sherry Morabito: Just one group.

Buck Harris: And so they wiped out the full slate... Of course, the rationale, the reason they didn't want a gay and lesbian and straight alliance was we were gonna start recruiting all the young students, so I thought initially before they banned all these clubs that we would just have to go to back to our old tactics, the way we recruit, the gay men joined a drama club and the lesbians joined the intramural sports leagues, 

Sherry Morabito: That's right.

Buck Harris: And that's how we get all these young homosexuals. 

[0:08:15.3 - 0:08:31.3] John Farina: 

Well you know that whole situation came out of a law that Orrin Hatch instituted to prevent the elimination of Christian clubs in schools, and so they couldn't be banned though specifically, and if you had to ban a Christian club, you had to anomaly, and so they ended up trying to ban these gay clubs and say, Well, wait a minute,  S1: You've gotta do it all.

[0:08:32.1] Buck Harris: 

Yeah, so Salt Lake City in the high schools here, they have no intramural sports now.

[0:08:36.7] Sherry Morabito: 

And that includes the beef club that was at the school... 

[0:08:9.7]

Buck Harris:

They had a a beef club? 

[0:08:41.7]

Todd Stewart:

Was that a gay club?

Sherry Morabito:

Yes, the sole purpose of it was, they ate steaks and hamburgers and went to monster truck rallies, and those students quotes was that the gays are ruining it for everyone

 (laughs).

[0:08:51.7] Buck Harris: 

Well... We rained on their parade. Didn't we?

[0:08:54.9] Sherry Morabito: 

No monster trucks.

[0:08:57.0] Buck Harris: 

Anyway, we have to move along. Right now, we're gonna take a short break to...Todd, you're gonna be on WVIZ in a... A short... 

Todd Stewart: 

Well, now yes, I am, I'm really excited. I'm going to start hosting... The pledge drives. 

Buck Harris:

That's a Vanna White Post. 

[0:09:12 - 0:09:33.2] Todd Stewart: 

It's a Vanna White kind of job, and it's on Channel 25 and March 1st, that's next Friday, I will be hosting along with Bob Olive from 7-11 PM, and we'll be playing "Much Ado About Nothing: with Kenneth Branagh. 

And so our listeners tune in, and you can get a look at Todd Stewart, see what he looks like. See how fabulous he is, and you too can wonder why I'm single. And then call us for dating information.

0:09:34.6 Buck Harris: 

It certainly beats running an ad in the Gay People's Chronicle. Just tell your pursuers to uh watch you on TV...

Todd Stewart: 

I'd love our listeners to watch on Friday and then call in next Sunday and we'll chat about it.

[0:09:46.1] Sherry Morabito: 

And wonder why he's not 6'5, and..

Todd Stewart:

That's right.

[0:09:49.2] Buck Harris: 

Well, we do need to take a break. Our number here is 578-1300. If you wanna start picking up the phone and calling in to talk to Dr. Ruby when we come back. This show by the way, sponsored by Glaxo Wellcome, so we'll be right back. This is the Gay 90s, I'm Buck Harris on WERE. 

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[0:12:09.7 - 0:12:17.2] ] Buck Harris: 

All right, we're back on the air now, and joining me now in the studio, it's Dr. Will or Bill, do you go by Bill or William?

Bill Ruby:

Actually I go by Bill, Buck. 

Buck Harris: 

All right, go ahead. I'd rather be a little more informal here is seeing Bill and I actually had the pleasure of meeting other about four years ago, when he attended the HIV as counselor training course I teach down in Columbus. It's about a four day course. And at that time, you were just sort of getting into the field you were in, your internship or residency and medical school. For our listeners, we're gonna be talking about ads for the rest of the... Well, the rest of this hour for the next 45 minutes and talking about the newest therapies and treatments, but at first, I'd like to find out a little bit more about you. You come from the Center for AIDS Research and Education, which is in Akron, at the Akron City Hospital. 

Bill Ruby:

That's correct.

Buck Harris:

And you're director of primary care and currently seeing about 400 people living with HIV and AIDS... 

Bill Ruby:

About 400. 

Buck Harris: I guess my first question would be to someone who is just exiting medical school, why would you pick this as your primary field of interest... 

[0:13:15.7] Bill Ruby:

Well, that's an interesting question, actually. I had no idea that's what I was gonna go into.

 And I think during my last year of my residency, I saw a need, and that was that there wasn't enough people, there weren't enough physicians out there that were dedicated to treating HIV and AIDS specifically from a primary care standpoint, much of the time it was spent with infectious disease doctors and they needed a primary doctor to go in there and see the patient as a whole. So I took advantage of that. 

Buck Harris:

I think the trend certainly is moving towards people with HIV being seen by family practitioners, general practitioners, and then either when they get into late stage illness or when they might have some peculiar opportunistic infection, then would you say it's appropriate or refer them to an infectious disease doctor?

