A Venezuelan man with AIDS died in U.S. Immigration and Customs Enforcement custody on Oct. 1.

An ICE press release notes Pablo Sánchez Gotopo, 40, died at Merit Health River Oaks in Flowood, Miss., which is a suburb of Jackson, the state capital. The press release notes the “preliminary cause of death was from complications with acute respiratory failure, Acquired Immune Deficiency Syndrome (AIDS), pneumonia, acute kidney failure, anemia and COVID-19.”

ICE said U.S. Border Patrol took Sánchez into custody near Del Rio, Texas, on May 17. He arrived at the Adams County Detention Center in Natchez, Miss., four days later.

“Upon arrival to an ICE facility, all detainees are medically screened and administered a COVID-19 test by ICE Health Service Corps (IHSC) personnel,” said ICE in its press release. “Sánchez’s test results came back negative.”

The press release notes Sánchez on July 28 received another COVID-19 test after he “began showing symptoms of COVID-19.” ICE said he tested negative, but Adams County Detention Center personnel transferred him to a Natchez hospital “for additional advanced medical care.”

ICE Enforcement and Removal Operations staff in its New Orleans Field Office, according to the press release, “coordinated with hospital staff to arrange family visitation” after Sánchez’s “health condition deteriorated.” Sánchez was transferred to Merit Health River Oaks on Sept. 25.

“ICE is firmly committed to the health and welfare of all those in its custody and is undertaking a comprehensive agency-wide review of this incident, as it does in all such cases,” says the press release.

Venezuela’s political and economic crises have prompted more than 10,000 people with HIV to leave the country, according to the New York-based Aid for AIDS International.

Activists and health care service providers in Venezuela with whom the Washington Blade has spoken in recent years have said people with HIV/AIDS in the country have died because of a lack of antiretroviral drugs. Andrés Cardona, director of Fundación Ancla, a group in the Colombian city of Medellín that works with migrants and other vulnerable groups, told the Blade last month that many Venezuelans with HIV would have died if they hadn’t come to Colombia.

The Blade has not been able to verify a Venezuelan activist’s claim that Sánchez was gay. It is also not known why Sánchez decided to leave Venezuela and travel to the U.S.

ICE detainee with HIV described Miss. detention center as ‘not safe’

Activists and members of Congress continue to demand ICE release people with HIV/AIDS in their custody amid reports they don’t have adequate access to medications and other necessary medical treatment.

Two trans women with HIV—Victoria Arellano from Mexico and Roxsana Hernández from Honduras—died in ICE custody in 2007 and 2018 respectively. Johana “Joa” Medina Leon, a trans woman with HIV who fled El Salvador, died in 2019, three days after ICE released her from a privately-run detention center.

The Blade in July 2020 interviewed a person with HIV who was in ICE custody at the Adams County Detention Center. The detainee said there was no social distancing at the privately-run facility and personnel were not doing enough to prevent COVID-19 from spreading.

“It’s not safe,” they told the Blade.

Elisabeth Grant-Gibson, a Natchez resident who supports ICE detainees and their families, on Wednesday told the Blade that she was able to visit the Adams County Detention Center and other ICE facilities in the Miss Lou Region of Mississippi and Louisiana from November 2019 until the suspension of in-person visitation in March 2020 because of the pandemic.

“Medical neglect and refusal of medical care has always been an issue in the detention center at Adams County,” said Grant-Gibson. “After the facilities were closed to public visitation, those problems increased.”

Grant-Gibson told the Blade she “worked with a number of families and received phone calls from a number of detainees, and I was told again and again that detainees were being refused the opportunity to visit the infirmary.”

“When they did visit the infirmary, they were given virtually no treatment for the issues they were presenting with,” said Grant-Gibson.

ICE in its press release that announced Sánchez’s death said fatalities among its detainees, “statistically, are exceedingly rare and occur at a fraction of the national average for the U.S. detained population.” ICE also noted it spends more than $315 million a year “on the spectrum of healthcare services provided to detainees.”

