Health
AIDS experts express hope at ‘Return to Lisner’
Whitman-Walker commemorates D.C.’s first AIDS forum 29 years ago


A panel of experts discussed the state of the AIDS epidemic Tuesday night at Lisner Auditorium, the same place where D.C.’s first AIDS forum was held 29 years earlier. (Washington Blade photo by Michael Key)
A panel of experts in the fields of AIDS-related medicine, research, public policy, and education discussed the state of the AIDS epidemic Tuesday night at George Washington University’s Lisner Auditorium, the same place where D.C.’s first AIDS forum was held 29 years earlier.
Tuesday’s forum followed an impassioned keynote address by Jeanne White-Ginder, mother of Ryan White, the Indiana teenager who was diagnosed with AIDS in 1984 at the age of 14. White, a hemophiliac who contracted the virus from contaminated blood products, became an internationally recognized advocate for AIDS research and education before he died in 1990.
D.C. Council member Jim Graham (D-Ward 1), who served as president of the Whitman-Walker Clinic at the time of the first AIDS forum at Lisner Auditorium in 1983, shared his recollection of the earlier forum at Tuesday’s event.
“When we came here to Lisner with nearly every seat filled on April 4, 1983, there was one thing that was certain,” he said. “And that was that something potentially devastating was about to happen. And we had to arm ourselves. We had to get ready.”
Graham noted that the 1983 forum was held at a time when little was known about the cause of AIDS and how it was transmitted. Although there were just a handful of reported cases in D.C., the city’s politically influential gay community was aware of the growing number of cases in New York, San Francisco, and other large U.S. cities, where otherwise healthy gay men were dying within months of being diagnosed with the disease.
“At a time when there was no Twitter, no Facebook, no Internet, no websites, 1,100 persons showed up on that night to find out what this was all about,” Graham said. “We believed then as we do now that if we could muster the will to marshal the resources we could stop AIDS dead in its tracks and we could care for those in dire need.”
The auditorium was about two-thirds full at Tuesday night’s forum.
Activists looking back at the early years of AIDS have often referred to that period as the “dark days,” when friends and loved ones died in increasing numbers.
With that as a backdrop, the panelists at Tuesday’s forum, while saying much still remains to be done, pointed to the dramatic scientific advances in the ensuring 29 years that have transformed an HIV infection from a near-certain death sentence to a chronic but manageable condition in which a person with HIV can live a normal lifespan.
“I think hope shines bright,” said Jose Zuniga, president of the International Association of Physicians in AIDS Care.
“We have saved millions of lives through the provision of antiretroviral therapies,” Zuniga told the forum.
“This hope also serves to shine a light on the inequalities, the inequities, all the horrible – the racism, sexism, homophobia, trans phobia that are all barriers to our achieving the goals we have in mind,” said Zuniga. “Having said all of that, I remain highly hopeful and optimistic.”
Robert Redfield, chief of Infectious Diseases and director of HIV programs at the University of Maryland, said he was hopeful that further advances in antiretroviral drugs will lead to a “functional cure” of HIV infection before the end of this decade.
Redfield said researchers define a functional cure as the ability of an as yet to be developed drug or drug combination to permanently suppress the viral load in a person with HIV to a point where it is undetectable and the person no longer needs to take anti-retroviral drugs.
Currently, people with HIV whose viral level is undetectable through the use of existing antiretroviral drugs experience a relapse, with the virus reemerging in large numbers after the person stops taking the prescribed regimen of the drugs.
According to Redfield, researchers are getting closer to developing improved drugs that can seek out and destroy the ‘hidden’ forms of HIV that remain dormant in patients taking the current drug regimens but that reemerge if the patient stops taking the drugs.
In addition to Zuniga and Redfield, the other panelists included A. Cornelius Baker, former Whitman-Walker Clinic executive director and senior communications adviser and project director for a D.C.-based international consulting organization that addresses AIDS issues; Regan Hofmann, editor of POZ magazine; JoAnne Keatley, director of the Center of Excellence for Transgender Health at the University of California-San Francisco; and Adam Tenner, executive director of Metro Teen AIDS.
