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Obama AIDS strategy targets gay, bi men

White House plan calls for shifting HIV prevention to high-risk groups

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Michael Weinstein, president of the AIDS Healthcare Foundation, called the proposed $30 million AIDS strategy and the $25 million proposed for ADAP grossly inadequate. Other AIDS activists disagreed with that assessment and praised President Obama’s plan. (Washington Blade photo by Michael Key)

A long-awaited National HIV/AIDS Strategy document the White House released this week calls for devoting more funds and attention to HIV prevention programs that target four high-risk population groups, especially gay and bisexual men.

In unusually blunt language, the 45-page strategy document that took 15 months to prepare says state and federal AIDS prevention programs have so far failed to adequately target gay and bisexual men and transgender people.

“Given the starkness and the enduring nature of the disparate impact on gay and bisexual men, it is important to significantly reprioritize resources and attention on this community,” says the document. “The United States cannot reduce the number of HIV infections nationally without better addressing HIV among gay and bisexual men.”

The document adds, “As with gay and bisexual men, transgender individuals are also at high risk for HIV infection. … Yet, historically, efforts targeting this specific population have been minimal.”

Other high-risk groups the strategy calls for targeting are blacks, Latinos and substance abusers.

The National HIV/AIDS Strategy and an accompanying 35-page Federal Implementation Plan call for reducing the overall number of new infections by at least 25 percent over the next five years; increasing access to medical care and “optimizing health outcomes” for people living with HIV; and reducing HIV-related health disparities.

“The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination,” the implementation plan declares as its goal.

The strategy and implementation document were released Tuesday amid a flurry of activity at the White House, which included a morning briefing on the document for the media and AIDS activists. Among those conducting the briefing were Melody Barnes, director of the White House Domestic Policy Council; Kathleen Sebelius, secretary of the Department of Health & Human Services, and Jeff Crowley, the gay director of the White House Office of National AIDS Policy.

Later in the day, President Obama hosted a reception in the White House East Room for about 150 national and community activists working on HIV/AIDS issues.

“From activists, researchers, community leaders who’ve waged a battle against AIDS for so long, including many of you here in this room, we have learned what we can do to stop the spread of the disease,” Obama told the gathering.

“We’ve learned what we can do to extend the lives of people living with it. And we’ve been reminded of our obligations to one another — obligations that, like the virus itself, transcend barriers of race or station or sexual orientation or faith or nationality,” he said.

“So the question is not whether we know what to do, but whether we will do it, whether we will fulfill those obligations, whether we will marshal our resources and the political will to confront a tragedy that is preventable.”

The president was interrupted briefly during his remarks by a man in the audience who shouted, “Mr. President,” prompting Obama to promise to talk with him after finishing his speech at the reception.

“Let’s hold on, you can talk to me after — we’ll be able to talk after I speak,” Obama said. “That’s why I invited you here, right? So you don’t have to yell.”

The audience member was later identified as Charles King, president and CEO of Housing Works, a New York City-based AIDS group that sometimes organizes AIDS-related protests involving arrests spurred by civil disobedience.

After completing his remarks, the president walked to where King was standing and spoke with him as news photographers hovered over the two.

King could not be immediately reached and it was not clear what he and Obama said to each other. But his brief interruption of Obama’s speech drew attention to concerns raised by some AIDS activists that the National HIV/AIDS Strategy does not include a call for significant new funds to fight the AIDS epidemic.

At the White House briefing earlier in the day, Sebelius and Crowley announced that the Obama administration would allocate $30 million to implement the strategy from a disease prevention fund created by the Affordable Care Act. The act is one of two landmark bills that Congress passed earlier this year to put in place the president’s sweeping health insurance reform proposals.

Sebelius and Crowley also noted that the administration would arrange for a separate emergency supplemental appropriation of $25 million to fund the struggling AIDS Drug Assistance Program, which provides life-prolonging anti-retroviral drugs for low-income people with HIV/AIDS who lack health insurance.

