Connect with us

Health

Takano ‘aghast’ at proposed UC affiliation with restrictive Catholic hospitals

Published

on

                                   Dignity Health (Wikimedia photo via dailycal.org)

The California congressional delegation is “deeply alarmed” by proposed new healthcare rules governing the affiliation between the University of California and Catholic hospital systems that operate under religious restrictions.

Hospitals such as Dignity Health and St. Joseph Health adhere to the Ethical and Religious Directives (ERDs) set by the U.S. Conference of Catholic Bishops, not by medical professionals, New Ways Ministry reported last June. “Dignity Health operates by the ERDs at 17 out of 31 of their hospitals.”

According to the ACLU, NCLR, and National Health Law,  “Contract language explicitly states that students and providers are restricted by Catholic Directives.”

“The ERDs do not allow the prescription of any FDA-approved methods for preventing pregnancy including sterilization, elective abortion; assistive reproductive technology such as in-vitro fertilization (IVF) or the use of a surrogate for pregnancy; gender-affirming care such as hormone replacement therapy or surgery or physician-assisted aid in dying,” The California Aggie reported June 5. “Some argue that partnering with Dignity restrict care to LGBTQ+ people, women, others argue more are harmed by not partnering.”

A previous attempt to expand Dignity Health’s affiliation with UC San Francisco (UCSF) was called off last year after 1,500 UCSF doctors and hospital staff signed a petition opposing the  proposed expansion. The UC Working Group on Comprehensive Access (WGCA) was formed to find a way forward but failed to reach a consensus.

In August 2019, the WGCA presented two options: UC Health-backed Option 1 would allow existing affiliations to continue, understanding that some people might be denied care because of the hospital’s adherence to religious doctrine. Option 2 would discourage the continued affiliation.

                                                       Evan Minton (Photo courtesy ACLU)

Evan Minton, a longtime California politico chair of the California Democratic Party LGBT caucus, was among the LGBTQ advocates who argued against the expanded relationship between UCSF and Dignity. He sued Dignity Health after his hysterectomy was cancelled because they learned he is a transgender man, about which he testified before Congress. The ACLU, which is representing him, argues that hospitals should not be able to “pick and choose” the care they provide to individual patients.

According to the student-run The Daily Californian, Dignity Health spokesperson Dan Loeterman said Dignity Health provides specialized services such as pediatric trauma programs, cancer treatment programs and behavioral health units that would not otherwise be available without the partnerships between UC Health and Dignity Health. “We are deeply committed to providing care to everyone, regardless of who they are,” said Loeterman.

UCSF noted in a statement that about half of the state’s doctors are trained through the UC system and without training at outside entities such as Dignity Health, UC would have to reduce its health-training enrollment, DailyCal.org reported.

Meanwhile, there is some concern the coronavirus pandemic may impact the Regents’ decision. After all, “Catholic health systems control one in six hospital beds and are often the only location for treatment in some rural areas,” New Ways Ministry reported last June 17.

The California congressional delegation wanted to register their disapproval.

In their Aug. 5 letter to UC President Dr. Michael Drake and the UC Regents, 39 out of 45 members of the Democratic delegation expressed “serious concerns” over UC’s affiliations with hospitals and providers “that impose religious restrictions” limiting medically necessary care. “The consequences of denying this care are serious and can even be life-threatening,” they wrote. (See the letter below)

Led by U.S. Reps. Barbara Lee (D-Oakland), Julia Brownley (D-Westlake Village), and Mark Takano (D-Riverside), the letter, issued with the backing of a coalition that includes NARAL Pro-Choice California, Equality California, and the ACLU of California, noted that many of the signers strongly oppose the Trump administration’s Refusal of Care Rule, which they describe as a “dangerous, discriminatory regulation…designed to allow health care institutions and providers to deny patients information and treatment based on personal religious or moral beliefs.”