The panel was moderated by NBC Channel 4 News correspondent Tom Sherwood.
Baker and Hofmann each said they expected to die within a few years after their HIV diagnosis in the 1980s but now are confident that the effective drug therapies will enable them to advance to old age. Baker said he was pleased to celebrate his 50th birthday recently.
Hofmann, who follows the latest scientific developments on AIDS in her role as editor of POZ magazine, joked that her birthdays recently have taken on a new meaning.
“I’ve always been grateful to have my birthdays,” she said. “But now I’m officially old enough to lie about my age as a woman.”
Keatley said that while advances in drug therapies have yielded great benefits for most people with HIV, many general practice doctors and infectious disease specialists are not trained to address the special needs of transgender women with HIV.
“My problem with the current strategies is that while we’re putting a lot of hope and effort on new medical technologies I don’t feel we’re doing enough to reach out and engage with transgender populations and keep them in care,” she said. “I don’t think we’ve made enough investment and training of providers to be able to care for transgender bodies.”
Tenner, whose organization provides AIDS education for LGBT youth, said that while he, too, is optimistic that an end to AIDS is a possibility in the not too distant future he’s also troubled over shortcomings in government programs aimed at AIDS education and treatment.
“I’m angry that not every young person gets HIV education or bullying education,” he told the forum. “We could get every young person high quality AIDS education but we are not getting that.”
Baker pointed to recently released findings of a National Institutes of Health study of HIV prevalence in black men who have sex with men in six large U.S. cities, including D.C. He noted that existing LGBT and AIDS organizations don’t appear to be addressing issues faced by this particular population.
The study found high levels of HIV infection, incarceration, unemployment and other social problems in black gay men to the same extent found in heterosexual black men.
In summing up the panelists’ views, Sherwood said each appeared to be highly optimistic while expressing reservations or concern over certain aspects of the response to AIDS.
“We all have hope with an asterisk,” he said.
White-Ginder told of how her son met a man undergoing tests for AIDS-related symptoms at New York City’s Roosevelt Memorial Hospital, where her son went for an experimental treatment a few years after his AIDS diagnosis in Indiana. At the time, most of the hospital’s AIDS patients were gay men.
“Ryan was sitting in the lab getting his lab work done and a gentleman came up to him and said, ‘Oh my gosh, you’re Ryan White, aren’t you?’” White-Ginder said. “And Ryan went, ‘Yes.’ He said they found 12 tumors in me. He said I haven’t been diagnosed with AIDS yet but they’re pretty sure that’s what I have. He said I want to thank you for all you’ve done for us people with AIDS.”
White-Ginder continued: “The gentleman turned away and Ryan looked at me and said, ‘You know mom I’m the only one who really knows what he’s talking about.’ He said, ‘We’re both fighting the same disease.’ We never took it to represent one cause or another. We wanted to represent everybody with this disease…So that is why I’m here with you today,” she said.
Before the panel discussion began, White-Ginder introduced a music video about her son produced by Michael Jackson, who released his song “Gone Too Soon” as part of the video. Jackson made the video shortly after Ryan White’s death in 1990.
She noted that both Jackson and singer Elton John befriended her son in the years after his diagnosis in a showing of solidarity to join Ryan White in the fight against AIDS discrimination. The two singers attended Ryan White’s funeral.
The Gay Men’s Chorus of Washington also performed at the forum prior to the start of the panel discussion.
Monkeypox
US contributes more than $90 million to fight mpox outbreak in Africa
WHO and Africa CDC has declared a public health emergency

The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa.
The U.S. Agency for International Development on Tuesday in a press release announced “up to an additional” $35 million “in emergency health assistance to bolster response efforts for the clade I mpox outbreak in Central and Eastern Africa, pending congressional notification.” The press release notes the Biden-Harris administration previously pledged more than $55 million to fight the outbreak in Congo and other African countries.
“The additional assistance announced today will enable USAID to continue working closely with affected countries, as well as regional and global health partners, to expand support and reduce the impact of this outbreak as it continues to evolve,” it reads. “USAID support includes assistance with surveillance, diagnostics, risk communication and community engagement, infection prevention and control, case management, and vaccination planning and coordination.”