[0:13:57.5] Bill Ruby:

Absolutely. What we're trying to do at this point is to have all of our patients to be seen by a primary care doctor, because the reality is we're treating HIV as as a chronic illness now, and when we come across some of the more interesting opportunity contacts and that's the time we need a specialist

[

0:14:13.5] Buck Harris: Okay, our number, by the way, it's 578-1300, and we encourage you to pick up the phone call in, especially those living with HIV, and those who have friends, family members living with HIV and find out, it's one of those freebie consults that you can just pick up the phone and call in. So it's 578-1300. So you started working in the field, how many years ago, but it was... 

Coming up on three years now, yeah. And how old are you now? 

Bill Ruby:

32.

Buck Harris:

32. So you really... AIDs has been around for 14 years. You were a youngster when this cropped up... 

Bill Ruby:

"Absolutely, yeah. In fact, when I, sometimes when I lecture, I think back and when I do a timeline of the virus, I think of it when I was a senior in high school. 

Buck  Harris:

"Wow, that's hard to fathom. What are the things that have changed the most? We'll get more specific, but since you've been working in this field and since you've been studying what are the most dramatic changes in treatment and the disease of HIV has evolved.

[0:15:13.7- 

0:15:30.5] Bill Ruby:

I think overall, we're seeing us as more of a manageable disease, whereas before it was a catastrophic illness, and if you were diagnosed with HIV, it eventually led to AIDS and you were going to die, and the reality is now that's not true, that we're seeing patients live a lot longer.

 And even most recently, we're looking at newer medications out there to treat the virus. 

Buck Harris:

Certainly, it was true when, for the first maybe 10 years of this epidemic, and basically people were told "You're HIV positive, get your affairs in order," and you can't expect a long lifespan what is... For someone who has recently found out their HIV positive, who may have been infected within, say the last five years, what is the prognosis today? Well.

[0:16:01.2] Bill Ruby:

Well, when we talk about the pathogenesis or the natural history of the disease, we say that what someone was initially tested HIV-positive, anywhere from six to 10 years without any therapy that's without a T, DDI, DDC and all the others that are out there. We would say six to 10 years before we would first see their first major problem. Now, with the advent of the new medications are out there anywhere from 10 to 15 years before you start having any difficulties with it, and we're seeing patients live to 20 years, 25 years.

[0:16:33.7] Buck Harris: 

Okay. Well, we don't know that we can expect patients to live 25 years. They used to say in the old days, and all days can be a year ago in this business, that what seemed to happen when someone first became infected was there was a tremendous influx of viral replication, that the virus was sort of floating freely through the body through the block and having a heyday, just reproducing and duplicating itself and injecting its genetic material all over the place. And that happened within what? The first month?

Bill Ruby:

T first two to four weeks. 

Buck Harris:

Okay, and they might experience something like flu-like symptoms during that period of time, and then everything seems to get better, that they find a difficult time now finding a high degree of virus in the blood, and so the belief was, Well, they've gone into a dormant stage later dormant state, where the virus is just laying low and really not causing any havoc, there are some new research that maybe says differently, what's the new research looking at...

[0:17:40.5] Bill Ruby:

Well, absolutely, that's the exciting thing that came out in the last year and a half, and that is we're looking actually at viral loads, we now have tests that are out there that can tell you exactly how many viral HIV particles are circulating in the blood at one time... And you're right, Buck, we used to think that they're in the first, maybe what we call the zero conversion stage when someone was becoming HIV positive, the virus was replicating out of control, and then went into a latent stage, now we know... Through some of these newer techniques called branch DNA analysis or QC PCR, that is no longer true, the virus is replicating out of control throughout the entire... In fact, we can quantify it now and say One times 10 to the ninth particle HIV variants each day are being produced whether you're latent or whether you are actually sick at the time.

[0:18:32.1] Buck Harris: 

And what is it actually doing in the lymph nodes? 

[0:18:36.4] Bill Ruby:

Well, what we're finding now is that we can measure it. We can measure the number of viral particles in the blood system at one time. if I drew a sample of blood, I could tell you how many particles are in the blood, what we know through calculations, now we can see what's going on in the lymph system and what we know, lymph, meaning lymph glands, your spleen, things like that, that it's really replicating absolutely at least one times 10 to the 9th per day.

[0:19:01.3] Buck Harris: 

So that ends up like billions 

Bill Ruby:

Billions.

Buck Harris:

Billions, and when does it leave that stage where it's concentrated in the lymph nodes and then start to reappear in the general bloodstream?

[0:19:16.1] Bill Ruby:

Well, that's an interesting question. We're actually looking at that now, what are the implications of this viral replication is going on in the lymph system, when does it actually go into what you're saying into the peripheral blood system, and when is it causing an illness? And we don't know the answers to that right now, but what I would say probably six to 10 years.