Given the Trump administration’s repeated attacks on “access to evidence-based health care,” the members wrote, “it is deeply alarming that the University of California, which has long been a national leader in comprehensive reproductive and LGBTQ-inclusive care, would be willing to involve its providers and patients in arrangements that subject them to religious rules that hold that basic reproductive health care is impermissible, and that directly exclude LGBTQ patients. Reproductive and LGBTQ-inclusive care is fundamental, basic health care, and we in California should stand strong in protecting it.”

They “strongly urge” the Board to vote against Option 1. “’Option 1’ does not require that contracts with outside health systems affirmatively state that religious directives will not apply to UC providers and students. It also does not state that hospital policies prohibiting gender-affirming services for transgender people or reproductive health services violate UC’s non-discrimination policy,” they wrote.

The delegation also rejected the proposition that the affiliation is necessary “to expand health care access to underserved communities. In fact, hospitals with Catholic religious directives often prohibit many types of medical services that communities of color critically rely upon, particularly in the areas of reproductive and LGBTQ-inclusive health, where some of the deepest racial health inequities exist. Indeed, patients of color, low-income patients, people living with HIV and AIDS, and others who experience health disparities and systemic barriers to health care access are most in need of science-based, comprehensive care that is not limited by religious restrictions.”

Moving forward with Option 1, “will send a message to the nation that it is permissible to impose such limits on care, just as the Trump administration has sought to do with the Refusal of Care Rule,” the delegation wrote, urging the Regents to vote to reject ‘Option 1’ and “contracts that impose religious restrictions on UC providers and patients.”

                 Rep. Mark Takano (screen grab of Takano online statement on Trump impeachment)

“We, as members of the California delegation, are fighting against members of the Trump administration but we’re really aghast at the idea that within California, which should be using all of its muscle to ensure that discrimination does not occur in healthcare,” Takano told the Los Angeles Blade. “The way they push back on this is they’re saying they need to reach more people of color and low-income people.”

Takano also noted that the LGBTQ community in Riverside County and all over low income areas – Latinos and African Americans, in particular — don’t have access to HIV counseling and healthcare services.

“This is still one of the most significant healthcare challenges – the continued spread of HIV among low income people and people of color” who may not have access to or may not have even heard about PrEP, Takano said. “And this cannot be solved by entering into discriminatory contracts that will inhibit the ability to reach out to these populations. So, I reject the notion that they’re going to reach more low-income people and people of color who need healthcare.”

Takano challenged UC Health to come up with alternatives. “We should not be stuck with providers who insist on discrimination,” he said.

“This really got brought to the Regents’ attention because UC San Francisco was trying to get into a four- hospital agreement with Dignity Healthcare. But we blocked them,” UC Board of Regents Chair John A. Perez told the Los Angeles Blade. “It was clearly the pattern of discrimination against LGBT folks, in particular transgender folks, but also the limitations on reproductive healthcare.”

UC Board of Regents Chair John A. Perez, California Assembly Speaker Emeritus (Photo via Regents)

The issue is personal for Perez. “I have a friend who went into emergency labor and was refused a medically necessary tubal ligation, which put her in very dangerous circumstances,” said Perez, an issue he addressed in open session.  “If you got an emergency room open to obstetrics and somebody comes in, in emergency labor, for you to put these constraints that are not based on science or medical best practice is fundamentally at odds with our obligation and our standards and our values as a public university hospital system.”

Perez, who notes that he is one of three out LGBTQ Regents, is adamantly opposed to Option 1.

“I will do everything in my power to make sure Option 1 is never adopted,” Perez said. “I believe that running a hospital or a health system and making decisions based on anything other than science — the medical best interest of the patient — is tantamount to the corporate practice of medicine, which California expressly prohibited by law.”

Perez notes that the “thorny issue” raised by Option 1 has not yet been put forward. Meanwhile UC Health is focused on fighting the COVID-19 crisis. He disputes the notion of temporarily disregarding state and UC non-discrimination laws and core values to expand healthcare to low income people of color.

