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Lebanon plans LGBT sexual health week

Hurdles remain for equality in Middle East country

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LGBT sexual health week, gay news, Los Angeles Blade

Although Lebanon is one the most progressive countries in the Middle East regarding LGBT issues, Article 534 of the Penal Code prohibits sexual relations that are ‘contradicting the laws of nature.’ (Photo by Bertil Videt; courtesy Wikimedia Commons)

Lebanon is hosting its first-ever LGBT sexual health week and will focus on the marginalization of the community, Gay Star News, a U.K. outlet, reports.

The Lebanese Medical Association for Sexual Health (LebMASH) will run the health week, which will focus on how the marginalization of the LGBTI community affects mental health.

In a series of videos the health campaign tackles the myriad of issues LGBT people face living in Lebanon.

One of the videos features Dr. Fadi (no first name given), a sexual health specialist.

“As a doctor, my mission includes raising awareness and not just treatment. But I’m unable to fulfill my duties when it comes to the sexual health of (LGBT) people and this worries me,” he said in the video.

Fadi explained a lot of LGBT people avoid going to doctors for fear of mistreatment and discrimination.

Although Lebanon is one the most progressive countries in the Middle East regarding LGBT issues, it is still taboo. Article 534 of the Lebanese Penal Code prohibits having sexual relations that are “contradicting the laws of nature.”

But in January, Lebanon came one step closer to decriminalizing homosexuality. A judge ruled that, “homosexuality is a personal choice, not a punishable offense.”

The ruling referenced Article 183: ‘An act undertaken in exercise of a right without abuse shall not be regarded as an offense.’

Which means if you’re exercising your freedoms and not hurting anyone, there’s no crime, Gay Star News reports.

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Recovery

Shining a light on the meth epidemic in the LGBTQ community

Breathe Life Healing Center is set to host the ChemSex Crisis Summit on March 14-15 in West Hollywood, California

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Brad Lamm is an author, teacher and interventionist best known for helping people make life-enhancing change. In 2012, Brad realized a dream come true as he opened the first Breathe Life Healing Center to provide powerful residential, insurance-friendly trauma treatment in urban environments. (Photo courtesy of Breathe Life Healing Center)

WEST HOLLYWOOD, Calif. — The silent epidemic of methamphetamine addiction in the LGBTQ+ community has reached a breaking point, leaving countless lives shattered in its wake. In response to this growing crisis, Breathe Life Healing Center is set to host the ChemSex Crisis Summit on March 14-15 in West Hollywood.

The event aims to bring together professionals to confront uncomfortable truths about addiction and exploitation, and to develop effective strategies for prevention, treatment and recovery.

The stories of those impacted by meth addiction paint a harrowing picture of the depths of this crisis:

Dr. J, a once-prominent epidemiologist, found himself on the wrong side of the statistics he knew so well. 

“I knew the data inside and out — I just never thought I’d become one of those grim statistics myself,” he recounts ruefully.

His journey from a rising star in the world of public health to a homeless addict on the streets of LA is a testament to the insidious power of meth addiction. After earning his PhD and advising on policies at a prestigious government agency, Dr. J’s groundbreaking insights into the LGBTQ community’s health disparities propelled him to a renowned university to lead cutting-edge research initiatives. With a generous salary and a beautiful home in the Hollywood Hills, Dr. J felt like he had it all.

But beneath the veneer of success, he was struggling with his own demons. “At first, meth was just a way to let loose and have fun,” he admits. “But then it became a way to cope with stress, a way to make sex hotter, a way to make myself feel more confident.”

As his addiction spiraled out of control, Dr. J found himself slipping further and further away from the life he had built. Within two years, he had lost everything: His job, his home, his relationships. He found himself living under an overpass, his once-brilliant mind consumed by the never-ending cycle of addiction.

It was only when he hit rock bottom, facing the grim reality that more than 1,900 people died from meth in LA in 2021 alone, that Dr. J found the strength to seek help. Medically-assisted treatment and LGBTQ+-affirmative rehab became his lifeline, helping him to slowly rebuild his shattered life.

Filling the emptiness 

Peter’s story is a cautionary tale of privilege and addiction. 

Born into wealth, his trust fund enabled a bohemian lifestyle that quickly descended into meth addiction. “I became idle and depressed,” he recalls. “That’s when meth lit me up like never before.” His recreational usage quickly spiraled out of control, leading him to burn through his allowance and pawn valuables to feed his habit.

“I sold a Warhol for a fraction of its value and it’s now worth many times more than it was then,” he laments, shaking his head at the memory. It was only through the intervention of friends who urged his family to cut him off financially and force him to return home, that Peter was able to break free from the grip of addiction.

“Those first sober years were just brutal,” he admits. “I resented everyone and everything. I was HIV-positive in a tiny, conservative rural town and my health was in the gutter.” 

Slowly, with the support of his loved ones, Peter began to reassemble the pieces of his life. He found solace in caring for his aging mother and threw himself into his recovery with the same intensity he once devoted to chasing his next high.

Today, 20 years sober, Peter is grateful for the second chance he’s been given. “I still think about meth sometimes, and the life I had in Hollywood,” he confesses. “But I know I’d be dead without the people who saved me.”

Trafficked

Perhaps most chilling is the story of Carlos, a young Colombian man who found himself trapped in a nightmarish cycle of exploitation and addiction after being lured to the U.S. with the promise of a better life. Upon arrival, he was taken to a lavish house party that quickly revealed itself to be a facade for a dark world of abuse.