[0:19:34.5] Buck Harris: 

Do we have any clue what sort of... Is the catalyst for that happening? Are there some predictors about, all right, now this person is gonna start to really reproduce more virus throughout the peripheral blood system? 

Bill Ruby:

Well, there are many theories that are out there that are being tested, and the most plausible at this point is that what we call the structure, the architecture of the... Of the lymph itself, a lymph tissue breaks down and can no longer contain the HIV virus, and then it starts to disseminate and going throughout the blood system, but we don't know, there are any specific that I'm aware of or any specific predictors to tell when that happens. 

Buck Harris:

Yeah, the Centers for Disease Control has sort of used for some time, its standard of window period, in other words, from the time that someone is infected to the point of which they have developed antibodies that we can test them and by three months, we will pick up all the people who have been exposed. And that's the basic definition of the window, or has that changed in a recent time...

[0:20:40.1] Bill Ruby:

I would say the Center for Disease Control still sticks to them, but what we know now is that within six weeks, about 98% of the population, if they are a set, what we term a successful transmission

[0:20:54.8] Buck Harris: 

It's a choice of words... Absolutely.

[0:20:56.6] Bill Ruby:

But that's the terminology that's out there within six weeks, 90% of the population will test positive.

[0:21:02.6] Buck Harris: 

Okay, so if someone had a sexual encounter or a needle-sharing encounter tonight, and they would be within reason to go in six weeks from tonight and not have to wait three months before they were testing... 

Bill Ruby:

That's correct. 

Buck Harris: 

Now, there's some new tests on the horizon that CDC may be licensing very soon, or may have already, but they're still not ready for general use, one is the saliva test, that is a stat test... Yeah, actually it's called Orasure.

[0:21:34.3] Bill Ruby:

I really want to take the opportunity to let people know about that. It is FDA-approved, and what that is, is taking some saliva from the mouth and also doing what we're looking for the antibody, and that's what I have to stress is looking for the antibody against the disease, not the antigen to

[0:21:49.9] Buck Harris: Indirect test. It's looking for evidence, but it's not looking for the actual virus itself 

Bill Ruby:

Exactly. And I have to tell you that it cannot... HIV cannot be spread through saliva. 

Buck Harris:

Okay, but this test is reliable.

[0:22:02.7] Bill Ruby:

It is about 98% sensitive and specific.

[0:22:05.8] Buck Harris: And can someone use this test more rapidly after exposure, do you have to wait six weeks, three months.

[0:22:13.8-0:22:23.6] Bill Ruby:

Yeah. You still need... The path of physiology is the same, it's your body's response to that virus, which is still gonna take anywhere from two to four, two to six weeks before you really have develop the antibody.

Buck Harris:

So it seems to me that there are two advantages in this new blood test, one is that you don't need to draw blood for it, you can just use the live, and the other is that the test can be done very quickly. 

Bill Ruby:

That's true, and some of the emergency rooms are now starting to use that as well as some of the infection control practices in a hospital after needle stick this... I'm sorry, is this something that might be available on the market as like a home test at my next... 

Buck Harris:

We're gonna go to that. The FDA has also approved a home anybody test. Now, it certainly seems for couples that are wanting to find out if a pregnant or not, to have a preliminary test at home may be useful, but for people who are wanting to find out what they have been exposed to HIV or... Or not, how do you feel about the home? Anybody tests?

[0:23:09.7] Bill Ruby:

I have some real problems with it. Most notably, what we know is that anyone who has an HIV test really ought to have pre-test counseling, pre-test and post-test counseling, what is this really going to tell you... Because people think this is an AIDS test. When in fact, it's not an AIDS test, an HIV test. I'm not for that. I think that we need to have some better counseling before you take that test at home and know what it's about.

[0:23:35.3] Buck Harris: 

And maybe this is in your area of expertise, but I would imagine that that even though FDA has approved is still a state-by-state kind of determination as to whether it's gonna be available in Ohio, and

...

[0:23:47.0] Bill Ruby:

It is definitely a state... Absolutely, and 41 out of the 50 states, and I'm aware of... Actually, for us to draw an HIV test, we need informed consent, so I'm not sure how that's gonna play out

. It is state by state. 

[0:23:57.7] Buck Harris: 

All right, what we need to do now is take a break for the news, our number here is 578-1300, we're gonna open up the phone lines and answer your calls to our Dr. Bill Ruby, this show is being brought to you by lack. So welcome, and this is the a90 owning. Now, sharing more of bettor gerrymandering. 

[0:24:34.0] Todd Stewart:

Welcome to the news of the Gay 90s, brought to you by Metro Toyota. I'm Todd Stewart.

