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Celebrating gay sex

Activist says male sexuality should be embraced in HIV fight

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In his role as president and CEO of the National Association of People with AIDS, Frank Oldham Jr. is upfront about where he stands on the AIDS epidemic.

He’s a 63-year-old gay man who has lived with HIV for more than 20 years. He has dedicated much of his career to fighting AIDS, both in the private sector and as a high-level official in city AIDS agencies in New York, Chicago and D.C. He served from 1993-1994 as chief of D.C.’s Agency for HIV/AIDS.

His driving ambition is to help bring about the eradication of AIDS for everyone, with a short-term goal of lowering the HIV infection rate in the United States over the next several years.

But Oldham says his efforts in organizing a series of D.C.-based events next week for the NAPWA-sponsored National Gay Men’s HIV/AIDS Awareness Day on Sept. 27 brings an often overlooked fact into clear view: Gay men account for more than 50 percent of the people with HIV in the United States and represent the only group at risk for HIV in the country that still has increasing numbers of new infections each year.

In an interview this week, Oldham presented the Blade with two fliers NAPWA is using to promote National Gay Men’s HIV/AIDS Awareness Day. Both feature photos of attractive, bare-chested young men, one black and one white.

“We’re doing something very interesting here and I think very bold,” Oldham says. “We have these pictures as part of the branding to capture gay male culture. Gay male culture is sexually celebrative. It is true that we like good-looking people, sexual people and sex is a healthy activity.”

According to Oldham, societal taboos against sex and homosexuality have always had a negative impact on gay men but that impact was heightened many times over as the AIDS epidemic struck the gay male community in the 1980s.

Among other things, Oldham says societal prejudice and homophobia “poisoned” the atmosphere for many gay men who, lacking information and encouragement now offered by AIDS advocacy groups, led to self-destructive behavior that contributed to the spread of HIV.

“I think that because society is so sex negative our gay male culture is always in collision with that society,” he says. “And I’m a product of this society so I also sometimes run into these kinds of challenges and conflicts,” Oldham says.

“But gay male culture, by the parties we have, the circuit parties, the bathhouses – all of that is part of a beautiful, gay male culture. And it is something that has to be embraced and especially embraced if you’re going to deal with the AIDS epidemic.”

Oldham was asked how he reconciles those views with advice by many AIDS experts that one means of curtailing HIV infection is sexual monogamy or the reduction of the number of sex partners. He says the best advice other experts give is to behave responsibly and respectfully and to use the best-known methods to prevent the spread of the virus.

“Just because there is a virus, which is chemical, which is scientific, doesn’t mean that the culture is bad,” he says. “You tell people that if you happen to be monogamous, that’s fine. If you happen to have 10 partners a week, fine. But you have to be safe. You have to use condoms.”

If you are HIV positive, Oldham says, “you have to take medication and be adherent so that you have a zero viral load and are less likely to infect someone because you love your culture. So this is all a positive thing. I love my culture so I will take care of it. I don’t want to infect anybody. I want people to be safe and healthy and beautiful.”

Since becoming head of NAPWA in 2006, Oldham says he and his colleagues at the Silver Spring, Md., based organization have carried out a series of programs to promote HIV prevention, treatment and testing, with many of those programs aimed at gay men.

Like other AIDS advocacy groups, NAPWA has emerged as a strong promoter of HIV testing for gay men, representing a clear break from past views by some LGBT and AIDS advocacy groups that opposed widespread HIV testing on grounds that it could lead to discrimination against those identified as HIV positive.

Oldham and other AIDS activists have expressed confidence that in the D.C. area, particularly in D.C., strong protections are in place to ensure full confidentiality in HIV test results and strong protection against HIV discrimination.

Under a policy started by Mayor Adrian Fenty and continued by Mayor Vincent Gray, D.C. offers “treatment on demand” for anyone testing HIV positive, regardless of their ability to pay for the treatment.

Oldham says the National Gay Men’s HIV/AIDS Awareness Day events and activities, which begin on Sunday and culminate with a rally in Dupont Circle on Tuesday, stress the need for more aggressive public education and media coverage of the continuing risk of HIV infection among gay men or “men who have sex with men,” the term used in government studies on infection rates.