AIDS activists have criticized the administration and Congress for declining so far to appropriate $126 million in emergency funds for ADAP this year, an amount that state AIDS office directors believe is needed to provide drugs for 2,300 people who are on ADAP waiting lists in at least a dozen states.

The AIDS Healthcare Foundation, which bills itself as the largest global AIDS organization providing medical care to people with HIV/AIDS, held a separate news conference in Washington on Tuesday to criticize the AIDS strategy document.

Michael Weinstein, the group’s president, called the proposed $30 million allocation for the National HIV/AIDS Strategy and the $25 million proposed for ADAP grossly inadequate. He also said that the strategy document contained few if any new ideas and would likely “collect dust at the Library of Congress.”

But officials with other national AIDS organizations did not share Weinstein’s assessment of the strategy, calling it an important first step and a first-of-its-kind effort to prioritize federal AIDS programs.

“Today, the Obama administration took a significant step forward in the domestic battle against HIV/AIDS,” said AIDS Action, a national AIDS advocacy group, in a statement.

The statement said that, if properly implemented, the strategy would become “the first truly effective, comprehensive national plan in response to the U.S. HIV/AIDS epidemic, now in its 30th year.”

Michael Ruppal, executive director of the AIDS Institute, another national advocacy group, praised the strategy as an “ambitious” effort to curtail the domestic U.S. AIDS epidemic.

“The strategy will serve as a meaningful roadmap to reduce the number of HIV infections in the U.S., provide care to those who need it, and help reduce the stigma and disparities often associated with HIV/AIDS,” Ruppal said.

But he added, “Now we must turn our collective energies to implementing it with the necessary leadership and resources to achieve its goals and provide results for people who are currently living with HIV/AIDS or may be affected in the future.”

Cornelius Baker, former executive director of D.C.’s Whitman-Walker Clinic and a member of Obama’s Presidential Advisory Council on HIV/AIDS, issued a statement in his role as an official with the National Black Gay Men’s Advocacy Coalition.

He said the coalition considers the National HIV/AIDS Strategy and its accompanying implementation plan “significant steps forward in our nation’s effort to end the HIV epidemic.”

“Black gay men represent one of the most highly impacted populations and suffer the greatest disproportionate burden of the disease,” Baker said. “The National HIV/AIDS Strategy represents a major advance in its recognition that black gay men must be a focal point of attention if the United States is to make progress in reversing the trends of the HIV epidemic.”

In addition to the strategy and implementation documents, Obama issued a separate presidential memorandum to the heads of more than a dozen executive branch departments and agencies, establishing goals and timetables for carrying out the strategy.

The Obama memorandum designates six departments and agencies as “lead agencies” for implementing the strategy. They include the Department of Health & Human Services; Department of Justice; Department of Labor; Department of Housing & Urban Development; Department of Veterans Affairs; and the Social Security Administration.

The White House Office of National AIDS Policy, in consultation with the Office of Management & Budget, is assigned the task of monitoring the progress of the strategy’s implementation and setting the administration’s priorities for the project, the memo says.

At the White House briefing Tuesday, Crowley acknowledged that the National HIV/AIDS Strategy doesn’t initially call for providing significant new funds in the fight against AIDS, although he and Sebelius noted that the administration is committed to continue its existing proposals for increases in the federal AIDS budget in fiscal year 2011 and future years. The two also said the expansion of health insurance coverage for people who currently can’t afford it under the Obama health care legislation passed by Congress will greatly boost treatment and care for people with HIV/AIDS between now and 2014.

Crowley said the economic downturn and other competing spending needs made it important for the strategy to focus on ways to better use existing resources.

“Gay and bisexual men have comprised the largest proportion of the HIV epidemic in the United States since the first cases were reported in the 1980s, and that has not changed,” says the strategy document. “They still comprise the greatest proportion of infections nationally.”