“We’re serving not only our patients, but we’re providing broader assistance to folks in other communities that aren’t part of our hospitals,” Perez said. “So, for example, Imperial County is about the most significantly impacted County in the state and we’re taking patients from Imperial County — not only in San Diego and Irvine, but as far away as Davis. We’re right now focused on direct patient care and direct research and helping turn the corner on COVID. And I think that really does speak to why nobody within the health operations has put this forward at this point.”

More comments and the congressional letter:

“University of California clinicians should not have their hands tied from providing reproductive and LGBTQ inclusive care because of religious directives,” said Rep. Lee. “While it is critically important to expand care to underserved communities, it should be comprehensive, not restricted care that is provided.”

“It is imperative that all Californians have access to quality and affordable healthcare, regardless of their gender or sexual orientation,” said Rep. Brownley. “The personal belief of healthcare providers should not be used to provide substandard care to classes of individuals. The University of California needs to make sure its actions do not narrow or restrict necessary healthcare, particularly for women and LGBTQ+ individuals, who have long faced roadblocks to getting the full healthcare they need and have a right to.”

“The University of California should not be limiting access to healthcare for LGBTQ+ people, women or other marginalized people who already face tremendous barriers to treatment —but proposing to do so during a public health crisis is particularly offensive,” said Equality California Executive Director Rick Chavez Zbur. “The UC is toeing a dangerous line by entertaining affiliations with hospitals that have long records of refusing LGBTQ+ inclusive and reproductive care. As Californians, we must — as we always have — set the example that everyone deserves care, regardless of religious belief, sexual orientation, the color of your skin or your gender identity.”

“California is a national leader when it comes to safeguarding and expanding reproductive freedom and LGBTQ-inclusive care — which makes affiliations between the University of California and hospitals like Dignity Health, that categorically refuse to provide basic reproductive and gender-affirming care, all the more troubling,” said Shannon Hovis, Director of NARAL Pro-Choice California. “Discriminatory restrictions imposed by Catholic health systems are an affront to California values, plain and simple. As the fourth-largest healthcare provider in the state, the UC has a public and moral responsibility to provide high-quality, evidence-based care, free from discrimination. With so much at stake for reproductive freedom and equality in 2020, we demand that the UC Regents take action to ensure that every body is able to access the care they need.”

[pdf-embedder url=”https://www.losangelesblade.com/content/files/2020/08/20.08.05.-Congressional-Letter-to-UC-Regents-on-UC-Healthcare-and-Dignity-1.pdf” title=”20.08.05.-Congressional-Letter-to-UC-Regents-on-UC-Healthcare-and-Dignity”]

 

 

Continue Reading
Advertisement

Health

FDA oks adverts for first condom specifically designed for anal intercourse

FDA authorized One Male Condom also aa a contraceptive to reduce risk of pregnancy and the transmission of STIs during vaginal intercourse

Published

on

Courtesy of Global Protection Corp.

WASHINGTON – Boston, Massachusetts-based Global Protection Corporation, a world leader in manufacturing and distributing sexual health products, condom manufacturing, lubricant manufacturing and much more was granted permission by the U.S. Food and Drug Administration, (FDA), to market its condoms designed for anal intercourse.

On Wednesday, the FDA authorized the marketing of the One Male Condom, are also indicated as a contraceptive to help reduce the risk of pregnancy and the transmission of STIs during vaginal intercourse.

Before today’s authorization, the FDA had not cleared or approved condoms specifically indicated for anal intercourse. Unprotected anal intercourse carries the greatest sexual exposure risk of HIV transmission. Consistent and correct condom use has the potential to significantly help decrease the risk of STIs. While today’s authorization underscores the public health importance of condoms tested and labeled specifically for anal intercourse, all other FDA-cleared condoms can continue to be used for contraception and STI prevention. It’s important to continue to use condoms consistently and correctly to reduce the risk of STI transmission, including HIV, and to prevent pregnancy.