[0:24:37.0] Sherry Morabito: 

And I'm Sherry Morabito. In national news, Pat Buchanan said He won't allow openly gay people to serve in his administration if he is elected President and reiterated his opposition to gays in the military. Buchanan spoke to the same sex marriage issue, declaring, quote, "there is no equality between what has been sanctified by God and what is fundamentally wrong, and we can't put gay marriage into law in any country that we continue to call God's country." The Human Rights Campaign, the nation's largest gay and lesbian political organization said Buchanan was exploiting the fears of people in a segment of American society who don't agree with homosexuality Buchanan's position on whether he would accept a gay person in his administration is another example of Buchanan's extremism. He continues to gay bash with very little remorse.

[0:25:25.9] Todd Stewart:

Nearly half the Republicans in Congress are at least neutral on issues affecting gay men and lesbians, despite strong anti-gay sentiment within its fold according to the Log Cabin Republicans. The gay Republican group conducted a study that surveyed votes statements, hiring practices and other actions of Senate and House Republicans scoring them on a scale ranging from leader to antagonistic. The group found 34 senators and 109 house who ranked at least tolerant, 145 lawmakers were deemed non-supportive, hostile or antagonistic. Two were given scores of zero, Senator Jesse Helms and Republican Bob Dornan of the other GOP presidential candidates in Congress besides Dorn and Senator Richard Lugar received a supportive and Bob Dole received a cooperative

.

[0:26:10.7] Sherry Morabito: 

And in Salt Lake City, Utah, rather than let gay high school students form their own organization, the Salt Lake City Board of Education voted to ban all extracurricular social clubs held in city schools. The decision was the latest in a better state-wide debate over a roofed by students to form a Gay Straight Student Alliance. School board members said they had only two options, allow all extracurricular clubs or eliminate them, all supporters of the gay club were sad and were determined to fight on. "I almost wish they could have found another way of stopping us without punishing everyone else," said Kelly Peterson, founder of the Gay Straight Alliance at East High School. The school board decision will only exacerbate the hate and violence that's been going on against us for years, but this is not over by a long shot. This is a declaration of war. 

Todd Stewart:

Our gay marriage update this hour comes from Pierre, South Dakota. The South Dakota Senate passed House Bill 1143 banning recognition of same-sex marriages. The bill will become law if signed by the governor. If approved, South Dakota will join Utah informally establishing an outright ban on gay marriage. 19 other states are currently considering similar bills. Activists said civil marriage is a civil contract and a civil right, the government of this state has allowed the legislation of hate and the creation of a second class citizen.

[0:27:32.9] Sherry Morabito: 

And in De Moines, Iowa, the Iowa House voted to ban recognition of same-sex marriages, and the bill now proceeds to the Senate, opponents charged that the legislation would encourage gay-bashing and would fuel the fires of ignorance, intolerance and hatred. Supporters of the bill responded that they were acting in the state's best interest, not out of malice toward any particular group.

[0:27:53.8] Todd Stewart:

And in Denver, the Colorado House State Affairs Committee approved a bill that would refuse to recognize same-sex marriages performed in other states. Opponents said Colorado's law against same-sex marriages would help create a patchwork of problems where such couples would be told, now you're married, but now you're not, and was yet another act that attacks a segment of our society

[0:28:14.9] Sherry Morabito: 

And in Madison, Wisconsin... The political landscape in Wisconsin for lesbians and gay men underwent a dramatic transformation recently when a state representative announced he would introduce legislation prohibiting recognition of same-sex marriage, saying legal recognition of gay marriage is a radical step, the people of Wisconsin haven't sanctioned. This bill ensure that regardless of what other states do, a union between a man and a woman is the only marriage our state government will recognize. And this has been The News of The Gay 90s brought to you by Metro Toyota. If you're in the market for a new car truck, be sure to stop in and see our good friend Jim Greenfield. Metro Toyota, proud sponsor of the News Of The Gay 90s. 

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[0:29:07.0] Buck Harris: 

And remember, U4ia is the official dance club for the Gay 90s, and if you're not at U4ia on Saturday night, you're nowhere.

[0:29:28.6] Advertisement: 

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[0:29:54.6 - 0:30:53.1] Advertisement:

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[0:30:59.2] Buck Harris: 

And

 we're back on the air, joined in the studio by Dr. Bill Ruby, who is a healthcare general practitioner, family practitioner, who works out of Akron, treats about 400 people with HIV AIDS, and the director of the primary care program, The Center For Aids Research and Education. Did I get that all in? 

[0:31:20] Bill Ruby:

That's right, yeah. That's an an acronym. CARE.

[0:31:56.7] Buck Harris:

CARE. Okay, good, how nice! We got a couple of calls, by the way, during our break, and I certainly welcome callers. Our number here's 578-1300. But one who was calling him saying he had just moved to Cleveland and couldn't believe what he was hearing on the radio, referring to the show, of course, and I just wanna welcome him to the big city... This is The Gay 90s. Another one called and said... Is this a sports talk for kids... For those of you who are confused now, this is not sports talk for kids, this is The Gay 90s, and we're talking about HIV as we start out the show, really talking about some of the news that may not be so good. It was sort of one of these, I got some good news and I got some bad news And we got rid of the bad news first, that HIV does not remain dormant, that it continues to replicate in the body and continue on a rather steady course of replicating. But the good news is there are many new therapies and treatments that help people to live a long, productive lives living with HIV. Let's talk about some of the new therapies they're using to slow down the virus. 