“The gringos that arrived later were wealthy looking people and I was told some of them were politicians, businessmen, married men with families,” he recounts with a shudder. Behind their masks of respectability, these men had paid the house and the young men were on the menu.

Drugged with meth and then exploited by powerful men, Carlos found himself trapped in a vicious cycle of addiction and sexual slavery. Even after a daring escape, fleeing into the unfamiliar streets wearing nothing but torn underwear, he found himself pulled back into the clutches of the trafficking ring, his hopes for a better life shattered.

It was only when a stroke nearly claimed his life that he found the courage to seek help, but even then, the path to recovery was fraught with obstacles. As an undocumented immigrant, Carlos faced countless barriers to accessing the support and treatment he so desperately needed. 

Fear of deportation and a lack of information about resources available to trafficking victims kept him silent, even as he struggled with the trauma of his experiences and the grip of addiction.

“I’m pretty sure the LGBTQ community isn’t aware of the grip the sex-trafficking network has on people like me,” Carlos says, his voice heavy with emotion. “I’m also sad about that because I know for sure concern is silenced and that people just look the other way. I guess it’s too messy to care about, but people are dying and being addicted and their lives ruined. Some people are even disappeared.”

Even when Carlos finally found the courage to seek help, he discovered that the path to justice was far from equal. As an undocumented immigrant, he faced countless barriers to accessing the legal protections and support services that could have helped him break free from the trafficking ring and rebuild his life.

Feeling hopeless and alone, Carlos made the difficult decision to return to Colombia, but even there, the shadow of the trafficking network loomed large, threatening him and his family. Today, he continues to grapple with the trauma of his experiences and the grip of addiction, a stark reminder of the urgent need for better protections and support for trafficking victims, regardless of their immigration status.

Examining the truth

These stories are just a few examples of the countless lives impacted by the meth crisis in the LGBTQ community. The ChemSex Crisis Summit aims to bring attention to this silent epidemic and work towards developing effective strategies for prevention, treatment and recovery.

“The ChemSex crisis is a complex issue that requires a multi-faceted approach,” says Brad Lamm, founder of Breathe Life Healing Centers and co-author of “Crystal Clear + Sexually Recovered” with Kathleen Murphy, executive clinical director of Breathe Life Healing Centers. “As these stories illustrate, meth addiction affects the entire LGBTQ spectrum, from the privileged to the marginalized. It’s one of the most urgent issues our community faces, and we must address it on every level — from the biological to the psychological to the societal.”

Murphy agrees. “We must address not only the biochemical effects of meth addiction but also the underlying traumas and social factors that contribute to it,” she explains. “Underlying childhood wounds from families and cultural institutions, from internalized homophobia — these are the roots that have to be healed.”

Melissa McCracken, a leading expert on substance abuse in the LGBTQ community, notes that many ChemSex users turn to substances, specifically meth, as a means to overcome fear and shame and to “hot wire” intimacy and connection. 

“Queer sex education is lacking, and many folks do not learn courtship or intimacy skills in their formative years, resorting to drugs to engage with others,” she explains. “Meth also eradicates emotional consciousness, so the allure of a shame-free sexual experience is very enticing to many users who may not have the means or resources to seek out professional help to resolve shame, trauma, or internalized homophobia.”

McCracken also warns that the meth of today is not the same as it was 10-20 years ago, before the rise of cartel-produced “P2P meth.” “Not only is it more potent, but it is also manufactured differently, using different chemicals,” she explains. “The adverse effects of meth are more prevalent in P2P meth users, with upwards of 90 percent of those seeking treatment reporting psychosis, paranoia, anhedonia, isolation and ongoing mental health issues well into recovery.”

“We are seeing the effects of P2P meth in treatment that resembles long-term chronic use in folks who use the drug one or two times a month.”

The summit will feature a range of speakers and panel discussions, covering topics such as the role of trauma in substance abuse, best practices for LGBTQ-affirmative treatment, and strategies for supporting long-term recovery. Attendees will learn from leading experts in the field and connect with others working to address the crisis in their own communities.

But the work does not end with the summit. Organizers hope that the event will serve as a catalyst for ongoing action and advocacy, both within the LGBTQ+ community and beyond.

“We must come together as a community to demand change and to support those who have been marginalized and left behind,” says Murphy. “It is only by confronting the uncomfortable truths about addiction, exploitation, and inequality that we can begin to create a society where everyone has the opportunity to heal and thrive.”

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AIDS and HIV

Gilead Sciences awards grants to HIV/AIDS groups in Caribbean, Latin America

Stigma, criminalization laws among barriers to fighting pandemic in region

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Free condoms in a São Paulo Metro station. Gilead Sciences has announced it has given grants to 35 organizations in Latin America and the Caribbean. The groups will use the funds to fight HIV/AIDS in the region. (Washington Blade photo by Michael K. Lavers)

FOSTER CITY, Calif. — Gilead Sciences this week announced it has given $4 million in grants to 35 organizations in Latin America and the Caribbean that fight HIV/AIDS.

A press release notes Asociación Panamericana de Mercadeo Social (Pan-American Association of Social Marketing) in Nicaragua, Fundación Genesis (Genesis Foundation) in Panama, Fundación por una Sociedad Empoderada (Foundation for an Empowered Society) in Argentina, Associação Nacional de Travestis e Transexuais (National Association of Travestis and Transsexuals) in Brazil and Caribbean Vulnerable Communities are among the groups that received grants. Gilead notes this funding through its Zeroing In: Ending the HIV Epidemic in Latin America and the Caribbean will “improve access to care, increase health equity and reduce HIV-related stigma for populations most affected by HIV.”

