Health
Health care reform, LGBT provisions in question
U.S. Rep. Tammy Baldwin (D-Wis.) (DC Agenda photo by Michael Key)
Complications on Capitol Hill over health care reform are raising questions about whether the final measure will include the LGBT-specific and HIV/AIDS provisions advocates are seeking — or even if lawmakers will manage to pass any kind of reform.
Lesbian Rep. Tammy Baldwin (D-Wis.), a proponent of LGBT language in health care legislation, told reporters Thursday the election of Massachusetts Republican Scott Brown to the U.S. Senate last week is “an enormous obstacle” to passing reform and puts the future of such legislation in doubt.
“I think talking right now, a little over 24 hours after the conclusion of the election in Massachusetts, that there are still abundant question marks on how health care reform will proceed — or even if health care reform will proceed in its current iteration,” she said.
Carl Schmid, deputy executive director for the AIDS Institute, said lawmakers are rethinking plans for the legislation.
“Some are saying it’s a timing thing and they should take a month break from health care reform,” he said. “Other senators are saying we should start again with a new bill and work with Sen. Brown to try to get the 60 votes.”
The House legislation has several LGBT and HIV/AIDS provisions the Senate plan lacks. The House bill bars discrimination in health care; allows the federal government to collect health data on the LGBT population; eliminates the tax penalty on health benefits received for same-sex partners under an employer plan; and allows states to cover under Medicaid low-income people living with HIV before they develop AIDS.
Both the House and Senate versions of health care legislation have a provision allowing the cost of drugs received through AIDS Drug Assistance Programs to count toward out-of-pocket expenses so that people who receive this medication can more quickly qualify for catastrophic benefits under Medicare Part D.
But Brown’s win in Massachusetts means Democrats no longer have the 60 votes in the Senate to overcome an expected Republican filibuster and pass legislation previously approved by that chamber. And U.S. House Speaker Nancy Pelosi told reporters Thursday that her chamber doesn’t have the votes to pass the Senate plan, which lacks a government-run health care option and taxes high-end health care plans to pay for reform.
Still, Democratic leaders have said they’re committed to passing some kind of health care bill. Those efforts could involve passing compromise legislation in the Senate through reconciliation — a process that requires 51 votes.
Ed Shelleby, spokesperson for Rep. Jim McDermott (D-Wash.), said going back to the drawing board presents a new opportunity to get the domestic partner tax penalty elimination provision in the final version of the bill. McDermott is the sponsor of standalone legislation similar to that provision in the House legislation.
“It turns out that it was questionable whether the defined beneficiary provision — which would benefit domestic partners, among others — was going to end up in the final bill that was negotiated before the Massachusetts election,” Shelleby said. “So we actually get another bite at the apple since Congress will now be reevaluating and renegotiating.”
Schmid noted that advocates are still pushing for the inclusion of HIV/AIDS provisions in the final bill. He said he didn’t know whether the expansion of Medicaid for people living with HIV would make it into the final measure, but the provision for the cost of AIDS drugs has a better chance because it’s in both the House and Senate versions of the legislation.
Schmid said advocates of these provisions are ultimately focused on the passage of health care legislation in its entirety to extend coverage to the estimated 30 million Americans without insurance.
“The biggest issue is getting health insurance coverage for people who don’t have it, and that’s what we hope any bill they come up with that passes will have,” he said.
Health
MISTR announces it’s now prescribing DoxyPE
MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTR’s telehealth platform to receive DoxyPEP online for free, according to a release from the company.
With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.
“Despite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,” said Tristan Schukraft, CEO and founder of MISTR. “I’m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.”
An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV.
MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.
Health
UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary
UN agency urges global action to protect human rights
As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.
Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.
UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health.
“The attacks on rights are a threat to freedom and democracy and are harmful to health,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’s health.”
Despite challenges, there has been notable progress.
At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.
To sustain and enhance these advancements; UNAIDS urges global support for women’s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.
Zero Discrimination Day is observed on March 1.
Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyone’s health is synonymous with protecting everyone’s rights.
“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world — for everyone,” said Byanyima.
Health
New CDC report finds transgender women at higher risk for HIV
More than 1,600 people in seven cities surveyed
The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV.
Researchers reviewed data from a 2019-2020 survey, the National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.
The Jan. 25 Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.
The study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”
The study stated that trans women’s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to “survival sex work” and violence, which increases the risk of contracting HIV.
The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”
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