To further show why greater resources must immediately be shifted to HIV prevention programs aimed at gay and bisexual men, the strategy document lists these facts:

• gay and bisexual men of all races are the only group in the United States where the estimated number of new HIV infections is rising annually;

• they are 44 to 86 times more likely to become infected with HIV than other men, and 40 to 77 times more likely to become infected than women;

• approximately one-half of the 1.1 million persons living with HIV in the United States are gay and bisexual men, and they account for the majority (53 percent) of new HIV infections each year;

• and high rates of HIV among gay men are found not only in large urban areas. More than half of all AIDS cases diagnosed in the United States are among gay and bisexual men irrespective of town or city size.

Jose Zuniga, president of the International Association of Physicians in AIDS Care, praised the strategy document’s call for participation by non-government entities and individuals to help implement the strategy, saying more than 13,000 members of his group worldwide and more than 5,000 U.S. members “stand ready” join in the effort.

“[W]e have a ready army of seasoned advocates — public health experts, clinicians and allied healthcare and laypeople providers, AIDS service organizations, community and faith-based organizations, academic institutions, and professional associations — that can help to accelerate implementation and thus allow for more quickly achieving many of the National HIV/AIDS Strategy’s objectives,” he said.

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Commentary

Asian American and LGBTQ: A Heritage of Pride

May is Asian American, Native Hawaiian and Pacific Islander Heritage Month

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Glenn D. Magpantay (Photo courtesy of Glenn D. Magpantay)

Asian Americans and Pacific Islanders (APIs) are the nation’s fastest growing racial minority group by 2040, one in 10 Americans will be of Asian ancestry. And, while many Americans think that anti-Asian hate and racism towards Asian Americans has disappeared, the community disagrees.

The Asian American Foundation which found that Asian Americans are continually subjected to hate, violence, and discrimination, baldly reveals that disparity. 

  • 33 percent of Americans think hate towards Asian Americans has increased in the past year, compared to 61 percent of Asian Americans themselves.
  • In the past year, 32 percent of Asian Americans across the country reported being called a racial slur; 29 percent said they were verbally harassed or verbally abused.
  • Southeast Asian Americans report even higher incidences of being subject to racial slurs (40 percent), verbal harassment or abuse (38 percent), and threats of physical assault (22 percent).
  • Many Asian Americans live in a state of fear and anxiety with 41 percent of Asian American/ Native Hawaiian/Pacific Islander (AANHPI) believing they will likely be the victims of a physical attack due to their race, ethnicity, or religion. These numbers are disturbing.  

I serve as the only Asian American Pacific Islander member on the U.S. Commission on Civil Rights. And, I am the first and only queer AAPI on the U.S. commission. I am deeply honored to both serve my country and represent my Asian Americans and Pacific Islander community.    

Last year, the commission investigated the Federal Response to Anti-Asian Racism in the United States. With congressional authorization, the report documented the experiences of AANHPIs in the U.S. since the dubbing of COVID-19 as the “China Virus” infecting people with the “Kung Flu” by government leadership. Words matter, as this report shows.

This report has a deep personal connection for me. I am the survivor of a hate crime of 25 years ago for being gay, and the victim of a hate crime for being Asian 25 months ago 

The Stop AAPI Hate Coalition reported that bias incidents against individuals who are Asian and lesbian, gay, bisexual, transgender or queer (LGBTQ) were most prominent between 2019 and 2022, highlighting the intersectional nature of these incidents. For example, two transgender Asian women stated: 

“I was with my new boyfriend at a restaurant. When we walked in the server started calling me names … a b—h, ch—k, tra—i.e. … He said I have a big fat p—s, and told me to go back to China. Then my boyfriend proceeded to walk in the restaurant and when I took a step forward, the server hit me, so I left.” 

“Left a restaurant with friends in the Asian district of town. A man began to follow me calling out ‘Hey you f—got c—k!’ and ‘Come here you virus!’ I began to walk fast towards a crowd until he stopped following me.”