“The HIV prevention and care needs of people throughout Latin America and the Caribbean are incredibly diverse, and each of these programs addresses a unique community challenge,” said Gilead Vice President of Corporate Giving Carmen Villar. “Our grantees are deeply embedded in their communities and best positioned to provide needed HIV care and support services.” 

“Their expertise will be essential to achieve the Zeroing In program’s goals of improving access to comprehensive care among priority populations, decreasing HIV-related stigma and reducing HIV and broader health inequities,” she added.

The pandemic disproportionately affects Transgender people and sex workers, among other groups, in the region. Activists and HIV/AIDS service providers in the region with whom the Washington Blade has previously spoken say discrimination, stigma, poverty, a lack of access to health care and criminalization laws are among the myriad challenges they face.

First Lady Jill Biden in 2022 during a trip to Panama announced the U.S. will provide an additional $80.9 million in the fight against HIV/AIDS in Latin America through the President’s Emergency Plan for AIDS Relief. 

Cuba in 2015 became the first country in the world to eliminate mother-to-child transmission of HIV. The Cuban government until 1993 forcibly quarantined people with HIV/AIDS in state-run sanitaria.

Antigua and Barbuda, St. Kitts and Nevis, Barbados and Trinidad and Tobago in recent years have decriminalized consensual same-sex sexual relations. 

The Inter-American Commission on Human Rights in 2021 ruled Jamaica must repeal its colonial-era sodomy law. The country’s Supreme Court last year ruled against a gay man who challenged it.  

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Human health studies & sciences

Genetic variations linked to human bisexual behavior

Behavior, risk-taking, & offspring numbers uncovered in a study from Professor Jianzhi ‘George’ Zhang at the University of Michigan

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Los Angeles Blade graphic

ANN ARBOR, Mich. – In a groundbreaking study published Wednesday in Science Advances, scientists have identified genetic variations associated with human bisexual behavior for the first time.

Led by Professor Jianzhi “George” Zhang at the University of Michigan, the research delves into the intricate relationship between genetics, behavior, and societal factors, shedding light on the long-standing evolutionary puzzle of why natural selection has not eradicated the genetics underpinning same-sex attraction.

The study, based on data from more than 450,000 people of European descent who participated in the UK Biobank, a long-term genomics project, builds on growing research, including a seminal 2019 paper in Science that found genetic variants influencing same-sex behavior, with environmental factors playing a significant role.

Professor Jianzhi George Zhang, Zhang Lab of Molecular & Genome Evolution at the University of Michigan. (Photo Credit: University of Michigan media affairs)

Zhang explained that the motivation for the new research was to differentiate between various forms of homosexual behavior, recognizing that there is a spectrum. “In the past, people lumped together all homosexual behavior…but actually, there’s a spectrum,” he said.

Analyzing participants’ complete sets of DNA and combining that information with survey responses, Zhang and co-author Siliang Song confirmed that the signatures associated with same-sex behavior and bisexual behavior were distinct. This allowed them to analyze these behaviors separately, leading to intriguing discoveries.

Male heterosexuals carrying markers associated with bisexual behavior (BSB)-associated alleles were found to father more children than average, suggesting reproductive advantages. Moreover, men identifying as risk-takers tended to have more children and were more likely to carry BSB-associated alleles.

“Our results suggest that male BSB–associated alleles are likely reproductively advantageous, which may explain their past persistence and predict their future maintenance,” the authors wrote.

Nature’s complexity was underscored by Zhang, noting that a single gene can influence multiple traits, a phenomenon known as “pleiotropy.” “Here we’re talking about three traits: number of children, risk-taking, and bisexual behavior—they all share some genetic underpinnings,” he said.

Exclusive same-sex behavior (eSSB) associated alleles, however, were correlated with having fewer children when carried by heterosexual men, indicating that these traits may diminish over time.

The UK Biobank data revealed a significant trend—the proportion of people reporting both bisexual and homosexual behavior has been rising for decades, likely due in part to growing societal openness.

In an additional report, scientists announced on Wednesday that they have identified genetic variations associated with human bisexual behavior. The study builds on the University of Michigan research and further emphasizes the link between these genetic variations and risk-taking behavior, as well as the impact on offspring numbers when carried by heterosexual men.

The authors of both studies estimated that approximately 40 percent of a person’s behavior regarding bisexuality is influenced by genetics, while 60 percent is influenced by the environment. Emphasizing the contribution to understanding human sexuality, the researchers stressed that their results are not intended to endorse discrimination based on sexual behavior.

This comprehensive research provides a nuanced perspective on the interplay between genetics, behavior, and societal factors in shaping human sexuality, opening the door to further exploration in this complex and evolving field.

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AIDS and HIV

Local, national events to mark 35th annual World AIDS Day

HIV disproportionately affects certain populations. Men who have sex with men accounted for 70% of 32,100 estimated new HIV infections

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(Washington Blade photo by Michael Key)

WASHINGTON – UNAIDS dubbed this year’s World AIDS Day theme as “Let Communities Lead.” This is how conversations around HIV and AIDS should be structured, Duante’ Brown said, who manages two programs at NMAC — a nonprofit dedicated to working to end the AIDS epidemic. People living with HIV need to be considered the subject matter experts, he said. 