[0:32:23:0 - 

0:33:02.4] Bill Ruby:

Well, one of the things that we really need to talk about is the buzzword in the medical community is combination therapy, and what that means is we no longer treat HIV and AIDS with one drug therapy, in other words, not just AZT any longer, what we now know in order to really suppress that virus, we need to use combination therapy, and the new therapies include 3TC, which was licensed, it's known as Epivir, that was licensed last month, and also a new one, a whole entirely new class of drugs called protease inhibitors, and this is what we've all been hearing about, and there's one that's been licensed at this point, known as Invirase, which is saquinavir.

It's the only one on the market at this point... 

Buck Harris:

Is that made by Glaxo Wellcome?

Bill Ruby:

Yes, that is made by Glaxo Wellcome. 

Buck Harris:

Good. Let me ask a little bit about the activity of the drug, the antivirals themselves, what I understand is to interfere with replication. 

Bill Ruby:

That's correct. 

Buck Harris:

Now, the problem is with HIV, when you use those alone, that this virus, like some of the other virus, is a very crafty culprit, and so it mutates rather quickly, and so you may go on AZT alone and see sort of a dramatic increase in T-cells and decrease in viral load and people are generally feeling better, but that period of time is rather short lived about a month?

Bill Ruby:

Not really a month at actually what we're looking at, the preliminary studies told us that we have up to almost 12 months with AZT alone, 

Buck Harris:

Bill, I'm not clear 2 months with AZT alone? 

Bill Ruby:

And still derive benefit from AZT. In other words, the virus hasn't become resistant to AZT until 12 months... 

Buck Harris:

Okay, all right, but then it says though, the AZT has no effect whatsoever, because most of the virus has replicated into a form, which is the mutation, and so the AZT is really not doing anything...

[0:34:19.7] Bill Ruby:

That's correct. 

Buck Harris:

And so then we come along with new drugs, 

Bill Ruby:

Absolutely. What we found is one of the reverse transcriptase inhibitors, which AZT, DDI, DDC, D4, all are... We came along with the new one and the 3TC, and what we found was when we use that in combination with the AZT, that mutation that took place and did not allow the AZT to be beneficial anymore. That's no longer the case, that if we combine those two drugs, AZT and 3TC, that we get benefit for longer than 12 months, then we came along and we said, Let's use these new... 

Buck Harris: 

Right before you get there, at what point in the course of infection? They used to look at T-cells. They say, once you hit that 500 mark, 50 and below is when you should start some of these therapies. I've also heard others suggest that you should really wait until you really need it, and I've heard some say You should, you should knock out this virus as quickly as you possibly connect 1200 T cells go after it. What do you think about that? 

[0:35:21.8]

Bill Ruby:

That is certainly the hot topic in our field right now, when do we initiate anti-retroviral therapy? We don't have all the answers at this point, you can talk to someone in San Francisco who will tell you one thing.

 Someone in Miami will tell you another thing in New York, they'll tell you a third thing. There is no gold standard at this point to say this is when you should start it, however, we are now looking more towards that viral load that we talked about earlier, as an indication to start therapy, in other words, if your viral load is very high, despite what your T-cell count is, it may be the time to start antiretroviral therapy. 

Buck Harris:

If your viral load is very low though, what it means is the virus is hanging out in the lymph nodes. Do these drugs not cross into the lymph nodes and attack the virus when it's replicating there? 

Bill Ruby:

Yes, yeah, it'll attack there. But what you're seeing is peripheral blood, we're measuring in the peripheral blood, what's going on in your T-cells are in your peripheral blood. 

Buck Harris:

Okay, all right, so now we know that... So there's no clear answer on when to attack this virus... 

Bill Ruby:

You got it. 

Buck Harris:

Okay, so we introduce... Now, first of all, before we go on to protease inhibitors, if we're talking about using like AZT and 3TC, how much might someone expect to have to spend for those drugs?

Bill Ruby:

I knew that was gonna come up.

Buck Harris:

On the course of a years treatment...

[0:36:44.6]

Bill Ruby:

I have to tell you, they're very expensive, and what we found is that AZT has actually come down in price from when it originally came out, and you could expect anywhere from $150 to $200 for AZT alone. 

Buck Harris:

A month. 

Bill Ruby:

Per month. 

Buck Harris:

So we're up to $1400 for AZT a year, right? 

Bill Ruby:

Correct. Well, $200 a month. 