“The risk of STI transmission during anal intercourse is significantly higher than during vaginal intercourse. The FDA’s authorization of a condom that is specifically indicated, evaluated and labeled for anal intercourse may improve the likelihood of condom use during anal intercourse,” said Courtney Lias, Ph.D., director of the FDA’s Office of GastroRenal, ObGyn, General Hospital, and Urology Devices in the Center for Devices and Radiological Health.

“Furthermore, this authorization helps us accomplish our priority to advance health equity through the development of safe and effective products that meet the needs of diverse populations. This De Novo authorization will also allow subsequent devices of the same type and intended use to come to the market through the 510k pathway, which could enable the devices to get on the market faster,” she added.

The One Male Condom is a natural rubber latex sheath that covers the penis. It has three different versions: standard, thin and fitted. The fitted condoms, available in 54 different sizes, incorporate a paper template to aid in finding the best condom size for each user. When used during anal intercourse, the One Male Condom should be used with a condom-compatible lubricant.

The safety and efficacy of the One Male Condom was studied in a clinical trial comprised of 252 men who have sex with men and 252 men who have sex with women. All participants were between 18 through 54 years old.  

The study found that the total condom failure rate was 0.68% for anal intercourse and 1.89% for vaginal intercourse with the One Male Condom. Condom failure rate was defined as the number of slippage, breakage or both slippage and breakage events that occurred over the total number of sex acts performed.

For the One Male Condom, the overall percentage of adverse events was 1.92%. Adverse events reported during the clinical trial included symptomatic STI or recent STI diagnosis (0.64%), condom or lubricant-related discomfort (0.85%), partner discomfort with lubricant (0.21%) and partner urinary tract infection (0.21%).

The symptomatic STI or recent STI diagnoses observed in the study were self-reported and may be the result of subjects having intercourse without a condom or may have preceded use of the One Male Condom, as STIs were not measured at baseline.

The FDA reviewed the One Male Condom through the De Novo premarket review pathway, a regulatory pathway for low- to moderate-risk devices of a new type. Along with this De Novo authorization, the FDA is establishing criteria called special controls that define the requirements related to labeling and performance testing.

When met, the special controls, in combination with general controls, provide a reasonable assurance of safety and effectiveness for devices of this type. This action also creates a new regulatory classification, which means that subsequent devices of the same type with the same intended use may go through the FDA’s 510(k) pathway, whereby devices can obtain clearance by demonstrating substantial equivalence to a predicate device.

The FDA granted the marketing authorization to Global Protection Corp.

Continue Reading

AIDS and HIV

New highly-infectious variant of HIV discovered by Dutch scientists

This new variant of HIV-1 damaged the immune system twice as fast, “placing individuals at risk of developing AIDS much more rapidly”

Published

on

The human immunodeficiency virus in the bloodstream (Photo Credit: NIH/CDC)

CAMBRIDGE, UK – A study published this week by Science (journal) detailed an alarming discovery by researchers, clinicians and epidemiologists in the Netherlands of a new, highly-infectious mutated variant strain of the human immunodeficiency virus, (HIV), circulating in the country.

The BEEHIVE project – which stands for “bridging the epidemiology and evolution of HIV in Europe and Uganda,” detailed the findings which showed that a distinct subtype-B viral variant of HIV-1 damaged the immune system twice as fast, “placing individuals at risk of developing AIDS much more rapidly”, and those with this variant were at a higher risk of transmitting the virus to others.

The variant, known as the “VB variant”, causes CD4 cell decline to occur twice as fast in infected individuals compared with other viral variants. This is a clinical hallmark, or “signature” of the extent of damage caused by the HIV virus. In addition, those infected with the VB variant also demonstrated an increased risk of transmitting the virus to others, the data suggests.

Individuals infected with the new “VB variant” (for virulent subtype B) showed significant differences before antiretroviral treatment compared with individuals infected with other HIV variants:

  • Individuals with the VB variant had a viral load (the level of the virus in the blood) between 3.5 and 5.5 times higher.
  • In addition, the rate of CD4 cell decline (the hallmark of immune system damage by HIV) occurred twice as fast in individuals with the VB variant, placing them at risk of developing AIDS much more rapidly.
  • Individuals with the VB variant also showed an increased risk of transmitting the virus to others.