“Bringing those people into the room, showing them that they have a voice and that there’s not just this group of people who are making a decision for them … is definitely the way that you go about this.”

Brown manages the ESCALATE program at NMAC, which aims to empower people to address HIV stigma, and the ELEVATE program, which is a training program for people with HIV to be more involved in the planning and delivery of the Ryan White HIV/AIDS Program, which is the largest federal program designed specifically for people with HIV. 

In the United States, it’s estimated 1.2 million people are living with HIV, according to HIV.gov. About 13% are unaware they have HIV.

HIV also continues to disproportionately affect certain populations. Men who have sex with men accounted for 70% of the 32,100 estimated new HIV infections in 2021. And Black individuals accounted for 40% of the new infections that year, while only comprising 12% of the population of the United States, according to the CDC

In 2023, stigma is a key inhibitor to ending the epidemic, Brown said. When stigma gets out of the way, there could be a day when there are no new cases of HIV transmissions, he said. To get around that stigma, people need to have meaningful and productive conversations about AIDS. 

“Not treating it as taboo, making sure that we are empowering people living with HIV and AIDS to tell their stories and to be empowered to feel that it’s OK,” Brown said. “And that nothing is wrong with you.”

And there are events in the locally and nationally to recognize World AIDS Day, many of them aimed at abolishing the stigma that comes with talking about HIV.

Icon Janet Jackson headlines the World AIDS Day Concert on Dec. 1 in Houston.

At a national level, Janet Jackson is set to headline the World AIDS Day concert on Dec. 1 — an annual fundraiser sponsored by the AIDS Healthcare Foundation. The concert will be at the NRG Arena in Houston, and will also honor actor and activist Blair Underwood with its lifetime achievement award. 

“[The concert] really is a way to commemorate World AIDS Day in a way that is both remembrance of those that we’ve lost, recognizing where we’re at, but also really celebrating and connecting the work that’s yet to be done. And having folks still leaving uplifted and elevated about what the future could hold,” said Imara Canady, AHF’s national director for communications and community engagement. 

Jackson has long been an outspoken advocate for people living with HIV. Her song, “Together Again,” is a tribute to a friend she lost to AIDS, as well as a dedication to patients around the world. 

The AIDS Healthcare Foundation, the largest nonprofit HIV/AIDS service organization and advocacy group, has several health care centers in the region and many across the nation and world. AHF also has a free HIV test locater online at freehivtest.net

AIDSWatch, the electronic memorial to people lost to HIV and AIDS, will be viewable on www.AIDSWatch.org and on the City of West Hollywood’s WeHoTV broadcast and streaming channels, including Spectrum Channel 10 within West Hollywood, beginning at 12:01 a.m. on Thursday, Dec. 1, for 24 hours.

The City of West Hollywood will join STORIES: The AIDS Monument and APLA Health in a World AIDS Day event on Friday, Dec. 1. The evening will begin at 5:30 p.m. with a reception at the West Hollywood Park Aquatic and Recreation Center (ARC) Respite Deck, located at 8750 El Tovar Place.

After a short program with refreshments, attendees will descend the grand staircase of the ARC at 6:30 p.m. in a candlelight procession through West Hollywood Park and along N. Robertson, Santa Monica, and N. San Vicente Boulevards to the City’s Council Chambers/Public Meeting Room, located at 625 N. San Vicente Boulevard. There, the evening will continue with a screening of the award-winning 2023 documentary “Commitment to Life.” Doors will open at 7 p.m. and the screening will begin promptly at 7:15 p.m. 

Events are free to attend and open to the public. Limited validated parking will be available at the West Hollywood Park 5-Story structure. 

Advance RSVP is requested by reserving a spot on Eventbrite.

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Commentary

New silent opioid epidemic: Secure LGBTQ+ spaces is the answer

There is an urgent need for more LGBTQ+ safe spaces and events that do not have access to drugs and alcohol

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Paramedics from Los Angeles County Fire-Rescue Dept. Squad 8 West Hollywood respond to an overdose. (Photo Credit: County of Los Angeles)

By Darwin Rodriguez | WEST HOLLYWOOD – In the shadows of the ongoing opioid crisis that continues to grip our nation, a new silent epidemic has emerged that has gone virtually unnoticed.

While the opioid epidemic has commanded national headlines and sparked urgent conversations about substance use disorders and treatment, the LGBTQ+ community continues to remain shrouded in silence – left in a battle to combat this crisis alone. Homophobia today contributes to more overdoses than ever before and our divisive politics stand in the way of saving the lives of our LGBTQ+ neighbors.

The tragic reality is that homophobia in our country continues to persist on a regular basis. The stigmatization and discrimination faced by LGBTQ+ individuals often leads them to adopt unhealthy behaviors to cope – many of which predisposes them to a long-term struggle with substance use disorders.

In 2020, LGBTQ+ individuals were found to use substances at nearly double the rate of the overall population. Consequently, LGBTQ+ individuals often enter treatment with more severe substance use disorders when compared to their heterosexual counterparts. While schools and community organizations have attempted to foster safe spaces to curb this pattern, our challenging and divisive political climate has hindered progress.

Over these past few years, nationwide anti-gay policies and legislation have threatened the safety of LGBTQ+ individuals. In 2022, Florida Governor Ron DeSantis introduced the controversial “Don’t Say Gay” bill.

Meanwhile, the University of Houston closed its campus’ only LGBTQ+ resource center in response to the passing of Senate Bill 17, which banned diversity, equity, and inclusion initiatives in higher education institutions.