The World Health Organization and the Africa Centers for Disease Control and Prevention last week declared the outbreak a public health emergency.
The Washington Blade last week reported there are more than 17,000 suspected mpox cases across in Congo, Uganda, Kenya, Rwanda, and other African countries. The outbreak has claimed more than 500 lives, mostly in Congo.
Health
Mpox outbreak in Africa declared global health emergency
ONE: 10 million vaccine doses needed on the continent

Medical facilities that provide treatment to gay and bisexual men in some East African countries are already collaborating with them to prevent the spread of a new wave of mpox cases after the World Health Organization on Wednesday declared a global health emergency.
The collaboration, both in Uganda and Kenya, comes amid WHO’s latest report released on Aug. 12, which reveals that nine out of every 10 reported mpox cases are men with sex as the most common cause of infection.
The global mpox outbreak report — based on data that national authorities collected between January 2022 and June of this year — notes 87,189 of the 90,410 reported cases were men. Ninety-six percent of whom were infected through sex.
Sexual contact as the leading mode of transmission accounted for 19,102 of 22,802 cases, followed by non-sexual person-to-person contact. Genital rash was the most common symptom, followed by fever and systemic rash.
The WHO report states the pattern of mpox virus transmission has persisted over the last six months, with 97 percent of new cases reporting sexual contact through oral, vaginal, or anal sex with infected people.
“Sexual transmission has been recorded in the Democratic Republic of Congo among sex workers and men who have sex with men,” the report reads. “Among cases exposed through sexual contact in the Democratic Republic of the Congo, some individuals present only with genital lesions, rather than the more typical extensive rash associated with the virus.”
The growing mpox cases, which are now more than 2,800 reported cases in at least 13 African countries that include Kenya, Uganda, Rwanda, and prompted the Africa Centers for Disease Control and Prevention this week to declare the disease a public health emergency for resource mobilization on the continent to tackle it.
“Africa has long been on the frontlines in the fight against infectious diseases, often with limited resources,” said Africa CDC Director General Jean Kaseya. “The battle against Mpox demands a global response. We need your support, expertise, and solidarity. The world cannot afford to turn a blind eye to this crisis.”
The disease has so far claimed more than 500 lives, mostly in Congo, even as the Africa CDC notes suspected mpox cases across the continent have surged past 17,000, compared to 7,146 cases in 2022 and 14,957 cases last year.
“This is just the tip of the iceberg when we consider the many weaknesses in surveillance, laboratory testing, and contact tracing,” Kaseya said.
WHO, led by Director General Tedros Adhanom Ghebreyesus, also followed the Africa CDC’s move by declaring the mpox outbreak a public health emergency of international concern.
The latest WHO report reveals that men, including those who identify as gay and bisexual, constitute most mpox cases in Kenya and Uganda. The two countries have recorded their first cases, and has put queer rights organizations and health care centers that treat the LGBTQ community on high alert.
The Uganda Minority Shelters Consortium, for example, confirmed to the Washington Blade that the collaboration with health service providers to prevent the spread of mpox among gay and bisexual men is “nascent and uneven.”
“While some community-led health service providers such as Ark Wellness Clinic, Children of the Sun Clinic, Ice Breakers Uganda Clinic, and Happy Family Youth Clinic, have demonstrated commendable efforts, widespread collaboration on mpox prevention remains a significant gap,” UMSC Coordinator John Grace stated. “This is particularly evident when compared to the response to the previous Red Eyes outbreak within the LGBT community.”
Grace noted that as of Wednesday, there were no known queer-friendly health service providers to offer mpox vaccinations to men who have sex with men. He called for health care centers to provide inclusive services and a more coordinated approach.
Although Grace pointed out the fear of discrimination — and particularly Uganda’s Anti-Homosexuality Act — remains a big barrier to mpox prevention through testing, vaccination, and treatment among queer people, he confirmed no mpox cases have been reported among the LGBTQ community.