“ICE’s Health Service Corps (IHSC) ensures the provision of necessary medical care services as required by ICE Performance-Based National Detention Standards and based on the medical needs of the detainee,” notes the ICE press release. “Comprehensive medical care is provided from the moment detainees arrive and throughout the entirety of their stay. All ICE detainees receive medical, dental, and mental health intake screening within 12 hours of arriving at each detention facility, a full health assessment within 14 days of entering ICE custody or arrival at a facility, and access to daily sick call and 24-hour emergency care.”

An ICE spokesperson on Wednesday pointed the Blade to its Performance-Based Detention Standards from 2011, which includes policies for the treatment of detainees with HIV/AIDS.

A detainee “may request HIV testing at any time during detention” and ICE detention centers “shall develop a written plan to ensure the highest degree of confidentiality regarding HIV status and medical condition.” The policy also states that “staff training must emphasize the need for confidentiality, and procedures must be in place to limit access to health records to only authorized individuals and only when necessary.”

“The accurate diagnosis and medical management of HIV infection among detainees shall be promoted,” reads the policy. “An HIV diagnosis may be made only by a licensed health care provider, based on a medical history, current clinical evaluation of signs and symptoms and laboratory studies.”

For Rachel Levine, the appointment to her new role as a four-star admiral complementing her existing duties as assistant secretary for health is another way for the first openly transgender Senate-confirmed presidential appointee to serve.

“I think that this just really comes from my desire to serve in all capacities,” Levine said in an interview Tuesday with the Washington Blade. “To serve the first day in my field of academic medicine and pediatrics, but then in Pennsylvania and now in the federal government, and it furthers my ability to do that.”

Levine, 63, also recognized the importance of the appointment as a transgender person within the U.S. Public Health Service, for which she was ceremonially sworn in on Tuesday

“I think for the LGBTQ+ community, it is a further sign of progress and our president’s commitment to equity, to inclusion and diversity,” Levine said. “So I think that it is a very important milestone, and I’m pleased to serve.”

As part of her duties, Levine will lead an estimated 6,000 public health service officers serving vulnerable populations, including deployments inside and outside the country for communities beleaguered with the coronavirus, according to the Department of Health & Human Services. The role involves working closely with U.S. Surgeon General Vivek Murphy, whom Levine called her “friend and colleague.”

The U.S. Public Health Service, Levine said, has deployed “many, many times,” including its greatest number ever of deployments to vulnerable populations during the coronavirus pandemic. Among the places the service has deployed, Levine said, was in her home state of Pennsylvania, where she recently served as secretary of health.

Not only is Levine the first openly transgender person to serve in the uniformed health service as a four-star general, but she’s also the first woman to serve in that capacity.

“We have 6,000 dedicated committed public servants really all focused on our nation’s health, and they serve in details to the CDC and the FDA and the NIH, but also clinically with the Indian Health Service, and the federal prison system,” Levine said. “They’re also detailed and deployed throughout the country, and they deployed like never before for COVID-19 as well as the border, as well as dealing with floods and hurricanes and tornadoes.”

Although the Public Health Service is primarily focused on addressing public health disasters within the United States, Levine said it has a record of deployments overseas, including years ago when it was deployed to Africa under the threat of Ebola.

Secretary of Health & Human Services Xavier Becerra had high praise for Levine in a statement upon news of taking on a leadership position in the service.

“This is a proud moment for us at HHS,” Becerra said. “Adm. Levine — a highly accomplished pediatrician who helps drive our agency’s agenda to boost health access and equity and to strengthen behavioral health — is a cherished and critical partner in our work to build a healthier America.”

Levine, however, was careful to draw a distinction between her appointment within the Public Health Service and being a service member within the U.S. armed forces.

“It is not a military branch, it’s not the armed forces: It’s a uniformed force, so it’s different,” Levine said. “For example, the Army, the Navy, our military, there are two other uniformed branches, and that is ours, the United States Public Health Service Commissioned Corps and NOAA.”

The new role, Levine said, would complement her duties as assistant secretary for health. Although not only secretaries of health have been commissioned to take the uniform, Levine said she wanted to undertake that as part of her role in the Biden administration.

The two appointments were not simultaneous, Levine said, because of a general process she undertook, which was completed just this week.