The project’s researchers, clinicians and epidemiologists did determine however, that those infected with the VB variant had “similar immune system recovery and survival to individuals with other HIV variants.”

However, the researchers stress that because the VB variant causes a more rapid decline in immune system strength, this makes it critical that individuals are diagnosed early and start treatment as soon as possible.

BEEHIVE project‘s lead author Dr Chris Wymant, from the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, said: “Before this study, the genetics of the HIV virus were known to be relevant for virulence, implying that the evolution of a new variant could change its impact on health. Discovery of the VB variant demonstrated this, providing a rare example of the risk posed by viral virulence evolution.”

“Our findings emphasize the importance of World Health Organization guidance that individuals at risk of acquiring HIV have access to regular testing to allow early diagnosis, followed by immediate treatment. This limits the amount of time HIV can damage an individual’s immune system and jeopardise their health. It also ensures that HIV is suppressed as quickly as possible, which prevents transmission to other individuals,” Senior author Professor Christophe Fraser from the University of Oxford’s Big Data Institute and Nuffield Department of Medicine, added.

In its Global HIV & AIDS statistics — Fact sheet, the UNAIDS Secretariat detailed the statistical data: 

GLOBAL HIV STATISTICS

  • 28.2 million people were accessing antiretroviral therapy as of 30 June 2021.
  • 37.7 million [30.2 million–45.1 million] people globally were living with HIV in 2020.
  • 1.5 million [1.0 million–2.0 million] people became newly infected with HIV in 2020.
  • 680 000 [480 000–1.0 million] people died from AIDS-related illnesses in 2020. 
  • 79.3 million [55.9 million–110 million] people have become infected with HIV since the start of the epidemic.
  • 36.3 million [27.2 million–47.8 million] people have died from AIDS-related illnesses since the start of the epidemic.

People living with HIV                                                                          

  • In 2020, there were 37.7 million [30.2 million–45.1 million] people living with HIV.
    • 36.0 million [28.9 million–43.2 million] adults.
    • 1.7 million [1.2 million–2.2 million] children (0–14 years).
    • 53% of all people living with HIV were women and girls.
  • 84% [67– >98%] of all people living with HIV knew their HIV status in 2020.
  • About 6.1 million [4.9 million–7.3 million] people did not know that they were living with HIV in 2020.

People living with HIV accessing antiretroviral therapy

  • As of 30 June 2021, 28.2 million people were accessing antiretroviral therapy, up from 7.8 million [6.9 million–7.9 million] in 2010.
  • In 2020, 73% [56–88%] of all people living with HIV were accessing treatment.
    • 74% [57–90%] of adults aged 15 years and older living with HIV had access to treatment, as did 54% [37–69%] of children aged 0–14 years.
    • 79% [61–95%] of female adults aged 15 years and older had access to treatment; however, just 68% [52–83%] of male adults aged 15 years and older had access.
  • 85% [63– >98%] of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2020.

New HIV infections

  • New HIV infections have been reduced by 52% since the peak in 1997.
    • In 2020, around 1.5 million [1.0 million–2.0 million] people were newly infected with HIV, compared to 3.0 million [2.1 million–4.2 million] people in 1997.
    • Women and girls accounted for 50% of all new infections in 2020.
  • Since 2010, new HIV infections have declined by 31%, from 2.1 million [1.5 million–2.9 million] to 1.5 million [1.0 million–2.0 million] in 2020.
    • Since 2010, new HIV infections among children have declined by 53%, from 320 000 [210 000–510 000] in 2010 to 150 000 [100 000–240 000] in 2020.