To address these and other equally appalling experiences, I helped shepherd the bipartisan Commission on Civil Rights recommendations to the president, Congress, and the nation that: 

  • Prosecutors and law enforcement should vigorously investigate and prosecute hate crimes and harassment against Asian Americans, as well as Asian Americans who are LGBTQ.
  • First responders should be trained to understand what exactly constitutes a hate crime in their jurisdiction, including the protections of LGBTQ people.
  • Federal, state, and local law enforcement and victim services should identify deficiencies in their programs for individuals with limited English proficiency

Greater language access will make an enormous impact for the Asian American community as one in five Asian individuals speak a language other than English at home. A third (34 percent) is limited English proficient. The most frequently spoken languages are Chinese, Korean, Vietnamese, Tagalog, Thai, Khmer, Bengali, Gujarati, Hindi, and Punjabi.   

For me, this report comes full circle. Since 1988, I’ve lobbied for passage of LGBTQ-inclusive federal and state laws to prevent hate crimes. Since 2001, I’ve supported South Asian and Muslim victims of post 9/11 violence. In response to the shootings at the Pulse nightclub in Orlando, Fla, in 2016; Atlanta Spa in Georgia in 2021; and Club Q in Colorado Springs, Colo., in 2022, I‘ve trained over 3,000 lawyers, law students, and community leaders on hate crimes law.  

And yet, our work is not yet done. 

May is Asian Pacific American Heritage Month. June is LGBTQ Pride Month. Despite these challenges, we are resilient. Let us join together in celebrating our Heritage of Pride 

Glenn D. Magpantay, Esq., is a long-time civil rights attorney, professor of law and Asian American Studies, and LGBTQ rights activist. Glenn is a founder and former Executive Director of the National Queer Asian Pacific Islander Alliance (NQAPIA). He is principal at Magpantay & Associates: A nonprofit consulting and legal services firm. In 2023, the U.S. Senate (majority) appointed Glenn to the U.S. Commission on Civil Rights to advise Congress and the White House on the enforcement of civil rights laws and development of national civil rights policy. 

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Health

CDC issues warning on new ‘deadlier strain’ of mpox

WHO says epidemic is escalating in Congo

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JYNNEOS mpox vaccine (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention has issued a health advisory regarding a deadlier strain of the Mpox virus outbreak which is currently impacting the Democratic Republic of Congo.

According to the CDC, since January 2023, DRC has reported more than 19,000 suspect mpox cases and more than 900 deaths. The CDC stated that the overall risk to the U.S. posed by the clade I mpox outbreak is low.

The risk to gay, bisexual, and other men who have sex with men who have more than one sexual partner and people who have sex with men, regardless of gender, is assessed as low to moderate the agency stated.

While no cases of that subtype have been identified outside sub-Saharan Africa so far, the World Health Organization said earlier this week that the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak according to a WHO spokesperson.

The spokesperson also noted that as Pride Month and events happen globally, there is more need for greater caution and people to take steps at prevention including being vaccinated.

The CDC advises that while there are no changes to the overall risk assessment, people in the U.S. who have already had mpox or are fully vaccinated should be protected against the type of mpox spreading in DRC. Casual contact, such as might occur during travel, is not likely to cause the disease to spread. The best protection against mpox is two doses of the JYNNEOS vaccine.

The CDC also noted the risk might change as more information becomes available, or if cases appear outside DRC or other African countries where clade I exists naturally.

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Commentary

Journalists are not the enemy

Wednesday marks five years since Blade reporter detained in Cuba

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The Hungarian Parliament in Budapest, Hungary, on April 4, 2024. Prime Minister Viktor Orbán and his government over the last decade has cracked down on the country's independent media. (Washington Blade photo by Michael K. Lavers)

Wednesday marked five years since the Cuban government detained me at Havana’s José Marti International Airport.