Uganda so far has reported two mpox cases — refugees who had travelled from Congo.
“We are for the most part encouraging safer sex practices even after potential future vaccinations are conducted as it can also be spread through bodily fluids like saliva and sweat,” Grace said.
Grace also noted that raising awareness about mpox among the queer community and seeking treatment when infected remains a challenge due to the historical and ongoing homophobic stigma and that more comprehensive and reliable advocacy is needed. He said Grindr and other digital platforms have been crucial in raising awareness.
The declarations of mpox as a global health emergency have already attracted demand for global leaders to support African countries to swiftly obtain the necessary vaccines and diagnostics.
“History shows we must act quickly and decisively when a public health emergency strikes. The current Mpox outbreak in Africa is one such emergency,” said ONE Global Health Senior Policy Director Jenny Ottenhoff.
ONE is a global, nonpartisan organization that advocates for the investments needed to create economic opportunities and healthier lives in Africa.
Ottenhoff warned failure to support the African countries with medical supplies needed to tackle mpox would leave the continent defenseless against the virus.
To ensure that African countries are adequately supported, ONE wants governments and pharmaceutical companies to urgently increase the provision of mpox vaccines so that the most affected African countries have affordable access to them. It also notes 10 million vaccine doses are currently needed to control the mpox outbreak in Africa, yet the continent has only 200,000 doses.
The Blade has reached out to Ishtar MSM, a community-based healthcare center in Nairobi, Kenya, that offers to service to gay and bisexual men, about their response to the mpox outbreak.
Health
White House urged to expand PrEP coverage for injectable form
HIV/AIDS service organizations made call on Wednesday

A coalition of 63 organizations dedicated to ending HIV called on the Biden-Harris administration on Wednesday to require insurers to cover long-acting pre-exposure prophylaxis (PrEP) without cost-sharing.
In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, the groups emphasized the need for broad and equitable access to PrEP free of insurance barriers.
Long-acting PrEP is an injectable form of PrEP that’s effective over a long period of time. The FDA approved Apretude (cabotegravir extended-release injectable suspension) as the first and only long-acting injectable PrEP in late 2021. It’s intended for adults and adolescents weighing at least 77 lbs. who are at risk for HIV through sex.
The U.S. Preventive Services Task Force updated its recommendation for PrEP on Aug. 22, 2023, to include new medications such as the first long-acting PrEP drug. The coalition wants CMS to issue guidance requiring insurers to cover all forms of PrEP, including current and future FDA-approved drugs.
“Long-acting PrEP can be the answer to low PrEP uptake, particularly in communities not using PrEP today,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The Biden administration has an opportunity to ensure that people with private insurance can access PrEP now and into the future, free of any cost-sharing, with properly worded guidance to insurers.”
Currently, only 36 percent of those who could benefit from PrEP are using it. Significant disparities exist among racial and ethnic groups. Black people constitute 39 percent of new HIV diagnoses but only 14 percent of PrEP users, while Latinos represent 31 percent of new diagnoses but only 18 percent of PrEP users. In contrast, white people represent 24 percent of HIV diagnoses but 64 percent of PrEP users.
The groups also want CMS to prohibit insurers from employing prior authorization for PrEP, citing it as a significant barrier to access. Several states, including New York and California, already prohibit prior authorization for PrEP.
Modeling conducted for HIV+Hep, based on clinical trials of a once every 2-month injection, suggests that 87 percent more HIV cases would be averted compared to daily oral PrEP, with $4.25 billion in averted healthcare costs over 10 years.
Despite guidance issued to insurers in July 2021, PrEP users continue to report being charged cost-sharing for both the drug and ancillary services. A recent review of claims data found that 36 percent of PrEP users were charged for their drugs, and even 31 percent of those using generic PrEP faced cost-sharing.
The coalition’s letter follows a more detailed communication sent by HIV+Hepatitis Policy Institute to the Biden administration on July 2.
Signatories to the community letter include Advocates for Youth, AIDS United, Equality California, Fenway Health, Human Rights Campaign, and the National Coalition of STD Directors, among others.
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