LGBTQ+ books across the US have been banned from libraries and schools with many believing that the art of drag poses a greater threat to our nation than deadly firearms.

With the unprecedented amount of vitriol the LGBTQ+ community is facing, now is the time to mobilize and unify efforts toward a positive paradigm shift. If our goal is to eliminate this new silent epidemic, we need to coalesce and diversify safe spaces for the LGBTQ+ community. While creating safe spaces is an arduous feat, history has also shown that unified efforts can achieve remarkable progress.

When HIV/AIDS was dubbed a silent epidemic during the 80s, The ACT UP coalition was formed to end misinformation, re-invigorate political action, and shift the public narrative surrounding the deadly disease.

Founded by members of the LGBTQ+ community, they mobilized public awareness campaigns, staged demonstrations and most importantly, gathered members together to discuss the problems in an inclusive manner.

ACT UP was instrumental to the change in public perception of HIV/AIDS, paving the way for advancements in the social and scientific aspects of the silent epidemic. If we want to tackle this new silent opioid epidemic head-on, we must commit to mobilizing in a manner similar to ACT UP to end LGBTQ+ overdoses. One of our first steps should be creating more community spaces for LGBTQ+ people that are affirming and sober.

There is an urgent need for more LGBTQ+ spaces and events that do not have access to drugs and alcohol. Coffee shops, bookstores, and community centers should take initiative to host LGBTQ+ activities and become cornerstones for inclusive community building.

Cuties, a Los Angeles coffee shop that opened in 2017, was founded with the intention of providing a safe space for members of the LGBTQ+ community that was not focused around alcohol and substance use. They would host a variety of events at the cafe quickly becoming a hotspot for many of its patrons. Unfortunately, the brick and mortar coffee shop closed its doors in 2020 due to the COVID-19 pandemic. The untimely closing of Cuties has contributed to the dwindling presence of LGBTQ+ safe and sober spaces in the greater Los Angeles region.

It is essential to support local LGBTQ+ meeting spaces. To be an ally to the LGBTQ+ community, reaching out to local school districts, chambers of commerce, and business owners to host LGBTQ+ nights is a first step in the right direction.

For people who identify as LGBTQ+, the time is now to connect with our fellow LGBTQ+ neighbors and mobilize movements for safe and sober areas, which will pave the way for healthier,  and safer substance use practices.

Even if these actions feel out of reach, simply talking to your families and neighbors about LGBTQ+ acceptance and sharing your own story of acceptance can move us toward a future where sexual identity does not put one at risk for an overdose.

******************************************************************************************

Darwin Rodriguez

Darwin Rodriguez is a program manager at the Institute for Public Strategies and oversees the Safer WeHo Coalition in West Hollywood, which meets once a month.

To learn more about IPS, visit https://publicstrategies.org/.

To follow the Safer WeHo Coalition on Instagram search for: @saferwehocoalition

The preceding commentary was previously published at the WeHo Times and is republished with permission.

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AIDS and HIV

Maxine Waters criticizes House GOP over proposed cuts to HIV/AIDS programs

Calif. Democrat spoke at U.S. Conference on HIV/AIDS in D.C.

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U.S. Rep. Maxine Waters (D-Calif.) speaks at the U.S. Conference on HIV/AIDS on Sept. 6, 2023, in Washington. (Washington Blade photo by Michael Key)

WASHINGTON — U.S. Rep. Maxine Waters (D-Calif.) on Wednesday sharply criticized House Republicans over their proposed cuts to HIV/AIDS prevention programs.

The California Democrat who represents the state’s 43rd Congressional District in a speech she delivered at the U.S. Conference on HIV/AIDS noted the House Appropriations Committee’s Fiscal Year 2024 Labor, Health, Human Services, Education and Related Agencies Appropriations Bill would cut $767 million from domestic HIV/AIDS programs.

Waters said the bill would cut funds to fight HIV/AIDS among underrepresented groups by 53 percent and “completely eliminates” funding for “Minority AIDS Initiative activities within the Substance Abuse and Mental Health Services Administration.” Waters also noted the appropriations measure “eliminates funding” for the Centers for Disease Control and Prevention’s Ending the HIV Epidemic Initiative, the Ryan White HIV/AIDS Program and community health centers.

“The cuts to the Minority AIDS Initiative will exacerbate racial disparities and the elimination of the (Ending the) HIV Epidemic Initiative,” said Waters.

Waters also criticized House Republicans for “refusing to authorize” the President’s Emergency Plan for AIDS Relief.” The California Democrat said ending PEPFAR “would endanger the lives of millions of people around the world who are living with HIV and endanger the lives of millions more who are at risk.” 

“Moreover, it would compromise United States leadership on global health issues,” added Waters. “These programs used to have widespread support. It’s shameful that House Republicans are now trying to eliminate them. We cannot allow these cuts to pass. We cannot compromise. We will not give up.”

U.S. Reps. Jim Jordan (R-Ohio) and Marjorie Taylor Greene (R-Ga.) are among those who Waters criticized by name in her speech.

“I will speak truth to power. I want to use words that they will understand. Hell no! We won’t go! We are not going to give up,” said Waters. “That’s the people’s money. You can’t decide who you’re going to spend it on and not who you’re going to spend it on.”

More than 3,000 people are expected to attend the National Minority AIDS Council-organized conference that will end on Saturday. This year’s theme is “A Love Letter to Black Women.”

