Orange Caps

by Miles Hamlin

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ABOUT THE AUTHOR

Orange Caps was written by an HIV positive man. Miles Hamlin is a pseudonym.

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ORANGE CAPS

Read by Anonymous

In the midst of San Francisco’s cold, foggy streets,

Dampness chilling me to the bone,

I walk in darkness all alone.

Chemicals pushing through my veins,

Wandering streets without aim.

From the Wharf to Union Square and back again

I ponder life’s answerless questions.

Do syringes have orange caps for a reason?

Is it so nurses don’t lose track of them?

Perhaps they are like a neon sign, flashing;

A warning to junkies everywhere.

People talk about that amazing feeling they had

That first time they got high,

And rarely speak of every other time

When the high was just not quite enough.

Walking in the dark,

Thoughts intensely focused,

Feet moving too fast,

Blood pumping too hard,

Eyes open too wide,

Every little sound magnified

and I wonder…..

How high am I?

Am I even high at all?

I cannot decide.

Is there a graveyard somewhere

For all these used syringes with orange caps?

Or do they get burned with the bodies of the junkies

That came and went long before me?

Orange Caps -

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THEMES

HIV and Injection Drug Use

Drug use is sometimes experienced comorbid with HIV. This is for the ability to acquire HIV from an infected needle, but also for reasons such as the influence of drugs impeding on the ability to make decisions such as using a condom to protect against HIV. Furthermore, being afflicted with addiction may make an individual more likely to be put in greater HIV risk situations such as engaging in transactional sex in exchange for drugs [1]. A study of new HIV cases in 2015 reveals that injection drug users account for 6% of new HIV cases by themselves, with an added 3% being injection drug users and men who have sex with men (MSM) [2]. The comorbidity of drug addiction and HIV adds extra complications to treatment because drug abuse can compound the physical effects of HIV such as neuronal injury and cognitive impairment [1].

[1] National Institute on Drug Abuse, “HIV/AIDS and Drug Abuse: Intertwined Epidemics,” May 2012.

https://www.drugabuse.gov/publications/drugfacts/hivaids-drug-abuse-intertwined-epidemics

[2] CDC, “HIV and Injection Drug Use,” November, 2016

http://www.cdc.gov/hiv/pdf/risk/cdc-hiv-idu-fact-sheet.pdf

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ABOUT THE PERFORMER

This piece was performed by an anonymous artist who identifies as a transmasculine spoken word artist and is a Duke junior. This artist chose to remain anonymous, which points to the significant stigma that exists for transgender people globally, but with special heightened stigma in the context of living as a transgender person in post-HB2 North Carolina (as this person does while they are completing their studies at Duke). Though this performer is not HIV+, the stigma against transgender people relates to the stigma against HIV+ people given that transgender people are disproportionately vulnerable to HIV, especially black, low income trans people (which this performer is).

This poses significant challenges to these individuals seeking health care, especially given that one survey revealed that 19% of trans people in the study reported being refused medical care due to their transgender status, with even higher numbers among people of color in the survey. Additionally, trans people are more likely to be targets of violence in all categories, with special vulnerability to sexual violence, and given how transness is fetishized in the media/pornography (“shemale” porn and sex tourism to see the “ladyboys” Thailand remain popular) as well as the significant financial challenges posed by workplace/hiring discrimination against trans people (which is legal in many U.S. states) and the financial burdens of transition related costs, many trans people must rely on sex work to survive. 1 in 2 trans people experience sexual assault in their lifetime, and 10.8% of trans people engage in sex work at some point in their lives.

Given these unique vulnerabilities to sexual violence and to becoming involved in sex work, as well as the stigma against transgender people and disrespect towards both transgender people and sex workers (limiting the social capital of transgender sex workers to negotiate condom usage), stigma against transgender people is inherently related to anti-HIV stigma. Murders and violence against transgender people continues to grow in the United States and globally, making HIV+ transgender people as a uniquely vulnerable population that is an example of the continuation of the stigma, hate, ignorance, and violence seen in the early years of the HIV epidemic (and today) into the modern day.

Sources and additional readings: