Category Archives: hiv

Thankyou San Francisco

podcastThis city was once called the “Paris of the West” for its corruption and wildness but I am proud of the recent past and current history that San Francisco brings to the HIV/AIDS community and doing much in these issues to write the rules. And let’s not forget San Francisco is the birthplace of our NABWMT.

Today an HIV infected person can go to a San Francisco clinic, get tested quickly, see a doctor, get 5 pills and a prescription and, if needed, file for public health insurance. This program is called Rapid and is a great success.

Thank you San Francisco

Thank you San Francisco

Some 40 years ago I emigrated from England to the Bay Area of California and witnessed the “Free Love” and “Peace” movements and the rise of San Francisco as a gay city. I was in awe at the excitement, freedom and vibrance of the area to which I owe much.

This city was once called the “Paris of the West” for its corruption and wildness but I am proud of the recent past and current history that San Francisco brings to the HIV/AIDS community and doing much in these issues to write the rules. And let’s not forget San Francisco is the birthplace of our NABWMT.

Today an HIV infected person can go to a San Francisco clinic, get tested quickly, see a doctor, get 5 pills and a prescription and, if needed, file for public health insurance. This program is called Rapid and is a great success.

The city, once the HIV epicenter has turned the tide on this dreaded epidemic like no other. Infection has plummeted and the World Health Organization has used their programs as models. So patients are encouraged to be treated with antivirals as soon as possible. Some data:1992 had 2,332 infected now it is 302. The same trend is with deaths, 1641 down to 177 (and the latter includes deaths due to natural causes).

Why is the city so successful? Factors include: wealth from the tech companies, politics, doctors with history of HIV, and a large LGBT population. San Francisco has made up for losses in federal and state funding for HIV.

San Francisco has always, for good forbad, always gone first in pilot programs and clinical trials. In 1987 it opened the first HIV hospital ward, followed by the first use of AZT anti retroviral drug and clean needle distribution.

And the latest thrust tis he PrEP (pre-exposure prophylaxis) drug program with Truvada. At once the heralded (the FDA approved) and vilified program, since it has been shown to prevent infection in HIV naive persons but evoked criticism of its use as inviting casual sex. Some gay men called others “Truvada Whores” for avoiding condoms. But San Francisco clinics, doctors and officials don’t apply blame or shame to patients.

Which brings me to the Bay Area communities at the margins. The city now is mostly well educated whites and asians as apposed to black and brown, the latter group has left because of high rent. The former group is more likely to be aware of can afford to be treated. Still, the lessons learned in the city can be applied to the nation where 63% of HIV infected people are black or brown.

The main rest of this great commitment is the loss of fear of this, one time, “dreaded” disease. In the ‘90s it crippled the gay population but now young LGBT and straight people are without fear. Let us learn lesson from this as our NABWMT brothers did and now are able to tell the tale.

Please visit us on nabwmt.org, Facebook and Twitter.

Transgender Health Discrimination

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This is an abstract of a recently published article[*] by the St. John’s Well Child and Family Center of South Los Angeles. Direct quotes are shown as italics.

The Well Child and Family Center is a pioneer in serving and hiring transgender people. This article was made available during a BWMTSC [†]chapter meeting.

During this moment in time heralded as the transgender1 tipping point, discussion about transgender people is entering mainstream discourse, now more than ever. Despite the surge in media attention regarding the transgender community and growing acceptance of transgender identities, systemic and societal barriers remain, such as lack of access to health insurance, stigma, lack of sensitivity and cultural competency, that contribute to persistent, unmet health needs for transgender individuals.

The local speaker gave an overview of the difficulties she had as a trans women which mirrored many of the studies concern. As gay men our group was faintly aware of the difficulties of these people but was brought into focus more. This is of importance since people of color are in the majority in this cadre and have HIV issues too.

According to the Centers for Disease Control, transgender women have HIV prevalence rates 25 times higher than the general population.

What was not as well known by our group transgender individuals have higher rates of transient housing, lower rates of education, have difficulty finding steady employment. Some transgender people have to resort to sex work. The incarceration rate of transgender individuals is much higher than the general population, with 42% of transgender women of color reporting previous incarceration.

1 For purposes of the article, the word ‘transgender’ reflects the mission of inclusivity, non-judgment and affirmation of multiple transgender identities and includes but is not limited to the following identities: transgender, two-spirit, genderqueer, genderfluid, non-binary, agender, third gender, bigender, transfeminine, transwoman, transfemale, transmasculine, transman, transmale, masculine of center, gender non-conforming, gender questioning, et cetera. The University of California, Riverside recently hosted the First Asterisk Trans* Conference; February 27-28, 2015, where organizers provided their definition of a term now appearing Trans*, “Trans* affirms all people who transcend gender norms” (http://asteriskconference.blogspot.com/p/faq.html). St. John’s Transgender Health Program utilizes the term trans* in order to reflect our mission of inclusivity, non-judgment and affirmation of multiple transgender identities

What needs to be done?

Transgender people need acceptance, respect and preservation of dignity, Often patients cannot or dare not speak freely about their experience, health concerns and health-related behaviors without fear of inciting barriers to obtaining the transgender-related health care services they need. We need more providers to address this.

We need to remove the delay in approval for and receipt of transgender-specific care among patients who are insured through Medi-Cal managed care health plans.

They have failed to take a supportive stance on the delivery of time-sensitive and medically necessary care that they are obligated to provide to their transgender identified beneficiaries.