“We need a love letter to Black women,” said Waters. “We need it not only from this conference. We need it from our families often times. We need it from our communities. We need it from the churches that we give so much attention to and give our resources to and don’t really get it back. We need a love letter coming from all over this country for what we have suffered, for what we have endured, for the way that we have been denied and for the way that we have been ostracized.” 

Waters in her speech specifically praised former Massachusetts Congressman Barney Frank and the late U.S. Sen. Ted Kennedy (D-Mass.) for their work in support of LGBTQ+ rights and efforts to combat HIV/AIDS. Waters also thanked Jewel Thais-Williams, who opened Catch One, a bar and restaurant on Pico Boulevard in Los Angeles that became a refuge for people with HIV/AIDS.

“They had nowhere to gather, nowhere to go, nowhere to be recognized as people who needed support,” said Waters.

B. Kaye Hayes, deputy assistant secretary for infectious disease in the Office of the Assistant Secretary for Health who is also the executive director of the Presidential Advisory Council on HIV/AIDS, is among those who are expected to speak at the conference. Mark S. King, an HIV/AIDS activist and blogger who published “My Fabulous Disease: Chronicles of a Gay Survivor” on Sept. 1, is scheduled to talk on Thursday.

Cal Benn contributed to this story.

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Health

Cases of multi-drug resistant “super strain” of gonorrhea multiply

Last February, cases of XDR, or “extensively drug resistant,” gonorrhea, are on the rise in the U.S., the CDC said

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Gonorrhea bacterium (CDC/Los Angeles Blade graphic)

ATLANTA, GA. – The U.S. Centers for Disease Control and Prevention (CDC) along with the World Health Organization (WHO) are raising red flags for the second time this year as cases multiply of a “super strain” of drug-resistant gonorrhea globally, but particularly among men who have sex with men.

This strain of gonorrhea has been previously seen in Asia-Pacific countries and in the United Kingdom, but not in the US. A genetic marker common to two Massachusetts residents and previously seen in a case in Nevada, retained sensitivity to at least one class of antibiotics. Overall, these cases are an important reminder that strains of gonorrhea in the U.S. are becoming less responsive to a limited arsenal of antibiotics.

Gonorrhea is a sexually transmitted infection (STI) with most people affected at aged 15–49 years, that remains a major public health concern. Antimicrobial resistance in gonorrhea has increased rapidly in recent years and has reduced the options for treatment.

Last February, cases of XDR, or “extensively drug resistant,” gonorrhea, are on the rise in the U.S., the CDC said.

Gonococcal infections have critical implications to reproductive, maternal and newborn health including:

  • a five-fold increase of HIV transmission
  • infertility, with its cultural and social implications
  • inflammation, leading to acute and chronic lower abdominal pain in women
  • ectopic pregnancy and maternal death
  • first trimester abortion
  • severe neonatal eye infections that may lead to blindness.

This past January, Fortune reported the U.S. is experiencing “a rising epidemic of sexually transmitted disease,” Dr. Georges Benjamin, executive director of the American Public Health Association, said with some experts referring to the issue as a “hidden epidemic.” 

Cases of gonorrhea—an STD that often shows no signs, but can lead to genital discharge, burning during urination, sores, and rashes, among other symptoms—rose by 131% nationally between 2009 and 2021, according to public health officials. While rates of STD transmission in the U.S. fell during the early months of the pandemic, they surged later in the year, with cases of gonorrhea and syphilis eventually surpassing 2019 levels, according to the CDC.

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Health

Meet the director of Johns Hopkins Center for Transgender Health

Dr. Fan Liang, is the medical director of the Johns Hopkins Center for Transgender and Gender Expansive Health in Baltimore, Maryland

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Dr. Fan Liang (Photo courtesy of Fan Liang)

BALTIMORE – The topic of gender affirming healthcare has never attracted more attention or scrutiny, presenting challenges for both patients and providers, including Dr. Fan Liang, medical director of the Johns Hopkins Center for Transgender and Gender Expansive Health and assistant professor of plastic and reconstructive surgery.

Speaking with the Washington Blade by phone last week, Liang shared her perspective on a variety of topics, including her concerns about the ways in which media organizations and others have shaped the discourse about gender affirming care.

Too often, she said, the public is provided incomplete or inaccurate information, framed with politically charged and polarizing language rather than balanced and nuanced reporting for the benefit of audiences who might have little to no familiarity with the topics at hand.

“This is an evolving field that requires input from many different types of specialists,” Liang noted, so one issue comes when providers “start to comment outside of their scope of practice, or extrapolate into everybody’s experience.”

A more intractable and difficult problem, Liang said, is presented by the fact that, “issues with transgender health have really taken center stage with regard to national politics, and as a result of that, the narrative has really been reduced to an unsophisticated representation of what’s going on.”

“I think that is dangerous for patients and for the community that these patients live in and have to work in and survive in because it paints a picture that is really inaccurate,” she said.

Conservative state legislatures across the country have introduced a record number of anti-LGBTQ bills this year, passing dozens, including a slew of anti-trans healthcare restrictions. The Human Rights Campaign reports 35.1 percent of transgender youth now live in states that have passed bans on gender affirming care, many of which carry criminal penalties for providers.

A big part of the Center’s work, Liang told the Blade, involves working closely with trans patients and organizations like Trans Maryland and the Trans Rights Advocacy Coalition “to make sure that the community’s voices are being heard, so that we’re able to represent those interests here.”