It hasn’t been an easy road for Levine. During her Senate confirmation process, when she was hounded by anti-transgender attacks in conservative media and rude, invasive questioning by Sen. Rand Paul (R-Ky.) on her gender identity.

Levine, however, said she hasn’t encountered any hostility regarding her new role (as of now) and shrugged off any potential attacks in the future and said the move is about her career “to serve and to help people.”

“I’ve continued that for our nation as the assistant secretary for health and this is just a further demonstration of my commitment to service,” Levine said. “I don’t know what others will say, but that’s the genesis of my wanting to serve in the United States Public Health Service Commissioned Corps, and to place on the uniform.”

Levine’s new appointment comes shortly after a group of Democratic senators led by Sen. Chris Murphy (D-Conn.) sent her a letter dated Sept. 30 calling on her and Miriam Delphin-Rittmon, assistant secretary for mental health and substance use, to issue new guidance for hospital or residential care on mental health needs of transgender people.

Asked about the letter, Levine said mental health issues are under the authority of Delphin-Rittmon and the two “will work together and we will respond.”

Specifically, the senators in the letter call on the Behavioral Health Coordinating Council, or BHCC, and experts in the field of adolescent trans care to offer guidance on best practices for inpatient mental health care among these youth.

Asked what the response will look like, Levine said, “We’re going to work on that.”

“We will be looking at what they’re asking for and the requirements, and we’ll talk with them and the stakeholders and we’ll look to issue appropriate guidance,” Levine said.

Colin Powell, the first ever Black secretary of state who served in top diplomatic and military roles in U.S. administrations, died Monday of coronavirus at age 84, leaving behind a mixed record on “Don’t Ask, Don’t Tell.”

The world continues to grapple with the pandemic and the public grows increasingly frustrated with its persistence as many remain unvaccinated despite the wide availability of vaccines. Powell was fully vaccinated, according to a statement released upon his death. Powell reportedly suffered from multiple myeloma, a condition that hampers an individual’s ability to combat blood infections.

Rising to the top of the military as chair of the Joint Chiefs of Staff, Powell supported in 1993 Congress moving forward with “Don’t Ask, Don’t Tell,” a law that barred openly gay people from serving in the U.S. military.

During a key moment congressional testimony, Powell and other top military officials were asked whether or not allowing gay people in the military would be compatible with military readiness. Each official, including Powell,” responded “incompatible.” Congress would enact “Don’t Ask, Don’t Tell” that year.

Things changed when President Obama took office 15 years later and advocates for repeal of “Don’t Ask, Don’t Tell” were eager to claim Powell’s voice among their ranks. After all, Powell was highly respected as a bipartisan voice after having served as secretary of state in the administration of George W. Bush and endorsing Obama in the 2008 election.

After the Obama administration in 2010 announced it would conduct a review of the idea of allowing gay people to serve openly in the military, Powell came out in support of that process. Advocates of repeal called that a declaration of reversal, although the statement fell short of a full support for gay people serving openly in the military.

“In the almost 17 years since the ‘Don’t Ask, Don’t Tell’ legislation was passed, attitudes and circumstances have changed,” General Powell said in a statement issued by his office, adding, “I fully support the new approach presented to the Senate Armed Services Committee this week by Secretary of Defense Gates and Admiral Mullen.”

Congress acted to repeal “Don’t Ask, Don’t Tell” and the policy was lifted in 2011. At the time, Powell was widely considered a supporter of ending “Don’t Ask, Don’t Tell” and publicly counted among supporters of repeal, although the Blade couldn’t immediately find any statements from him to that effect.

In 2012, Powell had similar vaguely supportive words on same-sex marriage, saying he had “no problem with it” when asked about the issue.

“As I’ve thought about gay marriage, I know a lot of friends who are individually gay but are in partnerships with loved ones, and they are as stable a family as my family is, and they raise children,” Powell said. “And so I don’t see any reason not to say that they should be able to get married.”

The Blade also couldn’t immediately find any statement from Powell on transgender people serving in the military. After the Obama administration in 2016 lifted decades-old regulations against transgender service, former President Trump issued a ban by tweet the following year. President Biden reversed that ban and allowed transgender people to serve and enlist in the military in his first year in office.