Buck Harris:

All right, okay, alright, $200 a month times 12 months. Okay, let's do... 

Buck Harris

So we're talking $6000. Let's talk then about the 3TC. Okay, how much is that actually?

[0:37:21.0] Bill Ruby:

The 3TC is about the same at this point,

[0:37:22.7] Buck Harris:

So $12,000 for just AZT and 3TC. All right, now, let us talk about the protease inhibitors, we're talking real expensive. 

Bill Ruby:

Yeah, the average wholesale price at this point is somewhere around... Close to $500 a month. 

Buck Harris:

A month. Yeah, so your question, I'm sure a major concern you have is when you have a patient is, I want these therapies for this person, how they're gonna handle it, what's gonna... Is insurance covering any of the protease inhibitors... 

[0:37:55.8] Bill Ruby:

Yeah.

 Actually, I have to tell you, I have to say that I do struggle with it. I struggle with when I know that something's available and it's out there and I see the benefit of it, and I want my patient to have it, how can I get them... How can I get best get them... The money to fund them. And it's tough.

 It's very tough. 

[0:38:12.2] Buck Harris:

But if they happen to have insurance.

[0:38:15.2] Bill Ruby:

If they happen to have insurance, actually, what we found is anything that's gone through the FDA, has gained FDA approval. Most insurance companies will pay for that.

0:38:24.9] Buck Harris: 

Otherwise, the Ohio does have a drug program... 

Bill Ruby:

Absolutely one of the best. Yeah, it's really... 

Buck Harris

But does it cover any of the new protease inhibitors yet? 

Bill Ruby:

As a matter of fact. No, not... 

Buck Harris:

Do you suspect it will... 

Bill Ruby:

We actually sit on that committee and we're looking into that, we had a special meeting actually last or two months ago, just to decide whether we were gonna pay for the 3TC, the new reverse transcriptase inhibitor, and we did put that on the formulary. We felt that at this point, Saquinavir, we still needed more data on that before... We wouldn't be able to pay for that. I would venture to guess that we... The issue will come up again and we'll have another meeting on that... 

Buck Harris:

All right so tell me what this protease inhibitor do? 

[0:39:08.9] Bill Ruby:

Well, AZT DDI, DDC, D4T and 3TC, those are the reverse transcriptase inhibitors that most of us are familiar with, they act in a certain area of the virus replication, and they block an enzyme that the virus needs to replicate, the protease inhibitor is somewhat different as far as where it attacks that virus, it's the same principle in that it doesn't allow it to replicate, and it has to do with the DNA molecules, it doesn't allow it to cleave the ends of the DNA molecule.

[0:39:38.0] Buck Harris: Like the scissors, it doesn't... Eleven the molecules attached to... Well.

[0:39:44.6] Bill Ruby:

Exactly, and then it needs to do that in order to be effective a virus.

[0:39:49.5] Buck Harris: 

We need to take one more short break. When we come back, we will be talking on with Dr. William Ruby, our number here is 578-1300. Where are you Cleveland? Call up, tune in, get a free consult with the doctor here, we're gonna be talking about some of the opportunistic infections and treatments they're using today to curb those, to eliminate them and not make them the threat that they once were. Pneumocystis pneumonia used to be the number one killer of people with AIDS, and now it's really a secondary kind of infection. So we'll find out more about that when we come back. Our number here, 578-1300

[0:40:17.2 - 0:41:15.7] Advertisement: 

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[0:42:16.0] Buck Harris:

Okay, we're back and reminder that the show is brought to Glaxo Wellcome, and they are a manufacturer a researcher company that has done a lot in the field of HIV / AIDS. We had a gentleman on our show two weeks ago who claimed that HIV has nothing to do with AIDS, and that it's really a big scam by some of these drug companies like Glaxo Wellcome, and that it's the drugs, the anti-virals, AZT and the... are doing in these people... What would you say to him? 

Bill Ruby:

Now, it's hard for me to comment on that because I've been trained that HIV and everything that I've read and seen that HIV does lead to AIDS.

[0:43:00.0 - 0:43:24.0] Buck Harris:

See that's his criticism, he said, we've had sort of tunnel vision. Since 1984, when they identified this retrovirus, we were so desperately looking for a culprit. They said, aha, we've got it, and boom, then they start to close the book on all other research. So his criticism is pretty on the mark, if you're saying that's all I've ever been told, that's all I've ever believed? What makes you believe that so strongly?

[0:43:29.0]Bill Ruby:

I guess I have to answer that and say that I've never had one of my AIDS patients who's passed away that hasn't been HIV positive...

[0:43:36.8] Buck Harris: Yeah, and people who don't have this virus don't come down with the kinds of conditions that you're seeing and the people that you..

Bill Ruby:

For the most part, that's correct. 

Buck Harris:

One of the diseases that seems to be less... Well, I don't see people with KS much anymore... Not like I did back in the late 80s, and the first part of the 90s, is that a disease that is on the decline? 