The “awareness day” events include a “Red Ribbon VIP Reception” and fundraiser at 6 p.m. Sunday at Town nightclub; an all-day conference on Monday on gay men and HIV to include nationally recognized experts on subjects ranging from homophobia to internal medicine, to be held at the Human Rights Campaign headquarters; a noon press conference on Tuesday outside the John A. Wilson Building, where Mayor Vincent Gray and other officials will recognize National Gay Men’s HIV/AIDS Awareness Day; and a “Red Flash Mob” rally in Dupont Circle at 5 p.m. Tuesday to commemorate the day and release red balloons “in hope and remembrance of those we have lost.”

A full list of events can be obtained at napwa.org.

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Monkeypox

Monkeypox vaccination effort shifts towards maintaining demand

‘Thousands of shots’ administered at gay events across country

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White House National Monkeypox Response Deputy Coordinator Dr. Demetre Daskalakis (YouTube screenshot)

As ensuring adequate supply and distribution of the monkeypox virus vaccine becomes “less of an issue,” efforts have shifted toward maintaining demand, Dr. Demetre Daskalakis, White House national monkeypox response deputy coordinator, said on Sept. 7. 

This will mean, “making sure that people know that a effective and safe vaccine is available for those that could benefit,” he said, during a press briefing that also featured National Response Coordinator Dr. Bob Fenton and White House Press Secretary Karine Jean-Pierre. 

The officials said they were pleased with the impact of their targeted allocations of vaccine doses to events with large numbers of gay and bisexual men who have sex with men, populations considered high risk for MPV infection. 

“Thousands of shots were administered” at Southern Decadence in New Orleans, Black Pride in Atlanta and Oakland Pride in the San Francisco Bay Area, Fenton said. These efforts “were, frankly, wildly successful,” Daskalakis said. 

During a Q&A with reporters that followed the briefing, Daskalakis addressed questions about the racial disparities that have begun to emerge with respect to infection and vaccination rates. 

According to the Kaiser Family Foundation, “Black people have received 22 percent vaccines, while they account for 36 percent of cases. In contrast, White people have received 63 percent of vaccinations but account for 42 percent of cases.”

Daskalakis explained the events that were targeted this summer were a major part of addressing the disproportionately higher rates of infection and lower rates of vaccination among people of color. 

“It’s not about just the vaccine allocation,” he said. “It’s about that intense community engagement that happens on the ground because, ultimately, public health is a local event.”

From the beginning of the outbreak, those engaged in the federal response were in touch with community organizations, Daskalakis said: “Giving the tools that people need to be able to sort of reach health goals is what we’ve been doing. And the support of organizations that serve Black and brown people have been pivotal in really turning the tide in what I think you’re going to see, the new vaccine numbers emerging over the next few weeks.”

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Health

Percentage of gay D.C. monkeypox cases rises slightly

Latest data show category of ‘unknown’ sexual orientation at 41.9%

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The latest weekly release of monkeypox case numbers by the D.C. Department of Health shows there were a total cumulative number of 431 monkeypox cases in the District as of Wednesday, Aug. 31, an increase of 26 cases since 405 cases reported one week earlier.

This week’s DOH data for the category of cases based on an individual’s sexual orientation show there were a total of 14 cases (3.2%) listed as straight/heterosexual, up from 11 cases (2.7%) from the previous week;  212 (49%) gay, up from 172 (42.5%) from last week; 24 (5.6%) bisexual, up from 18 (4.4% last week; and 179 (41.5%) in a category listed as “unknown” for the person’s sexual orientation, which was up from 172 (42.5%) from the previous week.

Officials at DOH, which is also known as D.C. Health, have said since the start of the monkeypox outbreak earlier this year that the overwhelming majority of cases in D.C., similar to across the nation, have been among gay, bisexual, and other men who have sex with men.

One DOH official speaking at a monkeypox town hall event last month placed the number of D.C. cases among all men who have sex with men at more than 90 percent. Officials have said the lower percentage of “gay” cases and the rise in the “unknown” category reported over the past two weeks is most likely due to a change in the data gathering policy.

In an effort to lessen the stigma associated with monkeypox infections, officials have said they do not want to appear as if they are applying undue pressure on people to disclose their sexual orientation when they apply for a monkeypox vaccination or seek a monkeypox test or treatment.

For the category of “lesbian” and “other,” the DOH this week included an asterisk instead of a number and a percentage.