AIDS-related deaths

  • AIDS-related deaths have been reduced by 64% since the peak in 2004 and by 47% since 2010.
    • In 2020, around 680 000 [480 000–1 million] people died from AIDS-related illnesses worldwide, compared to 1.9 million [1.3 million–2.7 million] people in 2004 and 1.3 million [910 000–1.9 million] people in 2010.
  • AIDS-related mortality has declined by 53% among women and girls and by 41% among men and boys since 2010.
Continue Reading

Coronavirus

CDC: 85% of gay & lesbian adults in U.S. are vaccinated against COVID

Data on COVID-19 vaccination among LGBTQ persons limited because of the lack of routine SOGI data collection at the national & state levels

Published

on

Photo Credit: Centers for Disease Control and Prevention/GSA

ATLANTA – A new study report released Friday by the Centers for Disease Control and Prevention, (CDC), found that found 85.4% of gay and lesbian Americans above age 18 had received at least one vaccine dose as of October 2021.

The study, conducted from August 29 until October 30, 2021, also found that by comparison, only 76.3% of heterosexuals reported receiving at least an initial dose by the same date.

The report noted that Lesbian, gay, bisexual, and transgender (LGBT) populations have higher prevalence of health conditions associated with severe COVID-19 illness compared with non-LGBT populations.

The potential for low vaccine confidence and coverage among LGBT populations is of concern because these persons historically experience challenges accessing, trusting, and receiving health care services

Data on COVID-19 vaccination among LGBT persons are limited, in part because of the lack of routine data collection on sexual orientation and gender identity at the national and state levels.

In March of 2021, the Blade reported the coronavirus (COVID-19) pandemic has revealed deep-seated inequities in health care for communities of color and amplifies social and economic factors that have contributed to those communities being hit hardest, and Mega-vaccination centers set up by California health officials and the Federal Emergency Management Agency have been addressing and tracking the issue- the LGBTQ communities are still not being tracked.

This lack of data collection has frustrated and angered California State Senator Scott Wiener who authored a bill last year that passed through the legislature and signed by Governor Gavin Newsom last Fall that mandates gathering sexual orientation and gender identity data related to the COVID testing in California.

“We’re one year into the pandemic, and LGBTQ people continue to be erased in our public health response to COVID-19 — similar to our invisibility throughout history. No government is successfully tracking COVID-19 cases in the LGBTQ community, despite a law I wrote mandating that California do so,” Weiner told the Blade. “And, we now know that LGBTQ people are more vulnerable to COVID-19. We’ve also just learned that vaccination demographic data doesn’t include LGBTQ data. It simply shocking that in 2021, progressive health agencies continue to forget about our community,” he added.

The CDC also noted that gay and lesbian adults were more likely to be concerned about COVID-19 and to believe in the safety and efficacy of vaccines.

“We know that the prevalence of certain health conditions associated with severe COVID-19 illness, such as cancer, smoking, and obesity, are higher in LGBT populations, and access to health care continues to be an issue for some people in the LGBT community,” Dr. A.D. McNaghten, a member of the CDC’s COVID-19 Emergency Response Team and corresponding author of the study, told ABC News. “We wanted to see if vaccination coverage among LGBT persons was the same as non-LGBT persons.”

The CDC data recorded that bisexual and transgender adults had similar vaccination rates to heterosexual adults with 72.6% of bisexual adults fully vaccinated by the end of October, as were 71.4% of transgender adults. The numbers however for Black and Hispanic lesbian women had lower rates of vaccination at 57.9% and 72.6%, respectively, compared to Black and Hispanic heterosexual women at 75.6% and 80.5%, respectively.

Higher percentages of gay or lesbian adults and bisexual adults reported that they thought COVID-19 vaccine was very or somewhat important to protect oneself (90.8% and 86.8%, respectively) compared with heterosexual adults (80.4%), and higher percentages of adults who identified as transgender or nonbinary reported they thought COVID-19 vaccine was very or somewhat important to protect oneself (83.2%) compared with those who did not identify as transgender or nonbinary (80.7%).

Continue Reading
Advertisement
Advertisement

Follow Us @LosAngelesBlade

Sign Up for Blade eBlasts

Popular