The California Department of Health Care Services requires them to cover gender surgery and hormone therapy. Likewise, insurance plans should add hormone therapy to a list of “life-

time approved” medications. However, the phrasing has allowed health plans to decide that a transgender person’s gender-affirming surgery may be considered “cosmetic” rather than “medically necessary,” and thus, would not be covered by insurance. Because gender-affirming surgeries for transgender patients are medically necessary and not “cosmetic in nature,” this language creates barriers to access to care and must be clarified. Gender identity should be protected from discrimination into the non-discriminatory hiring and employment.

Finally, a strong facilitation of legal name and gender change processes should be started. Too often when a transgender person changes name on forms and identity cards it very difficult for them to do so.

Legal name and gender change can increase an individuals’ comfort with accessing healthcare and employment as fears of discrimination, being called by the wrong name, and being confronted about gender identity are assuaged.

The National Association of Black and White Men has a proud record of supporting people at the margins and this should include the transgender community.

Note: St. John’s officially launched THP in January 2013 with 9 patients. Within 15 months, the program has close to 500 patients accessing care on a regular basis. Demand has been so high that St. John’s must expand its THP to additional days and health center site.

[*] http://www.wellchild.org/sjwcfcfinalthpwhitepaper.pdf

[†] http://bwmtsc.org

New HIV Vaccine

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A new compound has blocked H.I.V. infection so well in monkeys that it may be able to function as a vaccine against AIDS, the scientists who designed it reported Wednesday.

H.I.V. has defied more than 30 years of conventional efforts to fashion a vaccine. The new method stimulates muscle cells to produce proteins that somewhat resemble normal antibodies, which have Y-shaped heads. These proteins have both a head and a tail, and they use them to simultaneously block two sites on each “spike” that the virus uses to attach itself to a cell.

If both sites can be blocked on every spike, the virus becomes helpless and drifts off unattached into eventual oblivion by the immune system.

Source: New York Times

HIV Death Rates for African Americans Down

According to the LA Times, death rates of African Americans living with HIV dropped 28% between 2008 and 2012, according to a new report from the Centers for Disease Control and Prevention.

Still, black people with HIV were 1.5 times more likely to die in 2012 than white people with the virus. They were also 3.2 times more likely to die that year than Latinos with HIV, according to the published this week in the CDC’s Morbidity and Mortality Weekly Report.

Black people in America have been hit disproportionately hard by HIV, the virus that causes AIDS.

Although African Americans make up approximately 12% of the U.S. population, they account for 44% of new HIV infections. They also account for 43% of all Americans living with HIV and 48% of all deaths of people who had contracted the disease, the CDC says.

The reduction in mortality rates in the last few years may be the result of various projects that encourage black people to get tested and, if the test is positive, to receive long-term medical care, according to the study authors, from the CDC’s Division of HIV/AIDS Prevention.

Fifteen percent of African Americans with HIV in 2011 were unaware that they were infected, compared with 12% of whites. At the same time, 23% of black people with HIV were not getting treatment for the virus. That proportion was higher than for any other racial or ethnic group.

Source: http://www.latimes.com/science/space/la-sci-sn-hiv-bridge-20150129-story.html

Copyright © 2015, Los Angeles Times

HIV Weakening?

LATEST STUDY SHOWS EVOLUTION SLOWING

A number of our memnbers are HIV positive and, thankfully, are able to resist the scourges of this virus using the “cocktail” of drugs.  They have been able to live a “normal” life and our Association has educated our members at our National Conventions on these issues.

The virus can replicate in new forms to resist these drugs, but that may be weakening according to a recent study. Apparently, in the presence of these drugs the virus evolution slows down due to continual pressure on the “escape mutants”.

The researchers compared data from Botswana and South Africa. Studies showed that viral replication capacity decreased during the same time span.

Researchers wanted to know whether the same effect could be seen in a comparison of epidemiological data between Botswana and South Africa. Researchers tested the effects of antiretroviral therapy on the virus. They created a mathematical model that showed this treatment slightly accelerates the evolution of HIV variants with a lower replication capacity.

There is still caution that these ideas perhaps only adress a relatively narrow set of gene variants that affect AIDS progression. Nonetheless, they may allow scientists to reduce the destructive power of HIV over time.

Sources: Los Angeles Times and  Proceedings of the National Academy of Sciences.

Elton John: Marriage Equality: Great, AIDS/HIV status: Not So!

Elton John* reminds us we need to congratulate the victory in 35 states, now with Marriage Equality, but we are losing ground on the AIDS/HIV fight here and abroad

By a combination of stories of happy, productive  LGBT couples and children of same, activists have propelled gay marriage into succes in 35 states in the US. However, gay activists, human rights champions and social justice advocates need to once again address the spiraling AIDS crisis.

A recent Kaiser Foundation poll shows one in eight gay men is H.I.V.-positive, but most gay and bisexual men say they are “not concerned” about H.I.V. One third of the men even knew that H.I.V. infections were increasing in the United States. 30% said they had never been tested. Only a quarter had ever even heard of the use of the drug Truvada to prevent HIV infection. We as group have not kept up on HIV education. AIDS is among the leading causes of death for African-American men. In addition, this happens because of**:

  • Pervasive stigma and discrimination with reluctance for HIV testing, prevention and treatment;
  • Lack of state prevention funding accompanied by the lack of comprehensive and highly visible prevention efforts;
  • Lack of tranportation options;
  • Limited mental health and substance abuse treatment options;
  • Lack of affordable housing.

Finally our African brothers are still suffering***,  70% of all people living with HIV, (24.7 million), live in sub-Saharan Africa—including  91% of the world’s HIV-positive children. 73% of the world’s AIDS deaths in 2013 occured in the same area.

Until we redouble our efforts to end H.I.V., then and only then will we truly have won freedom and equality.

*Source: Elton John on the Unfinished Fight Against AIDS NYT: OCT. 27, 2014
** Source: http://southernaidsstrategy.org/research/