Bill Ruby:

Actually, it's a real interesting disease that we're conditioned... 

Buck Harris:

By the way, I shouldn't use acronyms, KS, Kaposi's sarcoma. It's a kind of cancer that runs pretty rapidly through people that they have it with HIV

.

[0:44:12.8] Bill Ruby:

And actually Kaposi's sarcoma. There's been a lot of research in the past year, it's very, very interesting, and what we've now been able to do is to isolate that there's a virus that we linked to those patients who have Kaposi's sarcoma, and so we're finding that it is... If you look at Kaposi's sarcoma in our AIDS population, we don't have any women.

 It's only in men. 

[0:44:30.1] Buck Harris: 

I've seen it one woman, but almost exclusively, not only in men, but almost exclusively in gay men.

Bill Ruby:

In gay men... That's correct. We think that there's probably some sort of a sexual transmission there.

Buck Harris:

And the link to poppers that they thought might have been the case back in the 80s, and there's really no link to drug use... 

Bill Ruby:

Not that I'm aware of. 

Buck Harris:

Why is pneumocystic pneumonia not so threatening as it was five years ago?

[0:45:01.6-0:45:29.5] Bill Ruby:

Well, pneumocystic pneumonia actually was the original AIDS defining diagnosis that was out there. You're right, and we saw a lot of it, and what we started to do at that time was to try to develop some type of prophylactic medications so that we didn't come up with this condition, and since that time, we've actually come up with about four or five first line therapies now for prophylactic medications now that don't allow that virus... I'm sorry, we're trying to decide what to call pneumocystic pneumonia. Is it a parasite, is it a bacteria? We don't know, but we actually... We can actually prevent that. Anyone who was a T-cell count of 200 or below really ought to be on some type of PCP prophylaxis. 

Buck Harris:

All in all now, the major opportunistic infections that seem to create havoc and be the demise of so many people, a lot of those are under wraps. Still, a major problem that confronts people living with HIV and AIDS is the wasting syndrome. What are they doing to combat that? 

Bill Ruby:

Wasting syndrome, actually, first of all, most people think that everyone dies from the wasting syndrome, that every paper patient who has AIDS is going to waste and die. That's not the case. A majority of our population does. There are a lot of theories that are out there as to why the wasting syndrome occurs, but most, I would say the most widely accepted at this point as a condition known as MAC or Microbacterium ABM Complex, which does attack the gastrointestinal system, does not allow our patients to absorb the nutrients that they need. 

Buck Harris:

And generally, a company that it's severe diarrhea and absolutely relentless. Any success in using human growth hormone in treating wasting syndrome?

[0:46:41:1-0:46:50.8] Bill Ruby:

Human growth hormone is still actually in clinical trials at this point.

 We talked about cost of meds, that is the most expensive.

 We're talking thousands and thousands for one shot of this, and we're looking at that right now.

[0:46:56.7] Buck Harris: 

Yeah, so it's not a real viable option for people who are experiencing wasting syndrome. What would you short of these inoculation of human growth hormone, what can they do to try to sustain weight?

[0:47:11.4] Bill Ruby:

Well, one thing I have to say is we have to be real aware of the benefits of proper nutrition early on in the disease, I mean, right, when someone is diagnosed HIV positive, they need to get some type of nutritional counseling at that point, because we now know there have been very good studies that show that the amount... There's a correlation between lean body mass and time to death, and so we need to keep that lean body mass, and there are many ways that we can do that. First of all, we were talking about MAC disease, and we now have prophylactic medications. There are two, one just got licensed last month.

Buck Harris:

That seems encouraging.

[0:47:43:1 - 0:48:29.3] Bill Ruby:

For the prevention of MAC disease. So anyone who has a T-cell count of 75 or below really needs to be on some type of MAC-prophylaxis. If we do see the disease of wasting syndrome, which by the way is to find a 10% loss of body weight from a baseline, it's not that much. Only 10%. There are things that we can do, one of them is testosterone shots. For some reason, we found in gay males who have HIV in the wasting syndrome, they're what we refer to as hypogonadism, their testosterone levels are low.

 And because of that, we started looking at ways of treating that and we were using intramuscular injections of testosterone, and we found that that really did work, it did help to maintain lean body mass.

 And so what we did is we went one step further and we had estrogen patches for females... Well, we came out with testosterone patches for males now. 

Buck Harris:

I was talking with a man at the last healing weekend that I was at, and he was on those, but what he also was... I got some good news. He also had some real good news, his sexual drive and desire just went off the charts, and he said that he really had a very, very strong urge to be sexual.

[0:48:55.3] Bill Ruby:

We find that... And we also find that a lot of times depression is lifted

. And we replace those low testosterone levels. 

[0:48:59.7] Buck Harris:

What do you... Speaking of sex, what do you say to couples where both partners are HIV positive in regards to safety practices?