“To help protect confidentiality, small numbers (between 0 and 4 are shown by an asterisk,” DOH states as an explanation for not including a number for the “lesbian” and “other” categories.

In last week’s data release, DOH said there were 0 recorded monkeypox cases for lesbians and one case in the “other” category.

In its category of “gender identity,” the DOH data released on Wednesday show that as of this week, out of the total cumulative cases of 431,423 (98.1%) were male. An asterisk is shown instead of a number for the categories of female; female-to-male transgender; male-to-female transgender; and gender nonconforming.

 A full breakdown of the latest monkeypox case number for all categories, including race/ethnicity, age group, and residential ward can be accessed at the D.C. Health website.

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Health

Biden health officials defend approach to monkeypox as cases grow

Contradictory information emerges on vaccine administration

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Biden officials defended their approach to monkeypox as contradictory emerges among health experts.

Top health officials in the Biden administration defended their approach Thursday to the monkeypox outbreak as cases continue to grow and contradictory information has emerged on appropriate vaccine administration.

Members of the White House monkeypox task force, in response to a question from the Washington Blade in a conference call with reporters, held fast to their new guidance on the JYNNEOS vaccine, which seeks to change the method of administration of the shot in an effort to expand use of the existing supply by fivefold — despite objections and even threats to cancel the supply from the vaccine manufacturer, according to a report this week in the Washington Post.

Meanwhile, cases of monkeypox in the United States are escalating — and beginning to extend outside the community of men who have sex with men — as the total number of confirmed cases has reached 13,517.

Bob Fenton, the White House monkeypox response coordinator, was first to respond to the Blade’s question on how the public can trust guidance from health officials amid the contradictory information by asserting “anytime that you have change, you’re going to have the need to update and educate the community on those changes.”

“The day…the FDA made that decision, we need signaled a week that this was being undertaken by FDA there already were a number of jurisdictions that started the training in anticipation of that decision,” Fenton said. “And that day, there were jurisdictions actually delivering intradermal shots that day [to] fivefold the number of shots and did that to areas of high risk and did that to areas that made equity a factor in those decisions where they vaccinated. So it is happening; it is being successful.”

The context of the Biden administration’s change in guidance last week — which shifts from injection through the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer) — is an announcement from localities, including the D.C. government, shifting from two doses to one dose to make up for limited supply. Biden officials discouraged the one-dose approach, pointing to data suggesting it was not effective in protecting against monkeypox.

In essence, contradictory information is coming from health experts on monkeypox on all levels localities offer on the vaccine, which in turn is criticized by the federal government as ineffective in favor of different approaches, which is in turn criticized by the vaccine manufacturer as untested and inappropriate.

Rochelle Walensky, director of the Centers of Disease Control & Prevention, responded to previously articulated concerns about the one-dose approach from localities by saying the Biden administration is working “really hand in glove in really fluid communication through this outbreak.”

“As I articulated we don’t yet know how well this vaccine will work in this outbreak,” Walensky said. “And as those data are evolving, as we had some resource constraints early on with the vaccine, we were working close with health departments so that they could maximize their coverage. We’ve met with them to talk about what data might be available for one dose, which are really limited [and] concerning in terms of how well it would work. And so when the strategy for intradermal dosing, which we anticipate will work just as well as subcutaneous dosing, we again met closely with the health departments…so that we could provide the data to them.”

Defense of changes in guidance in vaccine administration ended up overshadowing the announcements top officials were seeking to make, such as making an additional 1.8 million doses available for ordering starting Monday, a pilot program setting aside 50,000 doses for jurisdictions hosting large LGBTQ events, such as Black Pride in Atlanta and Southern Decadence in New Orleans; and making available next week 50,000 patient courses of TPOXX monkeypox treatment.

Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health & Human Services, said when asked by CNN about expanding the supply the administration may look elsewhere aside from the JYNNEOS vaccine manufacturer, Bavarian Nordic in Denmark, calling the company a “small manufacturer.”

“They currently have one active line and in the Copenhagen area that we’re relying on for 2.5 million doses to be filled and finished, but when we ordered that second 2.5 million to be built and finished, we made it a requirement that they work with a domestic U.S. contract manufacturing organization and we continue to partner with Bavarian Nordic as they solidify that relationship,” O’Connell said. “We are also helping them in other ways consider manufacturing capacity increases, potentially working with a larger pharmaceutical company.”

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