“Surviving Irma” was the topic for discussion at the Pozitive Attitudes weekly HIV support group at the World AIDS Museum (WAM) recently. A group of 20 or so men infected, or affected, by HIV—mostly middle aged—sat in the museum’s sleek, open gallery space and regaled tales of South Florida’s latest hurricane with a mixture of sadness, frustration, and humor—a permutation of perspective perhaps cultivated over decades of surviving a Plague.

The members of this group survived Irma relatively unscathed. That’s fortunate, as the tragic deaths at a Hollywood nursing home illustrated the potentially disastrous effects of a natural disaster on health care and human services.

WAM’s CEO Hugh Beswick pointed out the role that the intersection of identity—age, race, socio-economic status, and “the haves and the have nots”—naturally plays a role in these outcomes. Not everyone has the privilege of picking up and fleeing to a safe location. While the museum closed its doors for most of the week, one employee of the non-profit WAM slept on the floor of the museum’s back office to avoid the heat in his apartment which lost power.

And just weeks ago, Hurricane Harvey shuttered the AIDS Foundation Houston (AHF), as reported by poz.com. In response to both storms, over one million dollars have been donated to fund regional HIV organizations throughout Florida and Texas, according to AIDS United. The pharmaceutical company Gilead donated $1 million, while AIDS United appropriated $150,000 from the Southern HIV Impact Fund to provide relief. AHF is also asking for donations to help displaced clientele.

AIDS United CEO Jesse Milan Jr. said, “There is no greater emergency than the devastation of these powerful hurricanes.” Moreover, Center for Disease Control statistics rate Florida as number one and Texas as number three in new HIV infections, making the South the epicenter of the U.S. epidemic, and continuity of care all the more crucial.

Back at the World AIDS Museum in Wilton Manors, Pozitive Attitudes’ intimate circle discussion was framed by the museum’s large floor-to-ceiling windows and sliding exhibit walls chronologically outlining the history of HIV/AIDS.

Compliance was a common theme in the conversation. Given power outages and evacuations which disrupted routines, a few participants reported missing doses of their life-saving anti-retroviral medication. Two members missed doses while driving long hours over night. Another—a Millennial, more recently-infected—twice forgot his one-pill-once-a-day treatment while taking refuge across the country. It’s not likely that just a couple missed doses would result in the serious consequences of resistance, but one never knows.

HIV treatment experts always stress compliance (regular adherence to prescribed medication) as essential to management of the virus. In 2017, there are certainly more available therapies than there used to be. That’s comforting, but different drug combinations can have more severe side effects and, still, there are only three lines of defense if resistance to first line treatment develops. That’s one reason, the Texas Department of State Health Services (DSHS) website published a helpful page on natural disaster preparation for people who are HIV positive including maintaining an extended supply of medication in waterproof containers.

While navigating HIV in the waters of a hurricane and a politicized, profit-driven health care system can be frustrating, the consensus of the Pozitive Attitudes group was that there is much to be grateful for. And a worldwide view adds further perspective. While a 2010 study shows drug resistance at 7 percent in the United States, that number is more like 20 percent in developing countries where pharmacies often run out of drugs, as reported by Huffington Post. As global climate change progresses, the increased risk of natural disasters disrupting health care only grows.

Positive Attitudes meets every Wednesday from 7 p.m. - 9 p.m. with one hour on a focused topic or presenter and one hour of open discussion, in the World AIDS Museum at the corner of Wilton Station, 1201 NE 26th St.