I had tried to enter the country in order to continue the Washington Blade’s coverage of LGBTQ and intersex Cubans. I found myself instead unable to leave the customs hall until an airport employee escorted me onto an American Airlines flight back to Miami.

This unfortunate encounter with the Cuban regime made national news. The State Department also noted it in its 2020 human rights report.

Press freedom and a journalist’s ability to do their job without persecution have always been important to me. They became even more personal to me on May 8, 2019, when the Cuban government for whatever reason decided not to allow me into the country.  

Washington Blade International News Editor Michael K. Lavers after the Cuban government detained him at Havana’s José Marti International Airport on May 8, 2019. (Washington Blade photo by Michael K. Lavers)

‘A free press matters now more than ever’

Journalists in the U.S. and around the world on May 3 marked World Press Freedom Day.

Reporters without Borders in its 2024 World Press Freedom Index notes that in Cuba “arrests, arbitrary detentions, threats of imprisonment, persecution and harassment, illegal raids on homes, confiscation, and destruction of equipment — all this awaits journalists who do not toe the Cuban Communist Party line.” 

“The authorities also control foreign journalists’ coverage by granting accreditation selectively, and by expelling those considered ‘too negative’ about the government,” adds Reporters without Borders.

Cuba is certainly not the only country in which journalists face persecution or even death while doing their jobs.

• Reporters without Borders notes “more than 100 Palestinian reporters have been killed by the Israel Defense Forces, including at least 22 in the course of their work” in the Gaza Strip since Hamas launched its surprise attack against Israel on Oct. 7, 2023. Media groups have also criticized the Israeli government’s decision earlier this month to close Al Jazeera’s offices in the country.

• Wall Street Journal reporter Evan Gershkovich, Washington Post contributor and Russian opposition figure Vladimir Kara-Murza and Radio Free Europe/Radio Liberty’s Alsu Kurmasheva remain in Russian custody. Austin Tice, a freelance journalist who contributes to the Post, was kidnapped in Syria in August 2012.

• Reporters without Borders indicates nearly 150 journalists have been murdered in Mexico since 2000, and 28 others have disappeared.

The Nahal Oz border crossing between Israel and the Gaza Strip on Nov. 21, 2016. Reporters without Borders notes the Israel Defense Forces have killed more than 100 Palestinian reporters in the enclave since Hamas launched its surprise attack against Israel on Oct. 7, 2023. (Washington Blade photo by Michael K. Lavers)

Secretary of State Antony Blinken in his World Press Freedom Day notes more journalists were killed in 2023 “than in any year in recent memory.”

“Authoritarian governments and non-state actors continue to use disinformation and propaganda to undermine social discourse and impede journalists’ efforts to inform the public, hold governments accountable, and bring the truth to light,” he said. “Governments that fear truthful reporting have proved willing to target individual journalists, including through the misuse of commercial spyware and other surveillance technologies.”

U.S. Agency for International Development Administrator Samantha Power, who is a former journalist, in her World Press Freedom Day statement noted journalists “are more essential than ever to safeguarding democratic values.” 

“From those employed by international media organizations to those working for local newspapers, courageous journalists all over the world help shine a light on corruption, encourage civic engagement, and hold governments accountable,” she said.

President Joe Biden echoed these points when he spoke at the White House Correspondents’ Association Dinner here in D.C. on April. 27.

“There are some who call you the ‘enemy of the people,'” he said. “That’s wrong, and it’s dangerous. You literally risk your lives doing your job.”

I wrote in last year’s World Press Freedom Day op-ed that the “rhetoric — ‘fake news’ and journalists are the ‘enemy of the people’ — that the previous president and his followers continue to use in order to advance an agenda based on transphobia, homophobia, misogyny, islamophobia, and white supremacy has placed American journalists at increased risk.” I also wrote the “current reality in which we media professionals are working should not be the case in a country that has enshrined a free press in its constitution.”

“A free press matters now more than ever,” I concluded.

That sentiment is even more important today.

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