Bill Ruby:

One of the things we really need to educate and let them know is that there are literally thousands of strains of HIV virus that are out there, and so is it okay to have sex unprotected and the answer... My answer to that is no, that even though each one of you are HIV positive, your strain, it may be entirely phenotypically and genotypically very different than your partner's. Your partner's may be very virile, very active and could cause your demise.

Buck Harris:

Not to mention the other pathogens that they might have, MAC, all that stuff. 

Bill Ruby:

That's correct, yeah. 

Buck Harris:

One of the things I wanna get to before we close the show, 'cause the time has flown. And as a young man working in this field who was a member of the community, how do you deal with the... It's really sort of a bombardment... An overload of loss. You've worked in this field for six years now, and how many people have you lost...

[0:50:12.3] Bill Ruby:

I was actually looking at that and I can say about 30 patients per year. Actively in the last three years, it's been about probably about 90 patients, and it's very tough when you become very intimately involved in their healthcare to walk through that with them, but I have to say that it can also be very rewarding to be able to be there with someone the entire way through.

[0:50:36.6] Buck Harris: 

How do you deal with all that grief then?

[0:50:38.8] Bill Ruby:

It was tough, I had to learn... Actually, I give the same advice to myself that I give patients, and that is, I gotta take care of myself, that includes diet, exercise, what's very important, and I tend to do a lot of humor things...

I like to have fun with it. 

[0:50:51.6] Buck Harris: 

How about crying? What do you do with your tears?

[0:50:55.5] Bill Ruby:

There's a time for that, and I don't normally do that in front of a patient or family, I'm seen as the person who needs to be strong at that point when I go home and they come out...

[0:51:06.0] Buck Harris: 

Right, yeah. Let's talk with Penny from line one. How are you doing?

[0:51:09.6] Penny: 

Good evening Buck. I have a question for that, I actually just wanna comment from him... What is your comment on the recent bone marrow transplant, baboon bone marrow transplant that's been in the news?"

Buck Harris: 

Mr. Getty in San Francisco. 

Bill Ruby:

Well, actually, I knew that was gonna come up here, and I have to be honest and say, I haven't been keeping up so much with what's going on, it was certainly a novel idea. It certainly could lead to some very good research that's out there. I can say at this point that from what I've read, there hasn't been any increase in his immune status.

[0:51:42.8] Buck Harris: 

It's interesting though, he himself claimed the by and large, he's feeling much better and much more is... I think the most interesting thing is he hasn't had an asthma attack, since the baboonn transplant. Asthma is something that has plagued him for much of his adult life, so I don't know what was in that baboon bone marrow, but he's doing better on other counts, but... Right, there's no seeming improvement in CD4 counts.

[0:52:05.2] Bill Ruby:

But I do have to say in response to that, with a lot of the cooperative therapies that are out there and the new or things out there, we certainly drive a psychological benefit from all of these...

[0:52:13.9] Buck Harris: 

Sure, the old adage, If you think it's gonna work, I probably will have some benefit... 

Bill Ruby:

Absolutely. 

Buck Harris:

For those, Michael Callen, we're gonna be listening to a song by him very shortly, and you may know he was one of the long-term survivors, he lived with full-blown AIDS for almost a decade, and he died last December... A year ago, December, and he was a strong advocate and lectured to many people living with HIV and AIDS, don't take any of these drugs. How do you help people arrive at the dedication about whether to consider taking these new therapies, the combination therapies. And now with the protease inhibitors, how do you help people make that decision?

[0:52:51.0] Bill Ruby:

As a physician, what I really feel an obligation to do is to give them the pros and cons of taking each medication, whether it's a prophylactic medication or an anti-viral, and I'm very up front, very honest and say that you will have side effects... There is a good possibility that you may have side effects to this medication.

[0:53:06.5] Buck Harris: 

About 30% of people have side effects... 

Bill Ruby

That's correct. 

Buck Harris:

Ranging from what to what, what's a mild side effect?

Bill Ruby:

Headache, nausea, muscle aches and pains, 

Buck Harris:

And for many people that will pass...

[0:53:18.0] Bill Ruby:

That's correct, about 50% of the population. If they do have some type of a side effect, that will go away within about two to four weeks...

[0:53:25.3] Buck Harris: 

Okay, and severe ones can be anemia, just a lot of gastrointestinal problems as a result of...

Bill Ruby:

That's correct, yeah. 

Buck Harris:

But to try it out, wear it out, then go through it and see.

[0:53:38.4] Bill Ruby:

I normally tell patients too, this is what I know about this treatment, and what I need to tell you is, "Don't you feel you deserve a try on this... This may work for you.

"

[0:53:49.9] Buck: 

What are you gonna do when the headline reads "AIDS Cure Found" and they find some way... Actually, we need to wrap up...

End of Side A