She described “a generalized sense of anxiety and fear,” concerns that she said are “pervasive throughout the community,” over “access to surgery and to overall gender healthcare.”

“I get a lot of questions about that,” she said.

While Liang has not yet worked with any patients who traveled to the Center because gender affirming care was banned in the states where they reside, she said, “I do anticipate that will happen in the relatively near future.”

Challenges for clinicians

The political climate “really interferes in physician autonomy and basically using our training and discretion to provide the best therapies that we can,” based on research and evidence-based guidelines from medical organizations on best practices standards of care, Liang said.

“I earnestly believe that people who go into medicine try to do right by their patients and try to provide exceptional care whenever they can,” she said. “When I speak to other providers who are engaged in trans care, the reason they entered the field was because they saw patients that were suffering and had no other providers to go to and they were filling a need that desperately needed to be filled.”

“It is unfortunate that their motives are being misinterpreted, because it is causing significant emotional harm to these providers who are being targeted,” Liang said, noting “there is so much vitriol from the anti-trans side of things,” including “this narrative out there that physicians are providing trans care because of financial reasons or because of some sort of politically motivated, I don’t know, conspiracy.”

The political climate, along with the realities of practicing in this speciality, may threaten to stem the pipeline of new providers whose practice would otherwise include gender affirming care, said Liang, who serves on the interview board for incoming residents who are looking to specialize in plastic surgery.

Many, perhaps even most, she said, are eager to explore transgender care, often because, particularly among young trainees, they are friends with trans and non-binary people. “I don’t know how much of that interest persists as they move through the training pipeline, because — especially if they are at an institution that does provide trans care — they do see a lot of the struggles that physicians encounter in being able to offer these services.”

Liang noted the “significant hurdles from an insurance standpoint” and the “significant prerequisites in order to access surgery,” which require “a tremendous amount of back-end coordination and optimization of the logistics for surgical readiness.”

“And then,” she said, “they see a lot of the backlash in the media against trans providers, and I think that that does discourage residents who otherwise would be interested in the field because physicians, by and large, are a pretty conservative bunch. And having them start their practice where they’re sort of stepping into a political minefield is not ideal.”

Speaking up can be beneficial but risky

“Some physicians feel like they can make the most amount of impact by being advocates for the patient population on a national stage or being more vocal about how anti-trans legislation has been impacting their patients,” Liang said.

“My goal, as the director for the Center for Transgender Health here at Hopkins is really to normalize this care to allow for the open conversation and discussion amongst providers to create a safe space for people to feel comfortable providing this care,” she said.

Destigmatizing gender affirming care and connecting clinicians who practice in this space will help these providers understand they are not “functioning in isolation” and instead are part of “a national effort and a nationally concerted effort toward delivering state-of-the-art health care,” Liang said.

“It’s important,” she said, to “bring the generalized healthcare community to the table in offering these services and have a frank discussion when it comes to education, research and teaching.”

Other providers, however, “do not feel comfortable putting themselves into that place of vulnerability,” Liang said, “and I don’t fault them for it because I personally know people who’ve received death threats and who have been targeted because of what they say to the media,” in many cases because their comments were reported incorrectly or out of context.

In July, Liang participated in an emergency trans rights roundtable on Capitol Hill with representatives from advocacy groups like the Southern Poverty Law Center and the Transgender Law Center, as well as members of Congress including U.S. Reps. Mark Takano (D-Calif.), Barbara Lee (D-Calif.), and Sara Jacobs (D-Calif.).

She told the Blade it was “a really wonderful experience” to “hear the heartfelt stories” of the panelists advocating on behalf of themselves, their friends, and their families, earning the attention of members of Congress.

“I do think advocacy is important,” Liang told the Blade. “I try to make time for it when I can,” she said, “but I have to balance that with all of my other clinical obligations.”

Finding compassion and lowering the temperature

On Aug. 1, The Baltimore Banner reported that the director of the Mayor’s Office of LGBTQ Affairs in Baltimore filed a discrimination complaint with the city’s Office of Equity and Civil Rights against the Hopkins Center for Transgender and Gender Expansive Health.

Asked for comment, Liang said “it was an upsetting article to read,” adding, “I was upset that there wasn’t more due diligence done to investigate a little bit further” because instead the article presents “just this one person’s account of things.”

She noted there is “not much I can say from a physician standpoint because everything is contained within HIPAA,” the federal Health Insurance Portability and Accountability Act, which prohibits providers from even acknowledging which patients they may or may not have worked with.

The Banner article underscores the importance of journalists’ obligations to “make sure there is due diligence to confirm sources and make sure things are accurate,” Liang said, including, of course, when covering complicated and politically fraught subjects like gender affirming care.

“On the one hand, it’s really wonderful that there’s a fair amount of press being dedicated to trans issues around the country,” Liang said, but what is “frustrating for me is these conversations always seem to be so loaded and politically charged, and there doesn’t seem to be much space for people to ask earnest and honest questions” without taking heat from either side.

There is “compassion to be offered for patients who are struggling to receive basic health care” as well as for “people who are struggling to understand how this issue is evolving,” those for whom the matter is “uncharted territory” and therefore likely to “cause consternation and fear,” she said.

“Most of the time, the way to overcome” this is to cultivate “relationships with people who do identify as transgender or non-binary” on the grassroots level, she said, while leaving room “for people to ask earnest and honest questions.”

Removing the artificial “us-versus-them” paradigm provides “opportunity for more compassionate interactions,” Liang said.

At the same time, she conceded, amid the heightened polarization and escalation of an anti-trans backlash over the last few years, efforts to fight sensationalization with compassion and understanding have often fallen short, presenting hurdles that have long plagued other areas of science and medicine like abortions and vaccines.

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Health

CDC official talks about new STI prevention drug guidelines

Mena called DoxyPEP an “amazing tool,” noting the need for new ways to combat the increase in rates of STIs

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Dr. Leandro Mena, director of the Centers for Disease Control and Prevention's Division of STD Prevention (Screenshot/YouTube)

ATLANTA – The Centers for Disease Control and Prevention is expected to soon issue draft guidelines for the use of doxycycline to help prevent the spread of gonorrhea, chlamydia and syphilis in transgender women and gay and bisexual men who have sex with men.

Doctor Leandro Mena, director of the public health agency’s Division of STD Prevention, talked to the Washington Blade by phone on Thursday about the post-exposure prophylactic intervention — DoxyPEP for short — which he characterized as “the first important innovation that we have had in the field of STIs in almost three decades.”

Studies show a 200 mg dose of the widely available antimicrobial antibiotic, if taken within 72 hours after sex, has shown tremendous efficacy in reducing the risk of transmitting these three diseases, he said.

For now, research is limited to certain LGBTQ populations for whom “we know that network prevalence, the prevalence of STIs in the sexual network of this group, is sufficiently high that the benefits outweigh the potential risks,” Mena said, while “other strategies like the use of condoms, you know, are not really that feasible.”

Research on DoxyPEP conducted and published over the past couple of years has been game-changing, he said, “because it’s an antimicrobial that’s already approved, we know it’s very low-cost, and I think we have the evidence of its effectiveness.”

“Since the development of nucleic acid amplification test — which allows [providers to] diagnose gonorrhea and chlamydia by amplifying nucleic acids, by doing PCR, that really revolutionized access to STI testing — we really haven’t had much,” Mena said.

The CDC expects to work quickly on DoxyPEP, but a few hurdles must be cleared first.

“We have engaged with the communities, right, that are poised to benefit the most from this intervention,” Mena said. “And where we are is that we are finishing our guidance, we anticipate that it will be out for public comment close to the end of this fall, and shortly after we will be able to have the final guidance.”

“Guidelines like these that have important public health consequences goes all the way up to the highest levels of clearance in the CDC,” he added.

“While we know that that benefits are significant, there are some unknowns about the potential risks of taking antimicrobials to prevent infections, as they may perhaps have other effects [like] inducing resistance” in STIs and other types of bacteria, Mena said.

“Those are some of the unknowns that we’re trying to currently understand better, as we try to balance risk and benefits of the use of doxycycline as post exposure prophylaxis,” he said.

Another challenge for the CDC as it develops the guidelines, Mena said: They must be as relevant for folks in San Francisco as for people in Montgomery, Ala., and (the) Navajo Nation, based on each place’s “local epidemiology, local context and population.”

Additionally, the agency warns, doxycycline can carry side effects — namely, “phototoxicity, gastrointestinal symptoms, and more rarely esophageal ulceration.”

So, the CDC is working diligently, Mena said, to “better understand the potential risk that its use – its regular use, in this way, may present to the individual and potentially at the population level.”

Mena called DoxyPEP an “amazing tool,” noting the need for new ways to combat the increase in rates of STIs that has persisted for nearly a decade.

“In 2021, we had more than 2.5 million cases of syphilis, gonorrhea and chlamydia reported, and the reasons we’re seeing these increases, it’s really, you know, multifactorial,” he said. “There are subpopulations that are disproportionately affected — among these, racial-ethnic minorities, young people, men who have sex with men.”

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AIDS and HIV

American Red Cross ends ban on blood donations by gay men

Many healthy individuals who previously could not give will now be able to support their community through the gift of blood donation

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Photo Credit: American Red Cross

WASHINGTON – The American Red Cross announced a historic change in the organization’s policies regarding blood donations by gay and bisexual men. Under this new donor screening process, all donors answer the same eligibility questions regardless of gender or sexual orientation and will be assessed for blood donation based on individual risk factors, not on sexual orientation.

This change by the Red Cross falls within the U.S. Food and Drug Administration finalized guidelines for blood donation issued this past May that will use a uniform individualized risk assessment questionnaire for respondents regardless of their sexual orientation, sex, or gender.

In a statement the Red Cross noted:

“This change means many healthy individuals who previously could not give will now be able to support their community through the gift of blood donation.

Andrew Goldstein, a cancer researcher from Los Angeles, was a regular blood donor in his younger years before the FDA’s previous policies made him ineligible to donate as a gay man. His desire to influence change compelled him to register as a participant in the FDA funded ADVANCE Study in 2021, which sought to gather data to evaluate the possibility of moving to an individual donor assessment. He is proud he was able to be part of the study that led to this change and is excited to finally be able to give blood again.

“There’s so much in the world that you can’t help with, and you sometimes have to see people going through difficult times, but something like giving blood feels like something so small that you can do, and it means a lot to me that I’ll be able to do that again,” said Andrew. Now, Andrew and many others are able to share their good health with patients in need of lifesaving transfusions.”

The FDA’s new protocols issued in May note that prospective donors who have had a new sexual partner, or more than one sexual partner in the past three months, and anal sex in the past three months, would be ineligible.

So would those who are “taking medications to treat or prevent HIV infection (e.g., antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP),” because these drugs can delay the detection of HIV.

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